What to Include in Your Diet?

To lower blood cholesterol levels, your diet needs to include:

  • Foods low in cholesterol.
  • Foods low in total fat, especially saturated fat.
  • Foods that contain poly or monounsaturated fat to replace foods high in saturated fat.
  • A calorie level appropriate to obtain/maintain desirable weight.

Select foods from the Food Pyramid in order to meet daily requirements for protein, vitamins, mineral, calories and other nutrients using the following suggestions.

The Food Groups

Milk Group

  • Use skim or 1-percent milk to drink and in recipes that use whole milk or cream.
  • Use non fat or low fat sour cream in place of regular sour cream.
  • Use low fat or non fat processed cheese or skim milk cheese like mozzarella, ricotta or cottage cheese (check labels for skim milk as major ingredient).
  • Use sherbet, non fat frozen yogurt or sorbet in place of ice cream.

Vegetable Cheese

Layer some creamy cheese onto your sandwich and fight cholesterol at the same time! A Finnish study found that eating two ounces of vegetable cheese instead of dairy cheese every day for four weeks cut total cholesterol by 5-percent. It reduced unhealthy LDL by 6-percent in people with mild to moderate high cholesterol levels.

Vegetable cheese eliminates saturated fat and increases your intake of unsaturated fat. So, it helps cut cholesterol levels two different ways. Replace your sandwich cheese with vegetable slices made from either soy (such as Soy Kaas) or canola oil. All of these slices have 40 calories, 2 grams of fat and 200mg of calcium per slice.

Meat Group

  • Limit intake of meat to four to six ounces per day (a 3 ounce portion is the size of a deck of cards). Use vegetable protein foods such as dried beans, dried peas, lentils and nuts more frequently to replace meat.
  • Select lean cuts of meat and extra lean ground beef that have equal to or less than five grams of fat per ounce.
  • Limit organ meats such as liver to no more than three ounces once per month.
  • Avoid eating poultry skin, as it contains large amounts of fat.
  • Include fish and shellfish frequently in diet. Avoid fried or broasted fish, fish in high fat sauces or fish dipped in butter.
  • Limit consumption of egg yolks to three a week (not more than one at a time) including eggs used in cooking. You may eat as many egg whites or egg substitutes as you want, since these do not contain cholesterol. Two egg whites can be substituted in many baked recipes for one egg.
  • Avoid use of high fat luncheon meats such as sausages, bologna, salami, weiners, bratwurst, etc. Luncheon meats that contain less than three grams of fat per ounce are acceptable.
  • Remove all visible fat from meat and avoid heavily marbled meat such as prime rib.
  • Roast, bake, broil, poach, or grill meats. Allow fat to drip off the meat. Avoid fried or broasted meats.
  • Do not baste meat with fatty drippings or additional fat, and avoid self-basting turkeys.
  • Roast meats at low oven temperature (330 to 350-degrees) to increase fat drip-off. High temperatures sear the meat, sealing in the fat.
  • For braising and stewing to tenderize tough cuts of meat, or when making soup, cook meat several hours or a day ahead, refrigerate and remove hardened fat.
  • Make fat-free gravy by stirring ice cubes into meat drippings, remove ice cubes before melted and remove any congealed fat.
  • Marinate lean, less tender cuts of meat in appropriate vegetable oil and vinegar or fat free salad dressing before cooking. Herbs and sauces made with tomato and fruit juices also add flavor and variety.

Fruits and Vegetables

  • Fruits & Vegetables Include more vegetables, as they are low in fat and high in fiber, vitamins and minerals.
  • Use fruit to replace high fat dessert items.
  • Avoid high fat sauces on vegetables, such as scalloped or augratin potatoes, cheese sauce, hollandaise sauce, etc. Use skim milk and margarine high in polyunsaturated fat if making a cream sauce.
  • Avoid fried or broasted vegetables such as French fries and hash browns.
  • Mix non fat yogurt and cut up fresh fruit together for a tasty fruit salad.

Breads and Cereals (6 to 11 servings a day)

  • Include more pasta, spaghetti, and rice and less meat at the main meal. Use whole grain cereal products, especially oatmeal or oat bran, which adds fiber to your diet.
  • Choose low fat grains, such as bagels, English muffins, pita bread and hard rolls.
  • Avoid cereal product items which contain coconut or granola cereals which contain animal or vegetable shortening.
  • Avoid croissants, crescent rolls, biscuits and muffins unless made with appropriate ingredients.
  • Avoid high fat snack foods. Try air-popped popcorn, pretzels, and low fat or fat free crackers.
  • Make baked goods and dessert with appropriate ingredients (egg whites, skim milk, polyunsaturated margarine, cocoa vs. chocolate, etc.).
  • Avoid high fat and fried food doughnuts, pastries, pies, cookies, etc.
  • Avoid chow mein noodles.


  • Use herbs and spices or butter flavored sprinkles instead of butter or other fats to season foods.
  • Limit quantities of margarine, oils, salad dressing to three to eight servings per day depending on calorie needs.
  • Use polyunsaturated margarine or oil instead of butter or shortening.
  • Look for margarine that contains two times more polyunsaturated fat than saturated fat. Read the labels. Example: Four grams polyunsaturated fat, two grams saturated fat.
  • Avoid food such as whipped topping and non-dairy creamers that contains palm oil which is high in saturated fat.
  • Remember, “No Cholesterol” does not mean low in saturated fat.
  • Limit foods high in sugar if you need to lose weight.

Macadamia Nuts for Cholesterol Control?

Eating a daily handful of macadamia nuts could lower your cholesterol by almost 10 percent, according to researchers at Pennsylvania State University. That’s especially good news for women who like sweeter nuts (walnuts can be a tad bitter) and want to fight the rising risks of heart disease as they age. A 1.5 ounce serving of macadamias (about 12 to 18 nuts) does have about 300 calories, but they’re stuffed with heart-healthy monounsaturated fats and contain cholesterol-cutting phytonutrients like fiber and plant sterols. Get a heart-healthy boost: Toss macadamias in a salad or munch a bunch instead of saturated fat filled potato chips. And if you’re getting ready for Christmas Cookie Baking, consider splurging by using Macadamia’s in place of regular nuts in your cookies.

Portfolio Approach to Lower Cholesterol

Lowering Cholesterol

The Research and the Foods

From the University of Toronto comes promising news for those with high cholesterol.

Whether you need a 35 percent decrease, a milder decrease, or just want to maintain an already healthy heart, researchers have found a change in diet to be as effective as taking a starting dose of first-line drugs such as statins, without the side effects.

In three studies conducted to date, people with high LDL cholesterol levels have eaten a “portfolio” of foods with heart-health related health claims — Almonds as well as foods high in viscous fiber, plant sterols and soy protein — in a vegetarian diet low in saturated fat.

In four weeks, their LDL cholesterol levels decreased up to 35 percent, and their LDL to HDL cholesterol ratio decreased by 30 percent. This is similar to the results of first-line cholesterol lowering drugs.

While elevated cholesterol is a risk factor for heart disease, researchers have been learning that inflammation of the arteries may also contribute to an increased heart disease risk. That is why the researchers in this study also focused on an indicator of inflammation named c-reactive protein.

Almonds, with their high vitamin E content, may be one factor that decreased the subjects’ c-reactive protein levels more than other subjects’ on statins alone. Almonds also contribute fiber and vegetable protein to the eating plan, and they have less saturated fat than any other tree nut, which keeps the diet very low in saturated fat.

Viscous fiber, soy protein and plant sterols also work in various different ways within the body, and these various “modes of action” may contribute to the combined effect, the researchers say.

Clearly, these results are intriguing. With the great potential this eating plan has for those with high cholesterol, further research is currently taking place to learn more about why combining cholesterol-lowering foods in the same eating plan appears to be so effective.

Upcoming Learning

Future Portfolio studies will show how the Portfolio dietary approach could work outside of a controlled study, in “real life.” For example, in studies to date, participants were required to eat enough food to maintain their body weight. The research team wanted a controlled study that showed the decrease in cholesterol was a result of the foods eaten, not because of weight loss.

By conducting future studies, the researchers hope then to begin to answer such questions as, “What if I don’t mind losing weight while I am on this eating plan?” and “What if I don’t want to eat a vegetarian diet?” and even “What are the long-term effects of this eating plan — will it actually reduce my risk of a heart attack?”

These answers are unknown and cannot be conjectured, although it is known that elevated cholesterol and c-reactive protein are both independent risk factors.

Diet Instead of Statins?

Anyone with high cholesterol who is interested in following a Portfolio-type eating plan should first seek the advice of his or her health care professional before making any changes to their diet. A dietary approach should not be substituted for doctor-prescribed statins.

Statins have been proven to reduce the risk of heart attacks and death, whereas the Portfolio approach, while proven to lower LDL cholesterol, has not been put to that test. That said, those who are on statin therapy might benefit from making an effort to eat more Portfolio-friendly, heart-healthy foods every day. And, a Portfolio eating plan may have very exciting potential for those whom doctors are reluctant to prescribe statins due to elevations of muscle or liver enzymes, and for those who would prefer to work with their physician to control their cholesterol through non-pharmacological means.