Foods that help lower cholesterol

Cholesterol is not the enemy. Your body needs it to build cell membranes, hormones and vitamin D. The problem comes when too much LDL (“bad”) cholesterol circulates in the blood, where it can build up in artery walls over time. HDL (“good”) cholesterol helps carry cholesterol back to the liver for removal.

Genetics plays a role, but daily habits matter a great deal. These are the foods with the strongest evidence for improving your numbers.

First, cut the fats that raise LDL

Before adding anything, start by reducing saturated fat (found mostly in fatty red and processed meats, butter, cheese and many baked goods and fried foods) and avoiding trans fat. Replacing these with unsaturated fats from olive oil, avocado, nuts, seeds and fish is one of the most effective dietary changes you can make for your cholesterol.

Soluble fiber: oats, beans, barley and more

Soluble fiber forms a gel in the digestive tract that binds cholesterol-rich bile and helps carry it out of the body, so the liver pulls more LDL from the blood to make new bile. Getting 5 to 10 grams of soluble fiber a day can lower LDL by roughly 5 percent.

• Oatmeal and oat bran, the classic choice for breakfast.
• Beans and lentils, which are also excellent plant protein.
• Barley, apples, pears, citrus, Brussels sprouts and prunes.
• Psyllium or ground flaxseed stirred into a smoothie or oatmeal.

A handful of nuts

Walnuts, almonds and other tree nuts provide unsaturated fats, fiber and plant compounds that support healthy cholesterol and blood vessels. Nuts are calorie-dense, so a small handful (about 1.5 ounces) is plenty. Use them in place of less healthy foods: walnuts instead of croutons on a salad, or almonds instead of chips.

Fatty fish twice a week

Salmon, sardines, mackerel, herring, lake trout and albacore tuna are rich in omega-3 fatty acids. Omega-3s are best known for lowering triglycerides and supporting overall heart health. The American Heart Association recommends about two servings of fish a week, preferably fatty fish, baked or grilled rather than fried. Plant sources of omega-3s include flaxseed, chia and walnuts.

Plant sterols and stanols

These naturally occurring plant compounds partly block cholesterol absorption in the gut. Small amounts come from vegetables, nuts and whole grains; some foods are fortified with them. About 2 grams a day can modestly lower LDL. Because fortified products vary and aren’t right for everyone, ask before adding them, especially if you already take a cholesterol-lowering medication.

Where soy fits

Soy was once promoted as a cholesterol-lowering food. Later reviews by the American Heart Association found its direct effect on LDL is small. Whole soy foods such as edamame and tofu are still a nutritious protein source, especially when they replace processed or fatty meats.

Beyond the plate

Regular physical activity, reaching a healthy weight, not smoking and limiting alcohol all improve cholesterol and heart health. Combining several of the foods above works better than relying on any single one.

For some people, especially those with a strong family history or very high LDL, food and lifestyle are not enough on their own, and medication is the right choice. If you have been prescribed a cholesterol-lowering medication, keep taking it and talk with your prescribing physician before making any change. We are glad to work alongside your medical team.

The bottom line

Cut saturated and trans fats, add soluble fiber every day, enjoy a handful of nuts and fish twice a week, and keep moving. Then retest, so you can see the difference your choices make.

This article is for general education and is not medical advice. Please talk with your clinician before making changes to your care, and never stop a prescribed medication without speaking to the prescriber. If you are in crisis, call or text 988, or call 911.