How I Lowered My Cholesterol With Diet

When I started my direct primary care practice in January, my first patient was myself. Doctors are the worst patients, and I had no idea what my bloodwork would show. When the results came back, I was surprised see my LDL was 170! I was shocked. How could that be? I’m not overweight. I felt like my diet and exercise was pretty good. Ok, I didn’t exercise that routinely, but when I did, it was usually high intensity. But what about diet? The vast majority of what I eat is home cooked, and the rest is from restaurants a couple times a month. How can that be bad? Do I need a statin?

What is a healthy diet?

There’s a lot of evidence in medical literature that points towards the same concept for a healthy diet: less processed foods and meats, more whole fruits, veggies, grains, legumes, beans. Less to no alcohol. A commonly known diet that fits this is the Mediterranean diet.

What can I change?

After taking a good hard look at what’s really considered a healthy diet, I realized where my diet falls short. I eat way too much meat, and as a result, not enough fiber, healthy fats, whole grains. Based on a Mediterranean diet, red meat should be limited to once a week and chicken/poultry a few servings a week. A meat dish was typically the main dish I would make for two meals a day. This seemed normal to me – that’s what you’d order when you eat out right? Some sort of meat protein with maybe a side of veggies and carbs. I needed to find ways to replace what would usually be the biggest part of the meal with something else. This was daunting at first.

How am I supposed to feel full just eating veggies?

I started incorporating more whole grains, nuts, beans, tofu to make a meal more satisfying. I didn’t skimp on fats or carbs. I used plenty of olive oil in dressings. I ate plenty of bread with my salads. I ate until I was full. I didn’t try to eat less or calorie count. I snacked a bit more on nuts, granola, and fruit. I definitely wasn’t going hungry. I also didn’t completely cut out meat. We would still go to restaurants 4-6 times a month and I’d still order plenty of meat dishes then. But at home, I limited cooking meat to one meal per week or less.

And the result?

After about 3 months on this diet modification, I rechecked my lipid panel. My LDL decreased from 173 to 133. Based on medical literature, that 40mg/dL decrease reduces my relative risk of cardiovascular events (heart attack/stroke) by 20% and all-cause mortality by 10%. More importantly, this type of diet has been shown to be healthy in general, not just for cholesterol. It’s better for your gut microbiome. It’s better for your brain. It reduces cancer risk. It’s also a realistic change that I can stick to long term. I’m not strictly vegetarian or vegan. I’m not removing carbs, or fats from my diet. I don’t miss meat day to day, but I can still get a burger or a steak if I want to.

Is changing diet enough?

Maybe, maybe not. This question depends a lot on your risk factors and should involve your doctor’s opinion. However, that doesn’t mean making healthier dietary habits doesn’t matter. Besides genetics, the biggest factors to your health are diet and exercise. You are what you eat.