While cholesterol is essential for our bodies to function, keeping it within healthy ranges is vital for avoiding cardiovascular disease. A healthy plant-based diet is an excellent way to manage cholesterol and promote longevity.
This article examines cholesterol, explaining what it is and what experts determine as healthy ranges. It discusses saturated fats and how to manage your cholesterol with diet and lifestyle.
What is cholesterol?
Cholesterol is a waxy substance made in the body and consumed through dietary fats. Cholesterol is essential for human life, playing an important role in many body functions, such as the digestion and absorption of fat-soluble vitamins, the synthesis of hormones, and the structure of cell membranes.
However, cholesterol must be kept within specific healthy ranges to avoid adverse effects such as cardiovascular disease. Doctors may advise dietary and lifestyle changes or statins for people whose cholesterol profile is suboptimal or a risk to their health.
Fats circulate through the blood as lipoproteins consisting of cholesterol, triglycerides, phospholipids, and protein. The lipoproteins transport cholesterol and fats to the cells that need them.
There are several different types of lipoproteins that have different purposes. Doctors look at the levels of these to assess someone’s cholesterol profile.
High-density lipoproteins (HDL) take excess cholesterol to the liver to be excreted from the body. This type of cholesterol is known as “good cholesterol”.
There are several types of non-HDL cholesterol, known as “bad cholesterol”.
- low-density lipoproteins (LDL) —a major transporter of cholesterol throughout the body
- intermediate-density lipoproteins (IDL)
- very-low-density lipoproteins (VLDL)
These potentially harmful lipoproteins may cause a build-up of cholesterol in the blood vessels, narrowing them and becoming a risk for stroke and heart attacks.
What are triglycerides?
Doctors sometimes also look at triglyceride levels to assess a person’s risk of cardiovascular disease. Triglycerides are fats that can contribute to narrowed arteries.
Having excess weight, drinking too much alcohol, and eating a diet rich in fat and sugary foods can cause high triglyceride levels.
What are healthy cholesterol ranges?
A doctor can test your cholesterol levels with a simple blood test, and some pharmacies offer finger prick tests too. The tests measure total, HDL, and non-HDL cholesterol and triglyceride levels. The numbers will appear in either millimoles per litre (mmol/l) or milligrams per deciliter (mg/dL). There may also be a measure of the ratio of total cholesterol to HDL.
Heart UK outlines the ideal cholesterol and triglyceride levels for healthy adults in the UK. However, they note that if someone has a condition such as diabetes or heart disease, their target levels may be lower. A person should speak to their doctor to interpret their results.
|Total (serum) cholesterol||below 5.0||below 193|
|Non-HDL cholesterol||below 4.0||below 155|
|LDL cholesterol||below 3.0||below 116|
|HDL cholesterol||ideally around 1.4 ( above 1.2 for women and above 1.0 for men)||above 46 for women and above 39 for men|
|TC: HDL ratio||above 6 is high risk, the lower the figure the better||above 6 is high risk, the lower the figure the better|
|Triglycerides||fasting below 1.7 and non-fasting below 2.3||fasting below 150 and non-fasting below 204|
Familial hypercholesterolaemia (FH) is an inherited condition caused by a genetic mutation. FH makes it more difficult for the liver to remove excess LDL cholesterol, meaning that unhealthy levels can build up. The British Heart Foundation state that FH affects around one in every 250 people, but many people don’t know they have it. Doctors usually treat FH with statins to help lower cholesterol levels and the risk of cardiovascular disease. They may also advise lifestyle changes.
Apart from FH, other factors may lead to increased LDL cholesterol. These include stress, a sedentary lifestyle, medications, and hypothyroidism.
Saturated fats and cholesterol
A 2020 Cochrane review indicated that reducing saturated fat reduced the risk of cardiovascular disease by 17 percent. Additionally, replacing saturated fat with polyunsaturated fatty acids (PUFAs) appeared protective against heart disease.
The American Heart Association (AHA) advises people who need to lower their cholesterol to reduce saturated fats to less than six percent of total daily calories. So for someone who eats 2000 calories daily, that’s about 11-13 grams of saturated fat.
How to manage cholesterol
Saturated fats occur primarily in animal foods such as meat and dairy. However, they are also present in some plant-based foods, such as coconut oil. Sources of saturated fats include:
- Fatty meats such as lamb chops
- Dairy products such as cheese, butter, whole milk and yoghurt, cream, and ice cream
- Processed and fatty meats such as sausages, ham, bacon, kebabs, and burgers
- Lard, suet, dripping, ghee, and spreads made with animal fats
In addition, Heart UK advises that some foods that are low in saturated fat contain dietary cholesterol. People with high cholesterol of FH may also need to avoid or limit these foods, which include:
- Lean meat, especially offal such as liver, kidney, heart, and tripe
- Prawns, crab, squid, cuttlefish, and octopus
All animal foods contain some cholesterol, and plant foods contain no cholesterol at all.
The NICE guidelines advise people with a high risk of cardiovascular disease to eat a diet with 30 percent or less of total energy from fats and 7 percent or less from saturated fats. They recommend replacing saturated fats with mono-unsaturated fats such as olive oil and rapeseed oil.
A healthy plant-based diet reflects what experts advise to manage cholesterol. For example, the NHS emphasizes eating whole grains, nuts, seeds, fruits, and vegetables to help control cholesterol and avoiding meat products, dairy products such as hard cheese and cream, and sweet treats.
Heart UK recommends adding beans and lentils and aiming for at least five portions of fruit and veg daily to manage cholesterol. They note that fiber in plant foods helps to lower cholesterol by preventing some of it from being absorbed in the intestines.
Are plant-based diets good for lowering cholesterol and heart health?
There is compelling evidence that plant-based diets can lower cholesterol and protect the heart.
For example, a 2020 review suggested that plant-based diets lower LDL and cardiovascular risk. The study suggests this is due to the inclusion of foods known to have heart health benefits, such as vegetables, whole grains, nuts, and seeds. Plant foods are rich in unsaturated fatty acids and low in saturated fats, and contain phytonutrients such as phytosterols, vitamins, and minerals beneficial to heart health.
The Women’s Health Initiative Prospective Cohort Study showed that higher adherence to a plant-based diet reduced cardiovascular disease, coronary heart disease, and heart failure amongst postmenopausal women.
Another 2022 study of participants with chronic diseases found that they achieved a significant decrease in total cholesterol and fasting blood sugar with adherence to a healthy plant-based diet. However, regularly eating an unhealthy plant-based diet that included refined grains and sugary foods and drinks was associated with some risk factors for cardiovascular disease.
Finally, a 2023 review concluded that vegetarian or vegan diets may promote longevity and reduce cardiovascular mortality. The authors suggest this may be due to a favourable cholesterol profile and less frequent consumption of processed foods and pro-inflammatory substances in animal foods.
Experts advise that healthy plant-based diets are beneficial for managing cholesterol and protecting against heart disease. Evidence suggests this is due to less saturated fats and more unsaturated fats, more fibre, and protective phytonutrients such as phytosterols and antioxidants in plant foods.
To manage cholesterol, people can include whole grains, legumes, vegetables, nuts, and seeds and limit or avoid processed foods, animal products such as fatty meat and dairy, and high-sugar foods. Experts also recommend maintaining an active lifestyle, quitting smoking, and limiting alcohol to keep the cardiovascular system healthy.