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You may know that certain foods can affect the cholesterol in your body, but did you know that what you drink can also affect it? This is because beverages can also contain ingredients that increase your cholesterol, such as sugars and fats. Increased cholesterol is a condition medically known as hyperlipidemia or dyslipidemia (high or imbalanced levels of lipids in the blood).
However, just like foods, some drinks can help to lower your cholesterol. Reducing your cholesterol is important as it is thought that a 1% reduction in ‘bad’ cholesterol is linked with a 1% decreased risk of cardiovascular disease (CVD),¹ while a 1% reduction in total cholesterol can reduce the risk of CVD by up to 3%.
Additionally, a 2-3% increase in ‘good’ cholesterol reduces the risk of cardiovascular disease² by 2-4%.
But firstly, it’s important to understand what is ‘good’ cholesterol and ‘bad’ cholesterol. Low-density lipoprotein (LDL) is the molecule that carries cholesterol from the liver through the bloodstream to the cells.
While it is a crucial molecule in the body, too much of it can build up in the arteries and increase the risk of atherosclerosis (narrowing and stiffening of vessels), cardiovascular disease, and stroke — hence it is labeled as the “bad” cholesterol.
High-density lipoprotein (HDL) is considered to be the “good” cholesterol. This cholesterol picks up the LDL and transports it to the liver, where it is removed from the body. Having high levels of HDL is beneficial as it helps to decrease the build-up of the ‘bad’ cholesterol.
Other kinds of lipoprotein molecules are considered ‘bad’ cholesterol: very low-density lipoprotein (VLDL) and intermediate-density lipoprotein (IDL). These are ‘bad’ cholesterols for the same reason as LDL. However, they are less commonly discussed.
Sometimes, LDL, VLDL, and IDL are grouped together and called non-HDL cholesterol. It is thought that non-HDL cholesterol is a better indicator of cardiovascular disease than LDL alone.
Another type of lipid is triglyceride. Higher levels of triglycerides are also significantly associated with a higher risk of CVD.
So, when discussing the best drinks to improve your cholesterol, we are referring to drinks that lower your non-HDL levels, lower your triglycerides, improve your HDL levels, or lower your total cholesterol.
Green tea has been shown to have cholesterol-improving benefits for healthy people and those with obesity. Green tea lowers the total amount of cholesterol and LDL cholesterol while not reducing HDL cholesterol.
Green tea lowers the absorption of fats into the intestine and activates the pathway to decrease the synthesis of fatty acids, which helps to lower LDL levels in the body.
Additionally, a study³ in Japan found that those who consumed at least two cups of green tea per day for 7 to 10 years were significantly less likely to die from any cause of cardiovascular disease than those who did not drink green tea regularly. Drinking between 3 to 5 cups daily was associated with the highest risk reduction, particularly in women.
Beverages containing soy milk, or soy milk alone, may also help reduce your cholesterol levels. The benefit of soy for lowering cholesterol levels was first recognized in 1999 by the FDA.⁴ 25g of soy protein per day is thought to be sufficient for lowering cholesterol levels.
The LDL-lowering ability of soy is yet to be concluded, but researchers believe it is due to the formation of peptides during the digestion of soy protein. These peptides help to upregulate hepatic LDL receptors. It was also reported that the LDL-lowering ability of soy is more prominent in those who already have cholesterol above normal levels than those with normal levels.
A 1963 study⁵ that substituted white bread for bread containing rolled oats was the first to discover the cholesterol-lowering ability of oats.
Oats are rich in a fiber called beta-glucan. Research⁶ has shown that beta-glucan reduces non-HDL cholesterol. Beta-glucan may reduce non-HDL cholesterol by 0.20mmol/l when 3.5g of oats are consumed per day.
It is thought that oat drinks such as oat milk provide more consistent cholesterol-lowering benefits than solid oat products.
Another beverage option for reducing cholesterol is unsalted tomato juice. A study⁷ of 481 people in Japan found that unsalted tomato juice significantly reduced LDL cholesterol levels in their blood. It also improved both systolic and diastolic blood pressure, further reducing the risk of cardiovascular disease.
It is thought that this LDL-lowering ability is due to a compound called lycopene,⁸ which is abundant in tomatoes. This lycopene content can be increased when a tomato is pressed into juice form.
Studies⁹ have shown that an increased fiber intake can reduce the levels of components of ‘bad’ lipids (LDL cholesterol and triglycerides) circulating in the blood. Raspberries, blueberries, and strawberries are all high in fiber.
Berries are rich in flavonoids, particularly anthocyanins (this is the pigment that gives berries their deep red, purple, and blue colors). Studies¹⁰ have shown that this high flavonoid content in berries can improve lipid metabolism disorders and have an anti-inflammatory and hypoglycaemic effect on the body.
A meta-analysis¹¹ in 2016 confirmed that berries could reduce LDL cholesterol and lower systolic blood pressure. This improves cardiovascular health, reducing the risk of heart attacks and strokes associated with high cholesterol.
To improve your blood cholesterol levels, you could try blending strawberries, blueberries, and raspberries into a smoothie.
Sterols and stanols are similar to cholesterol in their structure. However, they are only found in plant-based foods, including nuts, vegetables, vegetable oils, seeds, and fruits. Sterols and stanols are also added to certain foods and beverages, such as fat spreads, yogurt, yogurt drinks, and milk.
Sterols and stanols are absorbed into the blood from the intestines and block the absorption of cholesterol into the blood. This blockage lowers cholesterol levels in the bloodstream, ultimately lowering the amount of plaque formed in the arteries.
The FDA recommends¹² consuming at least 1.3g of sterols and 3.4g of stanols daily. Please note that foods enriched with added sterols or stanols are not recommended for pregnant or breastfeeding women or children under five years old.
Despite being fairly safe, there is some indication from a few studies¹³ that supplemented sterols in these groups may reduce the child’s serum beta-carotene concentration or impact the absorption of certain vitamins.
There is some evidence¹⁴ that light to moderate consumption of alcohol may increase blood levels of HDL — good cholesterol. Moderate consumption of red wine may also reduce oxidative stress and blood pressure.
What is deemed as a moderate intake varies between men and women. For men, a moderate intake of alcohol is up to two standard drinks a day. For women, this reduces to one standard drink per day.
There are also many risks to consuming alcohol. Excessive intake can raise triglyceride and cholesterol levels and cause hypertension and type 2 diabetes. Additionally, alcohol intake can cause a build-up of lipids (such as cholesterol) in the liver.
This can lead to liver disease, which reduces the function of the liver. When the liver is not functioning optimally, it slows down the removal of waste and toxins from the body. As the liver is responsible for removing cholesterol from the body, cholesterol levels rise due to liver disease.
In 2016, up to 19% of deaths attributable to alcohol consumption were due to cardiovascular disease.
Additionally, many alcoholic beverages contain added sugar. Research¹⁵ has shown that beverages sweetened with sugar increase triglycerides and decrease HDL levels. These changes to cholesterol levels may increase the risk of cardiovascular disease.
In addition to consuming cholesterol-lowering beverages, here are some tips for managing your cholesterol.
Maintaining a healthy weight is crucial to managing your cholesterol. Excess body fat slows down the removal of LDL cholesterol, increasing the time LDL is present in the blood. This increases the chances of LDL cholesterol depositing in the arterial wall, causing plaque formation.
You can use BMI charts to get an estimate of whether your weight is healthy or not. However, BMI measurements are not entirely accurate and ignore some important factors in determining a healthy weight, as they don’t consider your muscle or fat mass. If you are concerned about your weight or are unsure if your body is a healthy weight, it is best to have a chat about this with your doctor.
Limiting foods high in saturated fats, such as animal products and palm oil, will help lower your cholesterol. Instead, you should opt for foods that primarily contain unsaturated fats, such as:
Olive, canola, and penutoil
Avoid foods high in trans fats as they increase LDL and decrease HDL. Foods that are high in trans fats include:
All fried foods
Commercial baked goods
Additionally, foods high in fiber will further help lower your non-HDL cholesterol levels and may help increase HDL cholesterol. These foods include:
Beans (kidney, black, pinto, lima)
It is also important to avoid foods and drinks containing high levels of added sugar when you are watching your cholesterol levels. Sugar-sweetened beverages can increase your levels of LDL.
Smoking damages your blood vessels and increases the hardening of your arteries, increasing the risk of cardiovascular disease. Additionally, smoking was found to be associated¹⁶ with higher levels of total cholesterol, LDL, and lower levels of HDL, further increasing the risk of developing heart disease.
To reduce your chances of developing cardiovascular disease, seek help from a doctor or people you trust to quit smoking.
What you drink affects your cholesterol levels just as much as what you eat does.
Ensuring you consume beverages that lower your ‘bad’ cholesterol and triglycerides levels are important for maintaining overall health and reducing the risk of cardiovascular disease, stroke, and heart attacks.
Cholesterol-lowering effect of rolled oats | Google Scholar
CFR - Code of federal regulations title 21 | U.S. Food and Drug Administration
Fiber in food chart | C.S. Mott Children's Hospital
Six cholesterol-busting foods | Heart UK
Preventing high cholesterol | Centers for Disease Control and Prevention