How to lower cholesterol on a vegetarian low carb diet

[potas]

Hi
I'm a veggie and have been following the low carb diet for over a year. Recently had bloods taken and have high cholesterol (7.3) although also high protective cholesterol (?) (2.8)
I eat a lot of eggs so will cut them down but otherwise I feel my diet is healthy. Lots of veg, usually roasted in olive oil. Lots of nuts and cheese and Greek yoghurt but already use the lower fat versions. Have a good amount of fibre and omega-3 from linseed or chia seeds.
I don't eat processed vegetarian 'meat' products.
I'm not sure where else I can make improvements to lower cholesterol. Does anybody have any advice or experience of this.
Thanks

F

It’s got to be the cheese.
Do you drink alcohol regularly? That can increase cholesterol.
Cakes? Chocolates?

I’m veggie. I eat full fat Greek yogurt and full fat cheese but only in very small amounts.
I eat nuts/seeds daily but again, only in small amounts.

Maybe it’s a quantity issue?

Hang on -low carb? Please tell me you aren’t using lots of coconut oil. There are 2 low carbers I know who ended up with sky high cholesterol. One was drinking bulletproof coffee each day, the other was using lots of coconut oil because she’d heard it was good for you.

No coconut oil! Maybe just too much olive oil, nuts and cheese?! Rarely drink alcohol, no cakes.

There's no need to restrict eggs. That's outdated info.

Have you been given a full breakdown of your 'scores'? Just one number isn't helpful.

And you don't need to be eating the lower fat options!

@StuntNun is the person you need to advise though. She's much more knowledgeable/expert than me.

@BIWI

There's no need to restrict eggs. That's outdated info.

Have you been given a full breakdown of your 'scores'? Just one number isn't helpful.

And you don't need to be eating the lower fat options!

@StuntNun is the person you need to advise though. She's much more knowledgeable/expert than me.

I know for a low carb diet I shouldn't restrict fat but what I meant by the comment is that I generally eat lower fat cheeses, eg feta and brie rather than cheddar, because those are the ones I prefer taste wise. Total cholesterol 7.3 Good/protective cholesterol 2.8 I usually eat three or four eggs on a weekday as they are easy for snacks and lunch.

You don't have "high" cholesterol, but "very high" cholesterol at 7.3. If you reach 7.8 , it will then be considered "extremely high" . Your LDL shouldn't be higher than 3.5. Your HDL is good, anything above 1.5 is great

Listen to your doctor and not people on social media, YouTube, ....

You need to normalise your levels and bring LDL down. Not everyone responds to food in the same way. Not everyone will develop high cholesterol on high saturated fats, but some do. It seems, you are one of these. Do you have family history of high cholesterol? Do you know what your baseline was before you started low carb? How old are you? There are several gene mutations that can affect the plasma levels of cholesterol one way or the other, either protecting you or making you more prone to high LDL . Unexplained high cholesterol in young people can be caused by mutations on these genes APOB, LDLR, LDLRAP1, PCSK9 . However , if the high levels are the results of a high fat diet, there is a dietary cause , which also means a dietary solution.

How much cheese do you eat? You will most probably need to cut all cheese as it is probably your highest source of saturated fat, or at the very least keep an eye on your saturated fat levels using a nutritional analysis website such as cronometer. It is free, and will detail how much saturated fat you are eating.
Some nuts are quite high in saturated fat, such as Brazil nut, macadamia , swap these for pine nuts or hazelnuts.
You could also eat a vegetable called okra. Okra has the ability to lower cholesterol because of its hypolipidemic activity . Okras will alter the expression of two genes, they will upregulate cholesterol 7α-hydroxylase (CYP7A1) and downregulate sterol regulatory element-binding protein 1c (SREBP1c). However it seems a bit silly to use a hypolipidemic vegetable whilst consciously eating a high fat diet.

Other lifestyle habits matter. Do you exercise? Do you occasionally fast? Some people are able to maintain high saturated fats intake because they will do more exercise or a fast which counteracts the intake of fats.

@potas Tackle your LDL for the next 4 weeks and then test again . It is great that your high cholesterol was caught early . There are specific cholesterol lowering diets you can read about. They are however low fat, such as the DASH.

Do you know your LDL and triglyceride scores as well? They're all relevant. Do you know whether you've had high cholesterol for a while or has it gone up recently? How long have you been eating a low carb diet? Is there any history of familial hypercholesteraemia? Are you overweight? There are definitely options for bringing your cholesterol down through some dietary changes. I suggest replacing some of your saturated fat intake with monounsaturated fats such as olive oil, avocado oil and, to a lesser extent, nut oils such as walnut or macadamia oil. I would also assess just how much cheese and nuts you are eating as it can be very easy to overeat these. My DH used to happily eat a bag of nuts without realising it was about 600 calories.

If you have a family history of high cholesterol it is likely you will struggle to bring it down enough. My consultant told me if it's genetic what you eat makes little difference.

How old are you? With peri menopause it's likely to go up and up.

I've been fully checked out and although my arteries are looking great I'm on statins due to other risk factors. I take a small dose and no adverse side effects.

My "good" cholesterol was about half of my overall level but year on year they both kept increasing throughout my 40s.

How about more foods that reduce cholesterol, like plant stenol drinks/spreads, oats, lentils etc

Op Im a veggie and found out I had high cholesterol back in November. Always been slim and thought I was healthy. Do you have any weight to lose?

It’s not fat you need to cut down on it’s saturated fat. Start tracking it and aim for less than 10g a day. All the nuts and olive oil you are eating will be contributing to your HDL (“good”) cholesterol rating so don’t stop them. You might want to start supplementing omega 3 if you haven’t already (there are veggie versions!)

Less saturated fat for me meant eliminating dairy except for rare treats and hardly eating eggs. I previously ate dairy nearly every meal and didn’t realise how bad for me it was.

Oats and other foods with beta glucan help bring it down so I eat a lot of porridge now. And have oat milk.

The other big change I made was cutting out “white carbs”. Which I would still do if I were you but this might not make a huge difference since you’re already low carb. I still eat bread etc but only whole grain.

Which brings me onto my next point, you want to massively up your fibre content if you can. Lots of veggies,beans and whole grains will do this.

I also upped my exercise having been fairly sedentary following pandemic. If you don’t exercise already this is another thing to try but I’m guessing you already do since your HDL is so high.

Lastly I stopped eating coconut because it’s high saturated fat. It’s in a lot of veggie alternatives but I see you already don’t eat those so again might not help! If you drink significantly I would cut that right back too.

After 3 months of this (which covered Christmas and a holiday where I went completely of the wagon) I brought my cholesterol (Total, LDL and triglycerides) down from high to just within “high normal” and now working on bringing it into optimum.

Just because it’s partly genetic doesn’t mean you’ve got not chance in most peoples cases. We have just normalised terrible diets and people are unwilling to make big changes. Try it for 3 months and retest.

I’ve noticed some conflicting advice on this thread already so please check out BHF advice and take theirs over anyone on this thread.

For example eggs are not the devil, but more than 2 a day is still to much. But people will tell you they are fine now because we used to think it was dietary cholesterol we have to watch out for but it’s saturated fat. But if you avoid saturated fat you will be default avoid cholesterol.

Op I’ve just seen you said you sometimes eat four eggs a day?? That’s 13g of saturated fat it itself!!

Now I'm more awake I have reread your usual diet and yep that is awful lot of high/saturated fat items. 15-20 eggs per week 😳 plus everything else.

Have you got my fitness pal? It's not merely a calorie tracker but it also tells you what fats, protein and carbs you are eating so using that should help you change your diet away from saturated fats.

Endame E beans are high protein for example.

Following up on the egg thing. I said keep eating nuts but if your nut consumption is like your egg consumption then you may need to reduce it. I have around 30g of nuts per day for reference which is about 2-4 grams of saturated fat depending on the nuts but 20g of “good” fat, again depending on the nut.

Thank you.
So much advice to consider I really appreciate it.
I'm not overweight and I do a good amount of exercise. No family history and never had high cholesterol before.
So I obviously need to alter my diet.
The doctor gave me no advice at all unfortunately. But from these comments I really need to find alternatives to my content egg and cheese diet....

Well the good news is that if there is no genetic bias then you should be able to improve it through diet alone.

It is very hard to reverse hypercholesterolaemia with a low carb diet in normal weight individuals.

In your case, it is most certainly the low carb diet that caused it , given your levels were normal before you changed diet in favour of 3-4 eggs a day + high amounts of cheese + lots of nuts .

A small number of people will tell you that high levels of LDL do not matter or that limiting your eggs is outdated information (seriously 21- 24 eggs per week is fine? not according to your blood test) however the real science, not the internet science, says that hypercholesterolaemia puts you at risk of severe atheroma with altered neovascularization . No diet trend is worth being at risk of stroke or heart attack. Some people do great on low carb and improve their health, others damage their health . Trust your blood test.

If you restrict healthy carbs such as lentils, beans, oats, whole grains, fruit, it is harder to improve your levels. Diet is very successful but not a high fat diet. You can control your LDL levels on a high fat diet, but not reverse them to normal levels if you are at 7.3 .

The last time I followed a low carb diet, my husband did it with me and his cholesterol levels shot up.Mine were fine and we ate more or less the same.