Nutrition Interventions for High Cholesterol: Recommendations from the National Lipid Association
Written by Kelsey Schaffstall Young MS, RDN, LDN
In June 2023, the National Lipid Association published a scientific article discussing diet and lifestyle changes to reduce cardiovascular disease risk cause by the three most common dyslipidemias: high LDL cholesterol, high triglycerides, and the combination of the two.
Dietary patterns to reduce cardiovascular disease risk
The National Lipid Association acknowledges the importance of a healthy dietary pattern to promote cardiovascular health. The organization endorses the Mediterranean style diet, the DASH diet, a vegetarian diet, and a vegan diet as heart healthy eating patterns that can support optimal lipid levels. These eating patterns share a number of principles. First, they emphasize whole, unprocessed, or minimally processed foods and therefore limit added sugar and salt. They promote high fiber intake in the form of fruits and vegetables, whole grains, nuts, and seeds. They emphasize lean proteins and plant proteins instead of fatty animal proteins in the form of fish, seafood, nuts, seeds, legumes, and low-fat dairy. They also emphasize unsaturated plant fats instead of animal fats or tropical oils.
Nutrition interventions for high LDL
High LDL, or the kind of cholesterol that deposits plaque in arteries, can be caused by excess saturated fat and dietary cholesterol intake. Foods rich in these nutrients include animal products such as fatty meat, dairy, egg yolks, and butter. Excess adipose tissue and excess calorie intake can also raise LDL, and just 5% body weight loss can improve LDL levels.
In order to lower LDL, replace saturated fats (animal fats) with unsaturated fats (plant fats). Polyunsaturated fats, or PUFAs, are especially helpful at lowering LDL. Good sources of PUFAs include walnuts, sunflower seeds, flaxseed, salmon, tuna, and plant oils. Increasing plant protein intake such as beans, legumes, tofu, nuts, and seeds can also lower LDL.
Another way to lower LDL is to increase soluble fiber intake. Foods rich in soluble fiber include oats, beans, legumes, chia seeds, apples, peaches, pears, asparagus, brussels sprouts, and sweet potatoes. Soluble fiber is also available in the form of supplements if necessary.
Phytosterols have also been shown to lower LDL. These naturally occurring compounds in plants mimic the molecular structure of cholesterol, reduce its absorption, and promote its removal from the blood. Research shows that 2g/day plant sterol intake (1g twice daily with meals) can lower LDL by up to 10%. It’s important to note that even vegan diets only provide 500-600 mg/day, therefore supplements may be necessary to achieve 2g/day.
When practiced together, these interventions could lower LDL by 22-37%.
Nutrition interventions for high triglycerides
High triglycerides (TG), or the fat present in your blood, are caused by excess added sugar, refined carbohydrate, and alcohol intake. Excess adipose tissue and poorly controlled blood glucose in people with diabetes also raises TG levels.
Limit added sugars refined carbohydrates, and alcohol to lower triglyceride levels. Practice adequate physical activity to remove TG from the blood, increase insulin sensitivity, and promote the loss of excess adipose tissue. Strive for at least 150 min/week of moderate intensity activity and 2-3 days/week of resistance training. Consuming > 2 servings/week of fish rich in omega-3 fatty acids such as salmon, halibut, and tuna can also lower TG levels.
These changes can have a huge impact on your health by lowering your lipid levels and reducing your risk of cardiovascular disease. If you are looking for support to help make these habits a part of your routine, reach out to a Registered Dietitian who can help you develop a personalized plan.
- Kirkpatrick, C. F., Sikand, G., Petersen, K. S., Anderson, C. A., Aspry, K. E., Bolick, J. P., … & Maki, K. C. (2023). Nutrition interventions for adults with dyslipidemia: A Clinical Perspective from the National Lipid Association. Journal of Clinical Lipidology.