Over 106 million Americans have high cholesterol levels, increasing the risk of heart attack or stroke. A cholesterol-lowering diet is recommended, with guidelines from the National Cholesterol Education Program (NCEP) suggesting reducing saturated and trans fats, increasing fruits and vegetables, and limiting total cholesterol and fat intake. The NCEP also recommends a more restrictive diet for those who have had a heart attack or have a total cholesterol level of 240 mg/dL or greater. The Therapeutic Lifestyle Changes (TLC) Cholesterol Diet is also recommended for those with high cholesterol and metabolic disorders.
According to the American Heart Association, more than 106,000,000 Americans age 20 and older have elevated cholesterol levels. Since high cholesterol translates to an increased risk of heart attack or stroke, a cholesterol diet is generally recommended to reduce these and other risks. In fact, most patients are encouraged to adhere to specific dietary measures to shed excess weight before resorting to cholesterol-lowering medications. However, what can be considered the best diet for cholesterol often varies between people. For example, existing medical conditions, such as diabetes, are important factors to consider.
However, the goal of every cholesterol diet is the same: to lower circulating levels of low-density lipoproteins (LDL, the bad kind of cholesterol) and to increase high-density lipoproteins (HDL). In general, this goal is achieved by reducing the intake of saturated foods and trans fats and increasing the 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 fat restriction.
According to NCEP, the best cholesterol diet for most people requires eating 300 milligrams or less per day of total cholesterol. Total fat intake should not exceed 30 percent of daily calories. Also, no more than 10 percent of daily calories should account for total saturated fat intake.
For those who have already had a heart attack, a more restrictive cholesterol diet is recommended. This diet, sometimes known as the Step II Diet, is also suggested for people who have a total cholesterol level equal to or greater than 240 mg/dL, indicating an increased risk of heart disease. According to these guidelines, total saturated fat intake should not exceed 7 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 people with high cholesterol and existing heart disease, as well as people with metabolic disorders, including diabetes. In general, the recommendations are the same as those described in the diet in Step II above. However, it also allows total fat to come from 25-30 percent of total calorie intake, with 10 percent or less polyunsaturated fat. Also, most of your fat intake should be monounsaturated, as this type of fat naturally lowers LDL cholesterol.
Without the help of a dietitian to write 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 (low-fat): 2-3 one-ounce (28.35-gram) servings per day*
Cereals, bread, rice, pasta: 6-11 half to one ounce (14.17-28.
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