How to lower cholesterol with diet.

Fortunately, it is possible to lower cholesterol levels naturally with dietary changes. And eating plant-based foods that are rich in fiber and healthy fats, long known as the portfolio diet, is a great way to go. In fact, staying close to food was recently shown in a large-scale, long-term (30-year) cohort study that was published in the journal Last Year. Circulation, Reducing the risk of heart disease by 14%.

“In general, patients can expect to lower their cholesterol levels…by as much as 20-25% through diet and exercise,” explains Dr. Sandeep Nathan, a cardiologist at the University of Chicago Medical Center. good luck. “The rest represents what is synthesized by the liver and, unfortunately, cannot be reduced by diet, exercise, nutrients or supplements.”

Although people with high cholesterol who have a genetic condition known as familial hypercholesterolemia may eventually need medication to lower their levels, the first course of action for anyone with high cholesterol is diet. Try to reduce it by changing the Below, everything you need to know.

What is cholesterol?

Cholesterol is a waxy substance found throughout the body that your body uses to build cells and make vitamins and hormones. Your liver makes all the cholesterol you need, the rest comes from what you eat — especially animal foods. And having too much—typically 200 milligrams per deciliter of total cholesterol for adults—can cause health problems.

The only way to know your levels is to have a lipid profile blood test. It measures both LDL cholesterol (bad, because it contributes to fatty deposits in the arteries) and HDL cholesterol (good, because it actually helps protect against heart attack and stroke), as well as triglycerides. , the most common type of fat. In the body, high levels of which combined with high LDL or low HDL cholesterol can increase the risk of heart attack or stroke.

The combination of a triglyceride-cholesterol problem, “pretty much means you have insulin resistance, which is a way to raise cholesterol,” says Dr. Raja Jaber, medical director of lifestyle medicine programs at Stony Brook Medicine. And it can be largely reversed with diet and exercise.

First, the good news: what to eat more of for healthy cholesterol.

“You want to add a lot of soluble fiber,” Jaber says, explaining that soluble, or viscous, fiber is fiber that swells up when you eat. “And when they do that, they trap your bile acids and prevent your cholesterol from re-entering the body. They’re like a sponge.” Some of the best sources are whole grains that include unrefined oats—so, rolled oats or instant oatmeal over steel-cut oats or oat groats (the purest, least processed form)—and beans other than barley. which also provide plant-based protein.

Some fruits also contain soluble fiber, including apples and pears, due to their pectins, as do many vegetables, such as Brussels sprouts, carrots and eggplant. The Portfolio Diet recommends consuming 20 grams of soluble fiber per day.

Also important are phytosterols, or plant sterols, natural compounds found in fruits and vegetables, whole grains, and nuts and seeds, which Jabber says have hormone-like effects and are “weak cholesterols,” the bad cholesterol. compete with Our small intestine helps regulate overall levels and also reduces the risk of cancer, obesity and diabetes. The Portfolio Diet recommends consuming only 2 grams per day.

Good sources of phytosterols include unprocessed (or cold-pressed) extra-virgin olive, sesame, safflower, and sunflower oils—about 3 tablespoons of which should be consumed daily, according to the Portfolio Diet. Other good sources of phytosterols include most vegetables but especially asparagus and broccoli; fruits including avocado, mango, and tangerine; all legumes but especially soybeans; and all nuts and seeds—which should be consumed in the amount of 45 grams (about a handful) per day according to the portfolio diet. Some fortified juices and yogurts also contain phytosterols, or they can be taken in supplement form.

Further, adds Nathan, “Omega-3 fatty acids—as found in certain types of fish such as mackerel, tuna, and salmon—improve HDL-C, or so-called ‘good cholesterol,’ and lower triglycerides.” can make

These supplements can also help with cholesterol levels.

Jaber recommends two main supplements in the fight against bad cholesterol, starting with psyllium, an excellent source of soluble fiber, from the seed husks of the Plantago ovata plant. It’s a bulk-forming laxative (and a key ingredient in over-the-counter remedies like Metamusle), a prebiotic, and, according to a 2017 review, can help lower LDL (bad) cholesterol by up to 24 percent. And total cholesterol up to 20%.

Psyllium can be found in capsule or wafer form, or in pure powder, which can be added to juices and smoothies.

Another heart-healthy supplement to consider is red yeast rice, a product of yeast grown on white rice, usually found in capsule form, Jaber says. It contains monacolin K, a component of the statin lovastatin. “It’s a natural statin,” Jaber says, with several studies, including a 2019 review showing that its use can lower LDL levels by 15 to 25 percent within six to eight weeks. is, which makes it seem effective. “And statins not only lower cholesterol, but they lower inflammation. So they have a dual role, which is why they’re such good drugs and red yeast rice does the same thing.

It can cause similar side effects, though, such as stomach problems, headaches, and dizziness, and possible liver or muscle damage. Talk to your doctor first.

Finally, Jaber says, some people have had good results with bergamot, a citrus fruit that can be taken in extract oil, supplement or juice form. A systematic review found that it reduced total cholesterol by 12.3% to 31.3% and LDL by 7.6% to 40.8%. “It has some effect on lowering cholesterol, but the research is not that strong,” she says. “But it’s relatively safe.”

Still, there is a risk of allergic reactions and increased sensitivity to sunlight, so again, talk to your doctor.

Now, the bad news: What to eat less of for healthy cholesterol?

There’s a trifecta to avoid: saturated fat, refined starches, and processed foods.

“So, big is saturated fat,” says Jaber. “People think that cholesterol leads to cholesterol, but that’s actually not true.” Shellfish, for example, contains cholesterol, but “as long as you Don’t put butter on it, because butter contains saturated fat, it won’t raise your cholesterol.” That’s because research shows that most cholesterol is made in the liver by an enzyme called sat. Activated by saturated fats, not cholesterol From foods.

Harvard Health Publishing notes that according to various studies, even eggs, once avoided by people with high cholesterol, appear to be safe.

So where is saturated fat found? Most animal protein, in the form of butter, full-fat milk, and lean meats, including steaks. Oh, and bad news, cheese lovers: cheese is loaded with it.

“Most health-conscious people aren’t eating tons of red meat, but they’re eating a lot of cheese,” Jaber says. But it is a huge driver of cholesterol. “It’s really hard for them to let go, but you don’t have to stop completely, just figure out how you can change your diet.” Make eggplant parmesan with very little cheese, for example, rather than “going overboard.”

“Avoiding fried and fatty foods can also help limit trans fat, a substance linked to various health outcomes and negatively affecting cholesterol levels,” Nathan added. known for.”

Another major driver of cholesterol is insulin resistance, which comes from consuming too many calories that overwhelm and inflame the body. This is largely from a diet high in refined starches and sugars—think white bread, pasta, cookies, and cakes—and processed foods in general. Although, says Nathan, “the interaction between simple/processed carbohydrates and cholesterol is complex and controversial and the science is still evolving.”

Research has found that with processed foods, “regardless of what’s in it, and even if it has the same composition of protein, carbohydrates, and fat as an unprocessed food, only the processing and Ultra-processing food also increases inflammation,” says Jaber.

“The best way to reduce insulin resistance is to eat an unprocessed diet, low in saturated fat, low in sugar, and very low in refined starches,” she says.

Consider replacing refined starches with unprocessed versions — sprouted grain bread, for example, instead of bread made from flour, as “even by taking a grain and turning it into flour, you can Processing a little bit, and your absorption is faster,” Jaber explained. You can also try brown rice, quinoa, and steel-cut oats instead of white rice and instant oatmeal.

And while vegetarians may think they’re in the clear, because completely removing animal protein from the diet means you’re eating less saturated fat, note: Two plant sources of saturated fat are—coconut oil and palm oil—and both are ubiquitous in processed vegan foods, including butter, cheese, and meat substitutes, as well as baked goods.

“Sometimes vegetarians rely too much on starches that can be refined, and that increases insulin resistance and raises cholesterol,” she says.

Still, it’s worth aiming for a largely plant-based diet, even if you can’t stick to it entirely, says Jaber. “Most people, if they switch to a completely plant-based diet that’s high in soluble fiber, can lower their cholesterol almost as much as a statin.”

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