Foods Proven to Lower Cholesterol

What you eat can have a significant impact on your health. Different diets tend to help people lower triglycerides and raise good HDL cholesterol, but they are less likely to have a big impact on bad LDL cholesterol.

We think that the best and the most effective way is not to diet but to eat proper food. So we compiled a list of foods with drastic cholesterol-lowering properties, and gave them the "Strength of evidence".

1 Nuts: almonds, walnuts, pistachios, hazelnuts

Since 2003, the FDA has allowed almonds, hazelnuts, pecans, pistachios, walnuts, and peanuts to make a qualified health claim regarding the relationship between eating nuts and the reduced risk of heart disease. The FDA cut Brazil nuts, macadamia nuts, cashew nuts, and some varieties of pine nuts from the qualified claim.


Scientific research consistently shows that people who eat nuts frequently have a dramatically reduced risk of heart disease. This beneficial effect is at least partially explained by cholesterol-lowering properties of nuts. Rich in polyunsaturated fatty acids, nuts also help to keep blood vessels healthy and elastic. They also contain dietary fibre, phytosterols, and other phytochemicals that may have cardio-protective effects.

Almonds, walnuts, and pistachios may be most effective at lowering cholesterol. Hazelnuts have also been reported to help lower cholesterol.

Almonds
Almonds are unique in that they have significant amounts of protein and have the highest concentration of alpha-tocopherol of all nuts. Several clinical trials involving almonds found that the almond diets significantly reduced total cholesterol (range 8-12%) and LDL cholesterol (range 9-15%)[35,36].

Walnuts
While most nuts are high in monounsaturated fats, walnuts are rich in polyunsaturated fats, including the Omega-3 fatty acids. Walnuts also contain other beneficial nutrients, including vitamin E, the B vitamins, fiber, and several minerals. Walnuts received their own, separate qualified health claim from the FDA in 2004, stating that they may reduce the risk of heart disease. Many studies have indicated the usefulness of walnuts in reducing cholesterol levels[37,38].

Pistachios
These tasty nuts contain antioxidants normally found in dark leafy vegetables like kale and the highest content of cholesterol-lowering phytosterols. Pistachios also contain more beta carotene (vitamin A) than other nuts. The latest study[39] evaluated 28 adults who had elevated LDL cholesterol levels when the study began. The researchers found that LDL cholesterol levels declined by 9 percent when the participants ate one daily serving of pistachios and by 12 percent when they had two daily servings. LDL cholesterol levels did not fall when participants ate the low-fat diet alone.

Hazelnuts
A recent hazelnut study[40] found that men with high cholesterol who supplemented a low-fat, low-cholesterol diet for four weeks with hazelnuts (40 grams daily) experienced a 5.2 percent drop in total cholesterol, 3.3 percent decline in LDL cholesterol, and 12.6 percent rise in "good" HDL cholesterol.

Strength of evidence: A

There is enough evidence to assert that diets including nuts on a regular basis reduce the risk of coronary heart disease.

A number of epidemiologic studies have consistently reported an inverse relation between the incidence of cardiovascular disease and the frequent consumption of nuts, even after adjustment for confounding variables. Five large prospective cohort studies (the Adventist Health Study, the Iowa Women Health Study, the Nurses' Health Study, the Physicians' Health Study, and the CARE Study) have examined the relation between nut consumption and the risk of atherosclerotic heart disease, and all have found a strong inverse association. When 21,454 male participants enrolled in the U.S. physicians' study were followed for an average of 17 years, researchers found a lower risk of sudden cardiac death and other coronary heart disease end points after controlling for known cardiac risk factors and other dietary habits. When compared with men who rarely or never consumed nuts, those who consumed nuts two or more times per week had reduced risks of sudden cardiac death by over 50 percent.

Series of well controlled dietary intervention studies have shown that the incorporation of nuts to any diet lowers total serum cholesterol and improves the lipoprotein profile. A review of 23 intervention trials using nuts demonstrated convincingly that eating nuts daily decreases total cholesterol and LDL cholesterol[34].

2 Oatmeal and oat bran

There's plenty of evidence that eating oatmeal and oat bran lowers total cholesterol and LDL cholesterol levels. It's such a well-accepted belief that the FDA gave it the status of a "health claim" in 1997. The most of oats cholesterol-lowering power comes from the soluble fiber beta-glucan. In fact, oats have a greater proportion of soluble fiber than any other grain. Recent research suggests that other components of oats - such as the protein and natural antioxidants - may also contribute to heart health.

Strength of evidence: A

Many studies have shown that oats, when combined with other cholesterol-lowering foods, can have a big effect on cholesterol levels[41-42]. In a study[41] published in the American Journal of Clinical Nutrition in 2005, researchers tested cholesterol-lowering drugs against cholesterol-lowering foods in a group of thirty-four adults with high cholesterol. Oat products were among the chosen foods. The results were striking. The diet lowered cholesterol levels about as well as cholesterol drugs.

The mechanism by which soluble fiber reduces LDL cholesterol is similar to the action of bile acid-binding resins, which are a type of medications used to control cholesterol levels. The fiber binds to bile acids and inhibits the formation of micelles. Micelles are tiny chemical complexes needed for the absorption of cholesterol and other fats in the gut. If the micelles cannot form, your body cannot absorb cholesterol and fat when you eat it. Bile acids themselves are also prevented from being reabsorbed. This prevention of bile acid resorption disrupts the pool of bile acids that are available to the body. This triggers another mechanism in the liver which causes the conversion of cholesterol into new bile salt acids, thus lowering cholesterol in the blood.

3 Barley

Barley isn't widely eaten in the U.S. However, barley deserves a place on your plate if you're trying to curb your cholesterol. The addition of barley to a healthy diet may be effective in lowering total and LDL cholesterol in both men and women.

In December, 2005 FDA allowed whole grain barley and barley-containing products to claim reduction in risk of coronary heart disease.

Strength of evidence: A

Scientific evidence continues to demonstrate that the consumption of barley products is effective for lowering total and LDL cholesterol.

Most clinical studies evaluating the effects of soluble fibers have used oats or psyllium even though barley contains at least as much beta-glucan as they do.

A combination of factors and mechanisms appears to contribute to the cholesterol lowering action of barley. Soluble fiber is suggested to reduce cholesterol by increased excretion of bile acids or neutral sterols, increased catabolism of LDL cholesterol, and reduced absorption of fat. Soluble fibers were shown to be fermented in the colon and thus to give rise to short-chain fatty acids that can be absorbed and may inhibit hepatic cholesterol synthesis. In addition to the soluble fiber, barley contains a wide range of phytochemicals, some of which are being investigated for their effect on metabolism.

Barley's cholesterol-lowering power was seen in a small study of 25 people with mildly elevated cholesterol levels[55]. Beta-glucan, a soluble fiber found in many whole grains, came exclusively from barley and not supplements. The diet with the most beta-glucan used barley flakes, barley flour, and pearled barley instead of rice and wheat. The barley-based foods made a difference. When participants ate diets with low, medium, and high levels of the soluble fiber beta-glucan, their total cholesterol dropped by 4%, 9%, and 10%, respectively. The diets with low, medium, and high beta-glucan levels cut LDL cholesterol by 8%, 13.8%, and 17.4%, respectively.

4 Legumes

Legumes (such as beans, pinto beans, and navy beans) are among the foods found to lower cholesterol. All of the legumes are especially high in soluble fiber. Soluble fiber has been shown to reduce total and low-density lipoprotein cholesterol levels as well as insulin resistance. In addition, legumes are generally low in sodium and rich in minerals such as potassium, calcium, and magnesium. Also, legumes are inexpensive, nutrient-dense sources of plant protein that can be substituted for dietary animal protein.

Adding one cup of cooked beans to your diet would add 12 g of total fiber and 4 g of soluble fiber per day. This increase in fiber intake would be expected to modestly lower serum cholesterol and risk of heart disease, especially in those with elevated blood cholesterol.

Strength of evidence: A

Data from several human intervention trials indicate that consumption of canned and dry beans reduce serum cholesterol[28-31]. Only two studies[32-33] did not found favorable changes in serum lipoproteins when beans were consumed. Generally, in carefully controlled clinical studies where the macronutrient intake was matched and the fiber content in the bean fed group was at least twice that of the control diet, significant reductions in both total and LDL cholesterol occurred. Significant increases in HDL cholesterol or reductions in triglycerides were also seen in several but not all of the studies.

In one test, 1 cup of canned baked beans in tomato sauce decreased cholesterol by 10 percent in middle-aged men with high cholesterol who ate a typical high-fat diet[28].

Researchers found that daily pinto bean consumption of a half-cup resulted in an average drop of total cholesterol and LDL cholesterol of more than 8 percent[29]. In this study the black-eyed peas appeared to have little effect on blood cholesterol.

In another study 20 men with hypercholesterolemia were randomly allocated 100 g of oat bran or 115 g (4 oz) of pinto and navy beans per day[31]. After 21 days, an average reduction of 19 percent in total serum cholesterol levels occurred in both the oat bran and bean groups. LDL cholesterol levels for the oat bran and bean groups were reduced by 23 percent and 24 percent, respectively.

Soya controversy

In 1995, the New England Journal of Medicine published a report from the University of Kentucky entitled, "Meta-Analysis of the Effects of Soy Protein Intake on Serum Lipids." It was financed by the PTI division of DuPont, "The Solae Co." St. Louis, Missouri, a soy producer and marketer. This meta-analysis concluded that soy protein is correlated with significant decreases in serum cholesterol, LDL cholesterol and triglyceride concentrations. But, HDL cholesterol did not increase by a significant amount.

However, this earlier research indicating that soy protein has clinically important favorable effects on LDL cholesterol and other CVD risk factors has not been confirmed by many studies reported during the past 10 years. A very large amount of soy protein, more than half the daily protein intake, may lower LDL cholesterol by a few percentage points when it replaces dairy protein or a mixture of animal proteins.

The Nutrition Committee of the American Heart Association has assessed 22 randomized trials conducted since 1999 and found that isolated soy protein with isoflavones (ISF) slightly decreased LDL cholesterol but had no effect on HDL cholesterol, triglycerides, or blood pressure[59].

5 Red Wine

One of most well-documented benefits of red wine is a heart protective effect. One to 2 drinks per day of red wine have been shown to increase HDL cholesterol by about 11-17%[14-15]. This extra HDL cholesterol can then serve to remove some of LDL cholesterol from the circulation and lessen the amount of material available for fatty plaque formation. Plaque formation may be further hindered by the polyphenols in red wine that possess antioxidant properties.

Some researchers believe that resveratrol might be the key ingredient in red wine that helps prevent damage to blood vessels, reduces "bad" cholesterol and prevents blood clots[16]. The resveratrol in red wine comes from the skin of grapes used to make wine. Because red wine is fermented with grape skins longer than is white wine, red wine contains more resveratrol.

Scientists at the University of California, Davis, have identified another group of chemicals in red wine that is linked to the ability to lower cholesterol. Called saponins, these glucose-based plant compounds are being found in an increasing number of foods. Saponins seem to lessen the risk of cardiovascular disease by preventing the absorption of cholesterol in the body. Interestingly, some of the same wines that show the lowest levels of flavonoids, like red zinfandel, contain high levels of saponins. The average red wine contains three to 10 times as much saponin as white wine and, in general, a higher alcohol content translates to higher saponin concentrations.

Strength of evidence: A/B

Regular red wine consumption reduces LDL cholesterol levels and increases HDL cholesterol. This is supported by considerable data from epidemiological studies (studies focused on disease within whole populations) and strong suggestions from experimental (interventional) research[15,20]. HDL cholesterol enhancing effects of red wine are attributed to both the alcohol component[17] and to antioxidant functions of its flavonoids[16,18].

High quality study[19] has demonstratded that red wine polyphenols reduce the susceptibility of low-density lipoproteins to oxidation. Oxidation of LDL is believed to contribute to the development of atherosclerosis.

6 Purple (or dark red) Grape juice

If you don't like wine, the latest studies show you can get almost all the same benefits from grape juice. Why? Purple grape juice contains the same powerful disease-fighting antioxidants, called flavonoids, that are believed to give wine many of its heart-friendly benefits. The flavonoids in grape juice, like those in wine, have been shown to prevent the oxidation of LDL cholesterol that leads to formation of plaque in artery walls.

Surprisingly, eating red table grapes won't provide as much benefits. That's because the juice is made by crushing not just the skin and flesh but the seeds, too, which are especially rich in flavonoids. White grapes and grape juice won't do either, because they don't contain the flavonoids that purple or red grapes do.

Strength of evidence: A/B

A strong body of science has reported that grape juice can reduce the oxidation of LDL cholesterol.

In a double blind crossover study[11] 17 men and three women with previously diagnosed heart disease were randomly assigned to drink either placebo or purple grape juice for 14 days. Grape juice drinkers had HDL levels of 50 mg/dL, compared with almost 45 mg/dL in the placebo group. An HDL level below 40 mg/dL is considered a risk factor for heart disease. The grape juice group also had lower levels of two indicators of inflammation: superoxide and soluble CD40 ligand. Inflammation plays a key role in atherosclerosis.

Thirty-two hemodialysis patients were randomly assigned to receive supplements of vitamin E and/or the red grape juice, a placebo, or no supplementation for two weeks[12]. At the end of the study only the red grape juice supplement was associated with lower blood levels of total cholesterol and apolipoprotein B (apoB). ApoB is the main apolipoprotein of LDL cholesterol and is responsible for the transport of cholesterol to tissues. In high concentrations it has been linked to plaque formation in the blood vessels, although the mechanism behind this is not clear. Furthermore, the red grape juice also increased HDL cholesterol levels.

The same researchers[13] report in the same journal in 2006 initial results of their studies with the red grape juice. Both healthy and hemodialysis patients were used in that earlier study, and the researchers reported that, in addition to reductions in markers of inflammation levels of plasma monocyte chemoattractant protein 1 (MCP-1), an inflammatory biomarker associated with CVD, were reduced by 56 per cent at the end of the supplementation period.

7 Dark chocolate and Cocoa

A daily treat of dark chocolate can improve overall heart health and reduce the risk of heart disease! Dark chocolate is also known as "bittersweet" or "semisweet" chocolate. It contains a high percentage (70% or more) of cocoa solids, and little or no added sugar. Dark chocolate contains a large number of antioxidants (nearly 8 times the number found in strawberries) and appears to retain the highest level of polyphenols, such as catechins and procyanidins.

Polyphenol-rich dark chocolate and cocoa powder has been shown to reduce LDL cholesterol, increase HDL cholesterol and protect LDL cholesterol from oxidation. The researchers report that eating 100 g of dark chocolate for two weeks reduced blood pressure and LDL cholesterol levels, improved flow-mediated dilation, and ameliorated insulin resistance in patients with hypertension[23].

Strength of evidence: A/B

Cacao beans are used as an ingredient in cocoa and chocolate and are known to be rich in polyphenols, such as catechin, epicatechin, procyanidin B2 (dimer), procyanidin C1 (trimer), cinnamtannin A2 (tetramer), and other oligometric procyanidins. Cacao polyphenols can decrease LDL cholesterol levels, inhibit LDL cholesterol oxidation[24-25], and increase HDL cholesterol[26].

Recent comparative, double-blind study demonstrated that daily intake of cocoa powder at a dosage of >13 g per day for 4 weeks contributed to a reduction in LDL cholesterol, an elevation in HDL cholesterol, and the suppression of oxidized LDL[27].

The LDL cholesterol-lowering effect in plasma has been demonstrated for various polyphenols, including tea catechins, genistein, daizein, naringenin, hesperetin, and polyphenols in red wine. These polyphenols have the ability to:

  • inhibit cholesterol absorption in the digestive tract
  • inhibit LDL biosynthesis by lowering the activity and expression of hydroxymethylglutaryl-CoA synthase, hydroxymethylglutaryl-CoA reductase, acyl CoA:cholesterol acyltransferase, and microsomal transfer protein in the liver
  • suppress hepatic secretion of apolipoprotein B100
  • increase expression of LDL receptors in the liver

8 Olive oil

The beneficial effects of olive oil are due to both its high content of monounsaturated fatty acids and its high content of antioxidants. No other naturally produced oil has as large amount of monounsaturated as olive oil. Studies have shown that olive oil offers protection against heart disease by raising HDL cholesterol levels and preventing the oxidation of LDL cholesterol[43].

The FDA recommends using about 2 tablespoons (23 grams) of olive oil a day to get its heart-healthy benefits. Some research suggests that the cholesterol-lowering effects of olive oil are even greater if you choose extra-virgin olive oil. While all types of olive oil are sources of monounsaturated fat, the fact that virgin olive oil is less processed than others means that it also contains higher levels of antioxidants. Olive oil is especially beneficial when it replaces saturated fat.


Strength of evidence: B

The study, published in the Annals of Internal Medicine, provides evidence that virgin olive oil increases the level of substances in the body that prevent the oxidation of LDL cholesterol[44]. First-pressed extra virgin olive oil contains appreciable amounts of polyphenolic compounds, which have inhibited the oxidation of LDL. Extra virgin olive oil also contains other antioxidants, such as tocopherols and flavonoids, which may account for some of its beneficial effects.

Another randomized controlled trial[58] supports the hypothesis that virgin olive oil consumption is effective in protecting LDL from oxidation and in rising HDL cholesterol levels.

9 Flaxseed

Flaxseed is high in fiber, omega-3 fatty acids and phytochemicals called lignans. Flaxseed can help reduce total blood cholesterol and LDL cholesterol levels. The fiber is probably mainly responsible for the cholesterol-lowering effects of flaxseed. Other health benefits, such as protection from heart disease and arthritis, are likely due to its high concentration of the omega-3 fatty acid alpha-linolenic acid.

Strength of evidence: B/C

Flaxseed's actions as a bulking agent may be its main effect on lipids. However, evidence for its efficacy in cholesterol lowering is limited to small, short-term, poor quality, mainly case and cohort studies with small or nonsignificant effects on cholesterol levels[46-49].

In recent double-blind, randomized, controlled study [45] consumption of 40 g per day of ground flaxseed in baked goods resulted in lowered LDL. However, the effect was modest and short lived. In addition, flaxseed was associated with lower HDL cholesterol, which warrants further attention.

In another recent 2008 study, conducted by researchers from Oklahoma, Arkansas, and Florida, three months of dietary supplementation with flaxseed, 30 g/d, lowered the total and LDL cholesterol levels of Native American postmenopausal women by approximately 7% and 10%, respectively[50].

There is not enough reliable data available to determine whether flaxseed is effective for heart conditions.

10 Avocado

Avocados are a great source of monounsaturated fat that may actually help to raise levels of "good" HDL cholesterol while lowering levels of "bad" LDL cholesterol. They contain cholesterol-smashing beta-sitosterol (a beneficial plant-based fat) more than any other fruit. Beta-sitosterol reduces the amount of cholesterol absorbed from food. So the combination of beta-sitosterol and monounsaturated fat makes the avocado an excellent cholesterol buster.

Strength of evidence: B/C

In short-term study[51] of people with moderately high cholesterol levels, after seven days on the diet that included avocados, they had significant decreases in total cholesterol and LDL cholesterol, along with an 11% increase in HDL cholesterol.

A randomized study[52] done in Australia has found that a diet rich in avocados lowered total cholesterol by 8.2% compared to 5% for a low fat diet.

There is not enough reliable data available to determine cholesterol lowering effects of avocado.

11 Garlic

For thousands of years, garlic has been used in nearly every culture in the world. Its nutritional value and flavor have made it a kitchen staple. Today, it is used therapeutically to lower cholesterol, prevent blood clots, reduce blood pressure, and protect against infections. Research has found that it helps stop artery-clogging plaque at its earliest stage (called nanoplaque). Garlic keeps individual cholesterol particles from sticking to artery walls.

Strength of evidence: B/C

Allicin is the bioactive compound in garlic that inhibits cholesterol synthesis in vitro. However, numerous studies have produced conflicting results regarding garlic's ability to lower blood cholesterol. So, cholesterol lowering potential of garlic remains unproven.

The older studies on garlic and garlic supplements looked pretty positive. Positive findings in 3 trials[1-3] exhibited a lowering of cholesterol in the range of 6.1% to 11.5%, primarily due to the lowering of low-density lipoproteins. One 12-week study tested the use of garlic powder in ambulatory patients, finding a 14% reduction of serum cholesterol.

More recently, however, several double-blind trials[4-7] have yielded neutral or conflicting results. A pretty well-done study of about 192 adults which looked at the use of garlic - raw garlic, an extract which was a powdered form and then another extract of garlic which was a standardized preparation and a placebo - four different groups in that study. And really what that study showed was no benefit on cholesterol from garlic.

Based on these findings, the use of garlic should not be considered a primary approach to lowering high cholesterol. However, garlic is known to act as a blood thinner and may reduce other risk factors for heart disease. For these reasons, eating garlic may be beneficial for the heart and cardiovascular system.

12 Brown rice

Brown rice can lower levels of LDL cholesterol. The thin brown layer that is milled off in the processing of white rice, rice bran, is just as effective as the other brans in fighting high cholesterol. Brown rice, of course, has the bran intact. Since rice bran contains little soluble fiber - the factor that helps oat bran to reduce cholesterol - the researchers[8] suggest that the oil in rice bran is the beneficial component. About 20 percent of rice bran's weight is oil.

In addition, rice bran can be tolerated by those who cannot digest gluten, the protein found in wheat, rye, oats, barley and other grains and grasses. Some people also find rice bran more palatable than oat bran.

Strength of evidence: B/C

Based on its soluble fiber content alone, rice bran should have less cholesterol-lowering effect than other sources of fiber. However, rice bran is 12-23% oil, a relatively high percentage compared to most other bran sources, and the oil has an unusually high unsaponifiable matter concentration (4.2%). Rice bran oil, possibly because of this unsaponifiable fraction or its fatty acid content, lowers cholesterol levels in hamsters, rats, nonhuman primates, and humans.

Full-fat rice bran was compared with oat bran and a rice starch placebo in hyperlipidemic people to see if it might have a role in the treatment of hyperlipidemia[9]. Moderately hypercholesterolemic (5.95-8.02 mmol/L), nonsmoking, nonobese adults were studied in a 6-week, randomized, double-blind trial. Researchers found that full-fat rice bran produces significant cholesterol reduction and improvement in the LDL-C:HDL-C ratio in 78% participants. There was no significant difference between the effectiveness of the rice bran and oat bran products used in this study to reduce serum cholesterol or between responses in men and women.

A human study[57] in which brown rice affected nutrient absorption did not show cholesterol reduction.

13 Pomegranate juice

Like many fruit juices, pomegranate juice contains antioxidants, especially polyphenols. However, pomegranate juice contains antioxidants at much higher levels than do other fruit juices. Preliminary research suggests that drinking concentrated pomegranate juice provides several heart-protecting benefits, including reducing LDL cholesterol.

Strength of evidence: B/C

A preliminary new study[10] shows that people with diabetes who drank pomegranate juice for three months had a lower risk of atherosclerosis. In addition, the pomegranate juice appeared to slow the absorption of unhealthy LDL cholesterol by immune cells.

Note: There is some concern that pomegranate juice may affect metabolism of some prescription medications. It may also cause blood pressure to become too low when combined with certain blood pressure medications.

14 Fish and omega-3 fatty acids

The beneficial effects of omega-3 fatty acids on cardiovascular health have long been recognized. In people who have already had heart attacks, fish oil - or omega-3 fatty acids - significantly reduces the risk of sudden death.

Among the many effects of omega-3 fatty acids that are believed to contribute to their cardiovascular benefits are:

  • small reductions in blood pressure
  • decreases in platelet aggregation (anti-thrombotic)
  • lowers triglyceride concentrations
  • improved endothelial function
  • potential antiarrhythmic effects

Omega-3 fatty acids have a pretty strong effect on lowering triglycerides. However, beneficial effects on blood cholesterol levels have not been demonstrated. Fish oil supplements appear to cause small improvements in high-density lipoprotein and increases (worsening) in low-density lipoprotein levels.

Strength of evidence: C

There is strong scientific evidence from human trials that omega-3 fatty acids from fish or fish oil supplements (EPA + DHA) significantly reduce blood triglyceride levels. Benefits appear to be dose-dependent.

Although fish oil is able to reduce triglycerides, beneficial effects on blood cholesterol levels are small and of uncertain clinical importance. Fish oil supplements appear to cause small improvements in high-density lipoprotein; however, increases (worsening) in low-density lipoprotein levels have also been observed.

Most evidence supports that omega-3 fatty acids inhibit hepatic triglyceride synthesis, decrease Very low-density lipoproteins (VLDL) production/secretion and increase VLDL metabolism, potentially increasing the conversion of VLDL particles to LDL particles. Overall, despite a potential increase in LDL cholesterol levels, many studies have reported that omega-3 fatty acids reduces non-HDL cholesterol (total cholesterol minus HDL cholesterol), which may be a better predictor of atherosclerotic coronary heart disease risk than LDL cholesterol alone.

Two randomized, double-blind, placebo-controlled clinical trials demonstrated that P-O3FA reduced triglycerides by 40-45%[53-54]. In addition, P-O3FA treatment was also associated with a 29-32% reduction in VLDL cholesterol, a 20% reduction in the total cholesterol:HDL cholesterol ratio, and a 6-13% increase in HDL cholesterol. LDL cholesterol increased by 17-32%.

15 Onions

The regular consumption of onions has been shown to lower high cholesterol and trigylceride levels. These beneficial effects are likely due to onions' sulfur compounds, its chromium and its vitamin B6.

Strength of evidence: C

Data on onions for lipoprotein improvement is based primarily on animal studies[21-22].

16 Blueberries

Blueberry compound, called pterostilbene, shows promise in preliminary laboratory studies of lowering cholesterol as effectively as a medication ciprofibrate.

Strength of evidence: C

Researchers from U.S. Department of Agriculture studied the effect of the blueberry compounds on rat liver cells. Pterostilbene showed the most potent effect in stimulating a receptor protein in the cells which plays an important role in lowering cholesterol and other blood fats. This is similar to the way the commercial cholesterol-lowering drug ciprofibrate works. This study claims that blueberries are particularly efficient at reducing cholesterol in a laboratory.

Key to grades

A - Strong scientific evidence. Reliable and relatively consistent scientific data showing a substantial health benefit.

B - Good scientific evidence.

C - Unclear or conflicting scientific evidence. Insufficient data, or low-quality studies suggesting a health benefit or minimal benefit.



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