February 2017: the written content below has been updated to reflect new research relevant to this article.
1. Reduce your calorie intake if you are overweight
While there are many lifestyle factors and nutrition changes you could make, perhaps the most important factor in improving your blood cholesterol levels is losing weight if you are carrying extra pounds. Even losing 10 pounds if you are overweight can also make a difference. While you may still have more than 10 pounds to lose, even small changes can help.
While there are many factors outside of nutrition and exercise such as genetics, sleep issues and more that cause your weight to be higher, the key nutrition consideration is your calorie intake. Since “calories are king” when it comes to weight loss, reducing your calories overall by choosing smaller portions sizes of calorie dense foods is a step in the right direction. Rather than an extreme makeover start by simply reducing the quantity of what you are eating such as having a slightly smaller bowl of cereal, slightly smaller serving of meat or smaller bowl of ice cream. Little changes done each day add up to be big over the long term.
2. The type of fat in your diet is more significant than the amount
Eating healthy levels of monounsaturated and polyunsaturated fats, lower risk of heart disease and improve blood cholesterol levels more than those who consume low-fat diets.
Nuts, seeds, avocado, olive oil, and other vegetable oils that are liquid at room temperature are heart-healthy fats. Fatty fish such as salmon contain the best sources of omega-3 fat. Aim to consume fish two to three times per week. If you don’t eat enough fish, consider taking a fish oil omega-3 supplement and/or eat hemp seeds, ground flax seeds, canola oil or omega-3 eggs.
3. Boost your soluble fibre intake
You might have heard that oatmeal and bran are good for digestion, but high-fibre foods, particularly those rich in soluble fibre such as bran cereals with psyllium, reduce cholesterol.
Consume oats, bran cereals and/or beans/legumes every day. Eat at least three pieces of fruit daily and have good portions of a variety of veggies more than once a day. Consider a psyllium fibre supplement to top up your intake each day.
4. Reduce trans fat and be mindful of saturated fat
Trans fats are a particularly negative class of fat found in packaged and processed foods such as deep fried items, commercial baked goods and pastries. Read food labels and be sure to limit — if not avoid — foods that contain hydrogenated vegetable oil and shortening.
Traditionally it was thought that saturated fat was harmful for heart health. Saturated fats are found in heavily marbled meats, the skin on poultry, butter, margarine, tropical oils (coconut oil, palm oil, cocoa butter), and high fat-dairy foods such as cheese. Newer research has found that saturated fats may or may not increase the ‘bad’ LDL-cholesterol in the body, which harms heart health. Part of the reason that there may be some conflicting results depends on which foods are being replaced for saturated fat. Monounsaturated fats (found in olive oil, nuts and avocado) as well as omega-3 fats (found in fish) when replaced for saturated fat is beneficial for heart health. Health depends on the quality of your whole diet, not just the type of fat or any other single nutrient. Rather than focusing on counting grams of fat, focus first on eating wholesome foods your grandmother would recognize that contain simple ingredients.
5. When looking at a food label, investigate trans fat and saturated fat rather than dietary cholesterol
There is a common myth that if you have high blood cholesterol levels you should avoid foods high in cholesterol such as shrimp or eggs. There is no Canadian recommendation to eat less dietary cholesterol, nor does the Dietary Reference Intakes report by the Institute of Medicine specify a target level for dietary cholesterol.
Most people with or without high cholesterol levels can have an egg a day without influencing their blood cholesterol levels. It is far more significant to reduce trans fats and saturated fats in your diet.