By: Gloria Tsang, RD
Last Updated on:
The Heart Smart Diet section of our web site is very popular with our readers. It lists many heart-healthy foods and supplements along with the latest clinical study results. Among all the foods listed there, I have decided to pick the top five super foods which have been shown to lower cholesterol and can be included in a healthy diet on a regular basis.
Top 5 Super Foods to lower cholesterol
1. Oat for Soluble Fiber
Oatmeal and oat bran are rich in soluble fiber, a type of fiber which lowers the bad Low Density Lipoprotein or LDL cholesterol without lowering the good High Density Lipoprotein or HDL cholesterol. In 1997, the FDA authorized a heart disease risk reduction health claim for beta-glucan soluble fiber from oat products. Food products containing oat bran and rolled oats, such as oatmeal, and whole oat flour can bear this health claim.
How much do you need? Five to 10 grams of soluble fiber a day decreases LDL cholesterol by about 5 percent. Some studies showed that this amount can lower cholesterol by as much as 23 percent. One bowl of oatmeal contains about 3 grams of soluble fiber. Include other soluble-fiber-rich foods such as psyllium, apples, kidney beans, pears and barley.
2. Fish for Omega 3 Fatty Acids
Fish is a good source of protein and omega 3 fatty acids – which has been shown to lower LDL cholesterol and raise HDL cholesterol. In particular, omega 3 fatty acids are noted for its triglyceride-lowering power.
How much do you need? In 2002, the American Heart Association recommended eating at least 2 servings of fish a week, particularly fatty fish such as mackerel, salmon, sardines, trout and herring. If you have high triglyceride levels, AHA recommends 2 to 4 g of EPA and DHA (two specific types of omega 3 oil) as supplements under your doctor’s care.
3. Nuts for Healthy Fats
Nuts rich in fiber, phytonutrients and antioxidants such as Vitamin E and selenium. These tasty snacks are also high in plant sterols and fat – but mostly monounsaturated and polyunsaturated fats, which have all been shown to lower the bad LDL cholesterol.
How much do you need? In 2003, the FDA recognized the benefits of nuts and their role in heart disease prevention by approving a health claim for seven kinds of nuts (almonds, hazelnuts, peanuts, pecans, some pine nuts, pistachios and walnuts). Limit your intake to ~ 1.5 ounces a day, as nuts are high in calories. The best way to reap the health benefits of nuts is to eat them in replacement of foods that are high in saturated fats such as meat products.
4. Foods Fortifed with Plant Sterols
Plant sterols or stanols are powerful substances naturally found in plant to have the ability to block cholesterol absorption. Studies showed that eating two servings of sterols-fortified foods daily result in a 10 to 15 percent drop in LDL cholesterol levels.
How much do you need? The National Cholesterol Education Program recommends that people who have high cholesterol eat 2 grams of plant sterols or stanols a day. You can find plant sterols in fortified foods such as margarine spread, orange juice, salad dressings, functional cookies etc. Most sterols-fortified foods contain at least 1 gram of plant sterols per serving. Please read the portion size and usage direction on the labels for details. It is important to note that plant sterols are not for everyone. The AHA recommends it only for people with high levels of LDL cholesterol.
Soy products are great substitutes for animal products. In 1999, the FDA recognized the health benefits of soy and heart disease by approving a soy health claim. However, due to conflicting results from a large-scale review performed by the U.S. Agency for Healthcare Research and Quality, the AHA Nutrition Committee no longer recommends eating soy to lower cholesterol.
Should you avoid soy then? A simple answer is No. Although soy may not lower cholesterol to the extent we previously thought it could, the US Agency review showed that it can still lower bad LDL cholesterol by 3 percent. Since soy products contain high levels of polyunsaturated fats, fiber, vitamins, and minerals and low levels of saturated fat, AHA does consider soy products a healthy replacement for meats and other foods high in saturated fat and total fat.
Numbers to know for a Healthy Heart
The American Heart Association (AHA) released a pocket printable guide which shows important numbers and goals you need to reach to keep your heart healthy and strong. Here are some vital numbers to remember:
- Total Cholesterol: < 200 mg/dL (5.2 mmol/L)
- Triglycerides: < 150 mg/dL (1.7 mmol/L)
- Blood Pressure: <120 / 80 mmHg
- BMI: < 25
- Fiber Intake: 25 – 30 g
Summary of the new Heart Disease Prevention Guidelines
A new guideline for heart disease prevention was published on May 16, 2006 by the American Heart Association (AHA) and the American College of Cardiology (ACC). Endorsed by the National Heart, Lung, and Blood Institute (NHLBI), the new guideline is intended to manage risk factors which enhances survival, reduces recurrent events and the need for intervention procedures, and improves the quality of life for coronary heart disease patients. This new guideline was co-published in the Circulation Journal as well as the Journal of the American College of Cardiology.
- Quit smoking
- Avoid second-hand smoke
- Blood Pressure
- < 140/90 mm Hg
- < 130/80 mm Hg if patient has diabetes or chronic kidney disease
- Blood Cholesterol
- LDL < 100 mg/dL (2.6 mmol/L)
- reduce intake of saturated fats, trans fats and cholesterol
- add plant sterols and soluble fiber to diet
- encourage intake of omega-3 fatty acids in fish oil capsule form
- Physical Activity
- 30 mins, 7 days a week (min 5 days)
- encourage resistance training 2 days a week
- BMI 18.5 to 24.9 kg/m2
- Waist circumference:
- Men < 40 inches
- Women < 35 inches
- HbA1C < 7 percent
In addition, here are some downloadable heart smart guidebooks / pamphlets developed by the National Heart, Lung, and Blood Institute (NHLBI).
- Your Guide to a Healthy Heart
- Your Guide to Lowering Cholesterol with TLC
- Your Guide to Living Well with Heart Disease
- Your Guide to Lowering Blood Pressure
TLC Diet – a diet for high cholesterol heart disease recommended by AHA
The TLC diet was introduced in May 2001 when the National Cholesterol Education Program NCEP released new diet guidelines for people with high cholesterol and risks of heart disease. The American Heart Association AHA accepted and endorsed this report and began incorporating these recommendations into its materials on dietary and lifestyle change for people with high blood cholesterol. For people at high risk or who have known cardiovascular disease, NCEP and AHA now recommend the new Therapeutic Lifestyle Changes TLC diet to replace the “old” Step 1 and Step 2 diets.
Summary of the TLC Diet for High Cholesterol
|Total Fat||25% – 25% total calories|
|Saturated fat||< 7% total calories|
|Polyunsaturated fat||up to 10% total calories|
|Monounsaturated fat||up to 20% total calories|
|Carbohydrates||50% – 60% total calories|
|Protein||~15% total calories|
|Soluble Fiber such as psyllium||10g – 25g|
Examples of food in the TLC Diet
|Lean Meat/Fish/alternatives||< 5 oz/day|
|Eggs||< 2 yolks/wk (whites unlimited)|
|Low Fat Dairy||2 – 3 servings/day (<1% fat)|
|Fats/Oils||< 6 – 8 tsp/day|
|Grains especially whole grains||>6 servings|
|Vegetables||3 – 5 servings/day|
|Fruits||2 – 4 servings/day|
Gloria Tsang is the author of 5 books and the founder of HealthCastle.com, the largest online nutrition network run by registered dietitians. Her work has appeared in major national publications, and she is a regularly featured nutrition expert for media outlets across the country. The Huffington Post named her one of its Top 20 Nutrition Experts on Twitter. Gloria’s articles have appeared on various media such as Reuters, NBC & ABC affiliates, The Chicago Sun-Times, Reader’s Digest Canada, iVillage and USA Today.