Diabetes Diet

10 Ways to Lower Your Cholesterol

By Jack Challem

By now you know that people with diabetes have a higher than average risk of developing coronary heart disease, so it’s especially important to maintain normal levels of cholesterol, a related blood fat. But drugs aren’t the only option for lowering cholesterol and triglyceride levels. Some foods and supplements work almost as well as meds — and without any risk of side effects.

1. Eat some oats. Oats are rich in beta-glucan, a particular type of fiber that can lower cholesterol levels, according to an article in the March 2007 American Journal of Therapeutics. Suggestion: Cook up a batch of steel-cut oats in the evening, and reheat portions for breakfast. Add some cinnamon or berries to vary the flavor.

2. Go fishing (at the supermarket). Coldwater fish, such as salmon and herring, contain omega-3 fats — the heart-healthiest fat you can eat. They’re especially good at reducing triglycerides. Tip: Pan fry a filet in olive oil, cooking it about 10 minutes per inch of thickness. Avoid deep-fried fish or seafood, though, because the bad cancels out the good.

3. Go fishing for supplements. Don’t like the taste of fish? Try the next best thing: fish oil capsules rich in omega-3 fats. The Food and Drug Administration recently approved their use in treating people with very high triglyceride levels. A study published in the March 2007 Lancet found that fish oil supplements cut the risk of heart attacks by almost one-fifth. And more good news: Some companies now add a lemon flavor to mask the fishy taste.

4. Avoid trans fats. Trans fats, found in “partially hydrogenated” vegetable oils and shortening, raise cholesterol levels. That’s bad. To avoid trans fats, pass on deep-fried foods and carefully read the ingredient lists on food labels. In restaurants, tell the waiter you want to avoid any foods made with shortening or any hydrogenated oils.

5. Go nuts. Eating a handful of raw nuts — especially almonds — each day can lower cholesterol, triglycerides, and blood sugar, according to an article in the September 2005 Journal of Nutrition. Pistachios and pecans are also top choices, but all nuts are good for you. Make your own trail mix with raw, unsalted nuts, and keep it handy in plastic bags you can take with you on the go.

6. Use olive oil. Rich in heart-healthy, monounsaturated fat, olive oil can lower cholesterol levels, reduce the risk of blood clots, and even help with blood sugar regulation. Tip: When you steam vegetables or eat salad, drizzle on extra-virgin oil for its delicious nutty flavor and health benefits.

7. Eat an avocado a day. Yes, they’re high in fat — but it’s good fat, the same type found in olive oil. Plus, avocados are rich in fiber, vitamins, and minerals. Eating an avocado a day can lower cholesterol levels as much as some drugs do, according to two studies. Tip: Make your own guacamole — with garlic, chili powder, and cumin — but hold the salt.

8. Take a hike. Or at least go for a daily walk! You’ll be surprised at the results. Most people aren’t motivated to work out at a gym. Just going for regular walks, however, can lower cholesterol and triglyceride levels. Try to increase your pace and distance over several weeks.

9. Supplement with phytosterols. Dozens of studies have found that these plant compounds lead to substantial decreases in total cholesterol and the “bad” low-density lipoprotein (LDL) form of cholesterol. Food makers add phytosterols to some brands of margarine, yogurt, and other foods. However, supplements make for an effective and calorie-free way of getting these beneficial compounds, too, according to an article in the April 2007 issue of Lipids in Health and Disease.

10. Consider niacin. Niacin lowers total cholesterol while boosting the “good” high-density lipoprotein (HDL) form of cholesterol. It’s had the green light for years from the FDA. But there is one downside: Niacin causes flushing, which can be accompanied by an intense tingling sensation, lasting from a few minutes to an hour. This side effect usually goes away over time. Some people are not affected as much as others. Talk with your doctor before taking it.


SOURCES:

Acuff RV, Cai DJ, Dong ZP, et al. The lipid lowering effect of plant sterol ester capsules in hypercholesterolemic subjects. Lipids in Health and Disease, 2007;6:11.

Ascherio A. Trans fatty acids and blood lipids. Atherosclerosis Supplements, 2006;7:25-7.

Boardley D, Fahlman M, Topp R, et al. The impact of exercise training on blood lipids in older adults. Am Journal of Geriatric Cardiology, 2007;16(1):30-5.

Covas MI. Olive oil and the cardiovascular system. Pharmacological Research, 2007;55:175-86.

Devaraj S, Jialal I. The role of dietary supplementation with plant sterols and stanols in the prevention of cardiovascular disease. Nutrition Reviews, 2006;64:348-54.

Josse AR, Kendall CW, Augustin LS, et al. Almonds and postprandial glycemia--a dose-response study. Metabolism, 2007;56:400-4.

Kocyigit A, Koylu AA, Keles H. Effects of pistachio nuts consumption on plasma lipid profile and oxidative status in healthy volunteers. Nutrition, Metabolism, and Cardiovascular Diseases, 2006;16:202-9..

Lerman-Garber I, Ichazo-Cerro S, Zamora-González J, et al. Effect of a high-monounsaturated fat diet enriched with avocado in NIDDM patients. Diabetes Care, 1994;17:311-5.

Lopez Ledesma RL, Munari ACF, Dominguez BCH, et al. Monounsaturated fatty acid (avocado) rich diet for mild hypercholesterolemia. Arch Medical Research, 1996;27:519-23.

McKenney JM, Sica D. Role of prescription omega-3 fatty acids in the treatment of hypertriglyceridemia. Pharmacotherapy, 2007; 27:715-28.

Mukuddem-Petersen J, Oosthuizen W, Jerling JC. A systematic review of the effects of nuts on blood lipid profiles in humans. Journal of Nutrition, 2005;135:2082-9.

Rajaram S, Burke K, Connell B, et al. A monounsaturated fatty acid-rich pecan-enriched diet favorably alters the serum lipid profile of healthy men and women. Journal of Nutrition, 2001;131:2275-9.

Reyna-Villasmil N, Bermúdez-Pirela V, Mengual-Moreno E, et al. Oat-derived beta-glucan significantly improves HDLC and diminishes LDLC and non-HDL cholesterol in overweight individuals with mild hypercholesterolemia. American Journal of Therapeutics, 2007;14(2):203-12.

Ruano J, López-Miranda J, de la Torre R, et al. Intake of phenol-rich virgin olive oil improves the postprandial prothrombotic profile in hypercholesterolemic patients. American Journal of Clinical Nutrition, 2007;86:341-6.

Senuzun F, Fadiloglu C, Burke LE, et al. Effects of home-based cardiac exercise program on the exercise tolerance, serum lipid values and self-efficacy of coronary patients. European Journal of Cardiovascular Prevention and Rehabilitations, 2006;13:640-5.

Yokoyama M, Origasa H, Matsuzaki M, et al. Effects of eicosapentaenoic acid on major coronary events in hypercholesterolaemic patients (JELIS): a randomised open-label, blinded endpoint analysis. Lancet, 2007;369(9567):1090-8.


Reviewed by Susan Weiner, R.D., M.S., C.D.E., C.D.N. 3/08