According to the American Heart Association, more than 106,000,000 Americans over the age of 20 have elevated levels of cholesterol. Since high cholesterol translates to an increased risk of suffering a heart attack or stroke, a cholesterol diet to reduce these and other risks is usually recommended. In fact, most patients are encouraged to adhere to specific dietary measures to shed excess weight before resorting to cholesterol-lowering medicine. However, what may be considered the best cholesterol diet often varies between individuals. For example, existing medical conditions, such as diabetes, are important factors to be considered.
The objective of every cholesterol diet is the same, though: to reduce circulating levels of low-density lipoproteins (LDL, the bad kind of cholesterol) and increase high-density lipoproteins (HDL). Generally, this goal is achieved by reducing the intake of saturated and trans-fat foods and increasing consumption of fresh vegetables, fruits, whole grains, and lean meats. The National Heart, Lung, and Blood Association’s National Cholesterol Education Program (NCEP) has further developed these recommendations by issuing specific guidelines regarding the restriction of fats.
According to NCEP, the best cholesterol diet for most people calls for the consumption of 300 milligrams or less per day of total cholesterol. Total fat intake should not exceed 30 percent of daily calories. In addition, no more than 10 percent of daily calories should represent total intake of saturated fat.
For those who have already had a heart attack, a more restrictive cholesterol diet is recommended. This diet, sometimes referred to as the Step II Diet, is also suggested for people who have a total cholesterol level at or above 240 mg/dL, which indicates an increased risk of heart disease. According to these guidelines, total saturated fat intake should not exceed seven percent of calories and total cholesterol should not exceed 30 percent of daily calories.
In 2001, the NCEP released new guidelines known as the Therapeutic Lifestyle Changes (TLC) cholesterol diet. This diet benefits those with high cholesterol and existing heart disease, as well as those with metabolic disorders, including diabetes. Generally, the recommendations are the same as those described in the Step II diet above. However, it also permits total fat to come from 25-30 percent of total calorie intake, with 10 percent or less being polyunsaturated fat. In addition, the majority of fat intake should be monounsaturated, since this kind of fat naturally reduces LDL cholesterol.
Without the aid of a dietician to actually write out a daily menu, it can be difficult to keep track of fat restriction and intake. So, for practical purposes, the following is a sample of what the TLC diet might look like on a daily basis:
- Lean meat, poultry, fish, legumes: 5 ounces (141.75 grams) or less per day
- Dairy products (low-fat): 2-3 one-ounce (28.35 grams) servings per day *
- Cereal, bread, rice, pasta: 6-11 one-half to one-ounce (14.17-28.35 grams) servings per day
- Vegetables: 3-5 one-cup (240 milliliters) servings per day
- Fats: 6-8 one-teaspoon (5 milliliters) servings per day
* Note that while egg yolks are limited to only 2-3 per week, there is no limit on egg whites