Cholesterol-Lowering Helper
Less saturated fat. Less dietary cholesterol. More fiber. A handful of nuts.
Cholesterol-Lowering Helper is built for people whose LDL stays high even on a regular heart-healthy diet — most often because of familial hypercholesterolemia (FH). It's not about eating less; it's about pulling specific levers that lower LDL. For most people with FH, diet works alongside medication, not instead of it.
LIMIT IT
When managing high cholesterol, saturated fats are the primary target to reduce. The American Heart Association recommends severely limiting these.
- Directly raises "bad" LDL cholesterol levels in the blood.
- Significantly increases the long-term risk of cardiovascular disease.
Food guidance
Three lists. Eat more of the first column. Be mindful of the middle. Limit the third.
Eat freely
The base of the plate.
- Oats — a bowl most days. Oats lower LDL.
- Beans and lentils — every other day or more.
- Barley as a substitute for rice.
- Vegetables — half the plate.
- Whole fruit — apples, pears, oranges, berries.
- Almonds, walnuts — about a handful a day, unsalted.
- Olive oil for cooking and dressing.
- Fish — salmon, sardines, trout, cod. Twice a week.
- Skinless chicken or turkey.
- Tofu, tempeh, edamame, plain unsweetened soy milk.
- Skim or 1 % milk, plain low-fat yogurt.
Be mindful
Smaller portions, less often.
- Egg yolks — four a week is plenty. Egg whites unrestricted.
- Shrimp and shellfish — once a week.
- Lean red meat — once a week, palm-size portion.
Limit
Save for occasions, or skip.
- Butter, ghee, lard — replace with olive oil for cooking.
- Coconut oil, palm oil, palm-kernel oil — these are saturated fats, not the healthy kind.
- Full-fat dairy — whole milk, butter, cream, cream cheese.
- Cheese — minimize, even part-skim.
- Pastries, croissants, biscuits — almost always made with butter or palm shortening.
- Cream-based sauces and gravies.
- Processed meats — bacon, sausage, hot dogs.
- Coconut creamers and ice creams.
- Sugary drinks.
Things worth knowing
What is FH?
Familial hypercholesterolemia is a genetic condition (about 1 in 250) where the body can't clear LDL cholesterol well. Diet and medication together work — diet alone usually isn't enough.
The single biggest food lever
Saturated fat. The fat in butter, cheese, fatty meat, palm oil, and coconut oil. Swapping olive oil for butter and fish for steak is most of the work.
Statins and food
Diet typically lowers LDL by 5 to 15 percent on top of your medication. If your doctor has prescribed a statin, keep taking it.
FH runs in families
If you have FH, your parents, siblings, and children should all get a lipid panel. Kids as young as 2 can be screened.
Talk to your care team if…
- Your LDL hasn't dropped at all after 3 months of consistent changes.
- You're considering stopping a statin because of cost or side effects.
- You're pregnant, planning pregnancy, or breastfeeding — most lipid medications need to be paused.
- You have new chest pain, shortness of breath, or pain in your calves or thighs.
- A first-degree relative was just diagnosed with FH — get yourself and your kids screened.
About this guidance
Based on the National Lipid Association's Recommendations for Patient-Centered Management of Dyslipidemia (2014-2015), the NLA Expert Panel on Familial Hypercholesterolemia (2011), the 2018 ACC/AHA/Multisociety Cholesterol Guideline, and the NHLBI Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents (2011). Diet does not replace medication for FH.
General education, not medical advice. Talk with your care team.