When people need to reduce their cholesterol, they often think about eliminating some foods from their diet. But research increasingly shows that adding certain cholesterol lowering foods can lower cholesterol levels significantly. In fact, a study found that people with high cholesterol who ate a diet not only low in saturated fat but high in plant sterols, soluble fibers, soy protein, and almonds effectively lowered their LDL (“bad”) cholesterol levels by 35%. (Although this cholesterol lowering foods diet would be very difficult to follow for long periods, the study illustrated the feasibility of lowering LDL cholesterol through diet.) To avoid consuming excess energy, it’s important to substitute the cholesterol lowering foods described below for other foods (preferably those high in saturated fat and cholesterol) rather than simply adding them to the diet.
Managing high cholesterol isn't a simple do-it-yourself project. You need to work with your health care provider. And while changing your diet may help a lot, many people still need drugs to reduce their risk of heart disease.

The American Heart Association recommends that people who are unsuccessful in lowering their cholesterol through other lifestyle changes boost their intake of dietary fiber to 25 to 30 grams each day. Fiber comes in two forms: soluble, the type in oatmeal that gets sticky when wet; and insoluble, the spongelike version in bran and fruit and vegetable skins that absorbs water. Both types of fiber are important, but soluble fiber is especially effective in lowering blood cholesterol levels. For this reason, you should include cholesterol lowering foods containing soluble fiber (such as oats, oat bran, barley, legumes, dried plums [prunes], apples, carrots, and grapefruit) in your diet regularly. A 2002 study from the Journal of the American Dietetic Association found that eating four servings of high fiber foods per day for seven weeks and receiving guidance about other lifestyle changes to lower cholesterol decreased total cholesterol levels by almost 6% and LDL cholesterol levels by over 7%. Fiber may help lower cholesterol by interfering with the reabsorption of bile acids from the intestine, so the liver converts more cholesterol to bile acids.

Although nuts are high in fats, the fats are predominantly monounsaturated and polyunsaturated, which decrease LDL cholesterol levels. Although a number of types of nuts help lower LDL cholesterol levels - including walnuts, peanuts, pecans, macadamias, and pistachios - the best evidence of cholesterol lowering foods exists for almonds. In one report, from a 2002 issue of Circulation, people with high cholesterol levels who added 37 grams of almonds (about a handful) to their diet each day lowered their LDL cholesterol levels by 4%; 74 grams of almonds daily lowered LDL cholesterol levels by 9%. People should be sure to choose dry roasted or natural nuts and not ones that contain added oil and salt.

Plant sterols and stanols, plant compounds that are structurally similar to cholesterol, partially block the absorption of cholesterol from the small intestine. They lower levels of LDL cholesterol without adversely affecting HDL (“good”) cholesterol levels. The American Heart Association states that people whose elevated cholesterol levels are not controlled by increased physical activity, weight loss, and dietary changes (decreasing saturated fat and cholesterol intake) might consider adding about 2 grams of plant sterols or stanols daily to their diet. This dietary change can lower LDL cholesterol levels by about 10% and, over a lifetime, may decrease the risk of a heart attack by up to 20%. However, consuming more than 2 grams per day of plant sterols or stanols will not lower cholesterol any more effectively and may lead to excess energy intake.

What foods contain sterols and stanols? The margarines Benecol, Take Control, and Smart- Balance OmegaPlus are fortified with either sterols or stanols. And an orange juice, Heart Wise by Minute Maid, has added sterols. In a March 2004 study from Arteriosclerosis, Thrombosis, and Vascular Biology, daily consumption of 16 ounces of orange juice fortified with plant sterols (for a total of 2 grams of sterols daily) decreased total cholesterol levels by 7% and LDL cholesterol levels by 12% over eight weeks. Other types of food fortified with stanols or sterols, like salad dressings, cereals, breads, and yogurt, may become available as cholesterol lowering foods. (Please note that these fortified products tend to be more expensive than the nonfortified versions.) There are potential concerns about the efficacy and safety of plant sterols: With time, their LDL-lowering effect diminishes, and their level in the blood increases. And plant sterols have now been found in atherosclerotic plaques. However, according to Johns Hopkins cardiologist Christopher Sibley, M.D., while these findings are rather worrisome, “we don’t yet know whether their presence in plaques actively predisposes to heart attack and stroke.” The LDL-lowering effect of plant stanols, by contrast, does not decline with time, levels of stanols in the blood do not rise, and they have the added benefit of lowering plant sterol blood levels.

Dr. Sibley comments, “Perhaps the most cautious response at present would be to choose supplements containing plant stanols to lower your cholesterol level until more definitive evidence is available regarding the long-term safety of sterol supplements. In short, plant stanols can provide the same benefits as the sterols with fewer question marks.” To account for the increased energy of adding these margarines to your diet, you will have to cut down in other areas to avoid gaining weight.

Finally, because increased dietary intake of either plant sterols or stanols may reduce absorption of beta-carotene (a vitamin A precursor), you should include more carotenoid-rich fruits and vegetables, such as carrots, sweet potatoes, pumpkins, tomatoes, and apricots, in your daily diet.

Soy products have received considerable attention for their potential ability to lower the risk of cardiovascular disease - a benefit supported by the Food and Drug Administration (FDA), which in 1999 began allowing food manufacturers to make health claims on soy products stating that consuming 25 grams of soy a day may reduce the risk of heart disease. The FDA concluded that foods containing soy protein, if included in a diet low in saturated fat and cholesterol, may reduce the risk of coronary heart disease by lowering blood cholesterol levels.

However, in 2006, members of the Nutrition Committee of the American Heart Association (AHA) reviewed more recent research on soy products. In most of 22 studies examining the effect of isolated soy protein with isoflavones (various active compounds found in soy), LDL cholesterol decreased less than 3% - a “very small reduction” that required consuming large amounts of soy (study subjects consumed an average of 50 grams daily). The studies showed no significant effects on HDL cholesterol or triglycerides. In 19 studies of soy isoflavones, the average effect on LDL cholesterol was negligible. For this reason, the AHA does not recommends using isoflavone supplements and takes the position that soy products should be beneficial to cardiovascular health not because of any special properties, but because they are low in saturated fat and high in fiber and polyunsaturated fat, so offer a healthy replacement for foods high in saturated fat.

• Apples: Apple pectin is a soluble fiber that helps draw cholesterol out of the system. The flavonoids (Quercetin) in apples act as a powerful anti-oxidant that seems to short-circuit the process that leads “bad” LDL cholesterol to accumulate in the bloodstream.
• Beans: Beans and vegetables are an excellent source of soluble fiber and high in vegetable protein. By properly combing beans with brown rice, seeds, corn, wheat you can create a complete protein. Properly combined beans become an excellent substitute for red meat protein that is high in saturated fat.
• Brown Rice: Cholesterol lowering without soluble fiber: it is the oil in whole brown rice and not its fiber what lowers cholesterol. Brown rice can be combined with beans to form an inexpensive complete protein low in saturated fat. In addition, this whole grain also supplies good doses of heart-healthy fiber, magnesium and B vitamins.
• Cinnamon: A study published in the journal diabetes Care found that half a teaspoon of cinnamon a day significantly reduces blood sugar levels in people with type 2 diabetes. It also reduces triglyceride, LDL, the bad cholesterol and the total cholesterol level.
• Garlic: Garlic contains the chemical allicin, which has been shown to kill bacteria and fungi, and alleviate certain digestive disorders. It also lowers the blood clotting properties of blood. But the most notable attention garlic has received over recent years is its possible usefulness in lowering cholesterol levels.
• Grapes: Flavonoids in grapes protect LDL cholesterol from free radical damage and reduce platelet clumping. The LDL lowering effect of grapes comes from a compound that grapes produce normally to resist mold. The darker the grape, the better.
• Oats: Oatmeal contains soluble fiber, which reduces your low-density lipoprotein (LDL), the “bad” cholesterol. Five to 10 grams of soluble fiber a day decreases LDL cholesterol by about 5 percent. Eating 1.5 cups of cooked oatmeal provides 4.5 grams of fiber — enough to lower your cholesterol.
• Salmon: The major health components in salmon include: Omega 3 fatty-acid and protein. These components have a favorable cardiovascular effect. The American Heart Association recommends that people include at least two servings of fish/week, particularly fatty fish (salmon, tuna, mackerel, sardines, anchovies and herring), in their diets.
• Soy: The top health promoting components in soybeans are isoflavones and soluble fiber. Isoflavones act like human hormone that can lower LDL cholesterol and raise HDL cholesterol. All soy products (soybeans, soy nuts, tofu, tempeh, soy milk, etc.) are complete proteins.
• Walnuts: Walnuts can significantly reduce blood cholesterol because they are rich in polyunsaturated fatty acids. Walnuts also help keep blood vessels healthy and elastic. Almonds appear to have a similar effect, resulting in a marked improvement within just four weeks. A cholesterol-lowering diet with a little less than 1/3 of a cup of walnuts/day may reduce LDL cholesterol by 12 percent.