High cholesterol is a silent alarm that rings loudly within the walls of your arteries, posing significant risks to your heart health and longevity. At the Span Clinic, we understand the intricacies of cardiovascular wellness and the very pivotal role diet and lifestyle plays in managing cholesterol levels.

This simple yet comprehensive guide written by our in-house nutritionist, Rebecca Taylor, provides some simple pointers for how you can use food as medicine and lifestyle techniques to keep your cholesterol levels in check.

Cholesterol: Balancing the Scales of Heart Health

Cholesterol is often cast in a negative light, yet it’s an essential substance for our wellbeing, playing a crucial role in building healthy cells and maintaining cellular structure. 

Cholesterol is a fat-like substance that is present in every cell in the body. It is also responsible for producing:

• the sex hormones oestrogen and testosterone
• vitamin D
• bile acids, which help the body digest fats

However, the narrative of cholesterol is very much one of balance. Within our bloodstream, cholesterol exists in two primary forms: Low-Density Lipoprotein (LDL), or “bad” cholesterol and High-Density Lipoprotein (HDL), known as “good” cholesterol. Managing the levels of these two forms is vital for our heart health.

Although people should aim to have more HDL cholesterol than LDL cholesterol, it’s recommended that adults keep their blood levels of total cholesterol below 200 milligrams per deciliter.

The Impact of Diet on Cholesterol

Understanding and managing cholesterol isn’t just about avoiding negative outcomes; it’s about being proactive in your health and wellness. There is no denying that diet plays a crucial role in managing cholesterol levels. 

Foods high in saturated fats, trans fats and cholesterol can elevate harmful LDL levels. Conversely, a diet rich in fibre, healthy fats and antioxidants can help reduce cholesterol levels and promote heart health. 

Let’s explore this in more detail below.

Key Dietary Strategies to Lower Cholesterol

1. Embrace Heart-Healthy Fats

Unsaturated fats, which include both monounsaturated and polyunsaturated fats, play a crucial role in managing your body’s cholesterol levels and reducing the risk of heart disease (Sacks et al. 2017).

Benefits of Heart-Healthy Fats

Lower LDL Cholesterol:

Unsaturated fats have been shown to lower LDL (low-density lipoprotein) cholesterol levels. LDL cholesterol is often referred to as “bad” cholesterol because high levels can lead to plaque build-up in your arteries, increasing the risk of heart disease and stroke.

Raise HDL Cholesterol:

Consuming unsaturated fats can also help increase HDL (high-density lipoprotein) cholesterol, known as “good” cholesterol. HDL helps remove other forms of cholesterol from your bloodstream, thus protecting against heart disease.

Improve Triglycerides:

Diets high in unsaturated fats can lead to lower triglyceride levels, reducing the risk of cardiovascular disease.

Anti-inflammatory Effects:

Polyunsaturated fats, especially omega-3 fatty acids found in fatty fish, have anti-inflammatory properties that can reduce the risk of heart disease.

When you have the opportunity, replace saturated and trans fats with heart-healthy unsaturated fats found in:

🫒Olive oil

🥑Avocados

🥜Nuts and seeds

🐟Fatty fish like salmon and mackerel

2. Increase Soluble Fibre Intake

Eating foods high in fibre can be beneficial for blood cholesterol levels by lowering LDL. There are two kinds of dietary fibre — soluble and insoluble. Soluble fibre is especially important for lowering cholesterol.

This is a form of fibre that’s water-soluble. Soluble fibre binds around bile (which is composed of cholesterol) and removes it with your body’s waste (Threapleton et al. 2013).

Incorporate fibre-rich foods such as:

• Barley and other whole grains
• Flaxseeds
• Oats and oat bran
• Legumes
• Apples, pears, and citrus fruits

Most people in the UK only consume about 20 grams of fibre a day. Try and make your goal to consume 30 grams a day.

Tip from our Nutritionist: Cooked, cooled and reheated potatoes provide a great source of resistant starch, which helps feed your gut microbes and lower cholesterol!

It is worth noting that consuming too much fibre may lead to constipation, bloating and stomach pain. So go low and slow when it comes to increasing your fibre intake to avoid any painful bathroom visits.

3. Add Plant Sterols and Stanols

These substances, found in plant foods, help block cholesterol absorption. 

While plant sterols and stanols are naturally found in small amounts in many fruits, vegetables, nuts, seeds, legumes and vegetable oils, the concentrations in these natural sources are generally too low to achieve a therapeutic effect. As such, they’re often added to products like margarine, orange juice, and yoghurt drinks. They can also be consumed in supplement form. 

Numerous studies have shown that consuming 2 to 3 grams of plant sterols or stanols per day can lower LDL cholesterol by about 10% to 15% (Gylling et al. 2014). 

That’s pretty significant, I think you’ll agree!

4. Focus on Whole, Plant-Based Foods

Focusing on whole, plant-based foods is a powerful strategy for improving overall health, particularly heart health. This approach emphasises the consumption of a wide variety of fruits, vegetables, whole grains, legumes, nuts, and seeds, while minimising or eliminating the intake of animal products and processed foods.

These foods also contain a wide range of phytochemicals—bioactive compounds that have been shown to have anti-inflammatory, antioxidant and lipid-lowering effects. 

Adopting a whole, plant-based diet can also help with weight management, which is a key factor in maintaining heart health. Plant-based foods are generally lower in calories and higher in fibre than animal products and processed foods, making them more satiating and helpful in reducing overall calorie intake.

5. Avoid Trans Fats

Trans unsaturated fatty acids (trans fats) are unsaturated fats that have undergone an industrial process known as hydrogenation. Food manufacturers use trans fats because they are relatively inexpensive and long-lasting and are often labelled as “partially hydrogenated vegetable oil”.

Sources of trans fats may include:

• margarine
• vegetable shortening
• partially hydrogenated vegetable oils
• fried foods
• certain processed and pre-packaged foods

6. Reduce Saturated Fat

Increasing your consumption of saturated fats to less than 7% of your total daily calorie intake can reduce your LDL cholesterol by 8% to 10%. For someone consuming 2,000 calories a day, this equates to about 16 grams or less of saturated fat daily.

Saturated fats are most commonly found in:

• Red meat (beef, lamb, pork)
• Poultry skin
• High-fat dairy products (butter, cheese, whole milk, cream)
• Lard and cream
• Some plant oils (coconut oil, palm oil, and palm kernel oil)
• Processed and baked goods made with these oils or fats
  

✅ Select Low-Fat or Fat-Free Dairy Products: Switch to low-fat or fat-free versions of milk, yoghurt and cheese to reduce saturated fat intake without sacrificing calcium and protein.

✅ Use Healthier Oils: Replace butter, lard, and tropical oils (coconut, palm, and palm kernel oils) with oils high in unsaturated fats, such as olive, canola, and safflower oils.

✅ Eat More Fruits and Vegetables: Fruits and vegetables are naturally free of saturated fat. Incorporating more of them into your diet can also help displace high-saturated-fat foods.

✅ Read Food Labels: Pay attention to the saturated fat content listed on nutrition labels, and choose products with lower saturated fat amounts. Be mindful of portion sizes as well.

✅ Cook Smart: Use cooking methods that require less or no added fat, such as baking, broiling, grilling, steaming, or sautéing with a small amount of healthy oil instead of frying or cooking with solid fats.

✅Choose Lean Proteins: Opt for lean cuts of meat, and remove the skin from poultry. Consider plant-based protein sources, such as legumes, nuts, and seeds, which are low in saturated fat and offer the added benefit of fibre.

Lifestyle Modifications

Exercise Regularly

Regular physical activity can help raise HDL cholesterol levels. For example, this study found that moderate and vigorous exercise lowered blood sugar and blood pressure and increased HDL levels (the ‘good’ cholesterol). 

Aim for at least 30 minutes of moderate exercise most days of the week for a total of 2.5 hours a week. 

Just make sure it’s something you enjoy and can stick to, as we know this makes committing to healthy habits so much easier in the long run!

Maintain a Healthy Weight

Even a modest weight loss of 5-10% can help lower cholesterol levels and reduce the risk of heart disease. Excess weight, especially around the waistline, can contribute to high cholesterol levels.

Some benefits of even a small weight loss include:

✅Improved lipid profile

✅ Reduced inflammation

✅Lower blood pressure

✅Improved insulin sensitivity

Quit Smoking

Smoking cessation improves HDL cholesterol levels and overall heart health.This is because the chemicals present in cigarette smoke can cause LDL to become stickier and also damage the lining of blood vessels, making them swollen and inflammed. As such, smoking can make it difficult to control cholesterol levels and increases the risk of a potential clog in the arteries (Ronksley et al., 2011).

Facts from our Nutritionist: Within a year of quitting, your risk of heart disease drops to about half that of a smoker. Over time, your risk of heart disease can fall to nearly that of someone who’s never smoked.

Limit Alcohol Consumption

While moderate alcohol consumption has been linked to a slight increase in HDL cholesterol levels, excessive drinking can lead to serious health issues, including higher levels of LDL cholesterol and an increased risk of heart disease, hypertension and liver disease.

Moderation is Key: Limiting alcohol intake to one drink per day for women and up to two drinks per day for men is considered moderate. One drink is defined as 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of distilled spirits.

Healthy Sleep Habits

Good quality sleep is essential for our health in so many ways and can also affect cholesterol levels. Lack of sleep has been associated with higher levels of LDL cholesterol and an increased risk of developing heart disease.

Aim for 7 to 9 hours of quality sleep per night. Establish a regular sleep schedule, create a comfortable sleep environment, and avoid stimulants such as caffeine and electronics before bedtime (all of this is easier said than done, we realise!). Managing stress and practising relaxation techniques can also improve sleep quality (St-Onge, et al., 2016).

Foods to Limit or Avoid

To manage your cholesterol levels effectively, limit your intake of:

🥩Red meat and too many full-fat dairy products

🍟Fried foods and fast food

🍭Processed snacks and sweets

Stay Hydrated

Staying well-hydrated by regularly consuming adequate amounts of water is crucial for overall health, especially for maintaining a healthy liver.

The liver is instrumental in regulating cholesterol levels, as it breaks down cholesterol in the body. When the liver isn’t functioning properly, cholesterol can accumulate, leading to health issues.

Research from 2021 on metabolic health in older adults underscored the importance of hydration, revealing a link between adequate hydration and increased levels of HDL cholesterol. This finding points to the role of water not just as a vital drink for health but also as a potential ally in managing cholesterol levels.

A Sample Week on a Cholesterol-Lowering Diet

Breakfast: Porridge topped with fresh berries and walnuts, served with a side of orange juice fortified with plant sterols.

Lunch: Quinoa salad with mixed greens, avocado, chickpeas, and a lemon-olive oil dressing.

Snack: Apple slices with almond butter.

Dinner: Grilled salmon with a side of roasted Brussels sprouts and sweet potatoes.

Dessert: A small serving of dark chocolate (at least 70% cocoa) and raspberries.

Here’s an example of what some of our delicious and nutritious, cholesterol-lowering meals look like on our personalised meal plans. Proving that healthy eating doesn’t have to be boring – and certainly no iceberg lettuce ‘sandwiches’ in sight!

Ready to Transform Your Health?

At the Span Clinic, we’re committed to guiding you on your journey to optimal health and longevity. Our personalised consultations delve into your unique health profile, offering tailored dietary and lifestyle recommendations to help you manage cholesterol levels and enhance your overall well being.

Book Your Consultation Today

Ready to take the next step? Contact us to schedule a consultation with our team of experts. 

Remember, lowering your cholesterol with diet isn’t just about avoiding certain foods; it’s about a 360 degree approach to your health and wellbeing. With the range of experts we have in clinic, you can be sure that we’ll take a holistic approach to optimising your health and longevity.

References:

Sacks, F.M., Lichtenstein, A.H., Wu, J.H.Y., et al. (2017). Dietary Fats and Cardiovascular Disease: A Presidential Advisory From the American Heart Association. Circulation, 136(3), e1-e23. 

Threapleton, D.E., Greenwood, D.C., Evans, C.E.L., et al. (2013). Dietary fibre intake and risk of cardiovascular disease: systematic review and meta-analysis. BMJ, 347, f6879. 

Gylling, H., Plat, J., Turley, S., et al. (2014). Plant sterols and plant stanols in the management of dyslipidaemia and prevention of cardiovascular disease. Atherosclerosis, 232(2), 346-360.

Satija, A., Bhupathiraju, S.N., Spiegelman, D., et al. (2017). Healthful and Unhealthful Plant-Based Diets and the Risk of Coronary Heart Disease in U.S. Adults. Journal of the American College of Cardiology, 70(4), 411-422. 

Mozaffarian, D., Aro, A., Willett, W.C. (2009). Health effects of trans-fatty acids: experimental and observational evidence. European Journal of Clinical Nutrition, 63(S2), S5-S21.

Hooper, L., Martin, N., Abdelhamid, A., Davey Smith, G. (2015). Reduction in saturated fat intake for cardiovascular disease. The Cochrane Database of Systematic Reviews, (6):CD011737. 

Kodama, S., Tanaka, S., Saito, K., et al. (2007). Effect of aerobic exercise training on serum levels of high-density lipoprotein cholesterol: a meta-analysis. Archives of Internal Medicine, 167(10), 999-1008. 

Wing, R.R., Lang, W., Wadden, T.A., et al. (2011). Benefits of Modest Weight Loss in Improving Cardiovascular Risk Factors in Overweight and Obese Individuals With Type 2 Diabetes. Diabetes Care, 34(7), 1481-1486.

Critchley, J.A., Capewell, S. (2003). Mortality risk reduction associated with smoking cessation in patients with coronary heart disease: a systematic review. JAMA, 290(1), 86-97. 

Ronksley, P.E., Brien, S.E., Turner, B.J., Mukamal, K.J., Ghali, W.A. (2011). Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis. BMJ, 342, d671.

St-Onge, M.P., Grandner, M.A., Brown, D., et al. (2016). Sleep Duration and Quality: Impact on Lifestyle Behaviors and Cardiometabolic Health: A Scientific Statement From the American Heart Association. Circulation, 134(18), e367-e386.