Cholesterol is a fatty substance found in your blood. There are two main types:

• HDL (high density lipoprotein) or 'good' cholesterol
• LDL (low density lipoprotein) or 'bad' cholesterol

Having high LDL cholesterol can block blood vessels over time and lead to a heart attack or stroke. To help lower LDL, follow a Portfolio eating pattern that is rich in soluble fibre, nuts, soy protein and plant sterols. Canada's Food Guide and the Mediterranean diet are also heart healthy styles of eating. All these ways of eating are:

• Low in saturated fat and cholesterol
• Rich in vegetables, fruits, whole grains and plant-based proteins

What dietary changes can help lower LDL cholesterol?

Choose foods with healthy fats instead of saturated fat

Healthy fats are found mainly in plant-based foods such as avocado, nuts, seeds, liquid vegetable oils and fatty fish. Saturated fat is found mainly in animal-based foods such as red and processed meats, cheese, cream, whole milk products, butter, ghee, lard, coconut and palm oils. To eat more healthy fats and less saturated fat:

• Use olive, soybean and canola oils instead of butter, lard or hard margarine when you cook
• Replace butter with olive oil and balsamic vinegar on bread
• Use nut butters on toast rather than cream cheese or butter
• Use lower fat milk instead of cream
• Sprinkle nuts or seeds on salad instead of cheese
• Replace red meat with beans, peas, lentils or fatty fish such as salmon, sardines or trout
• Choose lean cuts of meat such as skinless chicken breast and sirloin roast instead of higher fat cuts such as rib eye steak
• Replace deep fried foods with grilled, steamed or baked foods

Increase soluble fibre

Foods with soluble fibre include oats, barley, psyllium, nuts, seeds, beans, peas, lentils and some vegetables and fruit. To increase your intake:

• Choose oatmeal, oat bran or cereal with added psyllium for breakfast
• Add barley to your favourite soup or serve as a side dish
• Replace meats in soups and casseroles with beans, peas and lentils
• Use rye or whole grain oat bread instead of white bread in sandwiches
• Eat more vegetables and fruit. Include those higher in soluble fibre such as asparagus, sweet potatoes, okra, carrots, oranges, pears and apricots

Supplements with soluble fibre are also available. Speak with a dietitian, pharmacist or your health care provider to learn more.

Eat more nuts

All nuts such as peanuts, almonds and walnuts contain healthy fats and fibre. To increase the amount of nuts you eat:

• Try peanut or nut butter on toast, in a smoothie or with fruit
• Add nuts to oatmeal, yogurt or salads
• Grab a handful of nuts as a snack

Eat more soy protein

Foods with soy protein include soy beverage, tofu, soy nuts, soybeans and soy-based textured vegetable protein (TVP). To increase foods with soy protein:

• Try using soy beverage in your latte, smoothie or cereal
• Add soft tofu to smoothies
• Snack on soy nuts or sprinkle on granola or yogurt
• Add tofu or soybeans to stir fries, casseroles or salads
• Have steamed edamame (young soybeans) as a snack or side dish
• Add TVP to tomato sauce or chili

What else can help lower LDL cholesterol?

Plant sterols can lower LDL cholesterol if you eat enough of them. While plant sterols are found naturally in many foods, only supplements and fortified foods provide enough to lower your cholesterol.Although plant sterols can be added to certain foods in Canada, very few products are available. Speak to your health care provider or pharmacist to see if plant sterol supplements are suitable for you.

What about dietary cholesterol?

Heart healthy eating patterns are already low in cholesterol. Some people may need to further limit foods that are very high in cholesterol like egg yolk and shrimp. Speak with a registered dietitian or your health care provider if you have questions.

What else can I do to lower my risk of heart disease?

• Reach and maintain your best weight
• Be physically active
• Quit smoking
• Get enough sleep

According to Canada's Guidance on Alcohol and Health, no amount or kind of alcohol is good for your health. Alcohol increases the risk of many chronic diseases including heart disease, stroke, and several cancers. If you drink alcohol, consider limiting to 1 to 2 drinks per week as a lower risk option. Speak with your health care provider to learn more.

For More Information

• HealthLinkBC File #68f Dietary Fats and Your Health: https://www.healthlinkbc.ca/healthy-eating-physical-activity/food-and-nutrition/nutrients/dietary-fats-and-your-health
• HealthLinkBC Healthy Weights: https://www.healthlinkbc.ca/healthy-eating-physical-activity/healthy-weights

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