Dietitian

The American diet puts us at risk for heart disease and a host of other ailments because it is high in saturated fat and low in fiber — the perfect combo for creating high cholesterol. The ideal diet for lowering cholesterol is a vegan diet, because cholesterol is found only in animal products, such as meat, dairy, and eggs. Cholesterol is even found in the leanest meats. For example, although crustaceans like shrimp don't have much fat at all, they still have twice the cholesterol of beef or chicken.

But plant foods — including fruits, vegetables, beans, and grains — don't contain any cholesterol. Rather, they have fiber, which can help pull cholesterol out of your body. After the liver converts cholesterol into bile, it gets sent into the intestine where fiber bonds to the bile, and the body excretes both through the stool. If there is insufficient fiber in the diet, however, bile acids are broken back down into cholesterol and reabsorbed into the blood.

Soluble fiber also helps slow the absorption of cholesterol and reduce the amount of cholesterol the liver makes. Oats, barley, and beans are good sources.
-Susan Levin, RD; Physicians Committee for Responsible Medicine, Washington, D.C.

Cardiologist

About 90 percent of the intervention for high cholesterol relates to diet. First, eat less food and fewer calories. Second, change the source of those calories. I suggest what I call a paleolithic diet, which basically includes unprocessed foods such as fish, poultry, nuts, legumes, fruits, vegetables, and a little bit of low-fat or nonfat dairy.

You shouldn't eat red meat more than once a week because it has a lot of saturated fat, and you should avoid saturated and trans fats. Choose healthy oils like safflower, sunflower, canola, or olive oil. I also suggest people eat two eggs daily. Egg whites are the best source of protein available, and the yolks have essential fats and carbohydrates. (Contrary to what research indicated in the past, researchers now believe that moderate egg consumption does not contribute to high LDL [bad] cholesterol.)

The government cholesterol guidelines suggest you should get your LDL cholesterol below 100, but most cardiologists advise their patients to aim for under 70. We also try to get HDL (good) cholesterol over 50. You don't want to be better than average — you want to be superior, because that's the only real way to have an impact in preventing heart disease.
-Joseph Lee Klapper, MD; author of The Complete Idiot's Guide to Lowering your Cholesterol (Alpha, 2006), Laguna Hills, California

Naturopathic doctor

To treat high cholesterol, reduce or eliminate simple sugars from your diet and increase fiber consumption. The Dietary Reference Intake for fiber is 25 grams a day, but most Americans only get about 5 grams a day. Eat more beans and whole grains, such as whole wheat, oats, amaranth, quinoa, and millet. Fiber supplements can benefit people who don't like high-fiber foods.

I'm also very big on supplementing with red yeast rice. It contains 11 naturally occurring statins, which block specific enzymes involved in cholesterol production. Taking 600 mg twice a day is equivalent to taking 5 mg of a prescription statin drug — but without side effects like joint and muscle pain, and liver problems.

Depending on how high your cholesterol levels are, you can incorporate about a clove of garlic a day into your diet. Also, eat more soy milk, tofu, or whole soybeans; about 25 grams of soy protein per day can help lower cholesterol.

Finally, exercise four times a week, working at your target heart rate for at least 30 minutes. The frequency of the exercise seems to have a great impact.
-Darin Ingels, ND; New England Family Health Associates, Southport, Connecticut

Read more about cholesterol in our Health Conditions/Cholesterol archive