Heart disease is the biggest killer worldwide.
Having low HDL (the "good") cholesterol and high triglycerides is also linked to increased risk (2).
Fortunately, what you eat can have a powerful effect on your cholesterol and other risk factors.
Here are 13 foods that can lower cholesterol and improve other risk factors for heart disease.
Legumes, also known as pulses, are a group of plant foods that includes beans, peas and lentils.
Legumes contain lots of fiber, minerals and good amounts of protein. Replacing some refined grains and processed meats in your diet with legumes can lower your risk of heart disease.
A review of 26 randomized controlled studies found that eating half a cup (118 ml) of legumes per day is effective at lowering LDL cholesterol by an average of 6.6 mg/dl, compared to not eating legumes (3).
Other studies have linked pulses with weight loss, even in diets that are not calorie-restricted (4).
Bottom Line: Legumes like beans, peas and lentils can help lower LDL levels and are a good source of plant-based protein.
Avocados are an exceptionally nutrient-dense fruit.
They're a rich source of monounsaturated fats and fiber — two nutrients that help lower LDL and raise healthy HDL cholesterol (5).
Clinical studies support the cholesterol-lowering effect of avocados (6).
In one study, overweight and obese adults with high LDL cholesterol who ate one avocado daily lowered their LDL levels more than those who didn't eat avocados (6).
An analysis of 10 studies found that substituting avocados for other fats was linked to lower total cholesterol, LDL and triglycerides (7).
Bottom Line: Avocados contain monounsaturated fatty acids and fiber, two heart-healthy and cholesterol-lowering nutrients.
Nuts are another exceptionally nutrient-dense food.
They're very high in monounsaturated fats. Walnuts are also rich in the plant variety of omega-3 fatty acids, a type of polyunsaturated fat that's linked to heart health (8).
Nuts also contain protein. They're particularly rich in L-arginine, an amino acid that helps make nitric oxide. This, in turn, helps regulate blood pressure (8).
Nuts contain phytosterols too. These plant compounds are structurally similar to cholesterol and help lower cholesterol by blocking its absorption in the intestines.
Calcium, magnesium and potassium are also found in nuts. These minerals are linked to reduced blood pressure and lower risk of heart disease.
In an analysis of 25 studies, eating two to three servings of nuts per day decreased LDL cholesterol by an average of 10.2 mg/dl (9).
Eating a daily serving of nuts is linked to a 28% lower risk of both fatal and nonfatal heart disease (8).
Bottom Line: Nuts are rich in cholesterol-lowering fats and fiber, as well as minerals that are linked to improved heart health.
Fatty fish, such as salmon and mackerel, are excellent sources of long-chain omega-3 fatty acids.
Omega-3s are linked to improved heart health via increasing HDL cholesterol and lowering inflammation and stroke risk.
One large study tracked young adults, following their health for over 25 years (10).
It found that those who ate the most non-fried fish were the least likely to develop metabolic syndrome, a cluster of symptoms that includes high blood pressure and low HDL levels (10).
Another large study of elderly adults found that those who ate tuna or other baked or broiled fish at least once a week had a 27% lower risk of stroke (11).
Note that the healthiest ways to eat fish are baked, broiled, grilled or raw. Fried fish may actually increase the risk of heart disease and stroke (12).
Some of the heart-protective benefits of fish may also come from certain peptides found in fish protein (15).
Bottom Line: Fatty fish contain high levels of omega-3 fatty acids and have been linked to a decreased risk of heart disease and stroke.
Extensive research links whole grains to a lower risk of heart disease (16).
In fact, a review of 45 studies linked eating three servings of whole grains daily to a 20% lower risk of heart disease and stroke. The benefits were even greater with more servings of whole grains, up to seven servings a day (16).Whole grains have all parts of the grain intact, which provides them with more vitamins, minerals, plant compounds and fiber than refined grains.
While all whole grains may promote heart health, two grains are particularly worth noting:
- Oats: They contain beta-glucan, a type of soluble fiber that helps lower cholesterol. Eating oats is linked to a 5% reduction in total cholesterol and a 7% reduction in LDL cholesterol (17).
- Barley: Is also rich in beta-glucans and can help lower LDL cholesterol (18).
Bottom Line: Whole grains are linked to a lower risk of heart disease. Oats and barley contain beta-glucan, a soluble fiber that is very effective at lowering LDL cholesterol.
Fruit is an excellent addition to a heart-healthy diet for several reasons.
It does this by encouraging the body to get rid of cholesterol and inhibiting the formation of cholesterol by the liver.
One kind of soluble fiber called pectin has been shown to lower cholesterol by up to 10%. It's found in fruits including apples, grapes, citrus fruits and strawberries (20).
Fruit also contains bioactive compounds that help prevent heart disease and other chronic diseases due to their antioxidant and anti-inflammatory effects.
Eating berries and grapes, which are particularly rich sources of these plant compounds, can help increase HDL cholesterol and lower LDL cholesterol (21).
Bottom Line: Fruit can help lower cholesterol and improve heart health. This is largely caused by fiber and antioxidants.
Cocoa is the main ingredient in dark chocolate.
It may seem too good to be true, but research does back up the claims that dark chocolate and cocoa can lower LDL cholesterol (22).
One study found promising results after it had healthy adults drink a cocoa beverage twice a day for a month.
The cocoa drinkers saw a reduction in LDL cholesterol of 0.17 mmol/l (equivalent to 6.5 mg/dl). Their blood pressure also decreased and HDL cholesterol increased (23).
Cocoa and dark chocolate also seem to be able to protect the LDL cholesterol in your blood from oxidation, which is a key step in the pathway towards heart disease (24).
However, keep in mind that chocolate is often high in added sugar, which negatively affects heart health.
Therefore, you should use cocoa directly or choose dark chocolate with a cocoa content of 75–85% or higher.
Bottom Line: Flavonoids in dark chocolate and cocoa can help lower blood pressure and LDL cholesterol while raising HDL cholesterol.
It contains various powerful plant compounds, including allicin, which is the main active compound in garlic (26).
Many studies have strongly linked garlic to lowering blood pressure in individuals with high blood pressure. Others have suggested that garlic may help lower total and LDL cholesterol, although the effect is less strong (26, 27, 28).
Because relatively large amounts of garlic are needed to achieve this heart-protective effect, most of the research has been conducted using supplements.
Many studies have used aged garlic supplements, which are considered more reliable than other garlic preparations (29).
Bottom Line: Garlic contains allicin and other plant compounds, which may help lower LDL cholesterol and reduce other heart disease risk factors.
Soybeans are a type of legume that may be beneficial for heart health.
While study results have been inconsistent, the most recent research is positive.
A 2015 analysis of 35 studies found that eating soy foods was linked to reductions in LDL and total cholesterol and increased HDL cholesterol (30).
The effect seems to be strongest in people with high cholesterol.
Bottom Line: There is some evidence that soy foods can reduce heart disease risk factors, especially in people with high cholesterol.
Vegetables are an important part of a heart-healthy diet.
They're rich in fiber and antioxidants and low in calories, which is helpful for maintaining a healthy weight.
Some vegetables are particularly high in pectin, the same cholesterol-lowering soluble fiber found in apples and oranges (20).
Pectin-rich vegetables also include okra, eggplants, carrots and potatoes.
Vegetables also deliver a range of plant compounds. These plant compounds are linked to health benefits including protection against heart disease.
Bottom Line: Vegetables are high in fiber and antioxidants and low in calories, making them a heart-healthy choice.
Tea contains many plant compounds that are linked to improved heart health.
While green tea gets a lot of attention, black tea and white tea have similar properties and health effects.
These are two of the primary compounds in tea that deliver benefits:
- Catechins: Catechins may help your heart in several ways. They help activate nitric oxide, which is important for healthy blood pressure. They also inhibit cholesterol synthesis and absorption and help prevent blood clots (31, 32).
- Quercetin: Quercetin may improve blood vessel function and lower inflammation (33).
Bottom Line: Tea drinking may help lower cholesterol levels and reduce your risk of heart disease.
While all vegetables are good for your heart, dark leafy greens are particularly helpful.
Carotenoids act as antioxidants to get rid of harmful free radicals that can lead to atherosclerosis, which is the hardening of the arteries (36).
Dark leafy greens may also help lower cholesterol levels by binding to bile acids and making the body excrete more cholesterol (37).
One study suggested that lutein lowers levels of oxidized LDL cholesterol and could help prevent cholesterol from binding to artery walls (38).
Bottom Line: Dark leafy greens are rich in carotenoids, including lutein, which are linked to a lower risk of heart disease and stroke.
One of the most important foods in the heart-healthy Mediterranean diet is extra virgin olive oil.
One study gave participants 4 tablespoons a day, in addition to a Mediterranean diet.
The olive oil group had a 30% lower risk of major heart events, such as stroke and heart attack, compared to people who followed a low-fat diet (39).
Those were the results of a five-year intervention study in older adults at risk of heart disease.
Olive oil is a rich source of monounsaturated fatty acids, the kind that may help raise HDL cholesterol levels and lower LDL cholesterol.
It is also a source of polyphenols, some of which have been shown to reduce the inflammation that can drive heart disease (40).
Bottom Line: Olive oil is a primary component of the heart-healthy Mediterranean diet. It has monounsaturated fatty acids and antioxidants that are good for the heart.
High cholesterol levels are a major risk factor for heart disease.
Thankfully, you can lower this risk by including certain foods in your diet.
The 13 foods in this article all have research-based benefits that will help you keep your cholesterol low and your heart healthy.