by Dr. Josh Axe. What you need to know about cholesterol and the foods that can keep it in check (photo, ECWA Archive).
Cholesterol is often one of the most misunderstood aspects of heart health. For many people, a cholesterol-lowering diet brings to mind low-fat meals that lack flavor. However, as you’ll come to see, this couldn’t be further from the truth!
When it comes to lowering high cholesterol naturally, strictly avoiding all fats is not the answer. Even totally avoiding foods that contain cholesterol itself (like eggs or cheese) isn’t necessary the solution. It’s all about moderation and balance—eating a combination of nutrient-dense foods that fight inflammation and tackle the root of the problem.
You’ll be happy to know that cholesterol-lowering foods include all sorts of great-tasting fruits, vegetables, legumes, whole grains, fish, lean meats, and plenty of healthy sources of fat.
What causes high cholesterol?
First and foremost, it's necessary to clear up common misconceptions about what causes high cholesterol in the first place. For several decades, a widely held belief has been that dietary cholesterol is associated with an increased risk for coronary heart disease (CHD). This led government-mandated dietary recommendations to limit cholesterol intake to no more than 300 milligrams per day for healthy adults. However, based on recent evidence, there are some serious challenges regarding the cholesterol limit—leading to discussions about revising the national recommendation.
While factors like genetics, inactivity, diabetes, stress, and hypothyroidism can all impact cholesterol levels, a poor diet is the number one cause for high cholesterol. Unfortunately, the standard American or Western diet is highly inflammatory, which elevates LDL (bad cholesterol) and lowers HDL (good cholesterol) in most cases—the opposite of what we want.
How exactly does inflammation cause cholesterol levels to rise?
Cholesterol is a naturally occurring substance that is present in all of us and crucial for survival. It’s made by the liver and required by the body for the proper functioning of cells, nerves, and hormones. Cholesterol in our body is present in the form of fatty acids (lipids) that travel through the bloodstream. These particles normally don’t build up in the walls of the arteries, but when inflammation levels go up, low-density lipoprotein (LDL) builds up in the arteries and dangerously forms plaque clots, cutting off blood flow and setting the scene for a heart attack or stroke.
Cholesterol itself wouldn’t be nearly as dangerous without inflammation. Inflammation is the primary cause of atherosclerosis, the hardening of arteries that accompanies plaque deposits, which produces even more inflammation. Inflammation is at the root of most diseases, and heart disease is no exception.
While we used to think that high-fat diets led to high cholesterol levels, we now know that only certain people have problems properly metabolizing cholesterol (which might increase plasma LDL cholesterol levels). Countries such as Australia, Canada, New Zealand, Korea, India, and those in Europe don’t include a dietary cholesterol limit in their guidelines. And for good reason—strong evidence demonstrates that dietary cholesterol is not correlated with an increased risk for heart disease in most cases.
Aside from these certain individuals who are more sensitive to dietary cholesterol, it’s estimated that about three-quarters of the population can remain totally healthy while eating more than 300 milligrams per day of cholesterol. In fact, eating plenty of healthy fats will raise HDL cholesterol, the “good kind,” and increase the LDL/HDL cholesterol ratio, which are two key markers of general health.
Patients at an increased risk for cardiovascular diseases might need to limit their intake of cholesterol and saturated fats, but everyone else is better off focusing on limiting their intake of processed, packaged junk! Data shows that the impact of lowering dietary cholesterol is small compared to adjusting other important dietary and lifestyle factors.
What do all cholesterol-lowering foods have in common?
There’s no shortage of diet plans available online and in bookstores that promise the ability to lower cholesterol. Therapeutic Lifestyle Changes (TLC), for example, is a three-part plan that attempts to lower high cholesterol by focusing on a lower-fat diet coupled with exercise and weight control. Creators of TLC report that following this plan can lower LDL cholesterol by 20 to 30 percent. The DASH Diet, low in sodium and saturated fat, is another option that’s endorsed by the American Heart Association and proven to lower high blood pressure.
What foods do most cholesterol-lowering diets make you say good-bye to, and what can stay?
For starters, foods with trans fats and hydrogenated oils are the opposite of cholesterol-lowering foods and definitely need to stay off the table. Many plans also recommend avoiding foods with saturated fats, however this isn’t always necessary for everyone if the foods are natural and high quality, as explained above. In their place, monounsaturated fats (MUFAs) and polyunsaturated fats (PUFAs) are recommended. These include foods like benefit-rich avocados, olive oil, nuts, and seeds.
Aside from switching up your fat sources, one of the key elements to fighting high cholesterol is eating plenty of high-fiber foods. Fiber is found in all types of whole foods including vegetables, fruits, whole grains, and legumes. Where is fiber missing? In processed foods that are refined and full of sugar—including most breakfast cereals, pastries, breads, rolls, pasta, cookies, and granola bars.
When it comes to protein sources, “lean” is usually the name of the game. Healthy lean proteins include pasture-raised poultry like turkey or chicken, fish and other seafood, beans, and, yes, even eggs. While I’m not a fan myself, the DASH Diet and TLC both promote low-fat milk products, including yogurt and reduced-fat cheeses. For the average person, it’s also perfectly healthy to eat grass-fed animal products as part of an otherwise balanced diet, including beef and lamb.
This way of eating is closely related to the Mediterranean Diet—one of the most highly recommended dietary plans that doctors prescribe to their high-cholesterol patients. People in the countries surrounding the Mediterranean region rely heavily on eating what’s sourced and grown locally, rather than packaged foods that are full of refined vegetable oils, sugar, sodium, and artificial ingredients.
Historically, levels of heart disease are much lower in countries other than in the U.S., despite the fact that most people still eat a substantial amount of fat. Because of the diversity, flexibility, and adaptable approach to this style of eating, it’s easy to begin and to stick with. Also, the food tastes great!
Foods to Avoid for High Cholesterol
The key to lowering heart disease risk factors, including high cholesterol, is reducing inflammation. Inflammatory foods include:
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packaged foods of all kinds
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sugar
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refined grain products
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processed vegetable oils
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conventional dairy products (nonorganic, homogenized, and pasteurized)
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farm-raised animal products
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too much caffeine or alcohol
As mentioned above, fiber and antioxidants are crucial to keeping arteries clear and healthy. Increased intake of dietary fiber is associated with significantly lower prevalence of cardiovascular disease and lower LDL-cholesterol concentrations. Research also shows that some specific compounds found in plant foods, including plant sterol/stanol and isoflavones, can help reduce cholesterol levels. Most processed foods are extremely low in both—and the kinds that do have fiber or antioxidants normally contain synthetic, added types.
Poor quality animal products are highly inflammatory, as are toxic oils that are made using chemicals and solvents. Alcohol, sugar, and caffeine are all stimulants that the liver can use to produce more cholesterol, increasing levels of inflammation. While these can be okay in small doses (such as 1 to 2 cups of coffee or a glass of red wine per day), overdoing it can counteract any cardioprotective benefits these ingredients might normally have.
Top 12 Cholesterol-Lowering Foods
1. Vegetables (Especially Greens!)
No doubt about it, nutrient-dense, anti-inflammatory vegetables are one of the most high-antioxidant foods. Loaded with phytochemicals that fight free radical damage, they slow down the aging process and keep arteries flexible and healthy. Many dark leafy greens, like spinach and kale, contain very few calories but offer protection against heart attacks by helping artery walls stay clear of cholesterol buildup. While nearly every type is a good choice, vegetables—including benefit-rich beets, onions, cabbage, broccoli, and artichokes—are especially useful for upping your fiber intake and protecting heart health.
2. Nuts
Nuts of all kinds make a good source of healthy polyunsaturated and monounsaturated fats. They also provide a decent amount of fiber. Certain nuts including almonds specifically supply antioxidant flavonoids, plant-based compounds that improve artery health and reduce inflammation. Studies show nuts have a consistent “bad” LDL cholesterol-lowering effect, especially in individuals with high cholesterol and diabetes. They can help prevent damage forming within artery walls and protect against dangerous cholesterol plaque buildup, in addition to fighting weight gain and obesity.
3. Chia Seeds and Flaxseeds
Flaxseed benefits extend to being the richest source of the plant-based omega-3 fatty acid called alpha-linolenic acid (ALA). They also rank number one in terms of providing hormone-balancing lignans. Both chia and flaxseeds are extremely high in soluble and insoluble fiber, which can support detoxification and gut health and help with weight loss.
The soluble fiber content helps trap fat and cholesterol in the digestive system so that it is unable to be absorbed. Bile is then excreted through the digestive system, forcing the body to make more, using up excess cholesterol in the blood and lowering cholesterol overall. Use some seeds on your oatmeal, yogurt, in baked goods, or blended into smoothies.
4. Olive Oil
Olive oil benefits include being another anti-inflammatory ingredient that’s full of heart-healthy monounsaturated fatty acids which lower LDL cholesterol. Use extra virgin olive oil to make homemade salad dressings, add some to sauces, or use it as a flavor-boosting ingredient for stir-fries or marinades.
5. Avocados
Avocados are one of the world’s greatest sources of heart-healthy monounsaturated fat, the type that can help raise HDL cholesterol while lowering LDL. Avocados also contain high levels of soluble fiber and stabilize blood sugar levels, in addition to supplying anti-inflammatory phytochemicals such as beta-sitosterol, glutathione, and lutein. Besides making guacamole, get creative with these avocado recipes and add it to smoothies, salads, eggs, or even desserts.
6. Salmon
As one of the world’s best sources of anti-inflammatory omega-3 fats, the nutrition of salmon is also valuable because it’s linked to lower rates of heart disease, cognitive disorders, depression, and many other conditions. Other sources of omega-3 fatty acids include fatty fish like sardines, mackerel, and herring. All can help raise good cholesterol while also supporting a healthy weight and better brain function.
7. Gluten-Free Whole Grains
One hundred percent whole grains are tied to better heart health, mostly because they are a great source of fiber. However, because gluten is a common sensitivity and can promote inflammation, I recommend focusing on gluten-free grains like quinoa, rolled oats, buckwheat, and amaranth. These tend to be easier to digest, can be used in all the same ways as wheat or wheat flour, and provide plenty of nutrients, too. Oats, for example, contain a compound called beta-glucan, a substance that absorbs cholesterol.
8. Green Tea
Green tea is considered the number-one beverage for antiaging. Not only is it a rich source of cancer-fighting antioxidants, it’s also supportive for heart health since it prevents LDL cholesterol levels from rising. Epidemiological studies suggest that drinking green tea can help reduce atherosclerosis and risk of heart disease, lower blood pressure, reduce inflammation in arthritis cases, and also improve bone density and brain function.
9. Beans and Legumes
Beans are known for packing in fiber, which slows the rate and amount of absorption of cholesterol. They also contain antioxidants and certain beneficial trace minerals that support healthy circulation. Try nutritious black beans, chickpeas, kidney beans, mung beans, and other varieties in soup, salads, and, of course, hummus!
10. Turmeric
Consider turmeric the king of all spices when it comes to fighting inflammation. Turmeric benefits include lowering cholesterol, preventing clots, fighting viruses, killing free radicals, increasing immune health, balancing hormones, and more. Turmeric contains the active ingredient called curcumin, which has been studied in regards to protection against numerous inflammatory diseases including heart disease, cancer, ulcerative colitis, arthritis, and more.
11. Garlic
Garlic is one of the most well-researched heart healthy ingredients available. For example, the benefits of raw garlic has been shown to reverse disease because of its antioxidant, antiinflammatory, antiviral, antidiabetic, and immune-boosting properties! Garlic has been found to lower cholesterol, prevent blood clots, reduce blood pressure, and protect against infections, so use some every day however you can, whether in sauces, soups, roasted veggies, or marinades.
12. Sweet Potatoes
Sweet potatoes provide a good dose of filling, artery-sweeping fiber in addition to loads of vitamins and antioxidants. They’re also low in calories, low on the glycemic index (which means that they won’t spike your blood sugar), and high in potassium.
Dr. Josh Axe is a C.N.S. Certified Nutrition Specialist, expert in Natural Medicine, a speaker for Fortune 500 Companies (Nissan, Whole Foods) and a doctor of chiropractic. He is a nationally sought-after speaker, bestselling author of The Real Food Diet Cookbook, a Physician for Olympic level athletes (Ryan Lochte, among others) and a regular contributing writer for one of the largest U.S. natural supplement companies, Garden of Life. He’s the founder of draxe.com, which is the #9 most visited natural health site in the entire world.
