If you're one of the 30 million American adults with high blood cholesterol, chances are you've talked with your doctor about how to lower it. Maybe you're working on making new and healthier food choices. That's great! Changing your diet can be a great way to reduce your risk of dying from a heart attack or heart disease. Just make sure you don't let old myths and misconceptions get in the way of your new heart-healthy plan. Here's a look at the facts—and the fiction—to help you start eating a low-cholesterol diet.
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Fact: What you eat—and don't eat—is important to both prevent and reduce high blood cholesterol. But exercise, watching your weight, and not smoking all play a part, too.
Weight loss is especially key, says Sonya Angelone, M.S., R.D.N., C.L.T., a spokesperson for the Academy of Nutrition and Dietetics and an educator on heart health for 25 years. In fact, "weight loss is so powerful in lowering your cholesterol and improving your lipids, it almost doesn't matter what you eat at first for some people," Angelone says. But once you've dropped the pounds, your cholesterol will go up again if you don't watch what you eat. "If you can combine a healthy diet with weight loss, you're way ahead of the game," she says. Plus, eating the right foods can help you lose the pounds.
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Fact: "You have to know where the cholesterol is coming from," Angelone says. Some people make too much in their liver; others absorb too much in their intestines. Genetics, thyroid problems and age can be culprits, too. Working with your doctor to understand why your cholesterol is high—usually with an advanced lipid test—will help you take the right steps toward lowering it.
Recipe to Try: Soft-Boiled Eggs & Soldiers
Fact: Up until a few years ago, the standard advice was to steer clear of eggs, shrimp and other high-cholesterol foods. Since then, the thinking's changed.
Experts now say the cholesterol in food doesn't play that big a role in the cholesterol in blood. Instead, the 2015-2020 U.S. Dietary Guidelines say the real problem is choosing the right kind of fat. The advice? Limit saturated fat, found in foods like butter, cheese and red meat—and eliminate trans fats, the kind often added to store-bought cookies, crackers and other processed foods and snacks. Choose more healthy fats like those found in olive oil, fish, olives, nuts and seeds. Plus, too many refined carbs (think sugar and white bread) may also raise your cholesterol.
One caveat: If you already have heart disease, you probably do need to limit high-cholesterol foods. "How your body handles foods differs, especially once you have a lot of inflammation. Preventing disease is different than reversing it," Angelone says.
Fact: Learning to make cooking and eating changes after years of old habits may not be, well, a piece of cake. But with the right support, it's easier than you think. A registered dietitian can help you pinpoint your biggest challenges and work through them—right down to helping you make grocery lists, get your family on board or even find heart-healthy options at local restaurants. Don't know an R.D.? Your doctor can help connect you. In the meantime, focus on small changes that are realistic for you.
Try It: Low-Cholesterol Meal Plan
Recipe to Try: Bean & Veggie Taco Bowls
Fact: You may be introducing some new foods to your diet: fresh fruits and veggies, whole grains and soluble-fiber-rich foods like beans, lentils, oats and barley. Not a fan of black beans? Experiment with different recipes and flavors—or try a different bean.
In the morning, get out your blender and invent a new smoothie. Start with your favorite fresh or frozen fruit and add low-fat milk, almond milk or coconut water. Throw in some oats or flax or chia seeds for some soluble fiber, and you have a perfect drink to get your day started.
Even your kids can learn to like heart-healthy snacks. Spread apple slices with almond butter, or pair carrot and celery sticks with black bean dip or hummus. "Taste is the No. 1 reason we eat, so find ways to make new foods attractive and appealing," Angelone says.
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Recipe to Try: Sheet-Pan Roasted Vegetables
Fact: A cholesterol-lowering diet costs less than you might think, especially when you plan ahead. "I tell people to load up on produce, but make a plan so you can eat it all," Angelone says. "Otherwise you have to toss it out, and you end up wasting money."
Fix enough vegetables for two nights so you don't have to cook every night. "Some days are busier than others," Angelone says. "When you have good food ready at home, you're more likely to eat it rather than spend money eating out."
Recipe to Try: Frozen Chocolate-Coconut Milk with Strawberries
Fact: Most healthy people can still indulge now and then, Angelone says. The key is to go easy. Make a pretty parfait with layers of fresh strawberries and a small scoop of ice cream. Top it off with a little dark chocolate—it has less saturated fat and sugar, plus more heart-healthy antioxidants than other kinds. True, the ice cream has saturated fat and added sugars, but the fruit adds fiber—and that's good for your cholesterol levels. Think of sweets as treats, and enjoy them in moderation. You can also enjoy fruit on its own as a sweet treat that's good for your cholesterol.
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Fact: Step away from the double cheeseburger. Taking a statin or other cholesterol drug doesn't give you carte blanche to eat whatever you want. Stick to a healthy diet, and know what foods may interfere with your meds. Compounds in grapefruit juice, for instance, can interact with statins like Zocor (simvastatin) and Lipitor (atorvastatin), potentially leading to liver damage. And overdoing foods high in vitamin K—think leafy greens like spinach and kale—may cause problems with blood thinners like Coumadin (warfarin). If you're on cholesterol meds, talk with your doctor about which foods you need to nix or cut back on.
Fact: Try using olive, avocado, sesame or nut oils. Buy them in small amounts and store them properly—keep olive oil in a dark place, and sesame and avocado oils in the fridge so they don't turn rancid.
Don't heat oils for very long. "Heat, light and oxygen will make an oil turn oxidized, which can lead to inflammation," Angelone says. Limit coconut oil and butter, lard and bacon drippings due to their higher saturated fat content.
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Fact: Actually, you can see changes pretty quickly. Depending on the person, diet can have a significant impact on cholesterol," Angelone says. Stick with it every day, and you may see improvements in as little as three to four weeks.