What to eat to lower cholesterol

A healthy diet beginning as early as childhood can help keep your cholesterol numbers in check as you age. But many people don’t focus on foods that lower cholesterol until there is a problem.

The good news? You may be able to lower your “bad” cholesterol by changing your diet.

“A lot of people can drastically lower their overall lifetime risk by exercising and eating good food,” says Christopher Song, MD, a cardiologist with Atlantic Health.

Here, Dr. Song shares the differences between good cholesterol and bad cholesterol, and the best foods to eat — and what to avoid — to help keep your heart healthy.

What is cholesterol?

Cholesterol is a waxy, fat-like substance that’s mainly made by the liver, with some also absorbed from your gut. It’s essential for building cell membranes and making hormones, but an excess of certain kinds of cholesterol can be harmful. High-density lipoprotein (HDL), sometimes called “good” cholesterol, helps carry cholesterol away from blood vessels and back to the liver, where it’s broken down and removed from the body.

Low-density lipoprotein (LDL) cholesterol is considered the primary “bad” cholesterol. LDL cholesterol can deposit in the walls of your arteries, which can make them narrower and reduce blood flow. Cholesterol plaque can rupture and trigger a blood clot, which can abruptly block blood flow. If this happens in a brain artery, it causes a stroke. If this happens in the heart artery, it causes a heart attack.

Why is it bad to have high cholesterol?

High cholesterol affects your heart health and raises your risk of cardiovascular disease. People with high cholesterol usually don’t have symptoms, which is why it’s important to have regular blood tests with your primary care physician.

When high cholesterol causes too much plaque to build on the walls of your arteries, you may experience:

• Chest pain
• Heart attack
• Stroke

“These conditions are potentially preventable if you have a good lifestyle and good cholesterol control at an early age,” Dr. Song says. “Once cholesterol plaque has significantly built up, it’s harder to catch up.”

Dr. Song compares high LDL-cholesterol to smoking.

“One pack of cigarettes per day for one year is considered one pack-year of smoking,” Dr. Song says. “The more pack-years you have, the higher your risk of lung cancer and numerous other smoking-related conditions. We tell people to quit now, not after they have lung cancer.”

It is the same with cholesterol, Dr. Song says.

“We look at how much LDL-cholesterol you have carried over the years, which we call LDL-years, or cholesterol-years, which reflects your cumulative risk of plaque buildup,” he says. “We tell patients the same thing: Adopt a healthy lifestyle and lower the “bad” cholesterol now before running into complications of heart attacks, stents or even bypass surgery.

Foods to lower cholesterol

What you eat can significantly impact your cholesterol levels.

“We think about unsaturated fat intake, as well as things like avocados, olive oil, fruits, veggies, fish (particularly fatty fish) and nuts, such as walnuts and almonds. These foods can lower the “bad” cholesterol,” Dr. Song says.

Soluble fiber-rich foods help your body remove cholesterol before it reaches your blood. Certain Omega-3 fatty acids can reduce your triglyceride levels (the amount of fat in your blood) and can slightly raise HDL. Omega-3 fatty acids can be found in chia seeds, edamame, fatty fish, flaxseeds, soybeans and walnuts.

Foods to lower your LDL cholesterol include:

• Avocados: including avocado oil
• Dark chocolate: at least 70% cocoa content
• Fatty fish: mackerel, salmon, sardines, tuna and trout
• Fruit: apples, bananas, blueberries, kiwi, oranges, raspberries and strawberries
• Legumes: beans, chickpeas, lentils and peas
• Olive oil and safflower oil: olives count too
• Nuts: almonds, peanuts, pistachios and walnuts
• Seeds: chia seeds and flax seeds
• Soy: edamame, soy milk, soybeans, tempeh and tofu
• Vegetables: broccoli, Brussels sprouts, eggplant, kale, okra, spinach, sweet potatoes and tomatoes
• Whole grains with lots of soluble fiber: barley, brown rice, bulgur and oats

“If you can do a Mediterranean diet, that’s probably the best because it’s primarily fruit, veggies, olive oil, whole grains, and lean protein, such as chicken and fish,” Dr. Song says. “But if that doesn’t fit into your usual cooking, then adjust within your own habits.”

Foods to avoid with high cholesterol 

If you have high cholesterol, eliminating certain foods from your diet can help lower your LDL numbers. These foods include:

• Baked goods: bread, cookies, crackers, cakes, pastries, pie crust and pizza dough
• Dairy: whole or 2% milk
• Processed meats: bacon, canned meats, deli meats, hot dogs, jerky and sausage
• Fried foods: chicken wings, French fries, mozzarella sticks and onion rings
• Red meat: beef, lamb, liver and pork
• Some fats and oils: butter, coconut oil, ghee, lard, margarine, palm oil and shortening

“If someone’s on a Keto diet, for example, and eating only beef and butter, those patients can have drastically high cholesterol levels, which can be significantly reduced by changing to a balanced diet.”

Even if your cholesterol levels are in a good range, it’s worth considering these dietary changes for other reasons. Some of these foods, particularly processed meats, are associated with increased colorectal cancer risk.

“It’s much harder for older adults to change their habits, lifestyle and the foods they’ve been eating for decades,” Dr. Song says. “A good lifestyle, regular exercise and whole foods starting at a young age play a big role in cardiovascular health.”