If your diet gave you high cholesterol, it can lower it, too.
It's easy to eat your way to an alarmingly high cholesterol level. The reverse is true, too — changing what you eat can lower your cholesterol and improve the armada of fats floating through your bloodstream.
Doing this requires a two-pronged strategy: Add foods that lower LDL, the harmful cholesterol-carrying particle that contributes to artery-clogging atherosclerosis. At the same time, cut back on foods that boost LDL. Without that step, you are engaging in a holding action instead of a steady — and tasty — victory.
In with the good
Different foods lower cholesterol in various ways. Some deliver soluble fiber, which binds cholesterol and its precursors in the digestive system and drags them out of the body before they get into circulation. Some give you polyunsaturated fats, which directly lower LDL. And some contain plant sterols and stanols, which block the body from absorbing cholesterol.
Oats. An easy first step to improving your cholesterol is having a bowl of oatmeal or cold oat-based cereal like Cheerios for breakfast. It gives you 1 to 2 grams of soluble fiber. Add a banana or some strawberries for another half-gram. Current nutrition guidelines recommend getting 20 to 35 grams of fiber a day, with at least 5 to 10 grams coming from soluble fiber. (The average American gets about half that amount.)
Barley and other whole grains. Like oats and oat bran, barley and other whole grains can help lower the risk of heart disease, mainly via the soluble fiber they deliver.
Beans. Beans are especially rich in soluble fiber. They also take awhile for the body to digest, meaning you feel full for longer after a meal. That's one reason beans are a useful food for folks trying to lose weight. With so many choices — from navy and kidney beans to lentils, garbanzos, black-eyed peas, and beyond — and so many ways to prepare them, beans are a very versatile food.
Eggplant and okra. These two low-calorie vegetables are good sources of soluble fiber.
Nuts. A bushel of studies shows that eating almonds, walnuts, peanuts, and other nuts is good for the heart. Eating 2 ounces of nuts a day can slightly lower LDL, on the order of 5%. Nuts have additional nutrients that protect the heart in other ways.
Vegetable oils. Using liquid vegetable oils such as canola, sunflower, safflower, and others in place of butter, lard, or shortening when cooking or at the table helps lower LDL.
Apples, grapes, strawberries, citrus fruits. These fruits are rich in pectin, a type of soluble fiber that lowers LDL.
Foods fortified with sterols and stanols. Sterols and stanols extracted from plants gum up the body's ability to absorb cholesterol from food. Companies are adding them to foods ranging from margarine and granola bars to orange juice and chocolate. They're also available as supplements. Getting 2 grams of plant sterols or stanols a day can lower LDL cholesterol by about 10%.
Soy. Eating soybeans and foods made from them, like tofu and soy milk, was once touted as a powerful way to lower cholesterol. Analyses show that the effect is more modest — consuming 25 grams of soy protein a day (10 ounces of tofu or 2 1/2 cups of soy milk) can lower LDL by 5% to 6%.
Fatty fish. Eating fish two or three times a week can lower LDL in two ways: by replacing meat, which has LDL-boosting saturated fats, and by delivering LDL-lowering omega-3 fats. Omega-3s reduce triglycerides in the bloodstream and also protect the heart by helping prevent the onset of abnormal heart rhythms.
Fiber supplements. Supplements offer the least appealing way to get soluble fiber. Two teaspoons a day of psyllium, which is found in Metamucil and other bulk-forming laxatives, provide about 4 grams of soluble fiber.
Out with the bad
Harmful LDL creeps upward and protective HDL drifts downward largely because of diet and other lifestyle choices. Genes play a role, too — some people are genetically programmed to respond more readily to what they eat — but genes aren't something you can change. Here are four things you can:
Saturated fats. The saturated fats found in red meat, milk and other dairy foods, and coconut and palm oils directly boost LDL. So one way to lower your LDL is to cut back on saturated fat. Try substituting extra-lean ground beef for regular; low-fat or skim milk for whole milk; olive oil or a vegetable-oil margarine for butter; baked fish or chicken for fried.
Trans fats. Trans fats are a byproduct of the chemical reaction that turns liquid vegetable oil into solid margarine or shortening and that prevents liquid vegetable oils from turning rancid. Trans fats boost LDL as much as saturated fats do. They also lower protective HDL, rev up inflammation, and increase the tendency for blood clots to form inside blood vessels. The Institute of Medicine recommends getting no more than two grams of trans fats a day; less is even better. Although trans fats were once ubiquitous in prepared foods, many companies now use trans-free alternatives. Some restaurants and fast-food chains have yet to make the switch.
Weight and exercise. Being overweight and not exercising affect fats circulating in the bloodstream. Excess weight boosts harmful LDL, while inactivity depresses protective HDL. Losing weight if needed and exercising more reverse these trends.
Putting it all together
When it comes to investing money, experts recommend creating a portfolio of diverse investments instead of putting all your eggs in one basket. The same holds true for eating your way to lower cholesterol. Adding several foods that fight high cholesterol in different ways should work better than focusing on one or two.
That approach has been tested by Dr. David Jenkins of St. Michael's Hospital in Toronto and his colleagues. In a series of studies, their largely vegetarian "dietary portfolio of cholesterol-lowering foods" substantially lowered LDL, triglycerides, and blood pressure. The portfolio included margarine enriched with plant sterols; oats, barley, psyllium, okra, and eggplant, all rich in soluble fiber; soy protein; and whole almonds. These were added to a diet with plenty of fruits and vegetables, whole grains instead of highly refined ones, and protein mostly from plants.
Of course, shifting to a cholesterol-lowering diet takes more attention than popping a daily statin. It means expanding the variety of foods you usually put in your shopping cart and getting used to new textures and flavors. But it's a "natural" way to lower cholesterol, and it avoids the risk of muscle problems and other side effects that plague some people who take statins.
Just as important, a diet that is heavy on fruits, vegetables, beans, and nuts is good for the body in ways beyond lowering cholesterol. It keeps blood pressure in check. It helps arteries stay flexible and responsive. It's good for bones and digestive health, for vision and mental health. That's a portfolio worth protecting.