Given that the number one killer in the United States is heart disease, millions of Americans are on a mission to lower their cholesterol levels. Many start by modifying their diet in an effort to cut out certain foods, but figuring out what to eat — and what to avoid — can be a challenge.
Nutritional guidelines for lowering cholesterol consistently promote a low-fat diet, but amid these recommendations are an often bewildering array of studies on the benefits — and risks — of a variety of foods.
Fear not. In the midst of all this confusion “the fundamental diet guidelines to lower cholesterol levels have been known for years,” says Barbara Retzlasf, a research dietitian at the Northwest Lipid Research Clinic in Seattle. “They always have been about reducing saturated fats, animal fats and dairy fats.”
Many people trying to reduce their cholesterol levels naturally assume they should strictly avoid foods high in cholesterol. But studies show that foods rich in saturated fats (which are common in animal products), as well as the more recently recognized culprits known as trans fats (found in stick margarines and some baked goods like doughnuts and cookies), affect blood cholesterol levels to a greater degree, notes Dr. Roger Blumenthal, director of the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease.
The American Heart Association recommends that total dietary fat intake not exceed 30 percent of a person’s caloric intake each day. The group also says that intake of saturated fats and trans fats should not exceed 10 percent of calories for healthy people. And saturated fat intake should be less than 7 percent of total calories for those with heart disease.
Yet even though intake of cholesterol-containing foods doesn’t impact people’s cholesterol levels as much as those high in saturated and trans fats, it’s still important to limit cholesterol consumption.
The AHA advises that most adults consume less than 300 milligrams of cholesterol a day while those at high risk for heart disease get less than 200 milligrams.
Budgeting your diet
Choosing leaner cuts of meat over fatty ones and low-fat dairy products rather than the full-fat varieties can go a long way toward fending off elevations of the big, bad low density lipoprotein, or LDL, cholesterol.
But most people can stay healthy while still occasionally enjoying some of their favorite fatty foods, so long as they consume them in limited amounts and they make smart choices most other times, says Wahida Karmally, director of nutrition at the Irving Center for Clinical Research at Columbia-Presbyterian Medical Center in New York.
“It’s like budgeting. At the end of the month you want to make sure you don’t exceed your expenses by managing your fat and saturated fat budget,” Karmally says.
One good way to reduce overall fat intake, she says, is to cut back on fats in cooking and instead use herbs and spices for flavor. “People do not want to eat tasteless food,” she says, “so recipes should be modified, but not tasteless.”
Are eggs ok?
As for eggs, many cholesterol-conscious consumers are still confused about whether they should eat them. But an egg a day can be OK, says Karmally.
Each whole egg has about 213 milligrams of cholesterol, so for many people, one egg a day is fine. Here’s the catch: You shouldn’t eat much of anything else with cholesterol that day.
As an alternative, try egg whites, which don’t harbor the high cholesterol found in the yolks.
Shellfish is another food item that people hesitate to keep on their plates. One medium-to-large shrimp can have approximately 11 milligrams of cholesterol. But although high in cholesterol, shrimp is low in saturated fat — as long as it’s not soaked in butter or deep-fried.
Butter vs. margarine
Many consumers also wonder which is healthier — butter or margarine? Butter is high in saturated fat and cholesterol, but margarine contains trans fats. Trans fats are created when liquid vegetable oils are partially hydrogenated to become a solid.
The AHA recommends using soft, tub-packaged or liquid margarine instead of butter or solid margarine. Soft margarines contain lower levels of trans fats.
Better yet, the group says, use a little olive oil on your bread or cook with canola oil, both of which contain more healthful unsaturated fats.
To help reduce intake of trans fats, people should also limit consumption of foods made with partially hydrogenated vegetable oils, often used in cakes, cookies, pies and crackers, says Dr. Nieca Goldberg, cardiologist at Total Heart Care in New York City.
When trying to lower your cholesterol, experts say it’s also important to get plenty of soluble fiber, which has been shown to help decrease LDL levels.
Eating oat bran in breads, cereals and oatmeal can help, as can consuming other naturally fibrous foods such as fruits, vegetables and legumes.