Diet and Cholesterol


When after a check you discover that you have too high a level of cholesterol in the blood, one of the first concerns is to adjust your diet to bring these values ​​back to normal.

La high cholesterol diet is a diet aimed at normalizing the cholesterol (blood cholesterol value).

What are Cholesterol and Hypercholesterolemia?

Il cholesterol is a sterol (a type of lipid), with very important functions for the body.


  • If in excess (total cholesterol)
  • and / or if broken down badly, with excessive prevalence of LDL lipoproteins (bad cholesterol)

can increase cardiovascular risk (atherosclerosis).

Ultimately, hypercholesterolemia means an excess of total and / or LDL cholesterol.

What are the Symptoms of High Cholesterol?

Hypercholesterolemia is generally asymptomatic.

Only in severe congenital forms (which are not of interest to this article) can evident clinical signs be noted, called xantomi.

Other related symptoms concern the vascular diseases.

What are the Causes of High Cholesterol?

  • Genetic and hereditary predisposition;
  • Other primary diseases (for example, hormonal);
  • Incorrect diet (see below);
  • Sedentary lifestyle.


How much does the Diet affect Cholesterolemia?

Blood cholesterol values ​​are affected only 10-20% from food.

In fact, our body has an effective hepatic cholesterol synthesis mechanism, which allows it to cope with metabolic needs without relying too much on the amount taken with the diet.

For this reason, very often one healthy and balanced diet it proves insufficient to bring cholesterol levels back to the desired values.

La food therapy against hypercholesterolemia can guarantee a reduction in total plasma cholesterol in the order of 10-15% (average value).

On the other hand, we must not forget that, in addition to the overall amount of cholesterol, what increases the atherogenic effect is its excessive breakdown in LDL lipoproteins to the detriment of the HDL share (increase in bad cholesterol at the expense of good cholesterol).

Role of the diet in the treatment of hypercholesterolemia

Despite the often limited effectiveness, thedietary intervention and motor therapy they must always be adopted as first measure to lower blood cholesterol levels.

Only if diet and positive lifestyle changes are unsuccessful, the medical health insurance will eventually prescribe medicines specific to lower cholesterol.

Even for those who follow drug therapy, a correct diet is still essential to minimize the dose of drugs required and the consequent risk of side effects.

NB In some very serious (fortunately very rare) congenital forms, drug therapy is started at the time of diagnosis and lifestyle plays a complementary role.

Which cholesterol to lower?

When it comes to a cholesterol diet, it is important to first understand what the real goals of such a dietary strategy are.

In this regard, remember that cholesterol is a very important fat for the body and precisely by virtue of its leading metabolic role it would be impossible to do without it.

To distribute to various tissues, cholesterol, as well as many other fats, circulates in the blood bound to different transporters with different characteristics, called lipoproteins.

The most important lipoproteins for cholesterol metabolism and atherosclerotic risk are:

  • LDL ("low density lipoproteins"): also known as bad cholesterol, are responsible for bringing cholesterol to the peripheral tissues.
  • HDL (from the English "high density lipoproteins", high density lipoproteins): they are called good cholesterol and are responsible for the reverse transport of cholesterol to the liver.

LDL lipoproteins have a strong atherogenic power, because they tend to deposit cholesterol on the internal walls of the arteries, forming plaques in the long run that hinder blood flow to a greater or lesser extent.

The negative effect of LDL is counterbalanced by HDL which, in the role of "real scavengers", clean up the arteries preventing these deposits from forming.

Ultimately, the cholesterol diet is not simply aimed at reducing total cholesterol but also at improving the ratio of good HDL cholesterol to bad LDL cholesterol.

Fundamental principles

As an indication, the basic principles of a diet to combat high cholesterol I'm:

  • Low content of saturated fats, hydrogenated and in trans conformation (which must provide no more than 7% of daily calories);
  • Low cholesterol content (<200 mg / day);
  • High nutrient content with a positive effect on cholesterol:
    • Beneficial fatty acids:
      • Essential and semi-essential polyunsaturates;
        • Omega 6;
        • Omega 3 (have no significant effect on cholesterol, but lower cardiovascular risk);
    • Monounsaturated omega 9 (oleic acid);
    • Phytosterols and lecithins;
    • Antioxidants.

Medicines and supplements

The most frequently used drugs against hypercholesterolemia are statins.

Among the supplements, however, there are many products with different efficacy:

  • Vegetable lecithins;
  • Essential fatty acids;
  • Phytosterols;
  • Antioxidants: vitamins, polyphenols and minerals;
  • Phytocomplexes, generally composed of more molecules than those mentioned (phytosterols, vitamins, etc.).

What to eat

Recommended foods and cooking methods


Meat, Fish and Eggs

Lean meats (chicken, rabbit, pork loin, etc.). Lean or oily fish from cold seas or blue fish. A maximum of 3 eggs per week. The consumption of egg whites is free.

Milk and derivatives

Low-fat or semi-skimmed milk and yogurt. Light cheeses and ricotta.

Cereals and derivatives, tubers

Better wholemeal, used in recipes containing the foods listed in this table.


All, better fresh or dried and found.

Fats and oils for seasoning

For cooking, extra virgin olive oil; for frying (see below), you can also use peanut oil. For the raw dressing it is recommended to use, at least in part, seed oils rich in omega 6 and omega 3 (flax, kiwi, grape seed, walnut, chia, etc.).

Vegetables and Fruits Sources of Vitamin A and Vitamin C

All. At least 50% of the total raw consumption.


They are aimed at preserving the nutritional value of foods, in particular the potentially thermolabile molecules that can promote the metabolism of cholesterol (essential fatty acids, vitamins, etc.).

Recommended cooking methods include:

  • None, especially for fruit and vegetables; it may be useful to consume a few portions of raw fish (obviously previously chilled);
  • Boiling or poaching;
  • Steam powered;
  • Vasocottura;
  • Vacuum packed;
  • In a pan, without exceeding the flame;
  • In the oven, without exceeding the heat;
  • Occasionally, grilled without producing combustion residues.

Foods and cooking methods not recommended


Meat, Fish and Eggs

Fatty meats (belly, ribs, etc.). Chicken with skin. Fatty fish low in omega 3. Bivalve molluscs (mussels) and crustaceans (shrimps, crabs, etc.) can be consumed occasionally. More than 3 eggs per week. Yolks.

Milk and derivatives

Full-fat milk and yogurt. Whole milk cheeses and ricotta, especially seasoned.

Cereals and derivatives, tubers

Refined, used in recipes containing the foods listed in this table.



Fats and oils for seasoning

Butter, margarine, oils used several times, lard, tropical oils rich in saturated fats (such as palm kernel).

Vegetables and Fruits Sources of Vitamin A and Vitamin C

Those processed, for example candied fruit, jams, syrups, etc.


  • Frying;
  • Stewing;
  • Brazing;
  • In a pan, with excessive flame;
  • In the oven, with excessive heat;
  • Grilled producing combustion residues.
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Importance of the Lifestyle

The general lifestyle can positively or negatively affect blood cholesterol levels.

An extremely effective weapon is born from the modification of all the factors that make up the general lifestyle (diet, motor activity, use and abuse of harmful substances, etc.), which each of us can use to defend against hypercholesterolemia.

We have already spoken extensively about the diet; let's see the others in more detail.


Abolish smoking, since the toxic compounds that develop during combustion are able, by themselves, to lower the levels of good cholesterol (HDL).


Physical activity, regardless of diet, is able to increase the fraction of good cholesterol without significantly affecting the levels of the bad one.

It follows that total cholesterol tends to increase overall; However, this situation shouldn't frighten too much, given that - as we have seen - the real risk factor is the ratio of total cholesterol to good cholesterol (HDL).

The Total Cholesterol / HDL ratio must be less than five in men and four and a half in women (for example: if a person's total cholesterol is 250 mg / dl and HDL is 60 mg / dl, the index risk is equal to 4,16; it is therefore an optimal condition, while, according to the old reference tables, the patient would be placed in a medium risk range).

In the next article we will examine in more depth the combination of diet and cholesterol.

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