Cholesterol is often misunderstood and today’s article will attempt to dispel any myths and discuss evidence-based ways to help manage cholesterol levels.
What Is Cholesterol, and What Do the Numbers Mean?
Cholesterol is a fatty substance produced by the liver and also obtained from food. It plays important roles in building cell membranes, producing hormones, and helping the body digest fat. The problem is not necessarily cholesterol itself, but how it travels through the body and in what amounts.
Cholesterol travels in the blood attached to proteins called lipoproteins. The two you have probably heard of are:
LDL (low-density lipoprotein): Often referred to as "bad" cholesterol. High levels of LDL contribute to the buildup of fatty deposits (called plaques) in arteries, which can narrow them and increase the risk of heart attack and stroke.
HDL (high-density lipoprotein): Often referred to as "good" cholesterol. HDL helps carry cholesterol away from the arteries and back to the liver, where it is processed and removed. Higher HDL is generally protective.
Your healthcare provider will typically look at total cholesterol, LDL, HDL, and triglycerides together as part of a lipid panel to assess cardiovascular risk (Canadian Cardiovascular Society guidelines).
So Why Does Nutrition Matter?
Interestingly, the cholesterol found in food is generally not what contributes to high LDL or high cholesterol levels in the body. Most of the cholesterol in our bodies is produced by the liver. Food and nutrition influences how much is produced in the body and how efficiently it is cleared from the body.
What we know:
Saturated fat raises LDL cholesterol by reducing the liver's ability to clear it from the blood
Trans fat (found in some processed foods) raises LDL and lowers HDL, a double negative effect
Soluble fibre binds to cholesterol in the digestive tract and helps remove it from the body, which directly works to lower LDL levels
Healthy fats, including omega 3 fatty acids, can decrease LDL and increase HDL production
Plant sterols and stanols (found naturally in small amounts in plants and added to some fortified foods) block cholesterol absorption in the gut and work to reduce LDL levels (AHA dietary guidelines)
These effects are well-established and clinically significant. Research shows that dietary changes alone can lower LDL cholesterol by 20 to 30% in some individuals (Jenkins et al., 2003).
What Can You Do?
Strategy #1: Increase Soluble Fibre
Soluble fibre is one of the most evidence-backed dietary tools for lowering LDL cholesterol. It forms a gel-like substance in the digestive tract that traps cholesterol and bile acids and carries them out of the body. For most adults, aim for 25-30 g of fibre per day, with a focus on soluble fibre.
Best sources of soluble fibre:
Oats and oat bran
Legumes: lentils, chickpeas, black beans, kidney beans
Psyllium husk: highly concentrated source, often available as a powder or supplement
Barley
Apples, pears, and citrus fruits
Ground flaxseed
Strategy #2: Replace Saturated Fat with Unsaturated Fat
Reducing saturated fat and replacing it with unsaturated fat (particularly monounsaturated and polyunsaturated fats) is consistently associated with lower LDL cholesterol and reduced cardiovascular risk.
Saturated fat sources to moderate:
Butter, ghee, and coconut oil
Fatty cuts of red meat and processed meats
Full-fat dairy (cheese, cream, ice cream)
Unsaturated fat sources to increase:
Olive oil and avocado oil
Avocados
Nuts: almonds, walnuts, pistachios, cashews
Seeds: flaxseed, chia seeds, hemp seeds
Fatty fish
Strategy #3: Plant protein
Including one portion of plant-based protein per day can lower LDL by up to 10%. Plant protein sources include tofu, soy milk, any bean or lentil, veggie burgers or substitute meat products. One thing to note is that some plant-based packaged items can be high in sodium, so try to find options with under %5 DV sodium per day.
Strategy #4: Add Plant Sterols and Stanols
Plant sterols and stanols are compounds found naturally in vegetables, nuts, seeds, and legumes that block cholesterol absorption in the gut. At doses of 2 to 3 grams per day, they can lower LDL cholesterol by 5 to 10% (AHA dietary guidelines).
They are found in small amounts in a wide range of plant foods, and in larger amounts in fortified products like certain margarines and yogurt drinks specifically designed for cholesterol management. You can also take a supplement under the advisement of a healthcare provider.
Strategy #5: Reduce Added Sugar and Refined Carbohydrates
High intake of added sugar and refined carbohydrates contributes to high triglycerides and can lower HDL cholesterol, worsening the overall lipid picture. This is particularly relevant if your triglycerides are elevated alongside high LDL.
The Bottom Line
Lowering cholesterol through nutrition is absolutely achievable, and the changes required are more doable than most people expect. Done consistently, these shifts produce real, measurable results.
At RxFood, our dietitians work with people managing high cholesterol to build personalized nutrition plans that are practical, evidence-based, and designed to produce lasting change.
This article is for informational purposes only and does not constitute medical advice. Please speak with your healthcare provider about your individual cholesterol levels and appropriate management, including whether medication is right for you.