Best diet to lower your cholesterol

By Deborah Kotz, Globe Staff

For decades, those with high cholesterol have been given a list of don’ts when it comes to their diet: Don’t eat cholesterol-rich eggs; don’t eat butter; don’t eat red meat or regular ice cream. Well, now researchers have identified a list of dos for the diet that may work to lower cholesterol levels better than avoiding those don’ts.

In a study published yesterday in the Journal of the American Medical Association, researchers found that eating cholesterol-lowering foods like nuts, soy protein, and certain fiber-rich items result in bigger drops in “bad” LDL cholesterol than avoiding high-fat meat, eggs, and dairy foods.

“Doctors tend to focus on telling patients what to avoid instead of what to add,” said study co-author Cyril Kendall, a research scientist at the University of Toronto.

In the study involving 345 participants, one group was randomly assigned to get dietary advice on cholesterol-lowering foods such as oats, barley, soy milk, tofu, nuts, and legumes; they were also instructed to eat margarine enriched with plant sterols, which are plant chemicals that have been shown to reduce cholesterol. People in a control group were told to reduce their fat intake by eating low-fat dairy products, whole-grain cereals, and fruits and vegetables, advice endorsed by the American Heart Association.

The first group had nearly a 14 percent drop in LDL cholesterol -- the average level dropped from 171 milligrams/deciliter to 145 mg/dL -- while the control group had only a 3 percent decline, a drop from 171 to 163. (A level above 160 mg/dL is considered high.) The study didn’t address whether health outcomes, like heart attack prevention, would be affected by this level of decline.

Here’s the diet that brought the biggest drop in cholesterol levels. (The researchers didn’t test to see whether supplements worked, so stick with whole foods.)

-- Soy products. Eat four servings a day; each serving is equivalent to 4 ounces of firm tofu, 1 cup of soy milk, 1/2 cup of soybeans, 3/4 cup of soy yogurt, or 1/3 cup roasted soy nuts.

-- Nuts. Eat about 1.5 ounces per day of any kind of nuts, including almonds, peanuts, and cashews.

-- Foods fortified with plant sterols. Eat four servings a day of products fortified with plant sterols, including an 8-ounce glass of orange juice, cup of yogurt, and tablespoon of margarine. The US Food and Drug Administration allows such fortified foods to be labeled “cholesterol-lowering”.

-- Fiber-rich foods. Eat four to five 4-ounce servings a day of foods rich in viscous fiber, a kind of sticky fiber found in beans, legumes, oats, barley, and cereals that contain psyllium. Wheat bran and produce rich in insoluble fiber -- for all their nutritional benefits -- don’t contain much viscous fiber.