Did you know that six out of ten adults in England have high cholesterol? (1) It is no secret that high cholesterol increases a person’s risk of serious health conditions, such as heart disease and stroke, which are among the most common causes of death and ill health in the UK. (2) Lots of different things play a part in your cholesterol levels, including your lifestyle, other health problems, and your genes. And these can all add up to raise your cholesterol and your risk of illness. There may be very little you can do to change your genes, but it is totally within your power to opt for a healthy lifestyle, starting with a diet to reduce cholesterol. In an earlier RYH blog post we have already discussed one of the main foes to a healthy cholesterol level: saturated fat. Here we will turn to our friends: unsaturated fat and fibre.
Fats are not always bad: choose healthier fats
When it comes to healthy eating, fats get a bad rap. Some of this is justified. After all, all fats are high in calories, so eating too much fats can lead to weight gain, and being overweight or obese is a risk factor for heart and circulatory disease, among other health conditions. But not all fats are created equal. Some fats are better for you than others, and may even help you lower cholesterol.
There are two main types of fat: saturated and unsaturated. Saturated fat is a bad fat because it raises your LDL (bad cholesterol) level more than anything else in your diet. Foods high in saturated fat include sausages and fatty cuts of meat, butter, cream, hard cheeses, cakes and biscuits, and meat pies. It may surprise you that coconut oil is very high in saturated fat, despite being widely marketed as a superfood: it is about 90% saturated fat, which is a much higher percentage than butter (51%). (3)
On the other hand, research has shown that unsaturated fats are good for you. (4) Eating foods that contain unsaturated fat instead of saturated fat can actually help lower cholesterol. These fats come mostly from plant sources. For example, cooking oil that are liquid at room temperature, such as vegetable, sunflower, rapeseed, peanut, and olive oil, contain mostly unsaturated fat, which often can be used in place of the saturated fat-dense butter in cooking. Some of the top unsaturated-fat-rich foods that lower cholesterol will be discussed in more details below.
Oily fish such as salmon, tuna, and herring – are rich in unsaturated fats. In particular, oily fish is an excellent source of omega-3 fats (unsaturated), which increases ‘good’ HDL cholesterol and reduces inflammation. (5) Moreover, omega-3s can lower your triglycerides – a type of fat found in blood – as well as reduce your blood pressure and risk of developing blood clots. (5) For these reasons, a healthy diet that will keep your cholesterol level in check should include at least one portion of oily fish per every week (around 140g when cooked) (6).
Nuts and seeds are also foods that lower cholesterol. All varieties of nuts and seeds are high in unsaturated fats. In particular, walnuts are also rich in the plant variety of the heart-friendly omega-3 fats. What’s more, nuts contain fibre which can help block some cholesterol being absorbed into the blood stream from the gut. In an analysis of 25 studies, eating 2–3 servings of nuts per day decreased ‘bad’ LDL cholesterol by an average of 10.2 mg/dl (7). Besides the cholesterol lowering benefit, nuts provide protein, vitamin E, magnesium, potassium, natural plant sterols and other plant nutrients which help keep you in good health. The cholesterol charity Heart UK recommends eating 28-30g of nuts a day, which is around a handful. (6) Next time when you reach for snacks, why not swap those chocolate digestives for some mixed nuts?
Avocado are a potent source of nutrients as well as monounsaturated fatty acids. A 2019 research suggests that eating one avocado a day may help keep ‘bad cholesterol’ at bay. (8) According to the researchers, adding an avocado a day to a heart-healthy diet can help with the high LDL cholesterol levels in people who are overweight or obese. Specifically, avocados were found to help reduce LDL particles that had been oxidised. The oxidisation of LDL particles starts a chain reaction that can promote atherosclerosis, which is a potentially serious condition where arteries become clogged with fatty substances, increasing the risk of heart attacks and strokes, amongst other types of cardiovascular disease (CVD). In brief, oxidation is not good. Therefore, when it comes to cholesterol, avocado is a particular great food that not only helps you lower your numbers, but also targets the harmful oxidised LDL cholesterol.
Fibre is your friend
Eat more fibre. You’ve probably heard this before. The government guideline published in 2016 recommends adults to consume at least 30g of fibre a day. (9) But do you know why we should eat more fibre?
Well, there are actually multiple reasons, but here we will focus on those that relate to cholesterol. Dietary fibre is an umbrella term for all plant-based carbohydrates that are not digested by your body. Instead, it passes relatively intact through your stomach, small intestine and colon and out of your body. Some types of fibre can help lower cholesterol by blocking some cholesterol from being absorbed from the intestines into the blood stream. An example is pectin. A study shows that pectin lowers cholesterol by up to 10%. (10) It’s found in fruits including apples, grapes, citrus fruits, and strawberries, as well as vegetables such as carrots, beets, brussels sprouts, and peas. Now that you know fruit and veg are cholesterol reducing foods. That’s all the more reason to eat your ‘5 a day’ (or five 80g portions of fruits and vegetables).
Legume and Pulses such as beans, peas and lentils are also high in cholesterol lowering fibre. Scientific studies have definitively linked a diet high in legumes and pulses with both treating high cholesterol and reducing the risk of developing high cholesterol. A review of 26 randomised controlled studies showed that eating 100 grams of legumes and pulses per day is effective at lowering the bad LDL cholesterol by an average of 6.6 mg/dl, compared to not eating them. (11) There are lots of easy ways to add beans to your meals and reap the healthy benefits of the lovely legume. Go for the classic beans on toast for breakfast, add beans and peas to soups, salads, and pasta dishes for a hearty meal, or make homemade hummus or bean dip to spread on sandwiches or dip with wholegrain crackers or veggie – legume and pulses certainly qualify for the title ‘superfood’ for being tasty, versatile, and cholesterol lowering at the same time.
Oats and barley are some more examples of fibre-rich, cholesterol reducing foods. In particular, they contain a type of fibre known as beta glucan, which may help reduce cholesterol levels if you consume 3g or more of it daily. (12) When you eat beta glucan, it forms a gel which binds to cholesterol-rich bile acids in the intestines. This helps limit the amount of cholesterol that is absorbed from the gut into your blood. Your liver has to take more cholesterol out of your blood to make more bile, which also lowers your blood cholesterol. The cholesterol lowering effect of beta glucan is supported by several studies, with one of them concluding that eating oats with at least 3 g of beta glucan daily reduced bad cholesterol (LDL) levels between 5 and 7 percent. (13) Therefore, changing to a diet to reduce cholesterol could be as easy as having a bowl of oatmeal for breakfast and eating barley as a side dish instead of rice.
A well-balanced diet to reduce cholesterol for you
A heart-healthy eating plan can help you manage your blood cholesterol level and reduce your risk of heart disease and stroke. When it comes to a healthy diet, wholesome ingredients that provide you all the macro- and micro-nutrients are essential; for any cholesterol problems, it’s a good idea to incorporate foods that lower cholesterol, such as the ones mentioned earlier.
On the other hand, a healthy diet also calls for great recipes that transform the ingredients into nourishing meals. The RYH plan can help you manage your cholesterol level in an all-natural way, by implementing foods and recipes that contain cholesterol busting, heart healthy ingredients. Developed by nutritionists, dietitians, doctors, and amazing chefs, your fully personalised RHY recipes will have components similar to the Mediterranean diet, a way of eating that is scientifically proven to associate with reduced risk of heart disease. (14) We have included lots of healthy unsaturated fats, protein, fruits, vegetables, nuts and wholegrains (like oats, barley and quinoa) as part of a diet to reduce cholesterol, promising you a healthier body and happier mind. Plant sterols are also included in this plan (these contribute to the maintenance of normal blood cholesterol levels, and are found in soya products like tofu and edamame beans). Ready to take actions to lower your cholesterol? Try RYH’s recipes for a well-balanced diet to reduce cholesterol today!
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2. Heart disease [Internet]. British Nutrition Foundation. [cited 28 Jun 2020]. Available from: https://www.nutrition.org.uk/nutritionscience/health-conditions/heart-disease.html?start=2
3. Data from USDA Food Data Central: https://fdc.nal.usda.gov/index.html
4. Types of fat [Internet]. Harvard School of Public Health. [cited 28 June 2020]. Available from: https://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/fats-and-cholesterol/types-of-fat/
5. Chang CL, Deckelbaum RJ. Omega-3 fatty acids: mechanisms underlying ‘protective effects’ in atherosclerosis. Current opinion in lipidology, 2013; 24(4), 345–350.
6. Cholesterol lowering foods [Internet]. Heart UK. [cited 28 Jun 2020]. Available from: https://www.heartuk.org.uk/healthy-living/cholesterol-lowering-foods
7. Kim Y, Keogh J, Clifton PM. Nuts and Cardio-Metabolic Disease: A Review of Meta-Analyses. Nutrients. 2018;10(12):1935. Published 2018 Dec 6.
8. Wang L, Tao L, Hao L, et al. A Moderate-Fat Diet with One Avocado per Day Increases Plasma Antioxidants and Decreases the Oxidation of Small, Dense LDL in Adults with Overweight and Obesity: A Randomized Controlled Trial. J Nutr. 2020;150(2):276-284.
9. Government Dietary Recommendations: government recommendations for energy and nutrients for males and females aged 1 – 18 years and 19+ years. Public Health England. Published August 2016.
10. Brouns F, Theuwissen E, Adam A, Bell M, Berger A, Mensink RP. Cholesterol-lowering properties of different pectin types in mildly hyper-cholesterolemic men and women. Eur J Clin Nutr. 2012;66(5):591-599.
11. Ha V, Sievenpiper JL, de Souza RJ, et al. Effect of dietary pulse intake on established therapeutic lipid targets for cardiovascular risk reduction: a systematic review and meta-analysis of randomized controlled trials. CMAJ. 2014;186(8):E252-E262.
12. Dietary Fibre [Internet]. British Nutrition Foundation. [cited 28 Jun 2020]. Available from: https://www.nutrition.org.uk/healthyliving/basics/fibre
13. Othman RA, Moghadasian MH, Jones PJ. Cholesterol-lowering effects of oat β-glucan. Nutr Rev. 2011;69(6):299-309.
14. Martínez-González MA, Gea A, Ruiz-Canela M. The Mediterranean Diet and Cardiovascular Health. Circ Res. 2019;124(5):779-798.
 However, since oily fish can contain low levels of pollutant that can build up in the body, there are maximum recommendations for the number of portions some group should be eating each week. The NHS recommends that girls, women who are planning a pregnancy or may have a child one day, and pregnant and breastfeeding women should eat no more than two portions of oily fish a week. This is because pollutants found in oily fish may build up in the body and affect the future development of a baby in the womb. (for further information, see https://www.nhs.uk/live-well/eat-well/fish-and-shellfish-nutrition/)