Low Cholesterol Diet
How to Lower Your Cholesterol
Cholesterol Lowering Drugs and Cholesterol
Whatever the reasons may be for your high
blood cholesterol level - diet, heredity, or both - the treatment
your doctor will prescribe first is a diet. If your blood cholesterol
level has not decreased sufficiently after carefully following the diet
for 6 months, your doctor may consider adding cholesterol-lowering medication
to your dietary treatment. Remember, diet is a very essential step in
the treatment of high blood
Cholesterol-lowering medications are more
effective when combined with diet. Thus they are meant to supplement,
not replace, a low-saturated fat, low-cholesterol diet. See also Inherited
Summary of Diet Guidelines for Lowering
High Blood Cholesterol Levels
- Eat less high-fat food (especially
those high in saturated fat)
- Replace part of the saturated fat in
your diet with unsaturated fat
- Eat less high-cholesterol food
- Choose foods high in complex carbohydrates
(starch and fiber)
- Reduce your weight, if you are overweight
Eat Less High-fat Food
There are two major types of dietary
fat - saturated and unsaturated. Unsaturated fats are further classified
as either polyunsaturated or monounsaturated fats. Together, saturated
and unsaturated fats equal total fat. All foods containing fat contain
a mixture of these fats.
Reduce Total Fat Intake
One of the goals in your blood cholesterol-lowering
diet is to eat less total fat, because this is an effective way to eat
less saturated fat. Because fat is the richest source of calories, this
will also help reduce the number of calories you eat every day. If you
are overweight, weight loss is another important step in lowering blood
cholesterol levels (as discussed later in this brochure). If you are not
overweight, be sure to replace the fat calories by eating more food high
in complex carbohydrates.
Remember: When you decrease the amount
of total fat you eat, you are likely to reduce the saturated fat and calories
in your diet.
Saturated fat raises your blood cholesterol
level more than anything else in your diet. The best way to reduce your
blood cholesterol level is to reduce the amount of saturated fat you eat.
Animal products as a group are a major source of saturated fat in the
average American diet. Butter,
cheese, whole milk, ice cream, and cream all contain high amounts of saturated
fat. Saturated fat is also concentrated in the fat that surrounds meat
and in the white streaks of fat in the muscle of meat (marbling). Poultry,
fish, and shellfish also contain saturated fat, although generally less
Hydrogenated Fat - Known As Trans Fatty
Acids or Trans-Fats
Trans fats are created during the food manufacturing process when cheap
vegetable oils undergo a process called "hydrogenation" - they
have hydrogen added to them to make them solid and less likely to become
rancid. Unfortunately, trans fats are even worse for our heart
than saturated fat, as they encourage atherosclerosis
(narrowing of the arteries). For details of foods containing trans fatty
acids, see Trans
Fats and Heart Disease
A few vegetable fats - coconut oil, cocoa butter (found in chocolate),
palm kernel oil, and palm oil - are high in saturated fat. These vegetable
fats are found in many commercially baked goods, such as cookies and crackers,
and in nondairy substitutes, such as whipped toppings, coffee creamers,
cake mixes, and even frozen dinners. They also can be found in some snack
foods like chips, candy bars, and buttered popcorn. Because these vegetable
fats are not visible in these foods (unlike the fat in meats) it is important
for you to read food labels. The label may tell you how much saturated
fat a food contains, which will help you choose foods lowest in saturated
Remember: Saturated fats are found primarily
in animal products. But a few vegetable fats and many commercially processed
foods also contain saturated fat. Read labels carefully. Choose foods
Substitute Unsaturated Fat for Saturated
Unsaturated fat actually helps to lower
cholesterol levels when it is substituted for saturated fat. Therefore,
health professionals recommend that, when you do eat fats, unsaturated
fats (polyunsaturated and monounsaturated fats) be substituted for part
of the saturated fat whenever possible.
Polyunsaturated fats are found primarily
in safflower, corn, soybean, cottonseed, sesame, and sunflower oils, which
are common cooking oils. Polyunsaturated fats are also contained in most
salad dressings. But be cautious. Commercially prepared salad dressings
also may be high in saturated fats, and therefore careful inspection of
labels is important. The word "hydrogenated" on a label means
that some of the polyunsaturated fat has been converted to saturated fat.
Another type of polyunsaturated fat is
found in the oils of fish and shellfish (often referred to as fish oils,
or omega-3 fatty acids). This type of polyunsaturated fat is found in
greatest amounts in such fatty fish as herring, salmon, and mackerel.
There is little evidence that omega-3 fatty acids are useful for reducing
LDL-cholesterol levels. However, fish is a good food choice for this diet
play anyway because it is low in saturated fat. The use of fish oil supplements
are not recommended for the treatment of high blood cholesterol because
it is not known whether long-term ingestion of omega-3 fatty acids will
lead to undesirable side effects.
Olive and canola oil (rapeseed oil) are
examples of oils that are high in monounsaturated fats. Like other vegetable
oils, these oils are used in cooking as well as in salads. Recently, research
has shown that substituting monounsaturated fat, like substituting polyunsaturated
fat, for saturated fat reduces blood cholesterol levels.
Remember: Unsaturated fats when substituted
for saturated fats help lower blood cholesterol levels.
NOTE: To understand how our digestive
system digests and absorbs dietary fat, see Guide
To Food Digestion and Digestion
Eat Less High-Cholesterol Food
Dietary cholesterol is a waxy, fat-like
substance found in foods that come from animals. Although it is not the
same as saturated fat, dietary cholesterol also can raise your blood cholesterol
level. Therefore, it is important to eat less food that is high in cholesterol.
While cholesterol is needed for normal body function, your liver makes
enough for your body's needs so that you don't need to eat any cholesterol
Dietary Cholesterol in Food
Cholesterol is found in eggs,
dairy products, meat, poultry, fish, and shellfish. Egg yolks and organ
meats (liver, kidney, sweetbread, brain) are particularly rich sources
of cholesterol. High-fat dairy products, meat, and poultry all have similar
amounts of cholesterol. Fish generally has less cholesterol, but shellfish
varies in cholesterol content. Foods of plant origin, like fruits, vegetables,
grains, cereals, nuts, and seeds, contain no cholesterol.
Since cholesterol is not a fat, you can
find it in both high-fat and low-fat animal foods. In other words, even
if a food is low in fat, it may be high in cholesterol. For instance,
organ meats, like liver, are low in fat, but are high in cholesterol.
Because many foods such as dairy products
and some meats are high in both saturated fat and cholesterol, it is important
to limit the amount of these high-fat foods that you eat, choosing lean
meats and low-fat dairy products whenever possible.
Remember: Organ meats and egg yolks are
high in cholesterol. High-fat dairy products, meat, and poultry have similar
amounts of cholesterol. Some fish has less. Foods of plant origin like
fruits, vegetables, vegetable oils, grains, cereals, nuts, and seeds contain
Substitute Low GI Carbohydrates for Saturated
Breads, pasta, rice, cereals, dried peas
and beans, fruits, and vegetables are good sources of complex carbohydrates
(starch and fiber). Low-GI varieties are excellent substitutes for foods
that are high in saturated fat and cholesterol. The type of fiber found
in foods such as oat and barley bran, some fruits like apples and oranges,
and in some dried beans may even help reduce blood cholesterol levels.
For details about low-GI foods, see GI Diet.
Contrary to popular belief, high-carbohydrate
foods (like pasta, rice, potatoes) are lower in calories than foods high
in fat. In addition, they are good sources of vitamins and minerals. What
adds calories to these foods is the addition of butter, rich sauces, whole
milk, or cream, which are high in fat, especially saturated fat. It is
important not to add these to the high-carbohydrate foods you are substituting
for foods high in fat.
Remember: Foods that are high in complex
carbohydrates, if eaten plain, are low in saturated fat and cholesterol
as well as being good sources of vitamins, minerals, and fiber.
Maintain a Desirable Weight
People who are overweight frequently have
higher blood cholesterol levels than people of desirable weight.
You can reduce your weight by eating fewer
calories and by increasing your physical activity on a regular basis.
By reducing the amount of fat in your diet, you will be cutting down on
the richest source of calories. Substituting foods that are high in complex
carbohydrates for high-fat foods will also help you lose weight, because
many high-carbohydrate foods contain little fat and thus fewer calories.
Fat Contains Twice the Calories of Carbs
Fat has more than twice the calories
as the same amount of protein or carbohydrate. Protein and carbohydrate
both have about 4 calories in each gram, but all fat-saturated, polyunsaturated
or monounsaturated fat - has 9 calories in each gram. Thus, foods that
are high in fat are high in calories. And all calories count. So, to maintain
a desirable weight, it is important to eat no more calories than your
body needs. (To find your desirable weight, see Body Mass Index)
Remember: To achieve or maintain a desirable
weight, your caloric intake must not exceed the number of calories your
Further Help in Developing a Low Cholesterol
If you suffer from hyperlipemia,
hypercholesterolemia, or hypertriglyceridemia and you want
additional help in planning a heart-healthy diet, low in saturated fat
and dietary cholesterol, make an appointment with a registered dietitian
or qualified nutritionist. The American Dietetic Association maintains
a roster of registered dietitians. By calling the Division of Practice
(312) 899-0040 you can request names of qualified dietitians in your area.
Sources include: National Cholesterol Education
Program National Heart, Lung, and Blood Institute. U.S. Department of
Health and Human Services.