Lose weight, lower cholesterol: Which diet is best?

The following diets may help lower cholesterol, as well as support heart health.

Mediterranean diet

The Mediterranean diet has many health benefits and may help lower cholesterol. The Mediterranean diet focuses on the following foods:

The Mediterranean diet limits dairy, red meat, and processed meat.

The diet includes a high level of plant sterols from vegetables, fruits, nuts, and seeds, which help lower cholesterol levels.

A higher intake of nuts may help improve total cholesterol, LDL cholesterol, and triglyceride levels.

Legumes and whole grains, such as oats, contain soluble fiber and appear to have beneficial effects on LDL cholesterol levels.

A higher intake of fish may increase HDL cholesterol levels and reduce triglycerides.

Learn more about the Mediterranean diet with a 7-day meal plan.

Dietary approaches to stop hypertension (DASH) diet

The DASH diet is a dietary plan from the National Institutes of Health (NIH) to help lower blood pressure. This diet may also be highly effective in lowering cholesterol levels.

The DASH diet consists of:

• vegetables
• fruits
• whole grains
• fat-free or low fat dairy
• fish
• poultry
• beans
• nuts
• vegetable oils
• limiting saturated and trans fats, added sugars, and sodium

A 2021 study looked at the effects of the DASH diet with restricted calories on cardiometabolic health in 28 older Caucasian adults with obesity.

The research found that over 12 weeks, the DASH diet significantly reduced the participants’ total cholesterol levels by 4.9%, with a 4% reduction in LDL cholesterol levels.

The positive effects on cholesterol from this diet may be due to the high levels of dietary fiber and reduced levels of saturated fat.

The study also found that HDL cholesterol levels decreased in participants with this diet. Researchers are unclear as to whether this affected the overall function of HDL cholesterol, which could negatively impact cardiovascular health.

Researchers need further evidence to conclude the effects of the DASH diet on HDL cholesterol.

Learn more about the DASH diet and how to get started.

Vegetarian or flexitarian

A healthy vegetarian diet focuses mainly on plant foods, but may also include dairy and eggs. Flexitarians eat mostly plant-based foods, with some animal products.

According to a 2020 article, vegetarian diets generally have a higher intake of vegetables, fruits, legumes, grains, and nuts. Research suggests that vegetarians typically have lower LDL cholesterol levels than omnivores.

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Learn more about vegetarian or flexitarian diets and meal plans.

Vegan or plant-based diet

Vegans eat a plant-based diet with no animal products. According to a 2018 meta-analysis, a vegan diet may have beneficial effects on LDL cholesterol.

The research found that in most countries, people following a vegan diet had lower LDL cholesterol, as well as lower triglycerides. A vegan diet may help reduce the risk of cardiovascular disease and diabetes.

According to a 2017 review, plant-based diets, and particularly vegan diets, link to lower levels of total, LDL, and HDL cholesterol in the blood.

A vegan diet may only be beneficial if it is rich in whole foods. If a person’s diet is high in processed, packaged foods, fried foods, and refined carbohydrates, it may not be beneficial for cardiovascular health.

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Learn more about vegan diets and meal plans.

Portfolio diet

The portfolio diet is a vegan diet that focuses on foods that lower cholesterol and may help reduce LDL cholesterol. This diet recommends a daily intake of the following to lower cholesterol:

• 2 grams (g) plant sterols
• 50 g nuts
• 10–25 g soluble fibers from plant foods
• 50 g soy protein

The portfolio diet does not include meat, poultry, seafood, eggs, or dairy.

Learn more

Learn more about other diets and meal plans to try.

This section looks at some meal ideas that may help lower cholesterol.

Mediterranean

• poached eggs, avocado, and arugula on whole grain toast with an olive spread
• a vegetable omelet with tomatoes, mushrooms, peppers, onions, and spinach
• chickpea and lentil pasta with baked chicken, feta, fresh tomatoes, spinach, and olives
• baked cod with asparagus, peas, and roast potatoes
• Greek yogurt with berries and chia seeds
• a green salad with spinach, arugula, cucumbers, shredded beets, red onions, sunflower seeds, and a low fat dressing

Vegetarian

• shakshuka, or eggs poached in a tomato sauce with olive oil, onions, garlic, and peppers, spiced with paprika and cayenne pepper
• vegetable lasagna with fresh tomato sauce, peppers, spinach, onions, garlic, and a bechamel sauce
• an egg salad with spinach, arugula, and spring onions
• Greek yogurt with oatmeal, peanut butter, and bananas

Vegan

• oat granola with soy yogurt, berries, chia seeds, and almond butter
• scrambled tofu on whole grain toast, with a spinach, beet, and arugula salad
• baked butternut squash with cauliflower rice
• sweet potato curry with chickpeas, red lentils, and spinach
• whole wheat pasta with fresh tomatoes, peppers, spinach, and olives

Diets that may not be beneficial for lowering cholesterol include:

Ketogenic

The ketogenic, or keto diet, focuses on limiting carbohydrates and increasing fat intake.

In the short term, between 2–6 months, a keto diet may help lower triglycerides and help people lose weight. Following a keto diet for longer than 6 months may not deliver sustained results.

In the long term, a keto diet that heavily restricts carbohydrates may lack fiber and nutrients, as it is typically low in starchy vegetables, fruits, legumes, and whole grains.

Long-term ketogenic diets with a low carbohydrate intake and high intake of animal-based fat and protein may increase LDL cholesterol and increase the risk of cardiac and non-cardiac-related mortality.

Atkins diet

The Atkins diet is a low carbohydrate, high fat diet (LCHF) that includes animal-based protein and fats and limits carbohydrates.

A 2018 study looked at the effects of an LCHF diet on what the authors describe as “30 healthy normal weight” young adults. The study found that eating an LCHF diet for 3 weeks increased the participants’ LDL cholesterol levels by up to 44% compared to controls.

Low fat diet

A low fat diet may reduce LDL cholesterol in people with obesity, but it may decrease their HDL cholesterol and increase triglycerides.

Eating a diet low in saturated and trans fats, but incorporating monounsaturated and polyunsaturated fats, may have beneficial effects on a person’s cholesterol and overall cardiovascular health.

Foods that may increase cholesterol are higher in saturated and trans fats.

The American Heart Association (AHA) recommends that a person limit their intake of saturated fats to less than 6% of their total daily calories. They also recommend that people eliminate trans fats from their diet as best as they can.

Foods to avoid include:

• red meat
• processed meat, such as hot dogs and bacon
• poultry with its skin on
• full fat dairy
• butter and lard
• cream
• cheese
• fried foods
• foods containing hydrogenated oils, such as baked goods
• tropical oils, such as palm oil and coconut oil

Diets, such as plant-based, Mediterranean, or the DASH diet, may be best for lowering cholesterol. These diets focus on foods that can improve a person’s cholesterol levels, such as soluble fiber, unsaturated fats, and plant sterols.

Low carbohydrate, high fat diets may not be beneficial for cholesterol levels in the long term, as these diets may be high in saturated fats and low in fiber and plant foods.