Updated: Jun 20
« I have high cholesterol, which increases my risk of cardiovascular disease. Are there specific foods that could lower my cholesterol? »
Yes, there are specific foods and even specific dietary patterns that have been shown to lower blood cholesterol.
Foods To Decrease Cholesterol
When looking at specific foods associated with cholesterol lowering powers, one should start with those that are evidence based. Including specific foods like oats, soy, barley, plant sterols and nuts in your diet have all been independently shown to significantly reduce levels of blood cholesterol (Ho et al., 2016a; Asbaghi et al., 2021; Blanco Mejia et al., 2019; Ho et al., 2016b; Tokede et al., 2015; Trautwein et al., 2018). Other studies have shown that avocados and turmeric also caused reductions in LDL-cholesterol. Pulses, hazelnuts, walnuts, high-fiber/wholegrain foods, and green tea caused small to moderate reductions in blood levels of cholesterol (Schoeneck & Iggman, 2020).
When used in combination, these foods also seem to have additive effects in lowering blood cholesterol (Jenkins et al., 2003). In their study, Jenkins et al. showed significant reductions in cholesterol levels of close to 30%, similar to those seen with lovastatin, a potent cholesterol lowering drug. He called this combination of foods “The Portfolio Diet”. A systematic review and meta-analysis of all the clinical trials done on the Portfolio Diet demonstrated significant reductions in not only LDL-cholesterol, but also in other blood lipids (non-HDL-cholesterol, apolipoprotein B, total-cholesterol, triglycerides), blood pressure, inflammation and cardiovascular risk (Chiavaroli et al., 2018).
Foods That Increase Cholesterol
Additionally to including more cholesterol lowering foods, it’s of major importance to consider reducing foods that have been associated with increases in cholesterol. Saturated fat intake has been linked to an increased risk of cardiovascular disease, and this effect is thought to be mediated primarily by increased concentrations of LDL cholesterol. Major dietary sources of saturated fatty acids are full-fat dairy products and red meat and reducing saturated fat intake from these has been shown to reduce cardiovascular risk and blood cholesterol (Hooper et al., 2020). Dietary cholesterol also seems to significantly affect blood levels of cholesterol, although less significantly than dietary saturated fat, it could be prudent to reduce consumption of high-cholesterol foods, like red and processed meats, full-fat dairy and fried foods (Vincent et al., 2019). Eggs are often cited as containing cholesterol and have also been associated with increased cardiovascular risk (Zhuang et al., 2021). The consumption of trans fats, contained in fried foods and commercially baked goods, have also been associated with increased cholesterol (de Souza et al., 2015).
Why We Should Care About Cholesterol
The main reason it’s important to target low cholesterol levels is because of its association with cardiovascular disease, which can manifest in many ways. Erectile dysfunction, vascular claudication, arterial thrombosis and embolism, as well as heart attacks and strokes are all manifestations of cardiovascular disease and causally linked to higher levels of blood cholesterol. Since the main purpose of lowering cholesterol levels is to lower cardiovascular risk, it’s also very important to consider specific dietary patterns that are associated with lower cardiovascular risk. In addition to the Portfolio Diet, a vegetarian diet, the DASH diet, and the Mediterranean diet have evidence to support their relationship with reductions in cardiovascular disease risk (Chiavaroli et al., 2019; Dinu et al., 2018; Estruch et al., 2018; Quek et al., 2021; Satija et al., 2016).
My Plant-Based Prescription
Many different dietary patterns have been associated with cholesterol lowering potential and they all have one thing in common: they are plant-predominant. Whether you adopt a Mediterranean diet, or a plant-based vegan diet, make sure to include whole and minimally processed foods in order to boost its cholesterol reducing effects. Oats, soy, barley and nuts have all been shown to reduce cholesterol, and although other foods are less potent in reducing cholesterol, combining them can have additive effects. Make sure to consider reducing your consumption of foods rich in saturated fats, mainly meat, dairy and tropical oils like coconut and palm oils. Also limit your intake of trans fats, which are potent cholesterol boosters. Remember that your cardiovascular risk is mainly determined by what you eat for 80-90% of your calories, over the long term. Don’t sweat the small stuff or the cheat meals. Focus on increasing the amount of fiber, whole plants and plant-based protein in your diet. This is likely going to increase the amount and quality of years you have left.
Check out my website plantbaseddrjules.com and look for the “How To” section in the menu. There, you’ll find tips and tricks that helped me on my journey towards a plant-predominant diet. Everything there is completely free, no catches! If you're looking for quick, easy and healthy plant-based recipes, check out plantbaseddrjules.com and download my free recipe eBook!
Look for me on the socials, @plantbased_dr_jules on Instagram and go like my Facebook Page, Plant-based Dr. Jules. If you’re looking for some fitness motivation and are curious to see what a plant-based athlete can accomplish, follow me, @maritimeninja, on my fitness account on Instagram or check out my fitness group on Facebook, called Maritime Ninja Warrior. Me and my wife Melissa have recently qualified for the Las Vegas Ninja Warrior World Championships, an obstacle racing course that will be held in July 2022, and you can follow our journey to Vegas on IG! If you’d like to see what a plant-based athlete looks like, then check out our youtube channel here!
Thanks so much for reading! Please consider sharing this article!
Plant-Based Dr. Jules 💚🌱
Anderson, T. J., Gregoire, J., Pearson, G. J., Barry, A. R., Couture, P., Dawes, M., Francis, G. A., Genest, J., Jr., Grover, S., Gupta, M., Hegele, R. A., Lau, D. C., Leiter, L. A., Lonn, E., Mancini, G. B., McPherson, R., Ngui, D., Poirier, P., Sievenpiper, J. L., . . . Ward, R. (2016). 2016 Canadian Cardiovascular Society Guidelines for the Management of Dyslipidemia for the Prevention of Cardiovascular Disease in the Adult. Can J Cardiol, 32(11), 1263-1282. https://doi.org/10.1016/j.cjca.2016.07.510
Asbaghi, O., Moodi, V., Hadi, A., Eslampour, E., Shirinbakhshmasoleh, M., Ghaedi, E., & Miraghajani, M. (2021). The effect of almond intake on lipid profile: a systematic review and meta-analysis of randomized controlled trials. Food Funct, 12(5), 1882-1896. https://doi.org/10.1039/d0fo02878a
Basora, J., Munoz, M. A., Sorli, J. V., Martinez, J. A., Fito, M., Gea, A., . . . Investigators, P. S. (2018). Primary Prevention of Cardiovascular Disease with a Mediterranean Diet Supplemented with Extra-Virgin Olive Oil or Nuts. N Engl J Med, 378(25), e34. https://doi.org/10.1056/NEJMoa1800389
Blanco Mejia, S., Messina, M., Li, S. S., Viguiliouk, E., Chiavaroli, L., Khan, T. A., Srichaikul, K., Mirrahimi, A., Sievenpiper, J. L., Kris-Etherton, P., & Jenkins, D. J. A. (2019). A Meta-Analysis of 46 Studies Identified by the FDA Demonstrates that Soy Protein Decreases Circulating LDL and Total Cholesterol Concentrations in Adults. J Nutr, 149(6), 968-981. https://doi.org/10.1093/jn/nxz020
Chiavaroli, L., Nishi, S. K., Khan, T. A., Braunstein, C. R., Glenn, A. J., Mejia, S. B., Rahelic, D., Kahleova, H., Salas-Salvado, J., Jenkins, D. J. A., Kendall, C. W. C., & Sievenpiper, J. L. (2018). Portfolio Dietary Pattern and Cardiovascular Disease: A Systematic Review and Meta-analysis of Controlled Trials. Prog Cardiovasc Dis,61(1), 43-53. https://doi.org/10.1016/j.pcad.2018.05.004
Chiavaroli, L., Viguiliouk, E., Nishi, S. K., Blanco Mejia, S., Rahelic, D., Kahleova, H., Salas-Salvado, J., Kendall, C. W., & Sievenpiper, J. L. (2019). DASH Dietary Pattern and Cardiometabolic Outcomes: An Umbrella Review of Systematic Reviews and Meta-Analyses. Nutrients, 11(2). https://doi.org/10.3390/nu11020338
de Souza, R. J., Mente, A., Maroleanu, A., Cozma, A. I., Ha, V., Kishibe, T., Uleryk, E., Budylowski, P., Schünemann, H., Beyene, J., & Anand, S. S. (2015). Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: systematic review and meta-analysis of observational studies. BMJ (Clinical research ed.), 351, h3978. https://doi.org/10.1136/bmj.h3978
Estruch, R., Ros, E., Salas-Salvado, J., Covas, M. I., Corella, D., Aros, F., Gomez-Gracia, E., Ruiz-Gutierrez, V., Fiol, M., Lapetra, J., Lamuela-Raventos, R. M., Serra-Majem, L., Pinto, X.,
Ho, H. V., Sievenpiper, J. L., Zurbau, A., Blanco Mejia, S., Jovanovski, E., Au-Yeung, F., Jenkins, A. L., & Vuksan, V. (2016a). The effect of oat beta-glucan on LDL-cholesterol, non-HDL-cholesterol and apoB for CVD risk reduction: a systematic review and meta-analysis of randomised-controlled trials. Br J Nutr, 116(8), 1369-1382. https://doi.org/10.1017/S000711451600341X
Ho, H. V., Sievenpiper, J. L., Zurbau, A., Blanco Mejia, S., Jovanovski, E., Au-Yeung, F., Jenkins, A. L., & Vuksan, V. (2016b). A systematic review and meta-analysis of randomized controlled trials of the effect of barley beta-glucan on LDL-C, non-HDL-C and apoB for cardiovascular disease risk reduction(i-iv). Eur J Clin Nutr,70(11), 1239-1245. https://doi.org/10.1038/ejcn.2016.89
Hooper, L., Martin, N., Jimoh, O. F., Kirk, C., Foster, E., & Abdelhamid, A. S. (2020). Reduction in saturated fat intake for cardiovascular disease. The Cochrane database of systematic reviews, 5(5), CD011737. https://doi.org/10.1002/14651858.CD011737.pub2
Jenkins D, et al. Effects of a dietary portfolio of cholesterol-lowering foods vs lovastatin on serum lipids and C-reactive protein. JAMA. 2003 Jul 23;290(4):502-10. doi: 10.1001/jama.290.4.502.
Martinez-Gonzalez, M. A., Gea, A., & Ruiz-Canela, M. (2019). The Mediterranean Diet and Cardiovascular Health. Circ Res, 124(5), 779-798. https://doi.org/10.1161/CIRCRESAHA.118.313348
Mazidi, M., Mikhailidis, D. P., Sattar, N., Toth, P. P., Judd, S., Blaha, M. J., Hernandez, A. V., Penson, P. E., Banach, M., & International Lipid Expert Panel (ILEP) & Lipid and Blood Pressure Meta-analysis Collaboration (LBPMC) Group (2020). Association of types of dietary fats and all-cause and cause-specific mortality: A prospective cohort study and meta-analysis of prospective studies with 1,164,029 participants. Clinical nutrition (Edinburgh, Scotland), 39(12), 3677–3686. https://doi.org/10.1016/j.clnu.2020.03.028
Pearson, G. J., Thanassoulis, G., Anderson, T. J., Barry, A. R., Couture, P., Dayan, N., Francis, G. A., Genest, J., Gregoire, J., Grover, S. A., Gupta, M., Hegele, R. A., Lau, D., Leiter, L. A., Leung, A. A., Lonn, E., Mancini, G. B. J., Manjoo, P., McPherson, R., . . . Wray, W. (2021). 2021 Canadian Cardiovascular Society Guidelines for the Management of Dyslipidemia for the Prevention of Cardiovascular Disease in Adults. Can J Cardiol, 37(8), 1129-1150. https://doi.org/10.1016/j.cjca.2021.03.016
Quek, J., Lim, G., Lim, W. H., Ng, C. H., So, W. Z., Toh, J., Pan, X. H., Chin, Y. H., Muthiah, M. D., Chan, S. P., Foo, R. S. Y., Yip, J., Neelakantan, N., Chong, M. F. F., Loh, P. H., & Chew, N. W. S. (2021). The Association of Plant-Based Diet With Cardiovascular Disease and Mortality: A Meta-Analysis and Systematic Review of Prospect Cohort Studies. Front Cardiovasc Med, 8, 756810. https://doi.org/10.3389/fcvm.2021.756810
Schoeneck, M., & Iggman, D. (2021). The effects of foods on LDL cholesterol levels: A systematic review of the accumulated evidence from systematic reviews and meta-analyses of randomized controlled trials. Nutrition, metabolism, and cardiovascular diseases : NMCD, 31(5), 1325–1338. https://doi.org/10.1016/j.numecd.2020.12.032
Tokede, O. A., Onabanjo, T. A., Yansane, A., Gaziano, J. M., & Djousse, L. (2015). Soya products and serum lipids: a meta-analysis of randomised controlled trials. Br J Nutr, 114(6), 831-843. https://doi.org/10.1017/S0007114515002603
Trautwein, E. A., Vermeer, M. A., Hiemstra, H., & Ras, R. T. (2018). LDL-Cholesterol Lowering of Plant Sterols and Stanols-Which Factors Influence Their Efficacy? Nutrients, 10(9). https://doi.org/10.3390/nu10091262
Vincent, M. J., Allen, B., Palacios, O. M., Haber, L. T., & Maki, K. C. (2019). Meta-regression analysis of the effects of dietary cholesterol intake on LDL and HDL cholesterol. The American journal of clinical nutrition, 109(1), 7–16. https://doi.org/10.1093/ajcn/nqy273
Zhuang, P., Wu, F., Mao, L., Zhu, F., Zhang, Y., Chen, X., Jiao, J., & Zhang, Y. (2021). Egg and cholesterol consumption and mortality from cardiovascular and different causes in the United States: A population-based cohort study. PLoS medicine, 18(2), e1003508. https://doi.org/10.1371/journal.pmed.1003508