Even though it’s 2019, I’m finding more and more that cholesterol is still widely misunderstood as an “evil” lab value leading you to adopt a low or fat-free tasteless diet and/or place you within the population of folks taking cholesterol lowering medication (which has serious side effects!)

After all – haven’t we been conditioned to believe that all cholesterol is bad and high cholesterol leads to hardening of the arteries, heart disease and heart attacks? Twenty years ago, I would have agreed.

But years of reading peer reviewed literature has confirmed my belief that cholesterol isn’t so much the problem that needs addressing. How do we explain this? Ask anyone who avoids foods that contain cholesterol (like eggs and cheese). They all have the same complaint: “I cut out all of the foods my doctor told me are high in cholesterol for months and when he re-tested my labs – I still have high cholesterol.” What gives?

What Causes High Cholesterol

To understand the causes of high cholesterol, let’s discuss the misconceptions first. We’ve been led to believe for so long that dietary cholesterol places you at risk for heart disease (or other cardiovascular event such as atherosclerosis) which is why everyone stopped eating egg yolks in the 80’s and 90’s (remember that?)

But we now know that several factors such as inactivity, diabetes, stress and hypothryroidism all impact cholesterol levels, with a “poor diet” making the top of the list. When we talk about a poor diet, we are referring to the Standard American Diet which is highly inflammatory, elevates bad cholesterol (LDLs) and lowers good cholesterol (HDLs).

How Inflammation Causes Cholesterol to Rise

When high levels of cholesterol occur in the bloodstream, excess bad cholesterol begins to seep into the inner wall of the artery. (1) But, cholesterol itself wouldn’t be as scary of lab value without inflammation at play. If you have been following me for any amount of time you know I firmly believe that inflammation is the root cause of most disease and heart disease is no exception. It’s the intense inflammation that excess bad cholesterol creates which leads to plaque, rupture, and clots and unfortunately strokes and heart attacks. (2).

Eggs and Heart Disease

For decades we believed that a high-fat, high cholesterol diet equals high “blood” cholesterol levels. Thankfully through extensive research, we now know there is no evidence that supports the role of dietary cholesterol in the development of heart disease and that eating eggs is actually recommended as part of a balanced diet. (3) Granted there are some folks that simply have an increased risk for heart disease (diabetics, etc.) and will obviously consume less dietary cholesterol as a precaution, but for everyone else, eating plenty of foods containing healthy fats (like eggs!) will increase HDLs (good cholesterol).

The True Problem: Trans-fat

Finally, maintaining healthy blood cholesterol requires avoiding trans-fats. Processed, convenience, packaged and fast foods are notorious for containing trans-fats like genetically modified (GMO) cooking oil known as “hydrogenated oil.” Trans-fats are proven to cause high blood cholesterol by increasing LDLs (bad cholesterol) and creating plaque (atherosclerosis). (4)

Foods to Avoid for High Cholesterol

By now you are probably gaining a sense that there are foods we can eat which will either raise or lower bad cholesterol (LDLs). The key to keeping bad cholesterol (LDLs) low is to avoid the following foods which are highly inflammatory:

Conventional meat and dairy products
Processed, packaged, convenience foods
Trans-fats (partially hydrogenated cooking oils)
Sugar
Over-consumption of caffeine or alcohol

Unfortunately, when we are not purchasing grass-fed meats and dairy products and consuming conventional versions, these products are not only higher in cholesterol but are also highly inflammatory due to the presence of antibiotics and growth hormones. We know processed, packaged and convenience foods contain trans-fats but they also contain a ton of inflammatory, genetically modified ingredients. Sugar, caffeine and alcohol are all stimulants which will send a message to your liver to make more cholesterol thereby increasing inflammation, so it’s a great idea to exercise moderation when eating those foods.

Top 5 Foods to Lower Cholesterol

There are five foods I return to again and again for their cholesterol lowering benefits:

1. Dark Green Leafy Vegetables

Kale, spinach and broccoli are loaded with phytonutrients which will not only clean your blood, but keep your arteries healthy by not allowing cholesterol to build up. They are also loaded with trace minerals which maintain proper pH thereby managing inflammation (can I get a kale yeah!)

2. Seeds

Chia seeds, flax seeds and even pumpkin seeds are loaded with soluble fiber which will trap excess fat and cholesterol in the digestive tract. This assists our natural detoxification process by eliminating those bad fats and cholesterol from the body (seeds for the detox win!)

3. Nuts

Pretty much all nuts are a great source of healthy fat and fiber. Almonds, in particular contain antioxidant flavanoids which regulate the enzymes responsible for making bad cholesterol (LDLs) in your body; all while maintaining artery health and reducing inflammation. (5)

4. Avocado

This fruit is quite possibly the best known source of fiber and good fat, specifically, monounsaturated fat. Avocados are proven to raise good cholesterol (HDLs) and lower bad cholesterol (LDLs) all while maintaining healthy blood sugar levels (bonus!)

5. Garlic

Through research, garlic has proven itself to be an immune-boosting, antiviral, antioxidant and anti-inflammatory powerhouse. Not only are we seeing garlic being used as a significant component in treating high cholesterol, but also as a major preventative of heart disease and other metabolic syndromes like atherosclerosis and hypertension. (6)

Lowering Cholesterol with Functional Medicine

If you’ve already made significant dietary changes and are still not getting the results you want (i.e., lower cholesterol) then perhaps its time to see what functional medicine can do for you. In my practice, I’ve found that patients who have an additional underlying health challenge like heavy metal or mold toxicity, a gut infection or even an adrenal issue, are frustrated because they are not getting the results they want but are also unaware that other health challenges exist. Unfortunately, due to the conventional medical model, most patients come to me already on cholesterol lowering medication which doesn’t always work and leaves them with more problems then where they started, due to a myriad of side effects. A functional medicine practitioner like myself will perform a thorough analysis of your case history and order specific functional lab tests to identify any health challenges that are preventing you from experiencing lower cholesterol and/or a greater level of health.