Veggie Blog

The old version of this post was called “The Best Low Cholesterol Diet Plan,” and it made several large claims: that eating vegetables and soy can be just as effective as medicine, that a vegetarian diet can cut cholesterol by a third in a month, and that a plan followed “religiously” can lower it by 29 percent. Some of those numbers come from a real study, but they describe a tightly controlled trial and not what most people see at home. Here is a more careful version of the same advice, with the targets that official health agencies use.

Why does diet matter for cholesterol?

High LDL (“bad”) cholesterol raises the risk of heart disease and stroke, as our post on what cholesterol is and why too much is a problem explains. The National Heart, Lung, and Blood Institute says that the Therapeutic Lifestyle Changes (TLC) and DASH eating plans can help you lower LDL. They encourage limiting saturated fats from fatty cuts of meat, dairy products and desserts, eating whole grains, fruits and vegetables instead of refined carbohydrates, eating a variety of nuts and preparing foods with little or no salt.

What are the numbers to aim for?

MedlinePlus describes the TLC diet like this: no more than 25 to 35 percent of your daily calories should come from fat, and less than 7 percent of your calories should come from saturated fat. It also advises less than 200 mg of dietary cholesterol a day for people trying to lower their cholesterol, and 10 to 25 grams of soluble fiber a day. The old post’s “reduce saturated fat by seven percent” was a garbled version of that 7 percent limit. For everyone else, the Dietary Guidelines for Americans say less than 10 percent of calories from saturated fat and less than 2,300 mg of sodium a day. The old post gave 2,400 mg, an older figure, so I replaced it.

Which foods help most?

The old post’s food list holds up: oatmeal and oat bran, fruit, beans, nuts, soy foods and vegetables. MedlinePlus lists oatmeal and oat bran, apples, bananas, oranges, pears, prunes and legumes as high in soluble fiber, which helps prevent your digestive tract from absorbing cholesterol. For fats, it suggests swapping saturated fat for lean meat, nuts and unsaturated oils such as canola, olive and safflower. Our post on eating to lower cholesterol with oats, fruit, beans and healthy fats has practical ideas.

Can food work as well as medicine?

For some people it can come close, but not for everyone, and this is where the old post went too far. The study behind the “29 percent” figure was by Jenkins and colleagues and was published in JAMA in 2003. It followed 46 adults with high cholesterol for four weeks. Those on a “portfolio” diet of plant sterols, soy protein, viscous fiber and almonds, low in saturated fat, saw their LDL drop by 28.6 percent, compared with 30.9 percent in those taking the statin lovastatin and 8.0 percent in those on a low-fat control diet. That is a real result, but it came from a strict plan over four weeks, and most people find that hard to keep up. The old claim that a vegetarian diet cuts cholesterol by one-third in a month is not supported by this study, so I removed it. If your doctor has prescribed a statin, keep taking it and use food as an addition. See our post on what statins do.

What might a day of eating look like?

The old post gave a sample day: soymilk and oat bran cereal with chopped fruit and almonds, oatmeal bread and jam for breakfast, bean soup with soy cold cuts and fruit for lunch, and a vegetable and tofu stir-fry for dinner. That is a reasonable pattern. A few cautions: check labels for sodium and trans fat, because processed soy deli slices, margarine and canned bean soup vary a lot (this is general label-reading advice, not a figure from a study).

What else should you do?

Food is only part of it. Regular physical activity also belongs in the plan; see exercise and cholesterol. NHLBI also recommends getting your cholesterol checked and talking with your health care provider about treatment, which may include medicine. For the official guidance, read How to lower cholesterol with diet on MedlinePlus and the NHLBI page on treatment.