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Dear Dietician: Diet and exercise can reduce cholesterol

Leanne McCrate

Dear Dietitian,

My cholesterol level has slowly been creeping up, and now it’s up to 255! My doctor says I must get it down, but I don’t want to take medication yet. Do you think I could get my cholesterol down with diet and exercise?


Dear Charles,

Several healthy diets will help lower your cholesterol, and you are wise to try diet and exercise before medication. A healthy cholesterol level is 200 mg/dL or lower, so getting yours down can probably be achieved through diet and exercise.

The Ornish diet was created by Dean Ornish, MD, a clinical professor of medicine at the University of California, San Francisco. This diet is plant-based and emphasizes fruits, vegetables, and whole grains. It is very low in fat, with only 10% of calories coming from fat. Only 12 mg of cholesterol is allowed each day, and plant oils are prohibited. Exercise and stress management are also a part of the program.

Leanne McCrate, RDN, LD, CNSC

In a study of 48 participants, those who followed the Ornish plan for one year had a 37% reduction in LDL cholesterol. HDL remained the same. More important, there was a reversal in heart disease in these participants. A drawback of the Ornish diet is that it is strict and difficult for some to follow. Critics also point out that the study size was small, and more extensive research is needed (1).

Another diet that has gained global recognition is the Mediterranean diet. It consists of fruits, vegetables, whole grains, nuts, legumes, fatty fish and poultry. The oils permitted are canola and olive oil, and moderate amounts of dairy and eggs are included. Red meat is allowed occasionally, and alcohol, particularly red wine, is enjoyed with meals.

In the Lyons study, those who followed the Mediterranean diet only produced a 6% reduction in LDL levels. However, the same group saw a 70% decrease in death from any cause and 70% fewer nonfatal heart attacks after four years (2).

If you like doing things your way, you can lower your cholesterol with your own diet and exercise plan. In a 15-week study of 350 overweight volunteers, those who lost 5% to 10% of total body weight saw significant decreases in total cholesterol and LDL levels. The study participants were put on a calorie-restricted diet and expected to exercise 150 minutes weekly. This study was limited by its short duration (3).

If lowering cholesterol is a goal, these three very different diet plans will produce results. Choose the plan that works for you.

Until next time, be healthy!

Dear Dietitian


  1. Rosenthal R. Effectiveness of altering serum cholesterol levels without drugs. Proc (Bayl Univ Med Cent) 2000 Oct; 13(4): 351-355. doi: 10.1080/08998280.2000.11927704
  2. de Lorgeril M, Salen P, Martin JL, Monjaud I, Delaye J, Mamelle N. Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart Study. Circulation. 1999;99:779–785.
  3. Brown J, Buscemi J, Milson V, Malcolm R, O’Neil P. Effects on cardiovascular risk factors of weight losses limited to 5-10%. Transl Behav Med. 2016 Sep; 6(3): 339-346. doi: 10.1007/s13142-015-0353-9

Leanne McCrate, RDN, LD, is an award-winning dietitian based in Missouri. Email her at Dear Dietitian does not endorse any products, health programs, or diet plans.