Our 10 expert food steps to healthy cholesterol levels are easy to incorporate into your diet – and could make all the difference.
Limit processed meats
‘The culprit here is saturated fat, one of the major contributors to high cholesterol levels,’ explains Linda. Limit your intake of all processed meat products, including salami, ham, sausages, burgers, kebabs and meat pies, to no more than two servings per week.
‘You can still enjoy meat – just go for good-quality, lean cuts such as lean steak or skinless chicken breasts,’ she says.
Get your oats
A review of studies published in Nutrition Reviews found people with normal or high cholesterol who consumed oats reduced their total and LDL (bad) cholesterol levels by an average of 5% and 7% respectively. Oats contain high levels of beta-glucan, a soluble fibre that has been shown to lower both total and LDL cholesterol when consumed in amounts of around 3g a day.
‘You can get 3g beta-glucan by having two to three portions of oats and barley (also a good source) throughout your day. Go for jumbo rolled oats rather than milled,’ says Linda Main, dietetic advisor at Heart UK. Try eating porridge or bircher muesli for breakfast, adding barley to your soup for lunch, then having an oat-based muesli bar as an afternoon snack.
‘When you’re choosing oats, check the label. Some brands list the amount of beta-glucan per serving, helping you track your consumption,’ says Linda. ‘If a food item claims to be “cholesterol-lowering” on the packet, you know that it must contain at least 1g beta-glucan per serving.’
Have a handful of nuts a day
‘Nuts are high in heart-healthy monounsaturated fats, soluble fibre and plant sterols,’ says Linda. ‘And they’re a good source of essential nutrients such as magnesium, vitamin E and potassium.’ Including a small handful (around 30g) of nuts in your daily diet reduces both total and LDL cholesterol. Nuts are high in calories, but Linda explains, ‘People who eat nuts don’t tend to gain weight because they’re so filling. Don’t forget seeds, too – they also work to lower cholesterol by displacing saturates in our diets.’
Aim to eat more oil-rich fish each week
Oil-rich fish, such as salmon, trout, fresh tuna, sardines, herring and mackerel, are the best dietary source of omega-3 essential fatty acids and are famed for their heart-healthy properties. ‘They lower blood pressure, reduce clotting tendency and lower triglycerides,’ says Linda. ‘Aim for at least one 140g portion a week.’ As well as cooking fresh oil-rich fish for lunch or dinner, add tinned fish, such as salmon, to salads, sandwiches or jacket potatoes.
Try this: Start experimenting with oil-rich fish. Most of us tend to stick to salmon, but why not try herring, pilchards, kippers or bloater for a change?
Eggs? Don’t hold back
While eggs are a food source of cholesterol, we now know this doesn’t have a significant effect on blood cholesterol levels.
According to the Food Standards Agency, there’s no recommended limit on how many eggs you should eat. ‘It’s fine to enjoy eggs as part of a balanced diet,’ says Linda. ‘Indeed, they could even be useful for lowering cholesterol as studies have shown people who have two eggs for breakfast or lunch feel fuller for longer and go on to consume fewer calories all day.’ For more information, visit healthyegg.co.uk.
Include plant stanols and sterols
You’ve seen the TV ads for dairy products that promise to reduce cholesterol – and, consumed in the right quantities, there’s good evidence to show they do. ‘The active ingredients are plant stanols and sterols,’ says Linda. ‘They occur naturally in small quantities in plant foods, and work by displacing cholesterol in your gut, so you don’t absorb as much. You won’t get enough simply by eating fruit, vegetables and grains, so they’re added to food products – usually reduced-fat spreads, milks, yogurts, cheeses and yogurt drinks – in therapeutic amounts.’
Research shows consuming 2–3g stanols or sterols (equivalent to three servings) a day can help to reduce cholesterol in people with raised levels. However, they need to be consumed as part of a healthy balanced diet. Meanwhile, exceeding this amount hasn’t been found to offer any further benefit, nor has consuming them when your cholesterol levels are healthy.
Products containing plant sterols include Flora Pro-Activ, while Benecol provides stanols. There are numerous supermarket own brands, too. Get your daily quota by having an enriched milk with your breakfast cereal, slices of enriched bread in your lunchtime sandwich, and a pot of enriched yogurt after your evening meal.
Eat beans – especially soya
‘Beans and pulses (legumes), including soya, are high in soluble fibre, which helps to reduce cholesterol absorption in the gut,’ says Linda. A review of 43 studies found having between one and two portions (15–30g) of soya protein a day can result in an average reduction in LDL cholesterol of 5.5% and a 3.2% increase in HDL (good) cholesterol.
A smaller review of 10 clinical trials found including non-soya legumes in participants’ diets also resulted in significant decreases in LDL cholesterol and triglycerides, with an average reduction of total cholesterol of around 5%. Add chickpeas, lentils, borlotti beans and kidney beans to soups, salads, stews, curries and risottos. Or mash them up to make dips and spreads. ‘Increase your intake of valuable soya protein by including soya milk, soya nuts, tofu or soya-based vegetarian products throughout the day, too,’ advises Linda.
Choose heart-healthy fats
Many of us love a little butter, but with almost two-thirds of its fat being saturated, it’s not something we should be enjoying as a daily staple. As well as cutting right down on butter-rich foods (think cakes and pastries), work on replacing the butter in your diet with unsaturated alternatives. A recent Indian study found a blend of sesame and rice-bran oils helped reduce blood pressure while improving cholesterol profiles. Adults who cooked with a blend of the oils for 60 days saw their LDL cholesterol drop by 26% and their HDL cholesterol increase by almost 10%.
‘These and other plant oils, such as sunflower, avocado, safflower or corn, are best to cook with,’ advises Linda. ‘Rapeseed oil is my preference as it has the highest smoke point. Avoid palm or coconut oils as they’re predominantly saturated fats.’ And use low-fat spreads on bread and in jacket potatoes in place of butter.
Watch your alcohol intake
Anyone who likes a glass or two of wine has probably comforted themselves with the thought they’re looking after their heart. ‘And alcohol does indeed raise HDL levels in those who drink moderately – a couple of units a day,’ says Linda. ‘It’s also thought the antioxidant polyphenols in red wine (and grape juice, for teetotallers) have a protective effect.’
But before you rush out for a case of Merlot, remember alcohol equals calories – and empty ones at that. ‘Booze is also a common contributor to weight gain, which is one of the biggest risk factors for high total and LDL cholesterol,’ Linda points out. ‘So I’d never suggest someone start drinking for the modest health effects because the potential negative consequences are greater. Drinking to excess increases your risk of heart disease.’
Stick within the Department of Health guidelines of no more than two to three units a day for women and three to four for men*, with a couple of alcohol-free days a week. See nhs.uk/livewell/alcohol for useful unit-calculating and drinks-tracking tools.
Nothing beats a cuppa…
Good news for those of us who love a brew: research suggests compounds in tea called catechins may help lower cholesterol absorption. One study found people with mildly high cholesterol levels who drank five cups of tea a day, with or without milk, had an average 5% drop in total cholesterol and 11% in LDL cholesterol.
Another review of 14 clinical trials found a similar result with green tea – as a drink or in capsule form, it was found to reduce total and LDL cholesterol levels.
Consider your lifestyle, too. As well as making these dietary changes, there are two vital steps you can take to improve your cholesterol profile.
Stop smoking
Ditching this habit has been shown to increase HDL cholesterol levels by as much as 10%. Studies prove it’s easier to quit with support, so ask your GP about local stop-smoking services, and visit smokefree.nhs.uk for a wealth of resources.
Start moving
The effect of exercise on cholesterol levels is undisputed – it increases HDL cholesterol levels while decreasing LDL cholesterol and triglycerides. And, of course, it’s an essential weapon in the war against weight gain. Aim for 150 minutes of moderate intensity activity each week (that means getting out of breath and a little bit sweaty) for maximum benefit.
Most of us know how important it is to keep our cholesterol levels down, even if we’re not quite sure why. ‘Cholesterol is produced by the liver,’ explains GP Dr Gemma Newman. ‘While it’s needed for normal body functioning, an excess contributes to the build-up of fatty plaques on the walls of our arteries, which can lead to a heart attack or stroke.’
*Weight-loss results will vary and are down to your individual circumstances and the amount of weight you have to lose.