If you're one of the millions of Americans with high cholesterol, chances are your doctor has told you what not to eat—high-fat meats and dairy, for example. But certain foods actually can lower your cholesterol and, in some cases, eliminate the need for cholesterol-lowering drugs. Regular intake of these foods can have a particularly powerful effect on reducing LDL—the "bad" cholesterol that damages arteries and other blood vessels. High LDL levels are associated with an increased risk for heart attack and stroke.

Oat Bran, Barley And More

Soluble fiber is present in plant-based foods in the form of gums and pectins, The National Cholesterol Education Program Adult Treatment Panel states that 5 to 10 grams (g) of soluble fiber daily can help to lower LDL by 5%.

A specific type of soluble fiber—beta-glucan (found in oat bran and barley)-has an even more potent cholesterol-lowering effect…

  • In a 2004 study, men eating 6 g of soluble fiber from barley per day lowered their LDL cholesterol by an average of 24% in five weeks.
  • In a study published earlier this year, men given 6 g of beta-glucan in a fortified bread—who also were following a low-fat diet and walking 60 minutes per day-experienced an average reduction in LDL cholesterol of 28%.

How it works: In the intestines, soluble fiber attaches itself to cholesterol and bile acids. Bile acids help with fat digestion. They are made from cholesterol, so when the body needs to make more bile acids, it pulls cholesterol from the bloodstream. The process of binding soluble fiber to bile acids forces the body to make more bile and use up cholesterol from the body's supply. Because fiber is not digested, it carries the cholesterol and bile acids out of the body, lowering the body's cholesterol.

Best sources of soluble fiber: Oat bran, oatmeal, barley, apples, citrus fruits, pears, kidney and lima beans, carrots, broccoli and brussels sprouts. Psyllium seed husks also are a good source and are found in some cereals, such as Kellogg's All-Bran Buds cereal.

Hot cereal made of 100% oat bran has about 3 g of soluble fiber per serving...plain oatmeal has about 2 g. Most cold oat-based cereals have one gram. Fruits and vegetables have 0.5 g to 1 g of soluble fiber per serving.

Beware: Commercially prepared muffins, pretzels and breads made with oat bran may not contain much soluble fiber. Also, some may be high in saturated or trans fats, sugars and sodium. As a rough guide, check the label to make sure oat bran is one of the first ingredients listed on the food label. (Soluble fiber does not have to be listed separately from total fiber.)

Plant Sterols And Stanols

Plant sterols (phytosterols) and plant stanols (phytostanols) are substances that block absorption of cholesterol. They are particularly high in vegetable oils and, to a lesser degree, in fruits, vegetables, nuts and seeds. More than 25 studies have proved their effectiveness in cholesterol reduction. Examples…

  • In a 2001 study, 155 adults with high cholesterol took in 1.5 g per day of plant sterols from margarine. After six months, they had an average reduction in LDL cholesterol of 11% (and 9% reduction in total cholesterol).

In another study, 72 adults with high cholesterol took in 2 g per day of plant sterols from phytosterol-fortified orange juice. After eight weeks, their average reduction in LDL cholesterol was 12% (7% reduction in total cholesterol).

How they work: Plant sterols and stanols help block the absorption of dietary cholesterol and the reabsorption of cholesterol back into our intestinal tract. They compete with cholesterol for incorporation into mixed micelles, which are composite molecules that contain both water and fat-soluble substances. In the body, micelles are used to carry fats through the bloodstream. When cholesterol is blocked from being absorbed and incorporated into these molecules, it is excreted from the body.

Best sources: To get a cholesterol-lowering dose from ordinary food, you would have to eat hundreds of calories worth of oils per day or bushels of fruits and vegetables. But researchers have isolated plant sterols and stanols, and food companies have incorporated them into "functional foods."

Until recently, only certain margarines contained these cholesterol-lowering ingredients, but food companies now have put them into lower-fat foods, such as yogurts, juices, breads and more. A dose of 2 g to 3 g of plant sterols and stanols per day has the greatest impact on lowering LDL cholesterol, reducing it by 6% to 15%. Higher doses of sterols and stanols are not more effective.

Foods containing effective amounts of plant sterols and stanols include Promise, Benecol and Take Control margarines... Minute Maid Heartwise Orange Juice...Nature Valley Healthy Heart Granola Bars...Hain Celestial Rice Dream beverage... Lifetime low-fat cheese...Orowheat whole-grain bread. and Vita Muffins.

The FDA now allows foods containing sterols and stanols that meet certain criteria to put a health claim on the label that they can help reduce the risk of coronary heart disease.

Beware: Margarines and juices are dense in calories. Check food labels to see how much you need to eat to obtain 2 g to 3 g of sterols and stanols.

If you're worried about calories, you can take sterol/stanol supplements. Generally, they are called beta-sitosterol or sitostanol. It is safe to use these supplements along with statin drugs for an additional cholesterol-lowering effect.

Nuts

People who are trying to lower cholesterol levels often eliminate nuts from their diets because nuts are high in fat and calories. But nuts contain mostly monounsaturated fats, which, when substituted for the saturated fats found in high-fat meats and dairy, not only can lower LDL levels but also boost HDL "good" cholesterol levels.

Studies have shown the greatest effect when nuts comprise 20% of one's total calories, which typically amounts to 15 to 35 ounces of nuts daily (about one-quarter to one-half cup).

On average, LDL cholesterol levels fall 8% to 12% when walnuts or almonds are substituted for saturated fats. HDL levels may increase by 9% to 20%. Other nuts, such as peanuts (technically a legume), pistachios and pecans, have been shown to lower cholesterol, but fewer studies are available on these varieties.

How they work: The exact mechanism of nuts' healthful effects hasn't been discovered yet, but nuts contain a combination of plant sterols, fiber and healthy fats.

Beware: Because nuts are high in calories, the trick is to substitute nuts for less healthful, high-fat foods, including cheese and meat.

Lower Cholesterol with Soy Nuts

Women who substituted soy nuts (dry-roasted soybeans) for red meat for eight weeks had a 95% decrease in LDL (bad) cholesterol, reducing risk for cardiovascular disease, and a 5.1% decrease in blood sugar levels, lowering risk for diabetes, according to a recent study. These risk factors also improved when women substituted textured soy protein (imitation meat made from soy) for red meat.

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