High Cholesterol

The safest and most effective way to lower cholesterol is without medications and with a plant-based diet and lifestyle changes, this can lower cholesterol within days to weeks. Discover the foods and lifestyle changes scientifically proven to lower cholesterol below.

Cases per year

94 million adults in the U.S. have total cholesterol levels higher than 200 mg/dL, 28 million of which have levels higher than 240 mg/dL 1

General frequency

38% of adults in the US have total cholesterol above 200 mg/dL 2

Risk

High cholesterol is major risk factor for heart disease, which is responsible for 1 in 4 deaths per year in the US.

Lowering cholesterol with a plant-based diet and lifestyle medicine

Almost uniformly, several patients of mine who adopted a plant based diet improved their cholesterol levels, putting them at much lower risk of heart disease and strokes.

Dr Yashoda Bhaskar, who has seen the power of lifestyle medicine to lower cholesterol first-hand.

Podcasts

Here are some top scientific studies that support the results our clinicians have seen first-hand:

Plant-based diets result in lower cholesterol and apolipoprotein B levels than diets containing animal products  

Serum concentrations of cholesterol, apolipoprotein A-I, and apolipoprotein B in a total of 1 694 meat-eaters, fish-eaters, vegetarians, and vegans 

Scientists compared 424 meat-eaters, 425 fish-eaters, 423 vegetarians and 422 completely plant-based, and found those who were plant-based had the lowest blood cholesterol levels out of all the dietary patterns. Serum concentrations of total cholesterol, non-HDL cholesterol, and apolipoprotein B were all significantly lower in those following a completely plant-based diet. Results show that the more plant-based the diet, the lower serum concentration of total and non-HDL cholesterol, and apolipoprotein B 3.

Plant-based diets reduce LDL cholesterol levels by 35%  

Effects of plant-based diets on plasma lipids 

Scientists reviewed 27 scientific studies on dietary interventions for the lowering of low-density lipoprotein (LDL) cholesterol. They found completely plant-based diets were most effective for lowering LDL cholesterol levels compared to all other diets, with reductions of up to 35% 5

Low-fat plant-based diet significantly lowers body weight, total and LDL cholesterol levels 

A Mediterranean Diet and Low-Fat Vegan Diet to Improve Body Weight and Cardiometabolic Risk Factors: A Randomized, Cross-over Trial

52 participants assigned to a low-fat plant-based diet saw significant benefits for lowering total and LDL-cholesterol, which decreased 18.7 mg/dL and 15.3 mg/dL, respectively. These participants also benefited from an average weight loss of 6kg, and improvements in insulin sensitivity 4. Seven participants were able to reduce or discontinue lipid-lowering medications due to the plant-based diet; another 7 participants were able to reduce or discontinue their anti-hypertensive medications during the study.

Find out more about high cholesterol and treatment without medication below

High cholesterol

High cholesterol (or hypercholesterolemia) is a type of hyperlipidemia, where your cholesterol levels are too high; specifically, you have too much LDL cholesterol and non-HDL cholesterol in your blood.

What is cholesterol?

Cholesterol is a waxy substance made in the liver. It’s not required in the diet, because the liver makes all the cholesterol we need. It’s an essential part of our cell membranes, and is needed to make hormones, vitamin D, and bile acids (that help to digest fat), all of which are essential for a healthy body. 

Cholesterol travels through our bloodstream attached to lipoproteins. These have specific proteins on their surfaces called apolipoproteins. Cholesterol is carried by different lipoprotein packages which make, for example, LDL-cholesterol and HDL-cholesterol.

Low-density lipoprotein (LDL) cholesterol is commonly known as the ‘bad’ cholesterol. It’s responsible for transporting cholesterol through the body and is the vehicle for cholesterol to be deposited in your arteries, leading to atherosclerosis, hence its bad reputation. Cholesterol can be carried by more, small LDL particles or fewer, large LDL particles. Small, dense LDL is more associated with heart disease risk as it increases the number of Apolipoprotein B (ApoB)-containing lipoproteins 6.

Symptoms 

High cholesterol has no symptoms.

Nonetheless, it’s important that they’re detected because high cholesterol levels, or more specifically high levels of cholesterol-carrying apolipoprotein B, are a cause of atherosclerotic plaque build up in your arteries. Atherosclerosis can lead to the development of coronary heart disease, and increases your risk of having a heart attack or a stroke 7. Raised LDL cholesterol levels, total cholesterol levels, and triglyceride levels are all factors that increase your risk of heart disease.

A blood test is the only way to detect if you have it, so it’s important to have regular blood work done and work on lowering your cholesterol if necessary, to avoid developing heart disease later down the line. 

Diagnosis 

Your doctor will check your cholesterol levels with a blood test called a lipid profile— this typically reports the levels of: 

  • Total cholesterol 
  • LDL cholesterol 
  • HDL cholesterol
  • And triglycerides— a type of fat present in the blood

At Mora, we typically recommend an advanced lipid profile in addition to the traditional lipid panel. Most primary care providers are not ordering this more advanced test. This test allows our physicians and PAs to see the size and actual numbers of the different cholesterol particles which is extremely helpful in determining cardiovascular risk and the best treatment for you.

Treatment 

Ideally, total cholesterol should be below 150 mg/dL, to prevent plaque formation and atherosclerosis. Scientists suggest LDL-cholesterol should be around 70 mg/dL or lower. This is the level seen in populations mostly free of heart disease, and where the progression of atherosclerosis in our arteries is halted 8.

Diet is the main culprit for raised cholesterol, so it’s the first-line treatment method to bring it down again. Our clinicians help patients to incorporate foods that lower cholesterol into their diet, alongside cutting out foods that worsen cholesterol. They also support patients with exercise, sleep, and stress management— other lifestyle changes that lower cholesterol. 

A plant-based diet is the most effective dietary intervention to lower cholesterol, it limits components of food that raise cholesterol levels, such as saturated fat and dietary cholesterol, whilst having an abundance of other components that help to lower cholesterol, like fiber and plant sterols. 

Support from dedicated, lifestyle medicine clinicians could be the key to lowering cholesterol quickly, safely coming off cholesterol medications, and maintaining healthy cholesterol levels for the long run. 

Let food be your medicine and take charge of your health today.

Useful links

Health and Mora podcast with Dr Laurie Marbas

Think you may be struggling with this and need help? Book a free consultation with us today.

References  

1. Virani, S. S. et al. Heart Disease and Stroke Statistics—2021 Update: A Report From the American Heart Association. Circulation 143, (2021).

2. Tsao, C. W. et al. Heart Disease and Stroke Statistics—2022 Update: A Report From the American Heart Association. Circulation 145, (2022).

3. Bradbury, K. E. et al. Serum concentrations of cholesterol, apolipoprotein A-I and apolipoprotein B in a total of 1694 meat-eaters, fish-eaters, vegetarians and vegans. Eur. J. Clin. Nutr. 68, 178–183 (2014).

4. Barnard, N. D. et al. A Mediterranean Diet and Low-Fat Vegan Diet to Improve Body Weight and Cardiometabolic Risk Factors: A Randomized, Cross-over Trial. J. Am. Nutr. Assoc. 41, 127–139 (2022).

5. Ferdowsian, H. R. & Barnard, N. D. Effects of Plant-Based Diets on Plasma Lipids. Am. J. Cardiol. 104, 947–956 (2009).

6. Pencina, M. J. et al. Apolipoprotein B improves risk assessment of future coronary heart disease in the Framingham Heart Study beyond LDL-C and non-HDL-C. Eur. J. Prev. Cardiol. 22, 1321–1327 (2015).

7. Ference, B. A. et al. Low-density lipoproteins cause atherosclerotic cardiovascular disease. 1. Evidence from genetic, epidemiologic, and clinical studies. A consensus statement from the European Atherosclerosis Society Consensus Panel. Eur. Heart J. 38, 2459–2472 (2017).

8. O’Keefe, J. H., Cordain, L., Harris, W. H., Moe, R. M. & Vogel, R. Optimal low-density lipoprotein is 50 to 70 mg/dl. J. Am. Coll. Cardiol. 43, 2142–2146 (2004).

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