A “portfolio” of foods you eat in combination may help lower cholesterol significantly.
Changing your diet for the better is good for your overall health.
But when you are deliberately trying to lower cholesterol levels, there are many foods that have been found to lower them.
“Recent studies have suggested that including foods or factors known to lower blood cholesterol may be a more successful approach than merely avoiding saturated fat and cholesterol,” according to the Stanford University Prevention Research Center based on a study it conducted.
“Soy protein, soluble fiber, plant sterols, and nuts are examples of foods and dietary factors that have shown potential benefits in improving lipids.”
That dietary philosophy was recently supported by new U.S. Department of Agriculture guidelines that back away from a 50-year-old warning to avoid high-cholesterol foods. This means that eggs and bacon could be back on your breakfast table, if you eat them in moderation. (Although your body needs cholesterol to function healthily, eating more than one egg yolk a day is still associated with a higher risk of heart failure – and most Americans have more cholesterol in their diets than they need.)
Foods that lower cholesterol may work best, however, when eaten in a thoughtful pattern referred to as the “portfolio diet,” rather than just popping some almonds in your mouth as you work at your desk.
There is no single combination diet that will work for everyone. But experts agree that a diet rich in fruits, vegetables, and whole grains is universally effective.
Plant-based foods including oats, barley, and beans are high in soluble fiber, which acts like a sponge in the digestive tract, drawing cholesterol out of your body.
Some specific foods may lower cholesterol a bit on their own. Studies have found those include oats and barley, soybeans, almonds, peanuts, and berries, among many others. In some foods, it may be the fiber, others may contain substances that act directly on cholesterol to reduce its level from a few to several points.
Research also has found that phytosterols and stanols, substances at low levels in plants, can significantly lower LDL (“bad”) cholesterol levels. As a result, the food industry has come up with versions of margarines and other foods with added phytosterols or stanols, although researchers don’t yet know if these additives are beneficial.
Created by University of Toronto nutrition scientist David Jenkins, the portfolio diet can include tofu, oats, berries, almonds and margarines that are fortified with sterols and stanols.
Fiber is boosted by adding psyillum husk, the ingredient in over-the-counter fiber products.
Jenkins also added soy burgers and other meat substitutes to lower saturated fat that causes the body to produce cholesterol.
One study found that people who agreed to try the diet for six months saw an average reduction of about 13 percent in LDL-cholesterol. The best results were obtained by those who stuck closest to it.
Scott Harding, MD, from Kings College London ran a small four-week study at the request of the British Broadcasting Corporation (BBC) to see what people concerned about their cholesterol could accomplish without medication.
Harding randomly put volunteers into three groups, which changed their diets in different ways.
The first group went on a traditional low-cholesterol diet that involved a switch from animal fats to vegetables or other low-fat options. They also had to stop eating eggs, bacon, and sausage, adding skinless chicken instead.
The second group simply added 75 grams of oats per day to increase fiber intake, but otherwise didn’t change their diet.
The third group added 60 grams of almonds a day because tree nuts have high fiber and sterol content.
"Half the group had a positive response," Harding told the BBC. "And one individual had an 18 percent reduction in total cholesterol. On the other side of the coin some people had an adverse response. Their cholesterol actually went up, in some cases significantly."
Some participants who added almonds to their diet had higher cholesterol, which was balanced by people who lowered cholesterol in the same group. On average, there was no change.
Those who added oats and the group that lowered animal fat had an average fall in LDL cholesterol of 10 percent and 13 percent.
The biggest surprise was the BBC health reporter, who used himself as a test subject to combine aspects all of three diets by cutting back just a little on bacon and sausages while adding the almonds and the oats. His cholesterol plummeted 42 percent, which is in the range of reduction if you take statins.
“Why did I do so well?” asked Michael Mosley. “Hard to say. It could be that my combination approach (Portfolio-lite) worked better than doing things in isolation or it could be that my body responds more dramatically to a combination of oats, almonds and bacon-skipping than most people.”
The moral of his story, and that of other studies, is that there are no miracle foods that significantly lower your cholesterol by themselves, some might actually raise them, and some foods would lower more cholesterol in you than in the next person.
Additionally, adding a combination of cholesterol-fighting foods to your diet and sticking to it would work best of all.
You will find all sorts of cholesterol-lowering food lists, each one different, but the core is nuts, fruits, vegetables, beans, fiber, and plant sterols. Some lists tout other foods for their antioxidants.
You also need to keep in mind that regular exercise alone may do more to lower your cholesterol level.
When it comes down to it, combinations are what count. You might have to experiment to find out which work best for your body. That means keeping your doctor in the loop and getting tested regularly.
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October 19, 2015
Christopher Nystuen, MD, MBA