Cholesterol: how much influence do you have?

This is general information, not medical advice. Always discuss your blood values with your doctor.

1. 1

   What diet realistically does

   Replacing saturated fat with polyunsaturated fat lowers LDL by about 0.05 mmol/L (2 mg/dL) per 1% of your energy. Soluble fibre (3.5 to 7 g a day, for example from oats and legumes) lowers LDL by 0.2 to 0.35 mmol/L. Plant sterols (2 g a day, in fortified products) lower LDL by about 10%, more gives no extra effect and an effect on heart attacks has not been shown.

2. 2

   Combining works best

   In a randomised trial in 345 people with high cholesterol (Jenkins et al., JAMA 2011), LDL fell by about 13% after 6 months on a “portfolio” diet: nuts, soy protein, soluble fibre and plant sterols. That was more than on a standard low-fat diet. The better people stuck to it, the bigger the drop.

3. 3

   Exercise and weight

   Exercise and weight loss mainly lower your triglycerides and raise HDL. The effect on LDL is smaller. They remain important for your overall heart risk.

4. 4

   Where lifestyle is not enough

   At high risk the guideline asks for a reduction of at least 50%. Diet alone usually cannot achieve that, which takes statins, ezetimibe and other drugs, sometimes combined. For inherited causes (familial hypercholesterolaemia, high Lp(a)) diet is not the answer. Supplements without shown LDL-lowering effect and safety are not recommended by the guideline.

Updated in October 2026