It's now widely accepted that raised cholesterol is a risk factor for coronary heart disease. Globally, raised cholesterol is estimated to cause 2.6 million deaths (4.5% of total) and 29.7 million disability adjusted life years (DALYS). (1).
For most adults, the following are considered healthy:
For high-risk adults, the recommended levels are lower:
While average UK cholesterol levels are decreasing, over half of UK adults still have total cholesterol levels above 5mmol/L (4).
A varied diet low in saturated fats and containing plenty of fruits and vegetables is the cornerstone of a heart-healthy diet.
In addition to this, a number of foods have also been shown to lower cholesterol. For example, the soluble fibres found in foods like oats, foods enriched with plant sterols and stanols, and nuts and soya foods have been shown to have an additive effect in lowering cholesterol.
In fact, a series of studies by Prof. David Jenkins et al has lead to the popular ‘Portfolio diet,' a popular approach to lowering cholesterol. The Portfolio diet uses a combination of cholesterol-lowering foods — plant sterols and stanols, nuts and soya foods, and soluble (or viscous) fibres such as those found in oats — to achieve results that compare well to first-generation statins (5).
A recent systematic review and meta-analysis of controlled trials confirmed that the Portfolio diet leads to clinically meaningful improvements in LDL cholesterol as well as other established cardiometabolic risk factors and estimated 10-year CHD risk (6).
1. WHO. Global Health Observatory (GHO) data. Raised cholesterol. https://www.who.int/gho/ncd/risk_factors/cholesterol_text/en/ Accessed February 2019.
2. Joint British Societies’ consensus recommendations for the prevention of cardiovascular disease. Heart. 2014;100: ii1–ii67.
3. National Institute for Clinical Excellence.Lipid modification. Cardiovascular risk assessment and the modification of blood lipids for the primary and secondary prevention of cardiovascular disease. 2014; CG 181.
4. Main L. Oats and Oat Products in Cholesterol Lowering Diets. Complete Nutrition. Dec/Jan 2015;15 (6):63-65.
5. Jenkins DJA, et al. Direct comparison of a dietary portfolio of cholesterol-lowering foods with a statin in hypercholesterolemic participants. Am J Clin Nutr. 2005;81(2):380-387.
6. Chiavaroli, L, et al. Portfolio Dietary Pattern and Cardiovascular Disease: A Systematic Review and Meta-analysis of Controlled Trials. Progress in Cardiovascular Diseases. May-June 2018;61(1):43-53.
https://www.sciencedirect.com/science/article/pii/S003306201830094X?via%3Dihub. Accessed February 2019.