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What Is the Best Diet to Lower Cholesterol?

If you focus on vegetables, fruits and whole grains and avoid processed foods, you're on a good diet to lower cholesterol.

Have you ever wondered what you should be eating to optimize your health? Nutrition scientists have been arguing that the entire dietary pattern matters more than a handful of individual foods reputed to have near-magical powers. Fortunately, a recent study demonstrated that several different eating patterns can be beneficial as a diet to lower cholesterol.

The Best Diet to Lower Cholesterol and Prevent Heart Attacks:

Q. What is the best diet to lower cholesterol, lose weight and stay healthy?

A. According to a study of dietary patterns, you can adapt your diet to your personal tastes and traditions. However, you need to stick to an eating pattern that is healthy overall (JAMA Internal Medicine, online June 15, 2020). In general, you’ll want to eat more whole foods and cut way back on processed foods.

Over three decades, the researchers collected an enormous amount of data from nearly 200,000 health care professionals. There were 165,794 women who participated in the Nurses’ Health Study and the Nurses’ Health Study II. In addition, 43,339 men participated in the Health Professionals Follow-up Study. The researchers collected diet and health information from these volunteers every few years over decades, up to 32 years.

Can You Follow a Diet to Lower Cholesterol?

Those who scored higher on any of four different diet scales were approximately 20 percent less likely to have heart attacks or strokes. What the Healthy Eating Index-2015, The Adapted Mediterranean Diet Score, the Healthy Plant-Based Diet Index and the Alternative Healthy Eating Index share is a focus on vegetables, whole grains, legumes and fruit. None of them have much room for processed foods, refined grains or sugary foods and beverages. They vary in certain details, however. For example, the Mediterranean Diet Score adds points for fish consumption, while the Healthy Plant-Based Diet Index subtracts them.

A diet to lower cholesterol should be rich in fiber. Soluble fiber found in oats, barley and legumes, can help reduce total and LDL cholesterol (Nutrients, May 23, 2019). A British study compared the effects of a Mediterranean diet and a vegan diet in 24 healthy young volunteers (Nutrients, Dec. 3, 2018). After a month, the participants following the Mediterranean diet had better blood vessel function. Conversely, those on the vegan diet lost weight and lowered their cholesterol.

Will a Plant-Based Diet Protect People from Cardiovascular Disease?

Many studies suggest that following a plant-based diet could have significant health benefits. We’ve mentioned a few of them here. Research also suggests that men following a plant-based diet may be less likely to die from prostate cancer.

You might reasonably expect a plant-based diet to lower cholesterol and prevent heart disease. However, data from 26,349 people in the Canadian Community Health Survey failed to reveal protection from cardiovascular disease (American Journal of Clinical Nutrition, March 10, 2022). Each person filled out a questionnaire about what they had eaten the previous day. These data were analyzed for their adherence to a Plant-based Dietary Index, the Dietary Guidelines for American Adherence Index and the EAT-Lancet Reference Diet score. These are all measures of dietary quality.

Although two of these indices were meaningful measures of plant-based eating among Canadians, the investigators found no link between plant-based eating and a reduction in cardiovascular disease. This is a bit puzzling, since it is inconsistent with the studies cited above. Perhaps other factors are as important as cholesterol levels for the risk of heart disease.

The authors conclude

“Future large-scale analyses are necessary to further evaluate the role of plant-based eating in CVD prevention.”

Including Breakfast in a Diet to Lower Cholesterol:

Q. A few months ago, one of your readers wrote that he lowered his cholesterol by 40 points with a change in diet. His breakfast consisted of yogurt, blueberries, walnuts and cinnamon. I am not sure if there were additional ingredients.

Would it be possible to get that recipe? For years I had walnuts every day in my salad. Unfortunately, I have developed an allergy to walnuts. Could different nuts help with cholesterol?

I currently am taking a statin, but I’d really like to stop eventually. I have been on the medication for a year and take no other meds.

A. It is possible to lower cholesterol with dietary measures.

The reader with the breakfast recipe wrote:

“I began each day with a quarter cup of coarsely broken English walnuts, one cup of frozen blueberries, 1.25 cups of plain Cheerios, 1 tablespoon of ground flaxseed and 1 teaspoon of cinnamon with 8 to 9 ounces of 2 percent organic milk. All layered in a cereal bowl in that order.”

The flaxseed and the Cheerios (or better yet, unsweetened cooked rolled oats) contribute to the cholesterol-lowering effect. Cinnamon and blueberries also have beneficial effects (Nutrients, Feb. 2021).

Since you can no longer enjoy walnuts, consider almonds. They too can lower LDL cholesterol and reduce the risk of heart disease (BMC Public Health, April 25, 2020).

Take care not to sweeten your cholesterol-lowering breakfast. Sugar can raise triglycerides and undo the lipid control benefit (American Journal of Clinical Nutrition, Jan. 1, 2020).

Learn More:

You can learn more about lowering cholesterol in our eGuide to Cholesterol Control and Heart Health. You may also want to listen to our most recent interview with Dr. Mark Hyman, founder and director of the UltraWellness Center, the Head of Strategy and Innovation of the Cleveland Clinic for Functional Medicine, and Board President for Clinical Affairs for the Institute for Functional Medicine. It is Show 1202: How Can We Fix Our Broken Food System?

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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Citations
  • Shan Z et al, "Association between healthy eating patterns and risk of cardiovascular disease." JAMA Internal Medicine, online June 15, 2020. doi:10.1001/jamainternmed.2020.2176
  • Soliman GA, "Dietary Fiber, Atherosclerosis, and Cardiovascular Disease." Nutrients, May 23, 2019. DOI: 10.3390/nu11051155
  • Rogerson D et al, "Contrasting effects of short-term Mediterranean and vegan diets on microvascular function and cholesterol in younger adults: A comparative pilot study." Nutrients, Dec. 3, 2018. DOI: 10.3390/nu10121897
  • Lazarova SV et al, "Adherence to emerging plant-based dietary patterns and its association with cardiovascular disease risk in a nationally representative sample of Canadian adults." American Journal of Clinical Nutrition, March 10, 2022. DOI: 10.1093/ajcn/nqac062
  • Noce A et al, "Natural bioactive compounds useful in clinical management of metabolic syndrome." Nutrients, Feb. 2021. DOI: 10.3390/nu13020630
  • Wang J et al, "Daily almond consumption in cardiovascular disease prevention via LDL-C change in the U.S. population: a cost-effectiveness analysis." BMC Public Health, April 25, 2020. DOI: 10.1186/s12889-020-08642-4
  • Schwingshackl L et al, "Dietary sugars and cardiometabolic risk factors: A network meta-analysis on isocaloric substitution interventions." American Journal of Clinical Nutrition, Jan. 1, 2020. DOI: 10.1093/ajcn/nqz273
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