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Diagnosed with high cholesterol? 4 dietary changes to make to lower it

Diet plays a significant role in lowering cholesterol. Here are four ways to tackle your diagnosis.

Have you had your lipid panel checked recently? Were you told you have high cholesterol? If so, you are among approximately 94 million adult Americans with cholesterol levels over normal ranges. This condition, referred to as dyslipidemia or hyperlipidemia, doesn't just target adults. It’s estimated that about 7% of all children also have high cholesterol. Your doctor may prescribe medication, lifestyle change, or a combination of both to combat the condition.

What does having high cholesterol mean?

Your lipid panel contains multiple values; here’s a breakdown of what may be commonly displayed:

  • Total cholesterol: The combination of components of your lipid panel
  • Low-density lipoprotein (LDL) cholesterol: "Bad" cholesterol that can restrict blood flow as it builds up in blood vessels
  • High-density lipoprotein( HDL) cholesterol: "Good” cholesterol that reduces LDL buildup and carries cholesterol out of the body
  • Triglycerides: Fat found in food that can become elevated in the blood.
  • You may have also measured your LDL/HDL ratio or very low-density lipoprotein (VLDL).

Why does having high cholesterol matter to health?

A primary factor of high cholesterol is the increased risk of cardiovascular disease (CVD). That’s because LDL cholesterol (the bad cholesterol) can stick to the walls in our arteries, block blood flow, and lead to heart attack or stroke. High LDL cholesterol can also increase the risk of Alzheimer’s disease and vascular dementia. High HDL cholesterol, however, is found to be protective by removing and inhibiting the oxidation of LDL cholesterol.

Although the risk to women and men are similar, there are some nuances with each gender. For example, a 2022 study in the Journal Lancet found that younger women had a lower risk of cardiovascular disease than men but that dietary components had a more vital link to CVD risk than men overall. Women also have an increase in the risk of CVD as they enter into menopause. This risk is due to hormone alterations that may increase cholesterol levels. Conversely, men most at risk for CVD in the study were more likely to have higher LDL levels as well as symptoms of depression. It’s important to note that heart disease remains the leading cause of death for men, with high blood pressure, Type 2 diabetes, obesity, smoking, and alcohol as significant risk factors alongside a diagnosis of dyslipidemia.

4 ways to lower cholesterol with diet

Diet plays a significant role in reducing the risk of dyslipidemia. Here are four dietary ways to tackle your diagnosis.

1. Opt for more soluble fiber

Fiber is found in plants and may classify as either soluble or insoluble. Soluble fiber may contribute to reductions in cholesterol. The mechanism occurs when soluble fiber (which adds bulk to the diet) helps to absorb and isolate cholesterol in the body. The cholesterol is redirected from the bloodstream towards excretion out of the body. You don’t have to focus solely on soluble, however as a recent study has found that consuming fiber from any source benefits health. Fiber-rich foods that help manage cholesterol include fruits and vegetables, whole grains, oats, beans, and legumes. Aim for at least 25g grams of dietary fiber a day.

2. Focus on a good gut

Gut health is a critical factor in the overall lipid panel. A study in the Journal Circulation Research identified 34 different gut bacteria that played a positive role in triglycerides and HDL cholesterol. An animal study from Scripps research found that a healthy balance of gut microbes helped to lower cholesterol in the blood. Finally, a 2020 study in the Journal Nature identified statins (medications that help lower cholesterol) also helped to promote a healthy microbiome. Microbial diversity is an important factor in getting the best gut possible. Dietary measures to achieve this include consuming less sugar and processed foods and having more fermented foods and foods with prebiotics and probiotics. These include sauerkraut, kombucha, sour cream, kefir, tempeh, miso, and dairy food with live active enzymes like yogurt. Prebiotics can be found in bananas, berries, garlic, onions, leeks, asparagus, and whole wheat.

3. Embrace monounsaturated and polyunsaturated fats

Healthy unsaturated fats are associated with improvements in overall cholesterol. A 2022 study from Penn State showed that consuming one avocado daily helped reduce cholesterol levels. A Journal Circulation study found that consuming a Mediterranean dietary pattern rich in extra virgin olive oil, nuts, and seeds helped increase healthy HDL levels. Finally, studies on omega-3 fatty acids have been just as positive. Higher doses of marine-based omega-3 fatty acids are associated with beneficial impacts on triglycerides. Further, omega 3’s may also play a role in boosting good HDL and lowering bad LDL cholesterol. A 2021 study found that having a handful of walnuts daily could help reduce LDL cholesterol in healthy adults with dyslipidemia.  

4. Don’t forget about plants — including those from the sea

Eating a primarily plant-based diet can help in the overall management of dyslipidemia. That’s because plants can help fill you with fiber, phytonutrients, and plant sterols — all components associated with a better lipid panel. In addition to fruits, vegetables, whole grains, seeds, nuts, and legumes, you can also consider plants that grow in the ocean. Sea vegetables (think seaweed snacks and seaweed salad) may help reduce cholesterol via their fiber and antioxidant content.

Improving your lipid panel may take time and involve pharmacological assistance in addition to lifestyle change. In addition to diet, you may also help to lower your cholesterol by exercising more, reducing obesity through weight loss, eliminating cigarette smoking, and limiting alcohol consumption. Discussing your lipid panel with your doctor is the best first step to determining the right course of action that fits your lifestyle goals.