Low Cholesterol Diet

This article addresses how to follow a low cholesterol diet and a low cholesterol diet plan, highlighting 8 easy steps for managing your cholesterol and heart health. It also includes a low cholesterol food list with a few low cholesterol recipes. It also looks at the merits of the Mediterranean diet.

Six major risk factors for heart disease have been identified, and all can be treated or controlled: high blood pressure, unhealthy cholesterol levels, diabetes, exposure to tobacco, physical inactivity, and obesity. Before looking at low cholesterol foods or diet plans it is good to understand some basics about cholesterol.

What is cholesterol?

Cholesterol is a substance that’s found in the fats (lipids) in your blood. While your body needs cholesterol to continue building healthy cells and to produce certain hormones, having too high cholesterol can increase your risk of heart disease. When you have high cholesterol, you may develop fatty deposits in your blood vessels (a process referred to as atherosclerosis). Eventually, these deposits make it difficult for enough blood to flow through your arteries. Your heart may not get as much oxygen-rich blood as it needs, which increases the risk of a heart attack. Decreased blood flow to your brain can cause a stroke.

Cholesterol is carried through your blood, attached to proteins. This combination of proteins and cholesterol is called a lipoprotein. You may have heard of different types of cholesterol, based on what type of cholesterol the lipoprotein carries. They are:

• Low-density lipoprotein (LDL). LDL, or “bad,” cholesterol transports cholesterol particles throughout your body. LDL cholesterol builds up in the walls of your arteries, making them hard and narrow.

• Very-low-density lipoprotein (VLDL). This type of lipoprotein contains the most triglycerides, a type of fat, attached to the proteins in your blood. VLDL cholesterol makes LDL cholesterol larger in size, causing your blood vessels to narrow. If you’re taking cholesterol-lowering medication but have a high VLDL level, you may need additional medication to lower your triglycerides.

• High-density lipoprotein (HDL). HDL, or “good,” cholesterol picks up excess cholesterol and takes it back to your liver.

The great news is that factors within your control, such as how active you are and what you eat, contribute to high LDL cholesterol and low HDL cholesterol. So there is something that you can do to manage your cholesterol levels!

Factors beyond your control may play a role, too. For example, your genetic makeup may keep cells from removing LDL cholesterol from your blood efficiently or cause your liver to produce too much cholesterol.

Other useful resources:



A low cholesterol diet plan – The Miraculous Mediterranean diet

The Mediterranean diet is a collection of nutritional recommendations inspired by the traditional dietary patterns of certain areas surrounding the Mediterranean Sea, particularly Greece and Italy. Because food forms such an integral part of a nation or region’s identity, there are strong connections between geographic areas and types of food. This is why we associate pizza and spaghetti with Italy, cheese and pâté with France, paella with Spain, olives with Greece, and so on. So, what is the Mediterranean diet? Is it pizza, pâté, paella or olives?

The main characteristic of the Mediterranean diet is an abundance of plant food (fruits, vegetables, whole-grain cereals, nuts, and legumes) with splashes of olive oil as the main source of fat. Add to this grilled fish and poultry and some red meat on occasion. This is, of course, enjoyed with small glasses of red wine.

What benefits does the Mediterranean diet offer for a low cholesterol diet plan?

If you’re looking to live longer with less disability and chronic disease, the Mediterranean diet might be right for you. Clinical trials have shown that adherence to the Mediterranean diet can lead to a significant improvement in health, specifically a significant reduction in heart disease and certain cancers. The key seems to be the olive oil that forms such an integral part of the Mediterranean diet. It contains a very high level of monounsaturated fats, which may be linked to a reduction in coronary heart disease risk.

A low cholesterol diet plan: 8 ways to adopt a Mediterranean lifestyle that is heart friendly

The main characteristic of any heart friendly diet is an abundance of plant food (fruits, vegetables, whole-grain cereals and legumes). Include healthy fats such as olives, avocado, nuts and seeds in controlled amounts and then add some grilled fish, chicken or, on occasion, red meat. All this can be enjoyed with small glasses of red wine.

A lot of the foods recommended for heart health such as nuts, seeds, olive oil, avocado and even red wine are quite high in kilojoules, how do I include these into my diet without putting on weight? Nuts, seeds, certain oils, olives and avocado provide monounsaturated fat. Monounsaturated fat is a healthy fat that has been linked to a reduction in coronary heart disease risk. Although these foods are deemed healthy, you should remember that they still contain energy (kilojoules). The same rule still applies: if you take in more energy than your metabolism needs, you will not lose weight. In fact, you could even gain a kilo or two!

A low cholesterol diet plan: A typical heart friendly day may look like this

  • BREAKFAST: A bowl of cooked oats with grated apple, cinnamon and a handful of almonds
  • SNACK: Fresh fruit of choice and a small low fat yoghurt
  • LUNCH: A selection of crudités and 1 slice of rye bread with lower fat dip such as tzatziki or cottage cheese.
  • SNACK: A few whole grain crackers with hummus and a fresh fruit of choice
  • DINNER: Grilled salmon or pilchard fish cakes and roasted vegetables. Served with a large mixed green salad with oil free dressing and an optional glass of red wine.

1)      Have generous amounts of fruits and vegetables every day.

All fruits and vegetables can help to lower cholesterol and protect the heart. Two groups are particularly useful, namely those fruits and vegetables that are rich in vitamin C or rich in beta-carotene. If you have heart disease or raised cholesterol levels, make sure you get at least five portions of fruit and vegetables per day!

Correct portions: A portion would be one fistful or 1 cup i.e. 1 piece of fruit, ½ cup cooked vegetables, 1 full cup of salad.

Ideas for a low cholesterol diet plan: Ensure that an abundance and variety of plant foods make up the majority of your meals. Add about 2 fistfuls of vegetables and/or salad to at least 2 meals and snack on 2-3 pieces of fresh fruit daily.

Tips on how to eat more fruit and veggies according to the South African Food Based Dietary Guideline to eat 5 servings of fruit and/or vegetables daily:

•        Double your normal serving sizes of vegetables

•        Eat raw and dried fruit and raw vegetables as snacks

•        Use fruit in your cereal in the morning (bananas, apples, grapes, berries, etc.)

•        Make a fruit salad or try baked fruit for dessert (use fruit in season — apples, bananas, peaches, pears)

•        Eat a vegetarian dinner at least once a week

•        Enjoy a raw vegetable platter at parties

•        Try using all parts of the plant, e.g. beetroot bulb and leaves, carrot tops

•          Cook vegetables for the shortest time, using minimum amount of water

2)      Use healthier fats such as olives, olive oil, nuts and avocado.

Olives and avocados are rich in monounsaturated fatty acids and vitamin E. Research has shown that foods with a high monounsaturated fatty acid content lower “bad” low-density lipoprotein (LDL) cholesterol and increase ‘good’ high-density lipoprotein (HDL) cholesterol. Any meal should provide about 10-15g fat, preferably the healthier, unsaturated fats.

Correct portions: Add only one small serving of healthy fat to a meal. A serving would be:

A small handful or 1 tablespoon of nuts or seeds, ¼ – ½ small avocado, a teaspoon of olive oil or

5-8 olives.

Ideas for a low cholesterol diet plan: Have a handful of nuts as a quick snack. Try tahini (blended sesame seeds) and hummus as a dip or spread for bread and pass on the butter. Try olive oil as a healthy replacement for butter or margarine.

3)      Eat more legumes such as chickpeas, lentils, hummus, etc.

Legumes include dry, cooked or canned beans, lentils, peas and all the soya products (cooked or canned soya beans, soya mince, cubes, milk, tofu and tempeh). Legumes have a high fibre content, are naturally low in fat and they don’t contain any cholesterol. They are also all slow releasing (low glycaemic index), providing you with a more sustained source of energy. Try and eat legumes at least three to four times a week.

Correct portions: ½ cup legumes provides about 15g carbohydrate (1 slice of bread). A balanced meal providing 1500 kJ would contain about 15-45g carbohydrate.

Ideas for a low cholesterol diet plan: Try the easy hummus recipe below! Add lentils to mince; add chickpeas to salads; make hummus as a dip for crudites; have beans on toast as breakfast or add split lentils to stews and casseroles.

Watch this brief concise video on legumes and practical ideas on how to include them into your diet: http://www.youtube.com/watch?v=GndP9w_f_Pc

4)      Include more fish and eat less red meat.

Rein in the red meat and rather substitute it with fish or poultry. Researchers have discovered that people who eat fish rich in omega-3 fatty acids three or more times a week are less likely to suffer from heart disease and high blood pressure. The best fish sources of omega-3 fatty acids are fatty fish such as salmon, fresh tuna, trout and sardines, although eating any type of unfried or unbuttered fish is also beneficial. If you choose not to eat fish, taking a good omega-3 supplement will suffice, as long as it provides about 1000 mg of EPA and DHA daily.

Correct portions: When choosing fish, opt for tuna, salmon, trout, mackerel, pilchards and herring. When you do eat fish, chicken or red meat, keep your portions small (90-120 g or about the size of a deck of cards).

5)      Start your day with breakfast and eat small portions regularly throughout the day.

Oats and oat bran have a high soluble fibre content which can actively lower blood cholesterol levels. Wy not have oats for breakfast 3 or more times per week? Add oatbran to smoothies and baking and have a bowl of oats (not instant) every day to keep your cholesterol in check.

6)      Have some red wine (in moderation and if appropriate) with your meal.

If it’s OK with your doctor, have a glass of red wine at dinner. If you don’t drink alcohol, you don’t need to start!

Correct portions: A glass of wine provides about 600 kilojoules. When having wine, compensate for the extra kilojoules by having no starch with your (next) meal. If you use alcohol, do so in moderation. Limit your intake to 2 drinks/day for women and 3 drinks/day for men

7)      Spice up your life Instead of just using salt and pepper as seasoning, try including garlic, ginger, coriander, cinnamon, cumin and turmeric in your repertoire. These spices are proof that dynamite really does come in small packages. Not only do they add big flavour, but they add big nutritional value too while contributing almost zero kilojoules!

8)      Traditional eating in modern times

Take time to relax and de-stress as well as enjoy meals with others.  Unfortunately times are changing. Even those living in the Mediterranean are taking fewer siestas and are less likely to spend time preparing and enjoying food. Today we face a modern antithesis in food and lifestyle: fast versus slow; industrialisation of food versus fresh or organic ingredients; globalisation versus regionalisation; pre-packed versus fresh; super size versus balance; the list goes on. Most of us could certainly benefit from putting some of the principles of the Mediterranean diet into practice. Roberto Ferrari and Claudio Rapezzi stated in a Lancet article in March this year that the positive effects of the Mediterranean tradition are not just physical, but also psychological. The Mediterranean diet places emphasis on small portions, freshness and balance as well as the pleasure of eating and socialising. It is this more relaxed attitude to eating, combined with plenty of sunshine and more physical activity that makes it all work.

Even though a food is good for your heart, it doesn’t mean you have a license to indulge. Always be aware of your portion sizes and the kilojoules you are consuming. But that doesn’t mean your meals have to be bland! Make sure that whatever you are consuming is flavourful by adding interesting spices and try to make every meal an occasion. When your food gives you pleasure, you will be more satisfied and less likely to over indulge.

Low cholesterol recipes

Easy Hummus

Hummus makes for a great dip for crudités or as a spread on bread.

One tin of chickpeas (drained)

4 T lemon juice

1 t (or more) crushed garlic

4 T tahini or peanut butter

Seasoning of your choice

Whiz everything together in a liquidizer or food processor until smooth. Hummus can be stored in a sealed container in the fridge for up to one week.

Mediterranean Chicken With Rice

50 ml water

100 g  brown rice

250 g 2 small skinless chicken breasts

200 g 1 small aubergine, trimmed and diced

11 g 1 tbsp olive oil

10 g 1 heaped tbsp chopped fresh thyme

130 g 1 large courgette, trimmed and sliced

160 g 1 medium red or green pepper, or half of each, cut into large slices

1 clove garlic, crushed

1. Preheat oven to 180°C.
2. Place the chicken and aubergine in the base of an oven proof dish and drizzle over the olive oil and thyme.
3. Add the courgette, pepper and garlic, then pour over the water.
4. Cover and bake for 25 minutes. Remove from the oven, stir and return, uncovered for another 20 minutes until the chicken is cooked through.
5. Meanwhile, cook the rice according to the instructions on the packet.
6. Drain the rice and serve topped with the chicken and vegetables.

Serve with a mixed leaf salad drizzled with balsamic glaze, or some steamed green beans or broccoli.

Caprese skewers

Makes 4 skewers

8 slices of seed loaf bread, trimmed into cubes
80-100 g Mozzarella cheese, sliced into cubes the same size as the bread
8 cherry tomatoes whole or 4 large cherry tomatoes, halved
8 fresh basil leaves
Olive oil
Salt & black pepper for serving

  1. Pre-heat the oven grill to its highest.
  2. Place the cubed seed loaf on a wire rack and drizzle or brush with olive oil.
  3. Place under a hot grill for 1-2 minutes until the bread cubes are crispy and golden. Make sure to check it constantly as the bread can burn quickly.
  4. To assemble the skewers, thread a piece of bread followed by a tomato, basil leaf, slice of mozzarella, repeat. Continue until all the skewers have been assembled.
  5. Place on a serving platter and season to taste.

Green Citrus Salad (serves 2)

Lightly blanche 1 cup (100g) of broccoli florets. Rinse under cold water and place in a bowl.  Add the following: 1 medium (100g) peeled and segmented orange or naartjie; 1 tablespoon almond slivers, 1 (200g) sweet red pepper, cut into strips.  Drizzle with 2 teaspoons olive oil and 2 tablespoons lemon or orange juice. Season to taste.  Toss gently and serve as a side dish or add 200g lean protein such as chicken strips to make up a light meal.

Fresh Mango Shake (serves 2)

Combine all the ingredients below in a blender until thick and smooth:

1 small mango, pitted and peeled

2 small oranges/naartjies, peeled

200ml fat free plain yoghurt

A few ice cubes and a little water if too thick

Recipe (From Mathew at Fresh Earth)

Honey, Walnut and Rosemary dressing: Blend all these ingredients until smooth:

½ cup fresh rosemary

¼ cup honey

½ cup water

¼ cup lemon juice

½ cup olive oil

½ cup walnuts

1 tsp salt

This dressing is great for salads, dips, spreads or even with vegetables. It also freezes well.