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(Low-Density Lipoprotein [LDL] Lowering Diet)
The primary goal of this diet is to lower your levels of low-density lipoprotein (LDL), or bad, cholesterol. This diet may also raise your levels of high-density lipoprotein (HDL), or good cholesterol. Having too much LDL cholesterol, and/or not enough HDL cholesterol can lead to a condition known as atherosclerosis, which causes plaque to build up in your arteries. Plaque buildup narrows and hardens your arteries, increasing your risk of having a heart attack or stroke.
Cholesterol and Cardiovascular Disease Risk
Cholesterol level is one factor considered when determining your overall risk of having a heart attack, heart disease, or stroke. Other factors that are considered include:
A cholesterol-lowering diet may be recommended if you are at high risk for heart disease or stroke. The goal of this diet is to lower bad cholesterol and increase good cholesterol.
Diet and Cholesterol
Diet is just one of the factors that affect the level of cholesterol in the body. Adjusting certain elements in your diet may help to lower your blood cholesterol levels.
Fat is an essential nutrient with many responsibilities, including transporting the fat soluble vitamins A, D, E, and K; protecting vital organs, and providing a sense of fullness after meals. Fat can be broken down into 4 main types:
Fats that increase LDL levels and should be avoided or limited:
Found in margarine and vegetable shortening, shelf stable snack foods, and fried foods, it increases total blood cholesterol, especially LDL levels.
Hydrogenated or trans fat
Found in margarine and vegetable shortening, it increases total blood cholesterol, including LDL levels. It also decreases HDL levels.
Fats that improve cholesterol profile and should be eaten in moderation:
Found in oils such as olive and canola, it can decrease total cholesterol level while keeping levels of HDL high.
Found in oils such as safflower, sunflower, soybean, corn, and sesame, it can decrease total cholesterol.
Less than 5-6% of calories should come from saturated fat on a cholesterol-lowering diet. Trans fat intake should be kept as low as possible with a goal to eliminate them completely.
On an 2,000 calorie diet, this translates into less than 13 grams of saturated fat per day. The majority of fats you eat should be mono- and polyunsaturated fats.
Dietary cholesterol is found only in animal products. Although dietary cholesterol can increase LDL cholesterol, it does not affect it nearly as much as saturated or trans fats. On a cholesterol-lowering diet, you should eat as little dietary cholesterol as possible while eating a healthful diet.
Eating a diet high in soluble fiber can help lower your LDL cholesterol. There are 2 main types of fiber: soluble and insoluble. While both are very important to health, only soluble fiber impacts cholesterol levels. When soluble fiber is digested, it dissolves into a gel-like substance that helps block the absorption of fat and cholesterol into the bloodstream.
Soluble fiber is found in foods such as oatmeal, oat bran, barley, soy products, legumes, apples, and strawberries. On a cholesterol-lowering diet, you should consume at least 5-10 grams of soluble fiber per day, and ideally 10-25 grams.
Stanols and Sterols
Stanols and sterols are substances found in certain plants. Plant stanols and sterols can lower LDL cholesterol levels in a similar way to soluble fiber, by blocking their absorption from the digestive tract. Certain foods, including margarines and orange juice, are now being fortified with these cholesterol-lowering substances. Research shows that consuming at least 2 grams of plant stanols or sterols a day can reduce LDL cholesterol by more than 10%.
Eating Guide for a Cholesterol-lowering Diet
|Food Category||Foods Recommended||Foods to Avoid|
|Meat and beans||
|Fats and oil||
|Snacks, sweets, and condiments||
- Make whole grains, fruits, and vegetables the base of your diet.
- Look for products that are labeled as fat free, low-fat, cholesterol free, saturated fat-free and trans fat-free. However, a product can claim no grams trans fat, even on the label, but still have a small amount. Be sure to look for partially hydrogenated oil. If a product has this, avoid it.
- Become familiar with the Nutrition Facts panel, which lists information such as the amount of calories, saturated fat, trans fat, and cholesterol per serving of the item.
- Eat foods rich in omega-3 fatty acids. These include fatty fish such as salmon, mackerel, and tuna; flaxseed, walnuts, and canola oil. Eating fish at least 2 times a week is more effective than omega-3 fatty acid supplements. In fact, evidence about the benefits of supplements is not conclusive.
Try different foods and make changes based on what you like to eat. It may take some time to get comfortable with new changes.
- Prepare foods by using low-fat methods, such as steaming, boiling, grilling, poaching, baking, broiling, or roasting. If you are sautéing or stir frying, use a cooking spray or small amount of vegetable oil.
- Trim any visible fat off meat or poultry before cooking. Drain the fat after browning.
- Limit high-fat sauces. Add zest to foods by topping them with low-fat items such as fresh herbs, salsas, or chutneys.
- Increase fiber by adding fruit to your cereal or yogurt, beans to your salad, and choosing whole-grain breads.
- Cook at home more often. Restaurant food tends to be high in fat and calories.
- Engage in at least 30 minutes of moderate-to-vigorous physical activity most days of the week.
- If you are overweight, talk with your doctor about the best methods to lose weight.
- Talk to a registered dietitian for individualized diet advice.
Eat Right—Academy of Nutrition and Dietetics
National Heart, Lung, and Blood Institute
Dietitians of Canada
Heart and Stroke Foundation of Canada
Dietary guidelines for Americans 2015-2020. Choose My Plate—US Department of Agriculture website. Available at: https://www.choosemyplate.gov/2015-2020-dietary-guidelines-answers-your-questions. Updated January 7, 2016. Accessed September 14, 2016.
About cholesterol. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/Cholesterol/AboutCholesterol/About-Cholesterol%5FUCM%5F001220%5FArticle.jsp. Updated July 31, 2014. Accessed September 10, 2015.
Dietary guidelines for Americans 2010. US Department of Agriculture and US Department of Health and Human Services. Available at: http://www.health.gov/dietaryguidelines/dga2010/DietaryGuidelines2010.pdf. Accessed September 10, 2015.
Dietary interventions for cardiovascular disease prevention. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 21, 2015. Accessed September 10, 2015.
Eckel RH, Jakicic JM, et al. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;129(25 Suppl 2):S76-S99.
Goff DC Jr. Lloyd-Jones DM, et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;63(25 pt B):2935-2959.
Harland JI. Food combinations for cholesterol lowering. Nutr Res Rev. 2012;25(2):249-266.
Hypercholesterolemia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 1, 2015. Accessed September 10, 2015.
Know your fats. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/Cholesterol/PreventionTreatmentofHighCholesterol/Know-Your-Fats%5FUCM%5F305628%5FArticle.jsp#.V9ll9DVuMpk. Updated March 28, 2016. Accessed September 14, 2016.
Lowering your cholesterol with TLC. National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/public/heart/chol/chol%5Ftlc.pdf. Published December 2005. Accessed September 10, 2015.
What your cholesterol levels mean. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/Cholesterol/AboutCholesterol/What-Your-Cholesterol-Levels-Mean%5FUCM%5F305562%5FArticle.jsp. Updated August 21, 2015. Accessed September 10, 2015.
- Reviewer: Dianne Scheinberg Rishikof MS, RD, LDN
- Review Date: 09/2016
- Update Date: 11/12/2014