The cardiologist talked about a way to lower cholesterol through nutrition

Dietary changes help to reduce the level of "bad" cholesterol: first of all, the replacement of saturated fats, as well as foods with soluble fiber and plant sterols. However, even a noticeable improvement in the indicators does not mean that the patient can refuse the prescribed drugs. How such a diet works and in which cases dietary changes alone are not enough — in the "Izvestia" material.

Why High Cholesterol is Easy to Skip

High cholesterol usually does not cause noticeable symptoms. A person can feel well and find out about the changes only after a blood test. However, it is not enough to see one indicator of "total cholesterol" to assess the risk: it is important for the doctor to understand how much of it is LDL (low-density lipoproteins), as well as to take into account other diseases and risk factors.

Cholesterol itself is necessary for the body. It is part of the cell membranes and participates in the formation of a number of hormones, vitamin D and bile acids. Problems arise when an excess of particles carrying cholesterol to tissues, primarily LDL, persists in the blood for a long time. They contribute to the formation of atherosclerotic plaques in the walls of the arteries. If the plaque is damaged and a blood clot forms on its surface, blood flow may be blocked.

Therefore, food advice alone does not answer the main question for the patient: how high is his cardiovascular risk and what LDL reduction he needs to achieve.

What gives the greatest effect in nutrition

According to Patel, dietary changes are one of the most effective ways available to humans to influence cholesterol levels. Among the food components, he highlighted plant sterols and stanols. These substances are similar in structure to cholesterol and prevent some of the cholesterol from being absorbed in the intestine. They are found in plant foods, but in normal portions they are usually too few to significantly reduce LDL. Studies have more often examined special products with their additives, such as yogurts, drinks, and spreads.

With a daily intake of 1.5–3 g of sterols or stanols, the LDL reduction in the studies was approximately 7-12%, depending on the dose. These are the average results for the conditions studied, not the promise of the same effect to every person. The content of substances should be checked on the package: plain yogurt or vegetable oil cannot be considered the equivalent of an enriched product.

There is also a significant limitation. For sterols and stanols, a decrease in LDL has been well shown, but there are no direct studies that would convincingly demonstrate a decrease in the number of heart attacks and strokes due to such products. HEART UK considers them as an addition to the diet and, if necessary, to prescribed medications. Fortified foods are intended for people with high cholesterol; during pregnancy, breastfeeding and for young children, their use requires a separate evaluation by a specialist.

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Why does a cardiologist recommend oatmeal

A more familiar product that Patel draws attention to is oats. It contains beta-glucan, a type of soluble fiber. It helps to reduce the absorption of cholesterol in the intestine, including cholesterol that enters there with bile. Beta-glucan is also found in barley, so we are not talking about the need to eat oatmeal porridge for every breakfast.

According to the review, the studied daily dose is 3 g of beta-glucan from oats and barley. It is associated with a decrease in LDL by about 4-6%. It's easy to make mistakes when reading the label: three grams of dietary fiber in general and three grams of beta-glucan are different indicators. You can achieve the studied dose with several servings of oats or barley during the day.

Other sources of fiber also deserve a place in the diet: beans, lentils, vegetables, fruits and whole grains allow you to diversify your diet and can help control lipids. Scientists also identify nuts and soy products. Their expected effect on LDL is individually more modest than that of sterol-fortified foods, but dietary changes can complement each other. It is reasonable to add these products within the framework of the general diet, and not on top of the previous menu without taking into account its composition.

Which products should be replaced?

Equally important is the question of what exactly the new product will replace. It is difficult to noticeably change the diet for one serving of oatmeal if it is still based on foods with a lot of saturated fats. Their sources can be fatty meat, some meat products, butter, pastries, and coconut oil. Excess saturated fat contributes to an increase in LDL.

The practical principle is to choose unsaturated fat sources more often instead of saturated ones: for example, vegetable oil instead of butter when cooking, and legumes, fish or other suitable products instead of fatty meat dishes. The American Heart Association's 2026 recommendations consider such a substitute as an element of a healthy diet along with vegetables, fruits, and whole grains. She also advises limiting added sugar and choosing foods with minimal processing.

This also explains the change in attitude towards eggs. The yolk contains cholesterol, but the amount of cholesterol in food is not equal to its level in the blood.

According to the American Heart Association, for most people, the overall nutritional picture, including the ratio of saturated and unsaturated fats, is more important than trying to eliminate every product containing cholesterol.

As a result, the cardiologist's advice is not to ban eggs or switch to one "healthy" dish, but to steadily change the usual menu. In his commentary, he recommends a varied diet without excess saturated fats and with fewer highly processed foods. Certain foods with proven effects on LDL can enhance the result of this approach.

When food alone is not enough

The heading "lowering cholesterol without statins" requires an important caveat: it is sometimes possible to reduce the indicator without medication, but this does not mean that a particular person does not need medication. The decision depends on the level of LDL, previous cardiovascular events, concomitant diseases, heredity, and overall risk. The European guidelines determine the necessary intensity of LDL reduction, taking into account the risk category; after acute coronary syndrome, they provide for early intensive treatment.

People with very high LDL, possible hereditary hypercholesterolemia, or already established heart and vascular disease require special attention. The American recommendations of 2026 provide for early consideration of drug therapy with a pronounced increase in LDL and hereditary forms of lipid metabolism disorders. If statins are not suitable or their effect is insufficient, the doctor may consider other drugs — the choice is not limited to the opposition of "statins or diet".

Therefore, the first practical step is to find out your blood test results and discuss them with your doctor. Dietary changes, physical activity, and smoking cessation are useful for reducing cardiovascular risk, but the result should be evaluated by repeated tests and taking into account the initial state of health. If the drug has already been prescribed, you should not cancel it yourself after switching to a new menu.