Patient education: Can foods or supplements lower cholesterol? (The Basics)

Can I lower my cholesterol by changing my diet? — Maybe. Some people are able to lower their cholesterol by changing their diet. While this does not always work, you can still improve your overall health by eating better.

If you have high cholesterol, it might help to avoid or limit red meat, butter, fried foods, cheese, and other foods that have a lot of saturated fat. Other things that might help lower cholesterol include:

●Eating more soluble fiber – Soluble fiber is found in fruits, oats, barley, beans, and peas.

●A vegetarian or vegan diet – A vegetarian diet contains no meat. A vegan diet contains no animal products at all, including meat, eggs, or milk.

●Replacing meat with soy sometimes – Soy-based products include tofu and tempeh.

In general, you can improve your health by eating lots of fruits, vegetables, and whole grains. You can also cut back on carbohydrates, sweets, and processed foods.

Following a "Mediterranean diet" might help lower your cholesterol. This type of diet includes a lot of fruits, vegetables, nuts, and whole grains, and uses olive oil instead of other fats. It also includes some fish, poultry, and dairy products, but not a lot of red meat.

What about eggs? — Eggs are OK if you want to eat them, but don't overdo it. The news often has stories about the health benefits or risks of eggs. The truth is, eggs are a good source of protein and do not raise cholesterol much. Saturated fats (like in red meat, butter, and fried foods) affect cholesterol levels more than eggs do.

Are there specific foods that can lower my cholesterol? — Maybe. There are some foods that seem to help lower cholesterol, including:

●Foods rich in omega-3 fatty acids – Foods rich in omega-3 fatty acids include oily fish, and olive and canola oil. These foods seem to raise good cholesterol and might lower certain types of bad cholesterol. More important, studies show that people who eat lots of these foods are less likely than those who eat less of them to have heart disease. If you want, it's fine to eat 1 to 2 servings of oily fish a week (such as salmon, herring, or tuna).

●Nuts – Some studies show that eating certain nuts, such as walnuts, almonds, and pistachios, can help lower cholesterol and even lower the risk of heart attack or death.

●Fiber-rich foods – Fiber-rich foods, such as fruits, vegetables, beans, and oats, seem to lower cholesterol and are generally good for your health. Some doctors even recommend fiber supplements.

What about designer foods that claim to lower cholesterol? — Be careful with these foods. There are now many foods that have added plant extracts called "sterols" or "stanols." Examples include special margarines such as Benecol and Promise Activ. Foods with added sterols or stanols can lower cholesterol. But it's not clear whether those foods help reduce the risk of heart attack or stroke, or that they are safe to use long-term. Plus, research in animals shows that these extracts might actually cause health problems. Experts think more research is needed before they can recommend that people eat foods with added plant sterols or stanols.

Should I take supplements to lower my cholesterol? — Maybe. Some research has shown that certain supplements can lower cholesterol. But there is almost no research showing that supplements can help prevent heart attacks, strokes, or any of the problems caused by high cholesterol. If you decide to try supplements, keep in mind that in the US, the government does not regulate supplements very well. That means that what's on a supplement's label is not always actually in the bottle.

Here are some supplements that might help with cholesterol:

●Red yeast rice – This supplement can contain the same ingredient that is in a prescription medicine to lower cholesterol. Red yeast rice helps lower cholesterol, but the products that you can buy might not always have much of the active ingredient. If you are interested in taking red yeast rice for your cholesterol, you should speak with your doctor to see if the prescription medicine is a better choice.

●Omega-3 fatty acid supplements – Some omega-3 fatty acid supplements, such as krill oil supplements, might help lower cholesterol.

What supplements don't work? — There is no good evidence that calcium, garlic, coconut oil, coconut water, resveratrol, policosanol, or soy isoflavone supplements are helpful in lowering cholesterol.

More on this topic

Patient education: Diet and health (The Basics)
Patient education: High cholesterol (The Basics)
Patient education: High-fiber diet (The Basics)
Patient education: Coronary artery disease (The Basics)
Patient education: Vitamin supplements (The Basics)
Patient education: Vegetarian diet (The Basics)

Patient education: Diet and health (Beyond the Basics)
Patient education: High cholesterol and lipids (Beyond the Basics)
Patient education: High cholesterol and lipid treatment options (Beyond the Basics)