Go Low
Eating the right foods can help you control your cholesterol

By Lisa Turner

Most of us have heard that too much of certain foods can lead to high blood cholesterol, a significant risk factor for heart disease. As a result, a healthy diet has largely been defined by foods we should avoid. We've learned to forgo cheeseburgers, make omelettes without the yolks, and skip the buttered bagel. But staying away from specific foods isn't the only strategy. Research shows that emphasizing certain foods can have a profoundly positive effect on cholesterol levels, improving your heart health while still satisfying your appetite.

Fat Stats
Cholesterol is a soft, fatlike substance manufactured by the liver and present in foods of animal origin. Although it's vital for hormone production and other biological functions, too much cholesterol contributes to the buildup of plaque in the arteries, greatly increasing heart-attack risk. Cholesterol travels in your bloodstream as part of big molecules called lipoproteins. "Good" cholesterol moves around as part of high-density lipoprotein (HDL), which helps remove cholesterol from arteries and carry it to the liver, where it's reused, converted to bile acids, or excreted. The cholesterol in low-density lipoproteins (LDL)—"bad" cholesterol—oxidizes and deposits in artery walls, contributing to atherosclerosis, or hardening of the arteries.

The foods you choose directly affect your overall cholesterol level and your LDL-HDL ratio. Although high-fat foods have long been on the don't-eat list, even foods that you may perceive as lean can negatively affect your cholesterol. In particular, researchers are becoming increasingly suspicious of excessive carbohydrates; according to a small study presented at the American Heart Association's Scientific Sessions 2002, a low-carb diet has an even more beneficial effect on total and HDL levels than a low-fat diet. "When you eat highly refined carbohydrates, your body converts that extra energy into triglycerides, which are fats," says John McDougall, MD, co-author of The McDougall Program for a Healthy Heart (Plume, 1998). "When you increase the amount of fat in the bloodstream, it also increases cholesterol levels."

Fortunately, researchers laud several common and tasty ingredients for their cumulative beneficial effects on cholesterol levels, although the exact amounts needed to prevent disease remain largely unknown. With these well-known food allies, you can help yourself achieve a healthy cholesterol balance.

Herbal Helpers
Many traditional flavor-boosters contain compounds that help drop total cholesterol levels and may increase HDL levels. Ginger is among the best because it helps reduce total and LDL cholesterol levels while inhibiting LDL oxidation and the development of atherosclerosis (Journal of Ethnopharmacology, 1998, vol. 61, no. 2). Likewise, green tea's powerful compounds help lower total cholesterol while increasing HDL levels and slowing LDL oxidation (Proceedings of the Society for Experimental Biology and Medicine, 1999, vol. 220, no. 4). And garlic, a famously heart-friendly food, contains saponins and other cholesterol-lowering compounds; in some studies, garlic extracts have lowered total cholesterol by 7 percent and LDL levels by 10 percent (Journal of Nutrition, 2001, vol. 131, no. 3 Suppl). Integrating these herbs into your daily meals is easy. Spread bread with baked garlic cloves instead of butter; substitute green tea for your morning coffee; toss freshly grated ginger with steamed veggies.

Legumes And Nuts
Beans and other legumes are nutritional powerhouses high in soluble fiber that can cut cholesterol levels by up to 19 percent and reduce LDL by 24 percent. In one study, beans raised HDL and improved the LDL-HDL ratio even when dietary fat content remained unchanged (European Journal of Clinical Nutrition, 1992, vol. 46, no. 9). Nuts, rich in heart-healthy fats, also show promise; for example, walnuts may decrease total cholesterol by 12 percent and LDL by 16 percent and can lower the LDL-HDL ratio (New England Journal of Medicine, 1993, vol. 328, no. 9). In another study, people who ate almonds and almond oil showed a 6 percent decrease in LDL and a 6 percent increase in HDL (Journal of Nutrition, 2002, vol. 132, no. 4).

Other good-for-your-heart nuts include pecans and pistachios. But be careful—because of their high fat content, make sure you're substituting nuts for unhealthy fats. Add legumes and nuts to your diet by sprinkling slivered almonds and diced apples on salads, adding cooked lentils or garbanzos to soups, and garnishing steamed broccoli with crushed pecans.

Grains And Fruits
Fiber, abundant in grains and fruits, is an excellent cholesterol-lowering ally. In particular, barley is rich in beta-glucan, a soluble fiber that escorts cholesterol out of the body (Diabetes Care, 1997, vol. 20, no. 11). Oats, also high in beta-glucan, lower total cholesterol and promote excretion of cholesterol-rich bile acids (American Journal of Clinical Nutrition, 1995, vol. 62, no. 6). Whole, fibrous fruits such as apples contain pectin, a type of fiber that reduces blood fats. In one study, apples decreased overall cholesterol and LDL by 40 percent to 70 percent (Nahrung, 1990, vol. 34, no. 9). Enjoy these important low-cholesterol foods by tossing barley into hearty stews, adding a handful of oat bran to baked goods, or baking a treat of cored apples with walnuts and cinnamon.

Super Soy
Recent research has uncovered yet another benefit of soy. Soy helps reduce LDL by about 10 percent, lowers overall cholesterol levels, and increases HDL, and may inhibit atherosclerosis (Journal of Nutrition, 2002, vol. 132, no. 3). Many soy advocates recommend at least 10 grams of soy protein daily (a large glass of soy milk or a handful of roasted soy nuts should do it). Purée soy milk, berries, and bananas for a creamy smoothie; whip silken tofu with garlic, fresh herbs, and lemon juice for a creamy salad dressing; add cubes of cooked tempeh to brown rice.

Mix And Match
As you integrate these healthy cholesterol-lowering foods into your diet, don't try to consume heroic quantities of any one of them. "A mixture is better," says Neal Barnard, MD, president of the Physicians Committee for Responsible Medicine and author of Eat Right, Live Longer (Crown, 1997). "With a bowl of oatmeal for breakfast, a bean burrito for lunch, and stir-fried vegetables with tofu, ginger, and garlic for dinner, you'll cover all your bases."

Chef and writer Lisa Turner is the author of five books on health and nutrition, including Food Smart (Biomed, 2000).