I’m a 34-year-old with minimal risk factors for heart disease, aside from a family history. But because LDL (“bad”) cholesterol is associated with heart disease risk, and mine was on the rise, I wanted to take action.

I frequently tell patients I treat at The Ohio State University Wexner Medical Center that diet is key to help reduce cholesterol levels. A focus on a plant-based diet, reducing saturated fat and increasing fiber-containing foods like vegetables and whole grains has been shown to reduce cholesterol levels – with or without the use of statins.

In particular, cholesterol levels can drop further by incorporating supplements like soluble fiber products or plant sterols. Pushing back on the typical “meat and potatoes” norm of my upbringing, I decided to change the way I eat.

I cut back on steaks and burgers and replaced them with more greens and fish. At home, we switched to cooking with plant-based oils such as grapeseed or sunflower. I began eating more vegetables and grains and added over-the-counter plant sterol supplements.
Increase Healthy Proteins

For protein, non-fried fish is one of the highest quality sources you’ll find. Fattier fish, such as salmon or tuna, also have omega-3 fatty acids, which offer additional health benefits for lipids and metabolism. White fish is still a fine protein source, but you won’t get the added benefit of the omega-3 fatty acids. Plant-based options like tofu or vegan sausage can be great protein alternatives as well.

The main distinction in choosing fish or plant-based proteins instead of other meats is the lack of saturated fat. The body turns that saturated fat into bad cholesterol. If you do eat meat, look for lean cuts and trim the fat before cooking. I’m generally OK with white poultry meat – without the skin.

Cooking with plant oil rather than butter also cuts out saturated fat, and some plant oils can also offer omega-3 acids. Olive oil is mostly monounsaturated fat, which is preferred over fats that are solid at room temperature like shortening. Better still, grapeseed, walnut and sunflower oil are excellent alternatives due to higher polyunsaturated fatty acid content.

When planning my dietary changes, I knew there would be an impact. But when I checked the results, I was frankly surprised at how effective my changes were. By the end of the six-month experiment , I had reduced my LDL cholesterol by 29%, which is similar to what we often see from low- or moderate-intensity statin medication. Along the way, I learned it’s a plan my family and I can work into our normal routine.
Ideal Menu to Lower Cholesterol

I can’t claim perfection in my dietary choices, but here’s a look at my ideal menu for reducing cholesterol while still enjoying meals:

Breakfast

My days typically begin with a high-protein yogurt with little sugar or saturated fat. I add a banana or citrus fruit, along with oatmeal or a whole-grain breakfast bar.

On the weekends with my family, I’ll make egg-white omelets with fruit and a vegetarian sausage – a light and protein-packed breakfast.

Lunch

To me, lunch is the most controllable meal of the day. It’s often a choice of bringing food to work or stopping to get lunch while you’re out. I try to pack my lunch most days of the week.

One of my favorite lunches is a citrus and greens salad with tuna or tofu crumbles on top and a black-bean soup or coleslaw (with vinaigrette rather than mayo) as a side. Other days, I’ll have a homemade lentil, tomato and portobello soup along with a sandwich of tuna and cucumber on whole-grain bread with a side of carrots or kimchi.

Snacks

I like to have a little pick-me-up or something to munch on at work, but I want to avoid carbs and sweetened beverages.

I keep some nuts like almonds or pistachios at my desk and will sometimes add some dried fruit, though it’s important to watch out for sugar content. I like to drink unsweetened tea or black coffee, and sometimes I put a slice of citrus in my water bottle.

Dinner

For dinner, I try to keep my main course centered around fish or a plant-based protein source while still sticking to USDA nutrition recommendations.

For me, an excellent meal is a plate of salmon, roasted Brussels sprouts tossed in grapeseed oil, long-grain rice and a green salad. Sometimes we’ll replace the salmon with a plant-based option or add non-starchy vegetables like broccoli or asparagus. Bulgur or quinoa are higher protein- and fiber-containing grain options compared to pasta or white rice.
Healthy Moderation

I don’t like to think of foods as fundamentally bad or good, as counting down to a “cheat day” can breed some negative psychology. For example, I still savor and do not feel guilty about eating occasional cheese or dark chocolate, in moderation. The path to striving for more healthful choices while avoiding feeling discouraged by self-deprivation is a balance that can evolve slowly and is different for everyone.

As I grew comfortable with my new eating plan, I came to think of it as a version of the Mediterranean diet with less olive oil and chicken and a stronger focus on polyunsaturated oils and fish. Some have used the term “Flexitarian” to describe a predominantly plant-based diet that can still make peace with occasional meat.

I would never discourage statin use, if that’s what your doctor has prescribed. In fact, I’m one of the biggest proponents of statins you’ll find. A wealth of data suggests they’re not only effective in lowering cholesterol, but can also reduce cardiovascular risk and the level of inflammation in the body more than other cholesterol-lowering drugs. As always, it’s important to run all your plans by your doctor, including diet and medication changes, in case those changes could be dangerous for your health.

Unless you struggle with digestive diseases or are underweight, I believe a diet plan like mine can be an effective way to help manage LDL cholesterol with or without statin medications. In conjunction with statins, exercise or weight loss, some people could experience significant change.