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Low Cholesterol Diet

Fat is a source of energy for the body. However it is not the body’s primary source of energy and too much fat in the diet can be harmful. It is especially bad for the circulatory system because it raises blood cholesterol levels that can contribute to heart attack or stroke. This diet is designed to reduce total fat, saturated fat and cholesterol to levels recommended by the National Cholesterol Education Program (NCEP), NCEP is made up of 40 private and governmental groups coordinated by the National Heart, Lung, and Blood Institute, For people at high risk or who have known cardiovascular disease, the Therapeutic Lifestyles Changes (TLC) diet has been adopted by the NCEP. The TLC diet has the following goals:

  • decrease total dietary fat, especially saturated fat and so-called trans fat
  • decrease dietary cholesterol
  • increase intake of soluble fiber
  • adjust total calorie intake to maintain desirable body weight/prevent weight gain
  • include enough moderate exercise to expend a minimum of 200 calories per day
  • Decrease calories if needed to reach a healthy body weight

This diet is especially targeted to individuals with elevated [DL cholesterol, which is the bad form of cholesterol.

Nutritional Facts

This diet is designed to meet the National Research Council’s Recommended Dietary Allowances (RDA). For those who require weight reduction, the RDA can be met on a daily calorie level of 1200 for women and 1500 for men. However, if the patient requires a lower daily calorie intake, the physician may prescribe a multiple vitamin supplement.


The heart pumps blood through blood vessels called arteries and veins. This blood carries vital oxygen and nutrients needed by tissues and organs throughout the body. The heart itself is supplied with blood vessels called coronary arteries. When cholesterol levels rise above normal limits and stay high, some cholesterol is left behind in the arteries. Over the years, a hardened, waxy substance called cholesterol plaque builds up on the artery walls, and reduces or blocks blood flow. Organs supplied by these arteries then become damaged because they cannot get the oxygen and nutrients they need. For example, when blood flow to the brain is blocked, a stroke occurs. When plaque completely blocks a coronary artery, a heart attack takes place.

Cholesterol in the body comes from two sources. Most cholesterol is made by the liver from various nutrients and especially from saturated fats. The liver makes just about all the cholesterol the body will ever need. Since all animals can make their own cholesterol, some cholesterol in the human body comes directly from eating animal products. These foods include meats, egg yolks, organ meats, whole milk and milk products. This cholesterol is absorbed through the intestines and added to what the liver makes. It is also known that a diet high in saturated fat seems to increase cholesterol production in the body. Therefore, reducing dietary cholesterol and fats helps to keep blood cholesterol levels within a healthy range.

Fats in the Diet

Dietary fats can be saturated or unsaturated. An easy way to remember the difference is that saturated fats solidify or remain solid at room temperature. Unsaturated fats do not; they are liquid at room temperature. Trans-fats are naturally occurring liquid vegetable fats that have been “transformed” into solid, unhealthy fats. To reduce blood cholesterol levels, it is especially important to limit saturated fats. Saturated fats are found mainly in animal products and dairy products made with whole milk.

Unsaturated fats (polyunsaturated and monounsaturated) are found in plants, and are less likely to raise blood cholesterol levels. In fact, there is evidence that monounsaturated fats (olive, peanut, or canola oils) may even help to lower blood cholesterol. There are a few vegetable fats such as coconut oil, palm oil, and cocoa butter (found in chocolate) that act like saturated fats in the body, so they should be avoided.

The term hydrogenated or trans fat vegetables oils appears often on food labels. Hydrogenation is a manufacturing process for making vegetable oils solid at room temperature. The end result is a food that now contains trans fatty acids. These oils are frequently used in baked goods, snack foods, and margarine. Remember that all fat in the diet must be reduced, but it is especially important to avoid saturated fats and trans fatty acids. As of January 2006, manufacturers are being required to list the grams of trans fatty acids on the nutritional label.

Special Considerations

  1. Limit sugar and alcohol. They provide few nutrients but many calories. Therefore, they contribute to high cholesterol by increasing body weight. Any alcohol use should be discussed with the physician.
  2. Certain habits, such as cigarette smoking and a sedentary life, can increase the risk of heart disease. Cigarette smokers should quit. Regular aerobic exercise (at least 20 to 30 minutes, 3 times a week) can lower cholesterol levels and help to prevent the build-up of cholesterol plaque. It can also reduce stress that may cause high blood pressure, another heart disease risk.
  3. Fish should be eaten often, at least 2 times or more per week. Research indicates that certain deep-sea fish—mackerel, salmon, herring, albacore tuna, lake trout—contain an oil called Omega-3 faffy acid, This oil may help to lower blood cholesterol.
  4. Avoid high sodium content in foods. Some patients with high cholesterol also have high blood pressure. Reducing sodium or salt can help to keep blood pressure within normal limits. Sodium is an ingredient in many commercially processed foods. Common medications such as antacids, laxatives, and cough remedies can contain large amounts of sodium. Read product labels and use products with no more than 250 mg of sodium per serving. Herbs and spices can be used in place of salt to add flavor and variety to meals. Do not use a salt substitute unless the physician has approved it.
  5. Increase complex carbohydrates, (pasta, whole grains, and potatoes) in the diet. They are an excellent source of energy without the harmful effects fats can have on the body. But, read labels of commercially prepared baked goods, cookies, and crackers. These products are notorious for using highly saturated fats such as coconut or palm oils and trans fatty acids.
  6. Eat 10 to 25 grams of soluble dietary fiber every day. Foods such as legumes, oats, barley, brown rice, apples, strawberries, and carrots are good to eat because they contain soluble fiber. Research indicates that soluble fiber helps to lower blood cholesterol levels. Supplements such as psyllium mucilloid (trade names: Konsyl, Metamucil) can lower cholesterol up to 15% when used daily. Oat bran is another soluble fiber that has the same benefit.
  7. Choose meats carefully. Grading of meats (Prime, Choice, or Good) refers to fat content, with Prime grades having the most fat. Marbling refers to the threads of white fat running through a cut of meat—the greater the marbling, the more fat. Read labels and avoid any meat product with more than 3 grams of fat per ounce.
  8. Eating out can be a challenge. Avoid fast food restaurants; their foods are usually high in fats and sodium. However, many restaurants now understand the need to provide items for clients on fat or cholesterol-restricted diets. Their menus often contain words like “heart healthy” or have items marked with the symbol V. Ask about ingredients and how foods are prepared. Choose foods wisely and ask for smaller portions.

Note: the information in this section is provided as a supplement to information discussed with your healthcare provider. It is not intended to serve as a complete description of a particular topic or substitute for a clinic visit.

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