The Real Scoop on Cholesterol

By Melissa Halas-Liang, MA, RDN, CDE

3 min read

November is National Diabetes Awareness Month. Do you know where your blood cholesterol levels are? Make this month a time to take steps towards feeling and living your best! We’re helping you to “Be Smart About Your Heart: Control the ABCs of Diabetes.” Managing the diabetes ABCs – which are the A1C test, Blood Pressure, Cholesterol, and Stopping Smoking – can help lower one’s risk for heart disease.

Cut back on saturated fats and replace with healthy fats

Experts have known for decades, due to hundreds of research trials, that saturated fat raises blood cholesterol.¹ However, in recent news, there has been much buzz over the notion that full-fat dairy is fine and that saturated fat isn’t the culprit it was made out to be. That fact is, only a minority of studies have shown no association between saturated fat intake and elevated blood cholesterol levels. This may have been due to study design – for example, relying on food recall (which varies day to day), ineffective research methods, or research bias related to funding sources. The vast majority of studies still show a link between saturated fat consumption and cholesterol levels. The message remains: cut back on saturated fats (from meat, whole milk or 2% dairy, and butter) and replace them with healthy fats (such as oils, nuts, seeds, fish and avocados).²

In study after study, saturated fat has been shown to raise LDL cholesterol, also known as “bad cholesterol”.^2,3 In the past, I worked in clinical research studies where I was fortunate to provide nutrition counseling every two weeks for a year. In a control group, we replaced saturated fats with mostly healthy plant-based fats, switched to non-fat dairy, decreased meat and increased fish, and we saw LDL cholesterol come down. I’ll never forget when the head of the clinic came to me and said, “What are you doing with these patients? I can’t believe how much their LDL has come down.” That’s the power of a great combination of sound nutrition advice to cut back on animal protein that is high in saturated fat, full-fat dairy, and replace saturated fats with healthy fats. Of course, bi-monthly follow-up and emotional support helps too! It’s easier to encourage and make small diet changes with a cheerleader and educator you see regularly.

Eliminate trans-fats

It’s also important to completely eliminate trans-fats from your diet to lower your LDL cholesterol levels! Per Dr. Janet Brill, RD author of Prevent a Second Heart Attack, “Research has shown that people with the highest levels of trans fatty acids in their cell membranes have a three-fold greater risk of having a heart attack and a 1.5-fold greater risk of having a fatal cardiac event compared to individuals with the lowest level of trans fatty acids. Another major review on the health effects of trans fat concluded that on a per-calorie basis, trans fat increases risk of heart disease more than any other nutrient. A 2 percent increase in calorie intake from trans fat was associated with a 23 percent increase in new cases of heart disease. Concern over dietary trans fatty acids has led some scientists to state that trans fat is more detrimental with respect to promoting heart disease than even saturated fatty acids”.^4-6

What you can do to lower cholesterol

Most Americans have an overabundance of saturated fat in their diets, accompanied by excess refined foods and excess calories. One of the easiest and most cost-effective ways to naturally lower cholesterol and reduce your risk of heart disease is changing your diet. Try following an OmniHeart diet or Therapeutic Lifestyle Change diet to improve your heart health. In these diets, the focus is on eating more vegetables, fruits, and fiber, choosing food items that are low in sugar, selecting the right grains (whole grains), and substituting saturated fat with heart healthy fats. Commit to making some healthy changes that work for you and your lifestyle!

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Type2Diabetes.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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bignorsk Member
Trans fat elimination is good. Saturated fats are good fars, the more saturated fats are replaced by polyunsaturated, the sicker, the more obese, the country gets. The college of Cardiology came out saying yhere is no link between saturated fats and coronary heart disease. In the 1800’s when people ate lots of saturated fats and no vegetable oils, heart attacks were almost unknown. Today with saturated fats reduced and previously unknown oils being a major part of the diet, heart attacks are pretty much normal. Yet people persist in following the lies of Ansel Keys who knew corn oil was worse than saturated fats even as he pushed saturated fats as the problem.
richard-morris Member
Many studies have shown that when you change diet from unsaturated to saturated fatty acids, LDL-c goes up. Several large scale studies (eg: Framingham) have shown that people with elevated LDL-C have more heart disease. And over a dozen studies (including the recent PURE study in 18 nations with over a quarter of a million subjects) have show no association between saturated fatty acids in the diet and heart disease. So how do you reconcile that paradox? A causes B, and B is weakly associated with C, but A is not associated with C despite spending billions to prove it was (Nurses Health Study, Minnesota Coronary study, Sydney Diet-Heart study, PURE). We used to believe that all cholesterol was bad, because the molecule cholesterol was found concentrated in arterial fatty streaks and if you fed rabbits cholesterol they got heart disease. It was thus assumed that cholesterol was a nutrient of concern, and any lipoprotein carrying the molecule must be a biomarker for heart disease. Then after Framingham we realized that there was actually good cholesterol HDL-c that was protective against heart disease, and bad cholesterol LDL-c that was weakly associated with incident heart disease. Ronald Krauss discovered in 1990 that LDL had multiple subtypes. He found [ <a href='https://pubmed.ncbi.nlm.nih.gov/2372896/' target='_blank' rel='noopener noreferrer ugc'>https://pubmed.ncbi.nlm.nih.gov/2372896/</a> ] that large buoyant LDL was perfectly benign pattern A phenotype, and only the small dense subfraction was atherogenic. Krauss's subsequent work has elucidated that dietary saturated fatty acids do not preferentially elevate small dense pattern B LDL - explaining the paradox. The LDL elevated in saturated fat feeding experiments is not the same LDL associated with heart disease. In other words the association between saturated fatty acids and LDL-c are physiological not pathological (unless you have independently elevated small dense pattern B LDL), and most likely a homeostatic adaptation to maintain membrane biophysical properties [ <a href='https://academic.oup.com/ajcn/article-abstract/113/2/277/6104795' target='_blank' rel='noopener noreferrer ugc'>https://academic.oup.com/ajcn/article-abstract/113/2/277/6104795</a> ].