Diet that is recommended for cholesterol management

If you have hypercholesterolemia, or high cholesterol, and are considering the best diet to lose weight and manage your condition, you’re far from alone.

The Centers for Disease Control and Prevention (CDC) reports that 94 million adults in the United States over the age of 20 have borderline high or high cholesterol. Cholesterol can build up in your arteries, narrowing or stopping the flow of blood, and potentially causing a heart attack or stroke.

If you have high cholesterol, your healthcare team has likely recommended that you control your cholesterol level with lifestyle changes. These include getting more exercise and tweaking your diet or losing weight if you’re overweight or have obesity.

With so many weight loss diets trending, it may be hard to choose among a multitude of popular or highly publicized options. One of the most common bits of advice is to choose the diet you can stick with, but there’s a caveat. Some diet plans are more likely to lower your cholesterol, while others can make it worse.

Let’s look at which dietary choices can help you lower your cholesterol and which won’t.

When choosing an eating plan, it’s helpful to know which foods can be helpful in weight and cholesterol management. The American Heart Association (AHA) recommends the following foods as the basis for a heart-healthy diet:

• foods low in saturated fat (lean cuts of meat without skin, low fat dairy)
• minimally processed, healthy fats like those found in fish, avocado, seeds, and nuts
• fruits and vegetables, excluding white potatoes
• foods made mostly of whole grains rather than refined ones, such as whole wheat bread and pasta
• protein mostly from plants, and lean and unprocessed forms of meat
• at least two meals per week of fatty fish

Foods to avoid

Foods that can increase your cholesterol and contribute to weight gain include:

• red meats and fatty meats that aren’t trimmed
• full fat dairy products, such as whole milk, cream, ice cream, butter, and cheese
• baked goods made with saturated and trans fats like donuts, cakes, and cookies
• foods that list the words “hydrogenated oils” in the ingredients panel
• tropical oils, such as coconut, palm, and palm kernel oils
• solid fats like shortening, stick margarine, and lard
• fried foods
• foods with a lot of salt
• sweets and sugar-sweetened beverages

It’s nice to have general recommendations, but many people prefer to have a clearer plan to follow.

If you’re one of those people, here are some of the best research-backed, heart-healthy diets. These diets also boast a higher-than-average adherence rate. That’s how likely you are to stick to them in the long term.

Mediterranean

The Mediterranean diet is tops on most lists and has the most research backing it. It includes:

• lots of vegetables, beans, and legumes
• fish and seafood
• a little red wine
• fruits
• nuts
• whole grains
• extra virgin olive oil

DASH

The Dietary Approaches to Stop Hypertension (DASH) diet was crafted specifically to stop high blood pressure. It’s part of a plan that also includes exercise. But, it’s also proven to reduce cholesterol.

The recommendation is to eat a diet rich in:

• fruits
• vegetables
• whole grains
• low fat dairy products

The DASH diet also calls for reducing total fat, especially saturated fat.

TLC

The National Institutes of Health developed the Therapeutic Lifestyle Changes (TLC) diet to reduce your risk of heart attack and stroke. It includes eating based on certain numeric guidelines and getting 30 minutes a day of physical activity most days of the week. Key dietary recommendations are:

• less than 7% of your daily calories from saturated fat
• less than 200 milligrams a day of cholesterol
• 25% to 35% of daily calories from total fat (includes saturated fat calories)
• 2 grams per day of plant stanols or sterols
• 10 to 25 grams per day of soluble fiber
• only enough calories to reach or maintain a moderate weight

Dean Ornish

The Dean Ornish diet is a low fat, lacto-ovo-vegetarian diet. That means you avoid eating meat from animals, but you can have milk and egg products. In this case, it allows for egg whites and nonfat dairy.

This diet emphasizes eating mostly plants in their natural forms. You get most of your protein from plant sources, such as tofu, beans, and tempeh. It also emphasizes whole grains and healthy fats, and limits simple carbohydrates, especially sugar.

Though there isn’t much new research available, an older 2009 study found that the Ornish diet was effective at reducing total cholesterol, LDL cholesterol, and triglycerides.

Flexitarian

The Flexitarian diet has become more popular over the years. It’s a popular choice for some people who tried going fully vegetarian or vegan but may have found that eating plan too hard to stick to, or wanted some animal foods in their diets.

A 2015 study found that people who occasionally strayed from a vegetarian or vegan diet had significantly reduced their cholesterol and lost weight. A 2017 review also found that a Flexitarian diet improved metabolic health and blood pressure, and reduced the risk of diabetes.

The Flexitarian diet has no rigid rules, just lifestyle recommendations:

• Eat mostly fruits, vegetables, legumes, and whole grains.
• Focus on protein from plants instead of animals.
• Be flexible and incorporate meat and animal products from time to time.
• Eat the least processed, most natural forms of foods.
• Limit added sugar and sweets.

Vegan

The vegan diet has become one of the most hyped eating plans, followed by an ever-lengthening list of celebrities. It calls for cutting out all animal products. This can reduce cholesterol greatly, as long as you stick to:

• whole grains
• lots of fruits
• vegetables
• nuts
• seeds

A 2018 study concluded that, in most countries, a vegan diet can significantly reduce LDL cholesterol and triglycerides. The study also showed reductions in body mass index (BMI), waist size, blood sugar, and blood pressure.

South Beach (maybe)

Some studies suggest that low carb diets raise your LDL cholesterol levels. But the South Beach Diet claims to do just the opposite. An older study found that the South Beach Diet did reduce LDL and total cholesterol.

The South Beach diet doesn’t call for totally eliminating carbs, but rather choosing those with a low glycemic index. It’s a phased program that initially calls for cutting out carbs, then reintroducing them a little at a time.

The diet’s effect on your cholesterol level depends on the types of protein and fat you choose to eat. The South Beach meal plan reduces your intake of saturated fats, which should lower your LDL cholesterol.

Some diets stand out as being risky for heart health. Some of these are based on a popular low carb and high protein way of eating. While they may be effective for weight loss, they allow or recommend a high intake of foods known to raise cholesterol levels.

Some popular diets that recommend this approach may lead to weight loss but higher cholesterol. According to the AHA, some have been linked to early death. It all depends on the types of fat and carbohydrate you consume.

Some diets that can contribute to higher cholesterol include:

Keto

The ketogenic (keto) diet involves whittling down your total carbohydrate intake to 20 to 50 grams per day. You get the bulk of your nutrients from protein and fats to force your body to use ketones instead of glucose (a kind of sugar) for fuel.

The keto diet can be safe and healthy for many people. But for others, it may worsen high cholesterol. This is especially true if you have familial hypercholesterolemia.

The keto diet can especially raise cholesterol if you get your calories from processed foods and saturated fats. These are present in fatty cuts of meat and whole milk dairy and cheese.

Atkins

The Atkins diet entails eating all the protein and fat you want as long as you avoid high carb foods. Because it creates a calorie deficit, it’s effective for weight loss. But it also has the potential to include very high levels of saturated fat and processed meat, such as hot dogs and bacon.

A small 2018 study found a 44% increase in LDL cholesterol over 3 weeks in young, healthy adults on the Atkins diet compared to those who continued with their regular eating habits.

If you have high cholesterol or are at high risk of developing it, your doctor will first recommend lifestyle and dietary changes. Because there are so many popular diets, it can be hard to choose the right one for you.

Several diets have stood the test of time when it comes to lowering cholesterol. These include the Mediterranean Diet, the DASH diet, and the TLC diet. Plant-based diets like vegan and vegetarian diets can also help lower cholesterol.

Diets to avoid include high protein, low carb diets. Although these diets help many people lose weight, some of them call for unlimited consumption of foods that raise cholesterol, including red meat, fatty meat, and whole fat dairy.

Picking a diet you can stick to is the key to long-term success, so long as it’s heart-healthy. If you’re unsure about which diet to choose, talk with your healthcare team.