Diet for Lowering Cholesterol: Foods to Eat and Avoid

01Basics

How diet affects cholesterol

LDL cholesterol deposits in artery walls and drives atherosclerosis, whereas HDL helps remove cholesterol. The biggest dietary levers on LDL are saturated fat (which raises it), trans fat (which raises LDL and lowers HDL), dietary fibre, unsaturated fat and plant sterols (which lower it) and body weight. Dietary cholesterol (such as in eggs and shellfish) matters less for most people. See dieta para bajar el colesterol (Spanish).

02Eat

Foods that lower cholesterol

• Oats, barley and psyllium: beta-glucan soluble fibre; 3 g a day (about 1½ cups cooked oats) lowers LDL modestly.
• Beans, lentils and chickpeas: aim for several servings a week.
• Fruit and vegetables: apples, citrus, berries, carrots, aubergine, okra.
• Nuts: a handful (30 g) of walnuts, almonds or peanuts daily lowers LDL.
• Olive oil and avocado instead of butter and cream.
• Fatty fish (salmon, sardines, mackerel) twice a week.
• Soy foods (tofu, soy milk, edamame) in place of some animal protein.
• Plant sterol-fortified spreads and yoghurts (about 2 g a day lowers LDL by 5–10%).
• Whole grains instead of refined.

03Limit

Foods to limit

• Fatty cuts of red meat, sausages, bacon and processed meat.
• Butter, ghee, cream, full-fat cheese and whole milk in large amounts.
• Coconut and palm oil, found in many packaged foods.
• Fried foods, takeaways and pastries, biscuits and cakes (saturated and trans fats).
• Sugary drinks and excess alcohol, which raise triglycerides.
• Large portions of refined carbohydrates.
• Shellfish and egg yolks can be eaten in moderation by most people.

04Menu

Three-day sample menu

• Day 1: porridge with apple and cinnamon; lentil soup with whole-grain bread; grilled salmon with vegetables and brown rice; walnuts and a pear as snacks.
• Day 2: whole-grain toast with avocado and tomato; chickpea and vegetable salad with olive oil; tofu stir-fry with vegetables and noodles; yoghurt with berries.
• Day 3: muesli with soy milk and berries; tuna and bean salad; baked chicken without skin with roasted vegetables and potatoes; almonds and an orange.

05Lifestyle

Lifestyle partners of the diet

• Weight loss: losing 5–10% of body weight lowers LDL and triglycerides.
• Exercise: 150 minutes of moderate activity weekly raises HDL and supports weight loss.
• Stop smoking.
• Limit alcohol.
• Manage blood pressure and blood sugar.
• See DASH diet and foods high in fibre.

06Results

How much can diet lower cholesterol?

Diet changes typically lower LDL by about 10–20% when well followed, with larger effects when several strategies are combined (a “portfolio diet” of plant sterols, soluble fibre, soy protein and nuts can lower LDL by up to 25–30% in trials). The effect appears within 4–12 weeks, so repeat the blood test after about 3 months. The size of the reduction depends on your starting diet and genetics.

07Medication

When medication is needed

Doctors decide whether to prescribe statins or other drugs based on your overall cardiovascular risk, not on LDL alone. People with established heart disease, diabetes, very high LDL (190 mg/dL or higher), familial hypercholesterolaemia or high calculated risk usually benefit from medication in addition to diet. Taking a statin does not replace a healthy diet, and a healthy diet can sometimes allow a lower dose. Discuss options with your doctor.

09Cases

Three common situations

Slightly raised LDL and no other risk factors: try 3 months of diet and exercise, then repeat the test.

High LDL with family history of early heart attack: ask about familial hypercholesterolaemia and treatment.

Already on a statin but still eating a lot of processed food: diet adds benefit; talk to your dietitian.

10Eating out

Eating out and food labels

At restaurants choose grilled, baked or steamed fish and chicken, vegetable sides, olive-oil dressings on the side and fruit for dessert, and limit creamy sauces, fried dishes and pastry. On labels, compare saturated fat per 100 g (low is under 1.5 g, high above 5 g), avoid “hydrogenated” oils and note that “cholesterol-free” does not mean low in saturated fat. Fibre content above 6 g per 100 g marks a high-fibre product.

11Summary

Key points to remember

Swap saturated for unsaturated fat, add oats, beans, nuts, fruit, vegetables and fish, and combine with exercise and weight control. Repeat your test after 3 months and discuss medication with your doctor if your risk is high. Our nutrition team can design a personal plan.

This guide is for general information and does not replace an assessment by your own doctor or dietitian.