By Alexis da Silva, MD
High cholesterol such as LDL (also known as the "bad" cholesterol) is one of the biggest drivers of heart attacks and strokes. The good news is that everyday habits can meaningfully improve your numbers. Lifestyle changes are the foundation of cholesterol care for everyone, with or without medication. Here are some dietary recommendations that are supported by science:
Cut back on saturated and trans fats.
There is a clear link between saturated fat and higher LDL cholesterol. Saturated fat is found mostly in red meat, butter, full-fat dairy, coconut oil, and palm oil. Replacing these fats with healthier unsaturated fats reliably lowers LDL.
Choose healthy fats instead.
Swap in olive oil, avocados, nuts, and fatty fish. The swap matters more than just "eating less fat.” Replacing saturated fat with unsaturated fat lowers LDL better than cutting total fat alone.
Eat more fiber, plants, and nuts.
Fruits, vegetables, whole grains, beans, and lentils all help. A few specific, proven additions:
- Viscous (soluble) fiber such as oats—about 5–10 grams a day
- Nuts: roughly one serving a day is tied to about a 5 mg/dL drop in LDL
- Plant proteins in place of meat
- Examples include tofu, edamame, tempeh, seitan, beans, lentils, green peas and chickpeas
Consider a proven eating pattern
The Mediterranean diet, the DASH diet, and vegetarian or vegan diets are all linked to better heart health. Vegetarian and vegan patterns tend to lower LDL the most. When several of these food changes are combined (the so-called "Portfolio" approach of nuts, soy, fiber, and plant sterols), LDL can fall by around 25 mg/dL—and combining all the dietary strategies can lower LDL by up to 30–40 mg/dL in some people.
Limit added sugar and ultra-processed foods
The benefit of healthy fats can be cancelled out by too much processed sugar and heavily processed foods. These are also especially important if your triglycerides (another blood fat) are high.