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Some studies suggest that high-monounsaturated fatty acid and Mediterranean diets improve cholesterol profiles and reduce cardiovascular risk, while other studies indicate that ketogenic and high-fat diets may increase LDL cholesterol and pose concerns for blood lipid profiles.
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High cholesterol is a significant risk factor for cardiovascular diseases (CVD). Diet plays a crucial role in managing cholesterol levels and reducing CVD risk. This article synthesizes research findings on various dietary approaches to manage high cholesterol effectively.
High-MUFA diets, such as those rich in olive oil, peanut oil, and peanut products, have been shown to lower total cholesterol and LDL cholesterol by approximately 10% and 14%, respectively. These diets also reduce triacylglycerol concentrations by 13% without lowering HDL cholesterol, making them preferable to low-fat diets, which can decrease HDL cholesterol levels. Additionally, the Mediterranean diet, which is high in MUFAs and includes abundant plant foods, moderate wine, and low amounts of meat and dairy, has been found to improve serum lipids significantly.
Low-fat diets are traditionally recommended for managing hypercholesterolemia. These diets can lower total cholesterol and LDL cholesterol levels but may also reduce HDL cholesterol and increase triacylglycerol levels . A systematic review and meta-analysis found that while low-fat diets effectively reduce total and LDL cholesterol, they are less effective in increasing HDL cholesterol and reducing triglycerides compared to high-fat diets.
Despite their benefits, low-fat diets may not be as effective in improving the overall lipid profile as high-MUFA diets. The American Heart Association (AHA) recommends a balanced approach, emphasizing the consumption of vegetables, fruits, whole grains, and lean proteins while limiting saturated and trans fats.
Ketogenic LCHF diets, which are high in fat and low in carbohydrates, have been shown to increase LDL cholesterol significantly. This increase includes both small, dense LDL and large, buoyant LDL cholesterol, which could be detrimental to cardiovascular health. Therefore, while these diets may be popular for weight loss, they may not be suitable for individuals with high cholesterol.
Combining a low-saturated-fat, low-cholesterol diet with regular exercise can enhance the positive effects on plasma lipoproteins. Exercise, particularly in overweight individuals, has been shown to increase HDL cholesterol levels more effectively than diet alone. This combination approach is recommended for optimal cardiovascular health.
In summary, high-MUFA diets, such as the Mediterranean diet, are highly effective in managing high cholesterol and improving the overall lipid profile. Low-fat diets can also be beneficial but may have limitations in increasing HDL cholesterol. Ketogenic LCHF diets, while effective for weight loss, may increase LDL cholesterol and are not recommended for individuals with high cholesterol. Combining dietary changes with regular exercise offers the best outcomes for cardiovascular health. Adhering to these evidence-based dietary recommendations can significantly reduce the risk of cardiovascular diseases.
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