4 top foods that lower cholesterol
Many are surprised to learn that there are foods that lower cholesterol. While the word “diet” often conjures up images of restricting food and yo-yo dieting, we can use certain diets to nourish our bodies and help us treat things like high cholesterol or high blood pressure naturally with the food that we consume. In this case, we are using it in a “food is medicine” approach. One of the best studied diets to lower cholesterol is called the Portfolio diet. Let’s explore what it is and how well it can lower cholesterol.
Why is it important to lower cholesterol
I wrote in depth previously about how elevated LDL cholesterol contributes to atherosclerosis, or blockages in the arteries of the heart, as well as how to interpret your cholesterol panel. So go back and read those for a more in depth look at these important concepts. Briefly, elevated numbers of LDL particles, and by proxy LDL cholesterol, makes it more likely that cholesterol will get stuck in the artery wall and form plaques or blockages. By lowering cholesterol, either via diet or medications, you can powerfully lower your risk of developing heart disease or having a heart attack
What is the Portfolio diet?
It’s a specific plant-based dietary pattern that emphasizes four main food groups that have been demonstrated to lower cholesterol. Rather than focusing on what you shouldn’t be eating, it emphasizes what you should be eating.
The four components are:
nuts
plant proteins
viscous, soluble fiber
plant sterols
Additionally, an enhanced Portfolio diet in which 13% of carbs are swapped for monounsaturated fats, can result in additional cholesterol lowering.
How much can food lower cholesterol?
Each component has been demonstrated to lower LDL-c by about 5-10%, and when combined, can result in, about 17% LDL-c lowering (on average 28 mg/dL) when compared to a control low saturated fat diet (and an estimated 27% lowering when combined with a low saturated fat diet). In one trial, the Portfolio diet lowered LDL-c by 28.6%, which was equivalent to a low dose lovastatin combined with a low saturated fat diet. Both outperformed a low saturated fat diet alone.
It has also been shown to lower inflammation with reductions in CRP seen around 32%. The Portfolio diet may also lower blood pressure, apoB, and triglycerides.
How does food lower cholesterol?
Each component of the Portfolio diet may be responsible for lipid lowering by different mechanisms.
Viscous fiber increases bile acid losses by binding to the bile acids (thus forcing your body to use more cholesterol to make up for the lost bile acids). Plant sterols reduce cholesterol absorption by competing for cholesterol uptake in the intestine. Soy appears to reduce cholesterol synthesis in the liver, thus increasing the uptake of cholesterol in the bloodstream by the liver. And nuts likely lower cholesterol due to their high levels of fiber, protein, and monounsaturated fatty acid content as well other phytochemicals.
The foods that lower cholesterol
Nuts - 42 g (about one handful)
Consider almonds, peanuts, nut butters, pistachios, walnuts. Really any nut works!
My favorite way to consume is adding to my oatmeal, snacking on them, or putting them in my salads. A nut butter on whole grain toast in another great option.
Plant protein - 50 g
Consider soybeans, beans, peas, chickpeas, lentils, tofu, tempeh, soy milk, and plant protein powder
Start by switching out cow’s milk to soy milk (the plant milk with the most protein and is actually equivalent to cow’s milk). Other good swaps include baked chickpeas on your salad or grain bowls, lentils in bolognese sauce, and tofu or tempeh in place of chicken.
Viscous (aka soluble) fiber - 20 g
There are two kinds of fiber, soluble and insoluble. Both are good for you, but it’s the soluble fiber that lowers cholesterol. Foods high in soluble fiber in particular include oats, barley, beans, lentils, psyllium (aka Metamucil), eggplant, okra, Brussels sprouts, avocado, sweet potatoes, apples, oranges, and berries
Start by having daily oatmeal and berries. Aim to have at least five servings of fruits and veggies a day, with particular focus on those that are high in soluble fiber. Work your way up and go slow to avoid GI discomfort.
Plant sterols - 2 g
These occur naturally in many foods, but it is very difficult to consume them in sufficient quantities and so many choose to supplement or consume fortified products.
Lowering cholesterol with food - in summary
The evidence for certain foods and nutritional patterns to lower cholesterol is well established. The effectiveness of the Portfolio diet, particularly when combined with a low saturated fat diet, is about the same as the starting dose of a low-potency statin or ezetimibe. This particular dietary pattern also has evidence for lowering inflammation, blood pressure, and triglycerides - other important heart risk factors. It does, however, require some planning, motivation, and support as demonstrated by the improved cholesterol lowering power seen in trials in which food and nutritional support was provided. For those interested in lowering their cholesterol naturally with food, this specific type of plant based diet can be a great option.
Interested in working with Dr Harkin to lower your cholesterol with food?
