The American Heart Association estimates that 102.2 million (almost 50%) of adults in the United States have total cholesterol levels above 200 mg/dL, placing them at risk for cardiovascular disease - elevated cholesterol is one of the most important risk factors for heart disease.1
In the Framingham Heart Study, deaths due to heart disease were absent in subjects with total cholesterol levels below 150 mg/dL, but as cholesterol increased above 150 mg/dL, heart disease rates began to increase.2 A high nutrient diet is by far the most effective method of reducing cholesterol while avoiding side effects. Compare the effects of various 6-week dietary interventions on cholesterol levels published in medical journals:3-8
After just six weeks of following a high nutrient diet, subjects' LDL cholesterol decreased by 33%. No other dietary intervention was nearly as effective. What about cholesterol-lowering drugs? Drugs are not as effective for reducing cholesterol as a high nutrient diet. After six weeks of taking cholesterol-lowering statin medications, cholesterol levels decreased by 26% compared to a 33% with a high nutrient diet. Statins have many side effects and are associated with liver dysfunction, acute renal failure, cataracts, diabetes, and impaired muscle function.9 Furthermore, not only will a high nutrient diet lower cholesterol, it will also decrease heart disease risk by improving other factors such glucose levels, blood pressure, and body weight.
The safest and healthiest strategy for reducing cholesterol:
- Eat a high nutrient, vegetable-based diet with plenty of raw vegetables and cooked greens.
- Eat berries and pomegranates. The antioxidants in berries and pomegranates, such as anthocyanin and punicalagin, are especially effective in improving both LDL and HDL cholesterol.10,11
- Avoid trans fats and minimize saturated fats. High cholesterol and heart disease deaths are more closely associated with saturated fat intake than any other part of the American diet.12
- Avoid refined carbohydrates. Refined carbohydrates have been found to be just as damaging to the cardiovascular system as saturated fats.
- Eat at least one ounce of raw nuts and seeds daily. The phytosterols found in nuts and seeds lower blood cholesterol by blocking both cholesterol absorption during digestion and the re-absorption of cholesterol produced by the liver. Plus, nuts have additional cardio-protective effects that have yet to be discovered.13
- Limit your intake of animal protein to at most 6 ounces per week. If you have heart disease or significantly high cholesterol, avoid animal products altogether. Animal protein consumption directly increases heart disease risk.14
- Eat beans daily. Beans are packed with resistant starch, soluble fiber, and phytochemicals which help to lower cholesterol. A 19-year study found that people who eat beans at least four times a week have a 21% lower risk of heart disease than those who eat them less than once a week.15
- Have 1 Tbsp. of ground flaxseed each day. Flaxseeds contain beneficial omega-3 fats, lignans, flavonoids, sterols, and fiber. Clinical trials show that daily flaxseed consumption reduces total cholesterol by 6-11%.16 Try adding ground flaxseeds to smoothies or sprinkling them on salads.
1American Heart Association. Cholesterol Statistics. 2011. http://www.americanheart.org/presenter.jhtml?identifier=4506 (accessed January 2011).
2Gordon T, Castelli WP, Hjortland MC, et al. "Predicting coronary heart disease in middle-aged and older persons. The Framington study." JAMA 1977 Aug 8;238(6)497-499.
3Bemelmans, W.J., et al., Impact of Mediterranean diet education versus posted leaflet on dietary habits and serum cholesterol in a high risk population for cardiovascular disease. Public Health Nutr, 2000. 3(3): p. 273-83.
4Sharman, M.J., et al., A ketogenic diet favorably affects serum biomarkers for cardiovascular disease in normal-weight men. J Nutr, 2002. 132(7): p. 1879-85.
5Bunyard, L.B., K.E. Dennis, and B.J. Nicklas, Dietary intake and changes in lipoprotein lipids in obese, postmenopausal women placed on an American Heart Association Step 1 diet. J Am Diet Assoc, 2002. 102(1): p. 52-7.
6Barnard, N.D., et al., Effectiveness of a low-fat vegetarian diet in altering serum lipids in healthy premenopausal women. Am J Cardiol, 2000. 85(8): p. 969-72.
7Frolkis, J.P., et al., Statins do not meet expectations for lowering low-density lipoprotein cholesterol levels when used in clinical practice. Am J Med, 2002. 113(8): p. 625-9.
8Jenkins, D.J., et al., Effect of a very-high-fiber vegetable, fruit, and nut diet on serum lipids and colonic function. Metabolism, 2001. 50(4): p. 494-503.
9Hippisley-Cox J, Coupland C. Unintended effects of statins in men and women in England and Wales: population based cohort study using the QResearch database. BMJ 2010 May 20;340:c2197.
Sattar N, Preiss D, Murray HM, et al. Statins and risk of incident diabetes: a collaborative meta-analysis of randomised statin trials. Lancet. 2010 Feb 27;375(9716):735-42. Epub 2010 Feb 16.
10Qin Y, Xia, M, et al. "Anthocyanin supplementation improves serum LDL- and HDL-cholesterol concentrations associated with the inhibition of cholesteryl ester transfer protein in dyslipidemic subjects." AJCN 2009 Sep;90(3):485-92.
11Aviram M, Rosenblat M, Gaitini D, et al. Pomegranate juice consumption for 3 years by patients with carotid artery stenosis reduces common carotid intima-media thickness, blood pressure and LDL oxidation. Clin Nutr 2004;23(3):423-33.
12Mozaffarian D, Micha R, Wallace S. Effects on coronary heart disease of increasing polyunsaturated fat in place of saturated fat: a systematic review and meta-analysis of randomized controlled trials. PLoS Med. 2010 Mar 23;7(3):e1000252.
Mozaffarian D, Aro A, Willett WC. Health effects of trans-fatty acids: experimental and observational evidence. Eur J Clin Nutr. 2009 May;63 Suppl 2:S5-21.
Oomen CM, Ocke MC, Feskens EJ, van Erp-Baart MA, Kok FJ, Kromhout D. Association between trans fatty acid intake and 10-year risk of coronary heart disease in the Zutphen Elderly Study: a prospective population-based study. Lancet. 2001 Mar 10;357(9258):746-51.
Hu FB, Manson JE, Willett WC. Types of dietary fat and risk of coronary heart disease: a critical review. J Am Coll Nutr. 2001 Feb;20(1):5-19.
13Jakobsen MU, Dethlefsen C, Joensen AM, et al. Intake of carbohydrates compared with intake of saturated fatty acids and risk of myocardial infarction: importance of the glycemic index. Am J Clin Nutr. 2010 Jun;91(6):1764-8
Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. Saturated fat, carbohydrate, and cardiovascular disease. Am J Clin Nutr. 2010 Mar;91(3):502-9.
13Sabate J, Oda K, Ros E. Nut consumption and blood lipid levels: a pooled analysis of 25 intervention trials. Arch Intern Med. 2010 May 10;170(9):821-7.
14Menotti A, Kromhout D, Blackburn H, Fidanza F, Buzina R, Nissinen A. Food intake patterns and 25-year mortality from coronary heart disease: cross-cultural correlations in the Seven Countries Study. The Seven Countries Study Research Group. Eur J Epidemiol. 1999 Jul;15(6):507-15.
15Hyson DA, Schneeman BO, Davis PA. Almonds and almond oil have similar effects on plasma lipids and LDL oxidation in healthy men and women. J Nutr 2002:132(4):703-707.
16Bassett CM, Rodriguez-Leyva D, Pierce GN. Experimental and clinical research findings on the cardiovascular benefits of consuming flaxseed. Appl Physiol Nutr Metab. 2009 Oct;34(5):965-74.