Lowering High Cholesterol with a Healthy Diet, from the October 2014 Harvard Women's Health Watch

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Trans fats and saturated fats can raise LDL cholesterol levels. A diet rich in unsaturated fats, whole grains, and fruits and vegetables can lower them.

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A healthy diet is the best lifestyle choice to lower high cholesterol. Yet many women ignore this approach because they think it means switching to less appetizing food or eliminating dishes they love. A heart-healthy diet doesn't have to be an exercise in self-deprivation, according to the October 2014 Harvard Women's Health Watch.

It's a good idea to say goodbye to some snacks and fast foods, but they can usually be replaced with others that are equally satisfying. The key is exchanging bad fats for good ones. Because all fats contain the same number of calories—about 100 per tablespoon—the substitution isn't likely to leave you feeling hungry.

"The first thing I do when I'm counseling patients is to go over all the sources of trans fats in their diet and make substitutions," says Kathy McManus, director of the Department of Nutrition at Harvard-affiliated Brigham and Women's Hospital. Trans fats show up on food labels as "partially hydrogenated" oils. They are found most commonly in packaged bakery goods, crackers, microwave popcorn, and other snacks.

Trans fats boost the level of harmful LDL cholesterol, lower protective HDL cholesterol, and increase inflammation. Evidence implicating trans fats in heart disease has prompted the FDA to consider revoking their "generally recognized as safe" designation.

Another important switch is to use vegetable oils whenever possible. These contain a mixture of healthy monounsaturated and polyunsaturated fats. Other good sources of monounsaturated and polyunsaturated fats include most seeds and nuts, avocados, and fatty fish such as salmon, tuna, trout, herring, and mackerel.

Saturated fats and dietary cholesterol, which we get mostly from animal-based foods like red meat and milk, aren't exactly heart-healthy, but it's all right to eat them in small amounts, McManus says. That translates to four eggs a week and small servings of red meat, shrimp, lobster, cheese, butter, and organ meats every couple of weeks or so.

But don't make the mistake of substituting sugar for fat. Many foods advertised as low fat, like salad dressings and cookies, contain extra sugar to make up for the loss of flavor from removing fat. "It's one of the worst choices you can make," McManus warns. The higher-fat version may sometimes be a better choice.

Read the full-length article: "How to lower your cholesterol without drugs"

Also in the October 2014 Harvard Women's Health Watch:

  • Botox isn't just for wrinkles
  • 7 easy things to do today for a healthier tomorrow
  • Enjoying sex later in life

Harvard Women's Health Watch is available from Harvard Health Publications, the publishing division of Harvard Medical School, for $20 per year. Subscribe at http://www.health.harvard.edu/newsletters/womens or by calling 877-649-9457 (toll-free).

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