The first line of defense against rising cholesterol levels is a healthy diet. The National Cholesterol Education Program Adult Treatment Panel III report has targeted lowering LDL cholesterol as one of the most important aspect of heart disease prevention. This report recommends that in order to lower the risk of coronary heart disease that a therapeutic lifestyle change (TLC) must be undertaken. The components of this therapeutic lifestyle change include a diet to lower cholesterol that includes the following.

1. Saturated Fat and Cholesterol Reducing saturated fat and cholesterol in the diet is the foundation of the TLC diet. The strongest nutritional influence on serum LDL cholesterol levels is saturated fats. There is also a dose response relationship between saturated fats and LDL cholesterol levels. For every 1% increase in calories from saturated fats as a percent of total energy, serum LDL cholesterol increases roughly 2%. On the other hand a 1% decrease in saturated fats will lower serum cholesterol by about 2%. Although a weight reduction of even a few pounds will reduce LDL levels, weight reduction achieved with a diet low in saturated fats and cholesterol will enhance and maintain LDL cholesterol reductions. Although dietary cholesterol does not have the equivalent impact of saturated fat on serum LDL cholesterol levels, high cholesterol intake will increase LDL cholesterol levels.

2. Monounsaturated Fat Substituting monounsaturated fat for saturated fats at an intake level of up to 20% of total energy intake is recommended with a cholesterol lowering diet. Monounsaturated fats lower LDL cholesterol levels relative to saturated fats without decreasing HDL cholesterol or triglyceride levels. Plant oils and nuts are the best sources of monounsaturated fats.

3. Polyunsaturated Fats When used instead of saturated fats, polyunsaturated fats such as linoleic acid reduce LDL cholesterol levels. Unfortunately they can also cause a decrease in HDL cholesterol when compared to the effects of monounsaturated fats. The recommended intake of polyunsaturated fats is about 10% of total energy intake. The best sources for this type of fat include liquid vegetable oils, semi-liquid margarine, and other margarines low in transfatty acids.

4. Total Fat Saturated fats and transfatty acids increase LDL cholesterol levels, while serum levels of LDL cholesterol do not appear to be affected by total fat intake. For that reason the report suggests it is not essential to limit total fat intake as long as saturated fats are decreased to goal levels.

5. Carbohydrates LDL cholesterol decreases when saturated fats are replaced with carbohydrates. But high consumption of carbohydrates, over 60% of total energy intakes, are shown to decrease HDL cholesterol and increase serum triglycerides. This response to carbohydrate intake can be decreased by increasing soluble fiber intake. In fact by increasing soluble fiber to 5 to 10 grams a day LDL cholesterol can be decreased about 5%.

6. Protein Although dietary protein generally has little effect of serum LDL cholesterol levels, substituting plant-based proteins for animal proteins appears to lower LDL cholesterol. This may be caused by the lack of cholesterol and lower saturated fat content of plant based protein foods. Of course not all animal proteins are high in saturated fat and cholesterol. Fat-free and low-fat dairy products, egg whites, fish, skinless poultry, and lean cuts of beef and pork are low in saturated fat and cholesterol.

Using diet to lower cholesterol is the first step for anyone who has tested for high LDL cholesterol levels. By lowering serum cholesterol the risk of coronary heart disease is lessened, along with all the other health benefits of eating a more healthy diet.

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