What can I do to lower my cholesterol? It seems I've tried everything!

Image Credit: Russ / flickr

What can I do to lower my cholesterol? It seems I’ve tried everything!

Help! I went vegan for 4 months with no statins. My cholesterol shot up to 280. (From 180). On statins and a diet with rare “tastes” of meat and dairy, I am at 170-180. I would hate to take more statins, any suggestions?

Carolynn / Originally posted in Everything in Moderation? Even Heart Disease?

Answer:

For those who have tried eating a whole food plant-based diet and still have high LDL, you should make sure you’re not eating plant sources of saturated fat, such as palm kernal oil, palm oil, coconut oil, and cocoa butter (found in chocolate). Of course if you were you wouldn’t be eating a whole food plant-based diet, but you’d be surprised how many people tell me they are and they’re like “Yeah, and I eat a spoonful of coconut oil a day.” I’d also cut out unfiltered coffee. Then once you have gotten rid of the things that increase your cholesterol you need to pack your diet with foods that actively lower your choleserol. So, for example, the components of the portfolio diet for lowering cholesterol. I’ll highlight some of the diet tips found in Dr. Jenkins protocol using Dr. Greger’s videos as reference. 

1) Load up on foods high in soluble fiber. This means tons of beans (see what kind are best: canned or cooked), vegetables like okra, plenty of whole fruit, oatmeal, and flax/chia seed. Find ways to use beans. Lentil stew, dal, curries, bean burritos, bean soup. If you don’t like beans whole, like in a salad, maybe try them as a spread or as hummus? 

2) Take about 2 Tablespoons of ground flaxseed daily and 4 Brazil nuts monthly. Sprinkling ground flax on oatmeal in the morning is an easy way to get enough. Or add it to a smoothie. If you buy the flax whole just add it in the blender first, grind it, and then add the rest of your ingredients. 

3) Focus on several cups of greens daily to help keep nitric oxide flowing. Vegetables loaded with nitrates have been shown to improve heart health. Beets and arugula have tons! (See video on where other vegetables rank on nitrate levels). Yes, green smoothies count if you’re adding the right foods like berries and dark green leafy vegetables (kale, spinach, even parsley). What’s better? Raw or cooked vegetables? Well, it may depend on what veggies are cooked. Lastly, a word of caution for those going wild on greens is that overdosing on raw greens can happen.

Dr. Greger says to get thyroid function tested, too. A low-functioning thyroid can contribute to high cholesterol so it’s good to rule that out. Weight loss is also important if there is too much abdominal fat. Is your height more than twice your waist circumference? So  there are a lot of factors to consider, but if folks are practicing heathy eating and managing body weight and still find their LDL is not coming down they should definitely consider a statin. As I always say make sure to check with your doctor about all of this. It’s important to be transparent and communicate with everyone. 

Lastly, here are some of the best videos to help understand more about diet and cholesterol. Sometimes folks will ask questions like does cholesterol have a lower limit, or, what about the size of LDL particles does that matter? ​Thankfully Dr. Greger addresses this in his video: Does LDL size matter? and Cholesterol does not appear to have a lower limit. A few concerns with dietary cholesterol is that there’s a plateau effect issue and the postprandial (after eating) issue. These videos explain the issues further: When Low Risk Means High Risk and Eggs and Arterial Function. Find out what’s an Optimal Cholesterol Level to shoot for. 

 Image Credit Russ / flickr

Discuss


81 responses to “What can I do to lower my cholesterol? It seems I’ve tried everything!

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  1. I really am doing all the above: vegan diet, wholeplants, no oil, no salt, no sugar, no processed footds, lots of all the foods mentioned above + I exercise 1 hour a day (running) and I am very lean. Neverthelss, my LDL is still 116. As far as I am aware, it’s not my genetics, since heart disease doesn’t run in my family. What can I do more??




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    1. I am similar to you except I eat salt, some sugar and do not exercise. My LDL is 134. I just will not worry about it. I just don’t believe they know all there is to know about it and I have seen too many studies showing higher cholesterol equals lower overall morbidity. My non-professional opinion is, do not take statins and don’t worry about it. Maybe spend some time looking up studies about cholesterol and health. And notice how many times in medicine they say “we used to think” and were wrong.




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    2. Lynn,
      I am exactly situated as you. My local plant based doc spoke to Dr. Esselstyn on my behalf. He told he I shouldn’t worry about the numbers so much as long as I am eating a whole food no oil plant based diet. But I would like to hear from other plant based experts on whether I should still supplement with a statin. I read one can take a low dose statin just once a week to still get some benefit with little to no side effects.




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    3. I have noticed over the years how “normal” lab work parameters have become more restricted. For example, blood pressure was once considered textbook perfect at 120/80- now it’s 100/70. Blood sugar ranges were once considered healthy at 80 to 120; now if it’s at 100 or more and we are cautioned and monitored for pre-diabetes or treated. Cholesterol values have also changed. I sometimes wonder what impact big pharmacy gurus have had on these changes over the years? After all, they need to make a living too!




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      1. Hi Kim,

        I am a volunteer for Dr. Greger. Thanks so much for your question. You raise an interesting point.

        However, most of the studies showing that lower blood pressures, cholesterol levels, white blood cell levels, etc. are done on people that don’t use medications to drive down their levels. For example, we often see a step-wise decrease in BP, cholesterol, and WBC counts as you move from omnivore to semi-vegetarian to vegetarian to vegan. The evidence is pretty strong that individuals that get their levels lower without medications get less chronic disease and live longer. The pharmaceutical industry may use this evidence against people to suggest that people with “normal” blood pressures or cholesterol levels use medications to lower them further, but we know from the research that this can be done without medications–just a healthy, whole food, plant-based diet, with assistance from other healthy lifestyle changes.

        I hope this helps!




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      2. Kim,

        Your insights might be partially correct however, the changes have taken place with new and emerging evidence of better health outcomes with as an example, lower sugar levels.

        We also have better and more sensitive testing methods. The science behind many of our current tests methods has really improved, with advanced lab equipment. You might have noted how even in small medical clinics there is a move toward quick lab results, in minutes. Not just the dipsticks but also for a number of more complex testing.

        One of the larger overviews in our health has been a greater emphasis on the role of inflammation system wide. As a focus this has changed many of the recommendations and because it’s easy to measure, has been impactful in many medical arenas, including lab tests.

        Couple this with a social need to reduce health care costs and we have a number of factors changing many of the lab values.




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  2. What about Ubiquinol, or CoQ10 to lower blood pressure and cholesterol? I know our bodies make it, but is there any evidence of an advantage to taking supplements?




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  3. I have had digestive problems with diarrhea as long as I can remember. This Fall a gastroenterologist asked. me to try the FODMAP diet, and I have some relief, but I am also taking Bentyl 4 x daily and Imodium 8 x daily. since the diet is very restrictive for the cole family vegetables, most greens and legumes, it is almost the opposite of high fiber diets discussed here. I am really sold on plant based diets, but can’t see how to reconcile it with FODMAP. I will try try peppermint and cayenne suggestions first, but has anyone had successful ideas on how to meld these two ways of eating?




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    1. Dcs- your digestive issues are likely caused by your brain. Google search TMS and Dr. Sarno and IBS. You can also Google mind gut connection. Also go to TMS wiki




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  4. Cholesterol particle size question. Doctors dont know what to do with the results. I am eating a whole food/plant based diet 100% for 4 years. The doctor ordered the particle test at my request. It showed small particle size ( type B) and noted a high risk for heart disease. The question i have is this. While eating a whole food/plant base diet, is there any other natural intervention that helps to increase the fluffy LDL particles in the blood over the small dense LDL? Or is the WF/PB diet protective enough? I understand that the particle size testing is gaining traction with cardiologist. Thank you very much. Your book and viseos are greatly appreciated and well done!




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    1. Hi Judy,
      Anything that impacts insulin sensitivity should affect particle size, so aside from dietary intervention (WF/PB and low calorie, depending on your current body weight), your best bet is regular exercise to decrease intramuscular and intrahepatic (liver) fat stores. Hope that helps!




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    2. Judy: Dr. Greger addressed particle size in a video a couple years ago: http://nutritionfacts.org/video/does-cholesterol-size-matter/. The bottom line is that the focus on particle size is severely misplaced / a misinterpretation of the data. I can’t answer the question about whether your diet is 100% protective or not, but I do think that an effort to increase fluffy LDL would be very misguided. Based on the scientific evidence, the goal for high LDL people (those with LDL above 70) should be to decrease that total LDL number (regardless of particle sizes). Hopefully the ideas at the top of page (plus David’s exercise point to you earlier) would help you control your LDL. Make sense? What do you think?




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    1. Rebecca West: I’ve been struggling to figure out how to answer this question. I finally decided that it came down to this: Why do you think you need red meat and other animal products to have healthy blood? I’m guessing you have been told this idea your whole life. But the evidence does not back up this idea. It turns out, most people’s bodies can make all the red blood cells that it needs on a healthy whole plant food diet.
      .
      I found this quote: “Anemia has three main causes: blood loss, lack of red blood cell production, or high rates of red blood cell destruction.” from: http://www.nhlbi.nih.gov/health/health-topics/topics/anemia/ When it comes to diet, the first one is not an issue. The second two causes of anemia would be affected by diet I would think. But there is no reason to think that we need to eat animals to have our bodies properly make red blood cells.
      .
      Dr. Greger addresses a similar question in this “Ask the Doctor” page: http://nutritionfacts.org/questions/second-opinion-for-8-year-old-with-anemia/ And here is the whole list of videos and articles that mention anemia. There may be something in here that clarifies things for you: http://nutritionfacts.org/?s=anemia
      .
      Does that help?




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  5. I switched to a whole food plant based diet a month and a half ago. My total cholesterol is down to 189 off my statin med, but my LDL/HDL ratio is still out of whack. I am losing weight, but still considered obese at this time with a good portion of my weight being on my abdomen. Is this likely related to my weight? My Dr. wants me to resume my statin and I am just wondering if this would be a good idea until I get my weight under control.




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  6. I had a heart attack in 2011, with stent to the RCA, & on Plavix, Carvedilol, Valsartan & Simvastatin (40 mg.) ever since. I’ve had a host of medical conditions arise since then, & because of that I may have missed the possibility that some of the issues might be from the Simvastatin. I was so sick I went off of it on my own for abt a week & actually started to feel better, but went back on until I could talk to the MD. I finally asked her if I could ‘treat’ cholesterol with food (there is nothing familial or genetic in my history), but she said I can’t do that because of the stent. I’ve done some online research but really can’t find anything definite. Is there ever a chance of safely going off statins with a stent by maintaining a plant based diet? It seems senseless that the statins help the stent keep me alive only to very possibly fight cancer, liver & kidney diseases. I’m so sick right now I am thinking it best to have quality rather than longevity of life, just like the lady featured in the FOK movie. She really has been blessed that she could manage her heart condition without a stent. Please know that I’m eternally thankful that my life was (literally) saved, but now I don’t know in which direction to go. My MD is calling in Crestor to see if that has fewer side effects…..the pharmacist said that many are finding it has less negative effect on the liver. PS I take 200-300 mg. Ubiquinol daily, to help in being so tired, but still have headaches, terrible muscles spasms, weakness, trouble breathing, & some low blood pressure.




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  7. I went on a whole foods plant based diet (thanks Dr. G) and in 3 months my bad cholesterol dropped 100 points. I ate much walnuts, chia seeds, pumpkin seeds and ground flaxseed. Had no oil. The only highly refined food I ate was bread, which I didn’t eat too often, and it was Ezekiel.




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    1. Google Portflio Diet created by Dr David Jenkins. Advocates stressing these cholesterol lowering foods: Plant sterols, nuts, soy soluble fiber

      This might help: http://www.lipidgeneticsclinic.ca/pdf/2015%2009%2022%20The%20Portfolio%20Diet.pdf

      Dr Greger’s videos seem to jive with the Portfolio Diet.

      I’ve been on WFPB diet for about 6 months after a couple years as ovo/lacto veg with high BP and Cholesterol. BP is now normal but LDL/HDL is hanging around 117/79–still high. So, I’m going back thru Greger’s blogs/videos for specific cholesterol lowering food help and discovered there’s a lot I can eat more of. Here’re a couple good ones on phytosterols:

      https://nutritionfacts.org/2012/12/20/best-phytosterol-dose-and-source/
      https://nutritionfacts.org/video/optimal-phytosterol-dose/




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  8. I wonder whether I have a problem and would really appreciate your thoughts: My cholesterol is 223. However, it splits like this: HDL is 109, LDL is 104. Triglycerides is 45. My family doctor says that there is no reason to worry, just in contrary, since in my case the high cholesterol number is caused by HDL, and the significant ration of LDL to HDL would be a perfect 1.0. But is it true that I can just lean back? I am worried by the absolute number of the LDL. I started on a WFPB diet nevertheless – makes just sense to me.




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    1. Eva J.: I wouldn’t panic, but you do have cause for concern. Safe levels of cholesterol are 150 or below for total cholesterol and 70 or below for LDL. Levels at 150/70 or below are safe in terms of people not getting heart attacks. Above those levels, you incur risk. Hence, it is very good that you are starting on a whole plant food based diet. If you want to see the data that backs up my assertions and to learn more about what the science says about cholesterol, you can work your way through the NutritionFacts topic page for cholesterol: http://nutritionfacts.org/topics/cholesterol
      .
      Good luck to you. But I don’t think you will need luck since your common sense seems to be very good! ;-)




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      1. Oh, Thea, thank you so much for this very very quick reply! I had been told that these high HDL parameters are kind of a protective genetically coded feature. My mother has them, too – but she also had suffered from a stroke and light Alzheimer. Though I am from Germany, my very good friend of the US has been Cholesterol tested in her company as well – and they found the same thing: Elevated total cholesterol but high HDL. And she has been told the same thing: Don’t worry, that is a very good result. Thus, it seems that this results are not completely rare, and a whole (though maybe small) part of the population believes itself to be safe… Well, sorry for this long reply – I am just really glad not to be alone anymore with my “common sense”. Of course I will work my way through the pages, and through Dr. Greger’s book, which I just ordered :)




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        1. Eva
          I think that you may be right to be concerned. Recent research indicates that high HDL cholesterol may also be harmful.
          https://www.sciencedaily.com/releases/2016/08/160811190922.htm

          Although this finding is not in fact entirely new
          http://emedicine.medscape.com/article/121187-overview

          You may want to discuss this with your doctor. Certainly, a well-planned whole food plant based diet should set you on the road to lowering your total cholesterol.




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  9. Hello, tried to get to the ‘portfolio’ site, but got a Not Found error when it attempted to access: https://www.ncfamilydoctor.com/wp-content/uploads/2013/07/Portfolio-Diet.pdf Also, Dr. T. Colin Campbell stated in an interview with Guilt Free Vegan (youtube channel) that ldl levels for those of us who consumed dairy in childhood could remain high regardless of our current whole food plwnt based diets. Do you know of any studies on this? Thx very much!




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  10. Since switching to WFPB eating in January, my cholesterol has been great. Total = 95 LDL = 45. But my doctor has kept me on a high dose statin drug because of my 2014 heart surgery. He did agree to reduce dosage from 80 mg to 40, and my cardiologist agreed with this. My problem is that I don’t see any research/reports on people in my situation, that is being a post heart surgery patient on a successful whole food plant based eating regimen with excellent cholesterol figures, and still on a statin drug. My other vitals are also excellent, weight is good (but I am not at goal yet,) and I get good daily exercise. Do I keep working with the doctors to reduce my statin use, maybe on a phased reduction to none? Reduce on my own over time? The doctors tell me that there is more benefit to statin use than just cholesterol control. I don’t seem to have side effects from the statin use.




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    1. navyron: Even if you are not aware of any side effects to your statin use right now, my understanding is that those problems can build up or appear in the future–and they are very serious. I can’t think of any reason to stay on statins if you don’t have to. Did your doctors actually list the benefits that they think a statin drug provides beyond cholesterol lowering?

      Or put another way: My understanding is that the entire point of a statin drug is to lower cholesterol, with or without surgery. If you lowered you cholesterol using food alone, why on earth would you keep taking a potentially dangerous drug?

      I can’t recommend reducing the drugs on your own without supervision, because I’m not a doctor and don’t know what that would do. If your doctors are willing to work with you to phase out the drug, great. If not, hopefully you could find a responsible doctor who will. And if worse came to worse and you were able to, you might look up Dr. Klaper who does phone consultations. Dr. Klaper is a well-known, well respected plant based doctor who I’m sure can help you. He may even tell you to stop the statins right now since his opinion is that statins may lower cholesterol, but do nothing to prevent heart attacks. (At least, that’s what I understood him to say based on an article in a medical journal he read. I may have misunderstood.)

      Good luck. Let us know what happens.




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    2. Your doctors are correct. There are more benefits to statin use than just cholesterol lowering. This Harvard article provides a good summary of the argument:
      http://www.health.harvard.edu/blog/cholesterol-and-statins-its-no-longer-just-about-the-numbers-201311136868

      You can also look at the latest guidelines if you have the time. They are not easy reading but they are very informative:
      http://www.nice.org.uk/guidance/cg181/evidence
      http://circ.ahajournals.org/content/129/25_suppl_2/S1.full

      As Thea says, it is very important to keep working with your doctors on this.




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      1. I have been on a Whole Foods plant based diet for two years. I briefly went on a statin and then my numbers were great, but I went off thinking the whole food plant-based I would be enough but my numbers of going through the roof my total this last blood work was 226 with a very high LDM I don’t know what to do I’m really afraid of the statins and the doc said even with this that I would only have a 1% decrease any chance of having a heart attack or a stroke in the next 10 years right now he feels it’s a 10 percent chance. I don’t know what to do went to put me on a Statin 10 mg every other day.




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  11. Greetings from Spain! I would like to know your opinion on the following study: http://bmjopen.bmj.com/content/6/6/e010401.full#responses This was published in a fitness and nutrition website I follow and sounds rather strange to me (I went vegan only 3 months before but am reading a lot about health issues). We have a little discussion going on in that page about this study. And as you are used to analizing all sorts of studies and know their strong and weak points, please read this one and tell me your opinion. Any arguments I could use to prove this study isn’t serious or completely wrong? Thank you and congratulations for your great work!!!!




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    1. Hola, Manuel.

      This study was authored by people who are notorious for denying the evidence about cholesterol and health.

      The study shows nothing new. Previous studies have shown the same thing. This has been known for a long time. The reason for these results has also been known for a long time. See this commentary from 20 years ago:
      “”…….. a recent meta-analysis10 of cause-specific mortality (including unpublished data on noncardiovascular causes of death) from 10 large cohort studies and 2 international studies …… concluded that reduced serum cholesterol is not related to excess mortality among cohorts of employed individuals, whereas population-based studies did show a relationship. The investigators proposed that the discrepancy in results was probably due to a higher frequency of risk factors associated with low cholesterol, eg, alcohol abuse and ill health, in population-based study samples compared with employed cohorts.”
      http://circ.ahajournals.org/content/92/9/2365.full

      For a full answer, see my response to deepcleavage above.




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  12. A study just published in the British Medical Journal (lead researcher from University of South Florida) that looked at previous studies of 68,000 people over age 60 found no association or a small inverse relationship between LDL-C levels and cardiovascular death. There was speculation that the higher levels of LDL-C levels are protective of neurodegenerative disease in elderly people. The study also questions the prescribing of statins for such individuals. It would seem that the science is not supporting Dr. Greger. I remember reading back in the mid 1980’s that the Framingham study found that there was no correlation between high cholesterol and heart disease in people over the age of 50. Maybe this new study is lending confirmation to that.




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    1. Sorry but this is all flim flam .Older people tend to have higher rates of disease than younger people. Many diseases in older people lower cholesterol. It is therefore a commonplace that older people with low cholesterol seem to have increased mortality risk. However in Western societies, most older people have low cholesterol not because they eat whole food plant based diets or because they have genetically low cholesterol. They mostly have low cholesterol because declining cholesterol is a pre-clinical symptom of disease.

      “This conclusion is consistent with results of a recent meta-analysis10 of cause-specific mortality (including unpublished data on noncardiovascular causes of death) from 10 large cohort studies and 2 international studies that concluded that reduced serum cholesterol is not related to excess mortality among cohorts of employed individuals, whereas population-based studies did show a relationship. The investigators proposed that the discrepancy in results was probably due to a higher frequency of risk factors associated with low cholesterol, eg, alcohol abuse and ill health, in population-based study samples compared with employed cohorts.

      Two additional pieces of evidence that suggest that low cholesterol is not a causal factor for noncardiovascular disease are the normal to extended life expectancy experienced by individuals with genetically determined hypobetacholesterolemia11 and populations with low average blood cholesterol levels, such as the Japanese and Greeks, who do not exhibit an excess of noncardiovascular disease deaths.12

      One strength of the investigation by Iribarren et al9 is its ability (albeit limited to two measures) to track cholesterol over time. In an effort to eliminate the possible cholesterol-lowering effects of latent disease, previous studies have excluded from analyses deaths within the first 2, 5, or 10 years of follow-up. The results found by Iribarren et al7 suggest that a drop in serum cholesterol may occur over a decade before disease is diagnosed. This is plausible; at least two examples of long-term morbidity leading to cholesterol reduction are hepatitis B virus infection13 and chronic respiratory disease resulting in repeated respiratory infections.14”
      http://circ.ahajournals.org/content/92/9/2365.full

      As for your reference to a single trial that did not find a benefit for cholesterol lowering, this is contrary to many other trials which have have found reductions in death and other adverse events from cholesterol lowering eg

      “Reduction of LDL cholesterol with a statin reduced the risk of major vascular events (RR 0·79, 95% CI 0·77–0·81, per 1·0 mmol/L reduction), largely irrespective of age, sex, baseline LDL cholesterol or previous vascular disease, and of vascular and all-cause mortality. The proportional reduction in major vascular events was at least as big in the two lowest risk categories as in the higher risk categories (RR per 1·0 mmol/L reduction from lowest to highest risk: 0·62 [99% CI 0·47–0·81], 0·69 [99% CI 0·60–0·79], 0·79 [99% CI 0·74–0·85], 0·81 [99% CI 0·77–0·86], and 0·79 [99% CI 0·74–0·84]; trend p=0·04), which reflected significant reductions in these two lowest risk categories in major coronary events (RR 0·57, 99% CI 0·36–0·89, p=0·0012, and 0·61, 99% CI 0·50–0·74, p<0·0001) and in coronary revascularisations (RR 0·52, 99% CI 0·35–0·75, and 0·63, 99% CI 0·51–0·79; both p<0·0001). For stroke, the reduction in risk in participants with 5-year risk of major vascular events lower than 10% (RR per 1·0 mmol/L LDL cholesterol reduction 0·76, 99% CI 0·61–0·95, p=0·0012) was also similar to that seen in higher risk categories (trend p=0·3). In participants without a history of vascular disease, statins reduced the risks of vascular (RR per 1·0 mmol/L LDL cholesterol reduction 0·85, 95% CI 0·77–0·95) and all-cause mortality (RR 0·91, 95% CI 0·85–0·97), and the proportional reductions were similar by baseline risk. There was no evidence that reduction of LDL cholesterol with a statin increased cancer incidence (RR per 1·0 mmol/L LDL cholesterol reduction 1·00, 95% CI 0·96–1·04), cancer mortality (RR 0·99, 95% CI 0·93–1·06), or other non-vascular mortality."
      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3437972/




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  13. My son has inherited my husband’s high cholesterol. His Total is 259 and his LDL is 180. Since he is young, we are not interested in putting him on medication. He eats a healthy diet; we have tried the brazil nuts for three months but they have not had any impact. Other suggestions?




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    1. Iacole: I can definitely understand not wanting to put a young person on statins. I’m not a medical professional, but I have some thoughts for you.

      You mention that your son eats a healthy diet, but the devil is in the details. Is your son eating a diet of whole plant foods without any oils? Is your son following the recommendations listed on this page? I mention this because you mentioned trying brazil nuts. I think that it would be a good idea to hit a difficult case like this with all the tweaks possible at once. Just trying one little thing like nuts might not make a difference. But trying brazil nuts *and* greens *and* beans *and* etc seems to me like the way to go. The following topic page on cholesterol has some additional tweaks to try: http://nutritionfacts.org/topics/cholesterol

      I’ll also point you to the book: Prevent and Reverse Heart Disease: The Revolutionary, Scientifically Proven, Nutrition-Based Cure — by Dr. Esselstyn. The book would be well worth your whole family’s time, and it even includes recipes. If you want Dr. Esselsytn’s latest thinking in the big picture, here is his FAQ page: http://www.dresselstyn.com/site/faq/ . Also note that you can find several of Esselstyn’s talks for free on YouTube.

      Good luck!




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  14. I’m confused. About 6 months after I first gave up animal products I went to Walgreens and bought a cholesterol test. Using the test kit I pricked my finger and got a reading of 128 for my total cholesterol which i was very excited about. Last week I got my cholesterol tested again and there was no change from what it was prior to starting a WFPB diet. My total cholesterol was up to 210! About three months ago I stopped cooking with salt, sugar and oil, but I have been buying black bean burgers from the store (they probably have oil). Also, I have been using cocoa powder (in smoothies) and eating dark chocolate occasionally. Is the chocolate messing me up? Maybe the test from Walgreens was inaccurate too? I’m so disappointed but I’m committed to giving it another shot. How soon after eliminating these items can I expect to see results and have another blood test?




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    1. Those home lipid test thingies are far from reliable. Sorry, but you wasted your money, just discard it. Chocolate does have saturated fat, so eat it sparingly, or not at all. Want a great chocolate fix? Dice some fresh juicy fruits and add about half a teaspoon of natural unsweetened cocoa powder, stir.

      To give an approximation to your answer with regard to time, 6 months is about right, but changes will still occur even a year or more later. Just keep eating well, be sure and incorporate regular exercise (absolutely essential), and strive to eliminate all processed foods. Since you’re having smoothies, you should have one with a 1/2 cup of oatmeal daily.




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  15. I am wondering if anyone knows much about Lipoprotein a. I am trying to research it because both my dad and I have high levels of Lipoprotein a and we can’t find much information. What we are finding is unsettling since it goes against what I have always learned to be heart healthy eating and against what this website teaches. I would love any help if anyone knows much about it.




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  16. I am a strict ethical vegan, aged 68. Became vegan only 9 months ago but totally plant based, zero animal products ever. I eat too much whole grain bread and use Smart Balance on my toast and a bit of olive oil for soups but that’s it. Lots of greens, fruit, veggies and always whole grains, never refined. But I am at 238 cholesterol, down from 278, so that’s something but my LDL AND HDL went down, too. I am going to see an endocrinologist now. My vitamins and minerals and protein are fantastic and so is the B-12. (People don’t believe how you can be well nourished on a vegan diet.) Wish me luck.




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      1. Thank you! My dermatologist and internist think I have had a lifetime of an endocrine disorder which causes high cholesterol but I wanted desperately to avoid stating and do this all by diet




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  17. With my latest lab tests, my total cholesterol was 219, LDL 118, HDL 76, and Triglycerides 124. I am a 52 year old woman. I have been a vegetarian since I was 18 and 90% or more vegan for the past 2 or 3 years. I eat tons of beans, grains, greens, fruits and vegetables. I exercise at least 7 or 8 hours a week. I am surprised at the high total cholesterol and LDL level. Previously, while on certain birth control pills, my total level creeped up some, but never above 200. I believe menopause does indeed contribute to increased cholesterol level, but, given my diet and lifestyle, any words of wisdom for me? At what level does the benefits of statins outweigh the risks? What about hormone therapy? Would that be beneficial? Thank you!




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    1. Hi Corinne, the first thing I would ask is have you gone through all of the suggestions offered in this blog post? If not, that’s where I’d start. The large majority of people I find who aren’t able to get their cholesterol numbers down on a plant based diet are eating more processed foods than they realize and unhealthy plant based fats and inflammatory foods are finding there way into the diet. Let’s presume you have covered all the bases listed above, there could be a genetic component at play however people who have genetically elevated cholesterol generally tend to have significantly higher numbers so without even knowing you I wouldn’t think that was your case just based on your numbers. The final thing I would do is try and evaluate your risk (of a future coronary event) based on the numbers you have. For that it would be helpful to know if you have any other medical history but presuming you don’t, I’m not sure I’d be all that concerned about these numbers. If you do have other medical history that increases your risk then it may be worth considering the benefits of supplements or even medications to help you lower your numbers. I do agree that your numbers are higher than usual for someone who eats no animal products but in someone who has no other risk factors I don’t think I’d lose sleep over these numbers provided I had as I said earlier, done all the other things listed in the blog post above.




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      1. Thea – Thanks for responding and for your information. I agree with you. My other list factors are limited. When I feed my numbers and other information (BP, weight, smoking status, family history) into the heart risk calculators, my 10 year heart risk is about 2% so I know I should not worry. I was just curious and surprised mostly. I do eat all the items suggested on the blog post and follow the suggestions, and I limit my intake of processed foods, indulging occasionally. I looked around some last night after making my post and did indeed found that women’s cholesterol numbers jump almost exactly the amount mine did after menopause. So, I will talk to my doctor about these things when I go back in. Thank you for affirming what I expected already was the case. Your insight and information was helpful.




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        1. Corinne: Just to clarify, you did get a response from a moderator, but it wasn’t me! One of our excellent medical moderators (I’m just a plain moderator) gave you that nice reply above.
          .
          But since we are talking, I wanted to wish you well. I was really happy that payoung chose your post as one to answer today. She gives great answers and I wanted to know what the answer would be to your question. :-) Best of luck to you!




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  18. Dr. Greger mentioned about a Portfolio Diet to help with Lower Cholesterol in a recent holistic holiday conference for folks already on a WFPB diet but cannot get numbers low enough. Any study showing the benefits of this diet you can provide?

    Thanks.




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    1. Hi Michael, here’s a study that compared a portfoilo diet, to a statin and had a third group called a very low saturated fat diet which was used as the control group. The study found that the portfolio diet and the statin lowered cholesterol equally. In effect this means that the Portfolio diet could be used in place of other current therapeutic lifestyles in people whose cholesterol had not reached goals instead of adding a statin.

      http://ajcn.nutrition.org/content/81/2/380.full




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  19. Hello Sam, This site focuses on getting your sterols through your food. When you take a supplement for sterol you are taking in added fat (vegetable oil plant sterol esters) and with supplements there’s less chance of effectiveness. Please check out: http://nutritionfacts.org/video/optimal-phytosterol-dose/ and http://nutritionfacts.org/video/dangers-of-dietary-supplement-deregulation/ Since you’re taking a statin, why not focus on whole foods to help bring that cholesterol down? Although plant sterols are generally considered safe, they again are packaged in fat. Whole foods are a smarter approach and provide you with more benefits than just lowering cholesterol.




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  20. This site focuses more on getting your nutrients including your sterols though whole foods, Sam, so while a review of PubMed indicated Plant Sterols are genrally considered safe , there are good reasons why you might consider a more natural approach, thus avoiding the added fat found in the supplements
    Check out these videos: http://nutritionfacts.org/video/dangers-of-dietary-supplement-deregulation/ and
    http://nutritionfacts.org/video/optimal-phytosterol-dose/




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  21. Michael M- You asked about research on the Portfolio diet. THese links should point you toward what you’re looking for:
    https://www.ncbi.nlm.nih.gov/pubmed/26552742 The effect of a dietary portfolio compared to a DASH-type diet on blood pressure.

    https://www.ncbi.nlm.nih.gov/pubmed/26552742 The effect of a dietary portfolio compared to a DASH-type diet on blood pressure.

    http://jamanetwork.com/journals/jama/fullarticle/1104262 Effect of a Dietary Portfolio of Cholesterol-Lowering Foods Given at 2 Levels of Intensity of Dietary Advice on Serum Lipids in HyperlipidemiaA Randomized Controlled Trial




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    1. Is there a vegan portfolio diet I can follow? I am a bit concerns about the recommendation to use enriched margarine products to meet the plant sterols requirement of this diet.
      Also, the daily 40-50g (1/3 cup) of nuts/seeds are significant amount of calories.

      Sent from michael’s mobile




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  22. High dose Niacin will lower your cholesterol. It has to be the flushing kind however, not the sustained release. I take 1000 mg of Niacin as nicotinic acid every day. my cholesterol which was over 200 has now gone down to almost perfect as well as my HDL raised significantly.




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  23. I have Hashimoto’s thrombosis, my antibodies are elevated and I have become hyperthyroid. I have been eating mostly vegan for 8 months but occasionally have cheese when eating out or oil when I can’t control how my food is made. My total cholesterol has not gone down or my weight. My endocrinologist says diet doesn’t make a difference. I would like to see more information on this if available.
    Thank you.




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      1. Hi CrystalM,

        Thank you for your quick reply, I will check out the videos on autoimmune diseases as you suggested.

        Hopefully Dr. Greger will do a video about Hashimoto’s in the future.




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  24. Help!! Hi i am 34 yrs, not overweigth, for the last 4 years i became vegetarian. I eat fruit vegetables nuts and legumes, mostly vegan, just on the weekend when i go out eat wheats, and maybe cheese once a week. My triglycerides are 360; hdl 38; ldl 160; vit b12 315, and D 19. I did not take flax or chia, and eat 2 avocados a week. Avocado have 15 times omega 6 than 3. For sure i lack omega 3, and i searchs studys (not vegans) that says that the 3, vit d, vit 12 and omega 3 suplementation, can improve the lipids. Can it be that the problem? Thanks.




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  25. It’s good you’ve become vegetarian, Guillermo, but you can improve your cholesterol numbers more by becoming vegan, replacing that cheese and avoiding processed foods and oil. ARe you still eating eggs?
    Yes, Vit D, and B12 are important as well as Omega 3s, but you need to consider how you are obtaining that Omega 3 supplementation? If it’s from fish oil, that is a problem. Why don’t you start by reviewing some basic information on cholesterol and triglycerides?
    https://nutritionfacts.org/topics/cholesterol/ and https://nutritionfacts.org/topics/triglycerides/
    You will then see Dr. Greger has many videos that can help you work on those elevated triglycerides.




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    1. No, i didn´t consume eggs. So I start taking 1 tablespons of flax oil, and 1mg of epa+dha per day (fish oil, I live in Argentina, there is no algal or vegan dha oil) for the moment, b12 and D supplements. Do you thinks its ok? Thanks




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  26. Guillermo, I am glad you are not consuming eggs. To lower your cholesterol it would be better to stick with the flax seeds and not the flax seed oil and to minimize any processed foodsr.
    It may take a while to lower that cholesterol so stick as closely as you can to a whole food, plant-based diet with some good cardiovascular exercise, following Dr. Greger’s suggestions for lowered cholesterol and then best of health and improved cholesterol numbers.




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  27. Hello, I just recently started your plant based diet after discovering I have an LPa of 296 with the hopes that this is going to be the right diet that I should be following. I have been supplementing with fish oil and flax seeds to try and help lower. I was not able to tolerate the effects of niacin. I am a female 5.4 165 pounds and trying to lose weight but it seems impossible. I am just looking for any advice as to ways to lower my LPa ? I am also concerned because I developed kidney stones and am not sure of how strict I should be with avoiding oxolates? I do drink 4 mason jars a day of green and herbal teas throughout the day but sometimes I only get 2 or 3 jars in.
    I take methyl protect for mthfr and have one variant for thrombosis and have recently been plagued with a lot of pain due to some reticular and spider veins in my legs . I am considering sclerotherapy but am wondering if this might be a bad idea with my known history? Thank you any help or advice on this subject would be greatly appreciated




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  28. Mgrassel2003,

    Two medical inputs that do show reductions in Lp(a) include niacin and estrogens. You can get a higher niacin input via….the following foods:

    Peanuts 1 cup: 21.9 mg (over 100% DV) Mushrooms 1 cup: 7.6 mg (34% DV)

    Green peas 1 cup: 3 mg (15% DV) Sunflower seeds 1 cup: 3.8 mg (19% DV)

    Avocado 1 whole fruit: 3.5 (17% DV)

    Dr. Alan Kadish moderator for Dr. Greger http://www.Centerofhealth.com




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  29. My husband and I, ages 70and 65, started a low/no fat whole food plant based diet 3 1/2 months ago. I cook almost all meals following guidelines of Dr.s Greger, McDougall, etc. We both had lipid testing done recently and both saw increases in total cholesterol, LDL and triglycerides. The increase in triglycerides was significant for us both. We do not eat a lot of bread products or white rice. We were so perplexed and disappointed at these results and do not know what to do now. Any help would be appreciated.




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  30. Carol, It is frustrating to work hard to bring cholesterol and triglycerides down with a healthy diet and get results that are not what you’d hoped for. Are you still eating oil? That may be a factor and also the fact that you’ve not been on a WFPB diet for that long. Perhaps you’ll get better results at the 6 months mark.
    One of wise commenters had good advice on this topic so I’ll give you Joseph Gonzales RD had some good ideas for you to consider, so I’ll include them below. Don’t get discouraged because you are indeed minimizing your risks even if the blood tests temporarily do not reflect this.

    “For those who have tried eating a whole food plant-based diet and still have high LDL, you should make sure you’re not eating plant sources of saturated fat, such as palm kernal oil, palm oil, coconut oil, and cocoa butter (found in chocolate). Of course if you were you wouldn’t be eating a whole food plant-based diet, but you’d be surprised how many people tell me they are and they’re like “Yeah, and I eat a spoonful of coconut oil a day.” I’d also cut out unfiltered coffee. Then once you have gotten rid of the things that increase your cholesterol you need to pack your diet with foods that actively lower your choleserol. So, for example, the components of the portfolio diet for lowering cholesterol. I’ll highlight some of the diet tips found in Dr. Jenkins protocol using Dr. Greger’s videos as reference.

    1) Load up on foods high in soluble fiber. This means tons of beans (see what kind are best: canned or cooked), vegetables like okra, plenty of whole fruit, oatmeal, and flax/chia seed. Find ways to use beans. Lentil stew, dal, curries, bean burritos, bean soup. If you don’t like beans whole, like in a salad, maybe try them as a spread or as hummus?

    2) Take about 2 Tablespoons of ground flaxseed daily and 4 Brazil nuts monthly. Sprinkling ground flax on oatmeal in the morning is an easy way to get enough. Or add it to a smoothie. If you buy the flax whole just add it in the blender first, grind it, and then add the rest of your ingredients.

    3) Focus on several cups of greens daily to help keep nitric oxide flowing. Vegetables loaded with nitrates have been shown to improve heart health. Beets and arugula have tons! (See video on where other vegetables rank on nitrate levels). Yes, green smoothies count if you’re adding the right foods like berries and dark green leafy vegetables (kale, spinach, even parsley). What’s better? Raw or cooked vegetables? Well, it may depend on what veggies are cooked. Lastly, a word of caution for those going wild on greens is that overdosing on raw greens can happen.

    Dr. Greger says to get thyroid function tested, too. A low-functioning thyroid can contribute to high cholesterol so it’s good to rule that out. Weight loss is also important if there is too much abdominal fat. Is your height more than twice your waist circumference? So there are a lot of factors to consider, but if folks are practicing heathy eating and managing body weight and still find their LDL is not coming down they should definitely consider a statin. As I always say make sure to check with your doctor about all of this. It’s important to be transparent and communicate with everyone.

    Lastly, here are some of the best videos to help understand more about diet and cholesterol. Sometimes folks will ask questions like does cholesterol have a lower limit, or, what about the size of LDL particles does that matter? ​Thankfully Dr. Greger addresses this in his video: Does LDL size matter? and Cholesterol does not appear to have a lower limit. A few concerns with dietary cholesterol is that there’s a plateau effect issue and the postprandial (after eating) issue. These videos explain the issues further: When Low Risk Means High Risk and Eggs and Arterial Function. Find out what’s an Optimal Cholesterol Level to shoot for. “




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    1. Thank you for your reply. The issue is that my husband and I had much better lipid values on a SAD than on a very low fat WFPB diet. My triglycerides went from 133 in March of this year to 192 in early October after 3 1/2 months on a WFPB diet. My husbands triglyceride went from 59 to 262. This goes against everything I have read about the benefits of a WFPB diet and the reason we so drastically changed the way we eat. I have no idea what to do.




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  31. Thanks for your great question. There are plant based food that can raise triglycerides such as processes sugars. You may want to inventory your diet and make sure added sugars and oils are not sneaking in. There are also plant based foods that are known to lower triglycerides. You can try adding more of these foods into your diet. Please see this link:
    https://nutritionfacts.org/topics/triglycerides/

    You may also like this video Dr. Greger has:
    https://nutritionfacts.org/video/metabolic-syndrome-and-plant-based-diets/

    Good luck.
    Kelly
    Moderator.




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  32. I went Vegan for 5/weeks then Vegetarian for 2.5 months. I stopped taking Crestor, but my cholesterol is really high. I do use some oils (Olive and coconut oil) and do use cheese once in awhile. I went vegetarian because I missed cheese. So…for now I will go back on the Crestor, but I am going to request the VAP Test and CRP test. I will reduce the amount of coconut oil and coconut milk, too. I will use the vegetable broth more. Thank you for the info!




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