How Popular Diets Stack Up When It Comes to Lowering Cholesterol

Find Out How 5 Popular Diets Compare for Heart Health

If you are trying to lower cholesterol naturally, you might want to consider some of the popular diets that are available. Popular diet plans tend to focus on pound-shedding prowess. But these diets can also have an impact on total cholesterol and the "bad" cholesterol (LDL), according to Bonnie Liebman, director of nutrition at the Washington-based Center for Science in the Public Interest, an independent science-based watchdog organization.

When asked to rate the cholesterol-lowering potential of various plans, Liebman says that as long as they're followed carefully, the Mediterranean, South Beach and TLC diets would probably do the best job. She says the South Beach diet may make "the most sense" because it's relatively easy to follow. (One big problem with any diet is being able to stick with it.)

Here's a quick review of several popular plans and their likely impact on cholesterol levels.

1
Diet: Very low fat (including Ornish and Pritikin)

Oats are part of the Pritikin diet.
Oats are part of the Pritikin diet.. Credit: Westend61/Getty Images

What it entails: Very low-fat diet plans are (you got it) very low in total fat and sodium and rich in whole-grain carbohydrates, fruits, vegetables and legumes.

The Ornish diet allows unlimited amounts of fruit, grains and vegetables, and moderate amounts of nonfat dairy products. Meats of all kinds, oils, nuts and sugar are prohibited.

The Pritikin diet plan includes lots of complex carbohydrates (oats, brown rice), starchy vegetables (potatoes, yams) and limited refined grains (pasta, white bread). This plan also emphasizes raw and cooked vegetables and calcium-rich foods (nonfat milk or yogurt), but permits no more than one serving of meat or fish daily.

Nutritionist's take: These regimens are low in saturated fat, which is good for cholesterol levels. But their low-protein content is problematic, because the dieter must consume more carbohydrates to compensate. This can lead to a rise in triglycerides, a type of cholesterol that binds to protein in the blood to form LDL.

"There seems to be a problem with carbs and triglycerides," says Liebman, noting that "there's no simple explanation why. Even the American Heart Association [has] urged people not to follow a low-fat diet for [too] long for that reason."

2
Diet: Vegetarian

Vegans eat peas.
Vegans eat peas.. Credit: Martin Barraud/Getty Images

What it entails: Vegetarianism can cause confusion because of its distinctions. A vegan or total vegetarian eats only plant-derived foods, such as vegetables, grains or legumes (dried beans and peas). A lacto-vegetarian also eats cheese and other dairy, and an ovo-vegetarian adds eggs to the mix. A semi-vegetarian doesn't eat red meat, but consumes fish and chicken along with plant foods, dairy products and eggs.

Nutritionist's take: "I don't think I can say how this affects cholesterol," says Liebman, "because it depends on what's in someone's diet. If it's loaded with eggs, cheese and milk, it won't lower cholesterol at all.

"If they choose low-fat versions of these foods, they will experience a drop in LDL levels ["bad cholesterol"], but [it] may raise their triglycerides," she adds. "Most vegetarians do eat a healthy diet with fruits, vegetables, whole grains and beans, but there's no guarantee."

3
Diet: Mediterranean

Olive oil is part of the Mediterranean diet.
Olive oil is part of the Mediterranean diet.. Credit: Maximilian Stock Ltd./Getty Images

What it entails: Named for the traditional diet of countries bordering the Mediterranean Sea, this plan includes lots of fruits and vegetables and healthy unsaturated fats, such as olive oil. This diet also features small portions of nuts and regular servings of oily fish, such as tuna, salmon and mackerel. Red meat and other sources of saturated fat, such as butter are avoided.

Nutritionist's take: "This is good for cholesterol," Liebman says, "as long as people don't think that what they eat in their favorite Italian restaurant is the classic Mediterranean diet." Fatty fish, olive oil and canola oil are all rich in omega-3 fatty acids, which can help lower "bad cholesterol," but Liebman cautions against overdoing even healthy fats because fat is dense in calories.

4
Diet: Carb-Cutting (including Carb-Buster, Atkins, South Beach and Zone)

Low-carb diets include a lot of protein.
Low-carb diets include a lot of protein.. Credit: Andrew Unangst/Getty Images

What it entails: Low-carb diets are controversial because they center on consuming lots of protein, including red meats, which are high in saturated fat and can raise cholesterol levels.

The first two regimens (Carb-Buster and Atkins) avoid carbohydrates in any form, either simple (processed breads, white rice, cake, cookies) or complex (grains, some fruit and vegetables) carbs. The South Beach and Zone diets emphasize protein, but tolerate small amounts of complex carbs.

Nutritionist's take: "As long as you're losing weight, even a diet high in saturated fat probably won't raise your cholesterol," says Liebman. "But the diet that seems to make the most sense is South Beach, which has the advantage of allowing low carbs without raising cholesterol. Replacing carbs with unsaturated fat and protein may be the best plan to prevent heart disease."

5
Diet: Dietary-Guideline Based (including MyPlate and TLC)

The USDA MyPlate guidelines.
The USDA MyPlate guidelines.. Credit: LPETTET/Getty Images

What it entails: MyPlate is the USDA's replacement to MyPyramid. It urges people to make half their plate fruits and vegetables, a little less than a quarter of the plate protein and a little more than a quarter of the plate whole grains. By encouraging fruits, vegetables and whole grains, the diet could be high in cholesterol-lowering fiber. Since it also recommends choosing leaner cuts of meat, as well as fish twice weekly, the plan steers people to lower-saturated fat choices.

The Therapeutic Lifestyle Changes (TLC) diet is recommended by the National Cholesterol Education Program to specifically help lower cholesterol for those who have a cardiovascular disease or associated significant risk factors including high cholesterol levels. The TLC diet promotes up to 5 ounces per day of lean meat, poultry or fish, and plenty of fruits, vegetables, grains and low-fat dairy products, while limiting cholesterol intake to less than 200 mg per day (for example, one egg yolk has about 213 mg).

Nutritionist's take: "TLC is a little more precise. It lowers saturated fats and trans fats," which would both fuel a rise in cholesterol levels.

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