- New research finds that people who follow a vegetarian or vegan diet they have lower levels of LDL (bad) cholesterol than those who eat meat.
- People who ate a plant-based diet had 10% lower LDL cholesterol levels than those who ate meat.
- Experts say the reasoning is complicated.
About 86 million people in the United States have high cholesterol levels, putting them at risk for serious complications like heart disease and stroke. High cholesterol is treatable with some lifestyle changes and some medications, but new research suggests that two diets, in particular, may help reduce high cholesterol levels: a vegan and a vegetarian diet.
This is the main result of the scientific analysis, which was published in European Heart Journal. For the study, researchers analyzed data from 30 studies that examined the impact of vegetarian or vegan diets versus a meat-based diet on cholesterol in adults. The researchers found that low-density lipoprotein (LDL, or bad cholesterol) levels decreased by 10% in people who ate a plant-based diet compared to people who ate meat, while total cholesterol dropped by 7%. .
The study also found that a plant-based diet was linked to a 14 percent drop in apolipoprotein B (apoB), a protein found in the blood that measures the amount of a certain type of fat and cholesterol in the body.
Cardiovascular disease is on the rise worldwide, says study co-author Ruth Frikke-Schmidt, MD, Ph.D., deputy chair of the Department of Clinical Medicine at the University of Copenhagen. Timely prevention of high cholesterol is crucial because high cholesterol is a direct cause of cardiovascular disease.
But why is a vegetarian or vegan diet linked to lowering cholesterol? Here’s the deal.
Why might a vegetarian or vegan diet lower cholesterol?
The researchers didn’t explore this in the study, they simply found an association. However, there are some theories.
At a basic level, plant-based diets contain less cholesterol, says Dr. Frikke-Schmidt. Saturated fat is a major contributor to increased LDL cholesterol, and the main source of that comes from animal products like meat and butter, says Ali Haider, MD, an interventional cardiologist at NewYork-Presbyterian Queens. Eliminating that food source will naturally reduce dietary cholesterol.
But it’s a little more complicated than that. It often goes further, says Yu-Ming Ni, MD, a cardiologist at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in Fountain Valley, California.
Diets that include animal fats not only tend to be higher in saturated fat, they can also increase body inflammation that can contribute to increased cholesterol, she says. Plant-based diets may also contribute to a healthier body weight, which has also been linked to lower cholesterol levels, she says.
Even plant-based diets are high in fiber, points out Jessica Cording, RD, author of The Little Book of Revolutionaries. A plant-based diet includes lots of greens, legumes, whole grains, nuts, seeds and fruits, and all have lots of fiber, she says. Fiber, especially soluble fiber, has been shown to reduce LDL cholesterol.
Many foods high in dietary fiber also contain plant sterols, says Scott Keatley, RD, co-owner of Keatley Medical Nutrition Therapy. These are plant compounds that are structurally similar to cholesterol and can help block the absorption of cholesterol in the intestines, which can further reduce LDL cholesterol levels, he explains.
The fiber in plant-based diets may also help you feel fuller longer, says M. Wesley Milks, MD, a preventative cardiologist and assistant professor of internal medicine in the division of cardiovascular medicine at The Ohio State University Wexner Medical Center. The increased fiber may also help promote satiety with more food ingested per calorie than meat, thus filling the stomach and curbing appetite more efficiently, although the study was not focused on weight loss. he explains.
But a plant-based diet can do more than just lower cholesterol. I always recommend plant-based diets regardless of cholesterol levels as they not only reduce cardiovascular risk but also reduce the risk of cancer, diabetes, high blood pressure and dementia, says Thomas Boyden, MD, medical director for Preventive Cardiology and Cardiac Rehabilitation at Corewell Health in Grand Rapids, Michigan.
What else can lower cholesterol?
Dr. Ni points out that there are many factors that go into cholesterol levels. Diet is only part of the foundation of health, he says. He notes that the American Heart Association (AHA) lists eight different factors that can help promote a healthy heart. These include:
- Eat a healthy diet that includes whole foods, lots of fruits and vegetables, lean proteins, nuts, seeds, and cooking in non-tropical oils like olive and canola.
- Strive for 2.5 hours of moderate physical activity or 75 minutes of vigorous physical activity per week.
- Avoid tobacco products.
- Try to get seven to nine hours of sleep a night.
- Maintain a healthy body weight.
- Check your high cholesterol.
- Manage your blood sugar.
- Manage your blood pressure.
Anyone with high cholesterol should understand their individual cardiovascular risk and focus on improving their diet, regularly engaging in moderate physical activity, and taking cholesterol-lowering medications based on their individual risk, says Dr. Boyden.
Can a plant-based diet replace medications?
Dr. Frikke-Schmidt cautions against interpreting these findings as stating that a plant-based diet can do as much work as cholesterol-lowering drugs. Cholesterol-lowering drugs are much more effective at lowering cholesterol levels than plant-based diets, she says. If your doctor has prescribed you a cholesterol-lowering drug, it is very important that you continue with the drug treatment.
Dr. Ni agrees. There are many people with high cholesterol where dietary changes don’t affect much, he says. In some cases, medication is required.
However, Dr. Frikke-Schmidt says a vegan or vegetarian diet could be a factor in lowering cholesterol. Healthy plant-based foods are a supplement to drug treatment for patients, she says.
But Dr. Ni says every case is different with high cholesterol. Some people are able to lower their cholesterol with diet alone and others require certain medications, he says. Ultimately it involves working closely with your doctor to see which method of treatment is best for you, he says.
How to add more plant-based foods to your diet
Dr. Ni says you don’t necessarily have to go completely vegetarian or vegan to help lower cholesterol, and many people with high cholesterol don’t want to anyway. Some of my patients are motivated to follow a completely vegetarian or vegan diet, but most struggle to do so, he says. I tell them to just try to limit the amount of animal products they have more than anything else.
Dr. Ni recommends consuming red meat no more than once a week and getting leaner animal proteins like chicken and fish, along with some entirely plant-based meals.
Dr. Milks also says that a strictly vegetarian or vegan diet can be challenging for many of his patients. I usually tell them to focus on a Mediterranean-style eating pattern that emphasizes the intake of vegetables, whole grains rather than processed carbohydrates, and sources of fat and protein that ideally come from plants or seafood, and less from meats ( especially redheads), she says.
Every patient is different, and I tailor my recommendations to individual habits, culture and realistic expectations, says Dr. Haider. Patients must understand and believe concepts to make real change.
Keatley points out that there are many ways to be a vegetarian. I’d recommend going no further than a lacto-ovo-pescatarian, meaning you still consume dairy, eggs, and fish/shellfish, she says. This will allow you to have a varied diet, consume high quality protein and minimize your fat intake.
Cording recommends trying to increase your fiber intake to the recommended 25-30g per day. Do it gradually, says Keatley. Adding too much fiber to your diet too quickly can lead to digestive upsets like bloating, gas and cramping, she says.
And, if you’re concerned about your cholesterol, Dr. Frikke-Schmidt recommends talking to your doctor. They should be able to help you find a customized plan that works for you.
Korin Miller is a freelance writer specializing in general wellness, sexual health and relationships, and lifestyle trends, with work appearing in Men’s Health, Women’s Health, Self, Glamor, and more. She has a master’s degree from American University, she lives on the beach and hopes to own a tea pig and a taco truck one day.
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