Not all cholesterol is created equal. Cholesterol — a waxy substance made by the body and found in some foods — is something the body needs, at least in small amounts. Increased blood levels of cholesterol — particularly the LDL or "bad" cholesterol — have been linked to a greater risk of heart disease, according to the Centers for Disease Control and Prevention (CDC).
Cutting back on dietary cholesterol is a great place to start in lowering your LDL, but ensuring you eat more of the right foods is also important. Here's a list of nine cholesterol-lowering foods, which also provide a myriad of other heart health benefits.
Get ready to go nuts! They're a great source of polyunsaturated and monounsaturated fats — heart-healthy fats that help improve cholesterol levels — as well vitamins and minerals, fiber, antioxidants and omega-3 fatty acids according to the Mayo Clinic.
While many nuts are known for their heart benefits, a November 2018 study published in the Journal of the American College of Cardiology found that eating peanuts, tree nuts and walnuts one or more times per week was associated with a 13 to 19 percent lower risk of heart disease and a 15 to 23 percent lower risk of coronary heart disease.
Whole-grain oats, including oatmeal, oat flour and oat bran, are also well-known for their cholesterol-lowering properties, according to Harvard Health Publishing. Oats are rich in beta-glucans, a soluble fiber that is known for its metabolic health benefits, according to a 2011 article published in the Journal of Nutrition and Metabolism.
Populations with low incidents of coronary heart disease and cholesterol tend to eat diets generally low in total fat (especially saturated fat and cholesterol) and high in fiber-rich foods like fruits, veggies and grain products, like whole oat foods, according to the U.S. Food & Drug Administration (FDA).
Whole grain barley is also rich in beta-glucans and has similar LDL-lowering properties to oats, according to the Whole Grains Council. Of all the common cereals, barley has the largest seed amount of beta-glucans, totaling three to 11 percent, whereas the seed total is only about three to seven percent in oats, according to Agriculture and Agri-Food Canada.
Barley is also known for its ability to reduce blood pressure and may be able to help control blood sugar, according to the Whole Grains Council. Plus, it also has more protein than corn, brown rice or millet.
Avocado is rich in monounsaturated fats, fiber and phytonutrients like phytosterols and polyphenols — all of which are linked to improved blood cholesterol levels. In participants following a moderate-fat diet including one avocado daily, a 2015 study published in the Journal of the American Heart Association found a reduction in cholesterol — especially for small, dense LDL.
Whole soy foods, including edamame, tofu or soy milk, are known for their high-quality plant protein, antioxidants, fiber and estrogen-like compounds. The cholesterol benefits from this legume may seem modest — a 4 to 5 percent reduction in LDL from 25 grams of soy protein, or the amount found in 10 ounces of tofu or 2 and 1/2 cups of soy milk, according to a December 2016 article published in Nutrients.
6. Beans, Peas and Lentils
Beans, peas and lentils, also categorized as legumes, have many qualities that make them an asset to a cholesterol-lowering diet. Legumes are naturally low in fat, high in soluble and insoluble fiber and particularly good sources of protein, folate, iron, and magnesium, according to the Mayo Clinic.
Legumes are also known for their ability to potentially reduce LDL cholesterol levels, according to a May 2014 review published in the Canadian Medical Association Journal. After analyzing 26 different studies, researchers found that diets rich in legumes (about a serving per day) significantly lowered LDL cholesterol compared to other control diets.
Let's hear it for berries! Daily consumption of berries, berry juice or berry extract was associated with a nearly four-point reduction in LDL, according to a March 2016 analysis published in Scientific Reports. Although this may appear to be a small change, berries — and many whole plant foods — can benefit more than just your cholesterol levels.
Berries are also high in fiber, which can help lower blood sugar, according to the Mayo Clinic. Despite their sweet taste, berries have a low glycemic load, which means they digest slowly and don't affect blood sugar too strongly.
8. Fruits and Vegetables
Here's one that should come as no surprise: A diet that emphasizes all fruits and vegetables can lower LDL cholesterol and reduce heart disease risk, according to Harvard Health Publishing. Fruits and vegetables are abundant in vitamins, minerals, fiber and phytonutrients which provide anti-inflammatory and antioxidant benefits.
Diets rich in plant-based foods are associated with decreased total cholesterol, according to a September 2017 review of 8,385 studies published in Nutrition Reviews. To experience the benefits yourself, fill each of your meals with a variety of vegetables alongside whole grains and protein.
9. Dark Chocolate
Good news for your sweet tooth: Daily chocolate — 1/4 cup cocoa or 100 grams of dark chocolate — may decrease LDL levels by about 6 percent, according to a May 2011 meta-analysis of 10 clinical trials published in the European Journal of Clinical Nutrition. However, this amount of chocolate may not be wise to consume due to the high amount of calories in this serving.
On the upside, chocolate appears to have cardiovascular benefits which go beyond LDL-lowering. Regular or habitual chocolate intake of 25 grams per day may lower risk of heart attack and stroke, presumably due to cocoa's flavonoid content, which provides antioxidant and anti-inflammatory benefits, according to a 2015 study published in the British Medical Journal.
- Mayo Clinic: "Nuts and your heart: Eating nuts for heart health"
- Journal of the American College of Cardiology: "Nut Consumption and Risk of Cardiovascular Disease"
- Harvard Health Publishing: "Whole-grain oats: Best bet for lowering cholesterol"
- Journal of Nutrition and Metabolism: "Beta Glucan: Health Benefits in Obesity and Metabolic Syndrome"
- US Food & Drug Administration: "CFR - Code of Federal Regulations Title 21"
- Whole Grains Council: "BARLEY – FEBRUARY GRAIN OF THE MONTH"
- Agriculture and Agri-Food Canada: "Oat and Barley ß‐Glucans"
- Journal of the American Heart Association: "Effect of a Moderate Fat Diet With and Without Avocados on Lipoprotein Particle Number, Size and Subclasses in Overweight and Obese Adults: A Randomized, Controlled Trial"
- Nutrients: "Soy and Health Update: Evaluation of the Clinical and Epidemiologic Literature"
- Mayo Clinic: "Beans and other legumes: Cooking tips"
- Canadian Medical Association Journal: "Effect of dietary pulse intake on established therapeutic lipid targets for cardiovascular risk reduction: a systematic review and meta-analysis of randomized controlled trials."
- Scientific Reports: "Effects of Berries Consumption on Cardiovascular Risk Factors: A Meta-analysis with Trial Sequential Analysis of Randomized Controlled Trials"
- Mayo Clinic: "Berries and Health"
- Harvard Health Publishing: "11 foods that lower cholesterol"
- Nutrition Reviews: "Association between plant-based diets and plasma lipids: a systematic review and meta-analysis"
- European Journal of Clinical Nutrition: "Effects of cocoa products/dark chocolate on serum lipids: a meta-analysis"
- British Medical Journal: "Habitual chocolate consumption and risk of cardiovascular disease among healthy men and women"
- New England Journal of Medicine: "Primary Prevention of Cardiovascular Disease with a Mediterranean Diet"