While many associate high cholesterol with the consumption of animal products, the reality is that vegans can also experience elevated cholesterol levels. This article explores the complex relationship between vegan diets and cholesterol, examining the factors that can contribute to high cholesterol in vegans and providing practical steps to maintain healthy cholesterol levels.
What is Cholesterol?
Cholesterol is a fatty substance produced by the liver and present in every cell membrane of the body. It plays a crucial role in the production of vitamin D, hormones, and bile, which aids in fat digestion. While cholesterol is essential for bodily functions, elevated levels in the blood can increase the risk of heart attacks and strokes. According to HEART UK, a significant portion of the adult population in the UK has raised cholesterol.
There are two main types of cholesterol:
- High-density lipoprotein (HDL): Often referred to as "good" cholesterol, HDL helps remove lipids (fats) from peripheral tissues, transporting them to the liver for excretion.
- Low-density lipoprotein (LDL): Known as "bad" cholesterol, LDL delivers lipids to the tissues and can contribute to the buildup of plaque in arteries when levels are too high.
The Vegan Diet and Cholesterol: An Overview
A vegan diet excludes all animal products, including meat, dairy, and eggs. Because animal products contain dietary cholesterol, many assume that a vegan diet automatically leads to lower cholesterol levels. While studies like the EPIC-Oxford study have shown that vegans generally have lower cholesterol levels compared to omnivores, various factors can still lead to high cholesterol in vegans.
Why Might Vegans Have High Cholesterol?
Several dietary and non-dietary factors can influence cholesterol levels in vegans:
Read also: High-Fiber Diet for Better Health
Dietary Factors
Saturated Fat Intake: It's becoming increasingly easy for vegans to consume diets high in saturated fat, which can lead to high cholesterol. This is partly due to the popularity of coconut products and heavy use of saturated fats like coconut, palm, and shea oils in the manufacturing of some vegan alternatives, such as plant-based butter and cheese, and some convenience foods. Eating these products regularly can have a significant effect on the overall quality of our diets because they tend to add saturated fat, sugar, and salt and push out healthier choices. Certain plant-derived oils, such as coconut and palm oil, are naturally high in saturated fats. Including these oils in vegan diets can increase LDL cholesterol levels, especially if a person consumes them in significant amounts.
Processed Vegan Foods: Eating a diet containing lots of processed food can negatively affect cholesterol levels, regardless of whether or not those foods are vegan. Some vegan products are highly processed and contain large quantities of sugars, sodium, trans fats, and artificial ingredients.
Refined Carbohydrate Intake: A diet high in refined carbohydrates and sugars can also lead to elevated cholesterol. Research suggests that an excessive intake of refined carbs and sugar negatively affects blood lipids and cardiometabolic health.
Non-Dietary Factors
Genetic Factors: Some individuals have a genetic predisposition called familial hypercholesterolemia (FH). This affects how the body processes cholesterol, leading to high LDL cholesterol levels in the blood, regardless of dietary habits. Liz, a vegan food blogger, discovered she had FH after years of struggling with high cholesterol despite her healthy lifestyle. Her family history of high cholesterol and heart disease prompted her to seek genetic testing, which ultimately led to her diagnosis and treatment.
Physical Inactivity: Even with a vegan diet, a sedentary lifestyle can negatively affect cholesterol levels. Regular exercise can help increase high-density lipoprotein (HDL). Also known as “good” cholesterol, HDL aids in removing cholesterol from the bloodstream, thus promoting heart health.
Read also: Delicious High-Fiber Smoothie Recipes
Alcohol and Smoking: Excessive alcohol intake can elevate a person’s triglyceride levels. Smoking reduces HDL levels and damages arterial walls, making them more susceptible to fatty deposits.
Underlying Health Conditions: Hypothyroidism and chronic kidney disease may disrupt the normal balance and processing of blood lipids.
Age, Family Background and Genes: In reality, there are many dietary and non-dietary factors that affect our risk of high cholesterol, including some that we can’t influence like our age, family background and genes.
Vitamin B12 Deficiency: Regarding the wider aspects of heart health, vitamin B12 is a nutrient to consider. This is because low B12 status can result in a high homocysteine level, which has been linked to an increased risk of heart attacks and strokes.
Studies on Vegan Diets and Cholesterol
A meta-analysis of 30 trials, including nearly 2,400 people, compared vegetarian, vegan, and omnivorous diets. The study found that those following a vegetarian or vegan diet experienced average drops in total cholesterol, LDL cholesterol, and apolipoprotein B of 7%, 10%, and 14%, respectively, compared to those eating an omnivorous diet.
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The researchers concluded that plant-forward diets tend to be higher in healthy unsaturated fats but lower in saturated fat, cholesterol, and total fat, which likely explains the findings.
Maintaining Healthy Cholesterol Levels on a Vegan Diet
While vegan diets can be beneficial for lowering cholesterol, it's essential to make informed choices to ensure optimal heart health. Here are some preventive measures vegans can take:
Eat a Nutritious Diet: Prioritize a diet rich in whole foods, including fruits, vegetables, whole grains, legumes, nuts, and seeds. Guidelines about heart-healthy eating tend to encourage the consumption of fruit, vegetables, wholegrains, beans, peas, lentils and nuts. Reduce consumption of processed foods high in saturated and trans fats, sugars, and sodium.
Balance Fat Intake: Opt for healthy fats such as avocados, olive oil, flaxseeds, peanuts, nuts, seeds, avocado and small amounts of vegetable (rapeseed) and olive oils and vegetable spreads, and be cautious about consuming foods high in saturated fat, such as coconut and palm oil. People are also encouraged to replace saturated fats with plant-derived unsaturated fats.
Incorporate Grains and Beans: Adding whole grains to your diet in the form of multigrain and whole wheat bread/chapattis can be helpful. Whole grains are rich in fiber content which decreases cholesterol absorption from the gut and improves the overall gut health.
Eat Oatmeal: Oats have been found to lower cholesterol levels. Oats contain both soluble and insoluble fibers, a soluble fiber called β-glucan helps decrease cholesterol absorption in the intestine from the diet.
Consume Fresh Fruits and Vegetables: Making vegetables and fruits part of daily meals aids in lowering LDL cholesterol. Vegetables and fruits are low in saturated fats and rich in fiber, vitamins, and minerals.
Eat Nuts and Healthy Snacks: Replace processed snacks like chips, muffins, cookies, and buttery popcorns rich in trans and saturated fats with healthy snacks like Avocado whole wheat toast, Guacamole with sliced veggies, and roasted nuts. Avocado is a rich source of monounsaturated and polyunsaturated fats like omega 3 and omega 6 fatty acids, which are beneficial for health.
Use Heart-Healthy Oils: Heart-healthy oils like canola oil, olive oil, corn oil, and avocado oil are rich in monounsaturated and polyunsaturated fatty acids such as omega-3 and omega-6 fatty acids, which help lower cholesterol.
Get Regular Physical Activity: Engage in at least 150 minutes of moderate-intensity aerobic exercise or 75 minutes of vigorous-intensity exercise weekly. Include strength training exercises for all major muscle groups 2 or more days a week. Exercise plays a vital role in managing cholesterol levels in addition to the diet. Exercise helps in increasing HDL cholesterol (good cholesterol).
Avoid Tobacco and Limit Alcohol: Limit alcohol intake to moderate levels. This refers to up to one drink daily for females and two for males. Decreasing alcohol consumption: Heavy drinking, which is associated with numerous health risks, is defined as four or more drinks on any given day, or more than 14 drinks per week for males and three or more drinks on any given day, or more than seven drinks per week for females. Heavy alcohol consumption increases LDL cholesterol and triglyceride levels, which is harmful to heart health.
Avoid Sugary Drinks: Drinks containing high fructose corn syrup and sugar can increase bad cholesterol and lower good cholesterol levels.
Get Enough Sleep: Getting proper and sufficient sleep of at least 6-7 hours is essential. Too little sleep leads to high LDL cholesterol and triglyceride levels and low HDL levels.
Monitor Cholesterol Levels: Monitor cholesterol, blood pressure, and blood sugar regularly to catch potential problems early. This is particularly important for people with a family history of heart disease.
Maintain a Moderate Weight: Focus on a balanced diet and regular exercise to maintain a moderate weight. A weight loss of just 5-10% can increase HDL cholesterol.
Medical Interventions
Treating and managing high cholesterol requires a multi-faceted approach that may encompass medical interventions and lifestyle modifications. Initially, doctors may recommend lifestyle changes to manage cholesterol levels. These changes center around making balanced dietary choices, exercising regularly, and limiting alcohol intake. If a person is overweight, their doctor may recommend strategies to lose weight. Depending on cholesterol levels and other risk factors, doctors may prescribe medications such as statins or other cholesterol-lowering drugs.
Questions to Ask Your Doctor
Vegans can confidently manage their cholesterol levels through regular health screenings, informed dietary practices, and open dialogue with healthcare professionals. Here are some questions a person may wish to ask a doctor:
- How can I ensure my diet provides all the necessary nutrients to support healthy cholesterol levels?
- Are there specific plant-based foods that can help lower LDL cholesterol?
- Are there any particular deficiencies a person with a vegan diet should watch out for that might affect cholesterol or heart health?
- How do plant-based sources of omega-3 fatty acids, such as flaxseeds and walnuts, compare with animal sources regarding heart health benefits?
- Are there vegan-friendly supplements or medications that can help manage cholesterol?
- How might processed vegan foods influence cholesterol levels and overall health?
- Can a vegan diet provide enough soluble fiber to benefit cholesterol levels, and which foods are the best sources?
- How often should a person get blood tests to monitor their cholesterol and their levels of nutrients of concern for vegans, such as vitamin B12, iron, and omega-3 fatty acids?
Resources for Vegans and Heart Health
Several organizations offer valuable resources for vegans seeking to maintain healthy cholesterol levels and overall heart health:
The Physicians Committee for Responsible Medicine (PCRM): PCRM is dedicated to saving and improving human and animal lives through plant-based diets and ethical and effective scientific research. They provide information on how to maintain cholesterol levels and maintain good heart health through plant-based diets.
- PCRM's Cholesterol webpage provides information on how you can lower your cholesterol with a plant-based diet.
- PCRM's Heart Disease webpage provides information on how you can prevent, manage, or reverse heart disease with a plant-based diet.
- PCRM's Cholesterol Fact Sheet provides detailed information on what cholesterol is and how to lower your cholesterol by following a plant-based diet.
The Heart Truth®: The Heart Truth® connected with Anna Herby, PCRM Nutrition Education Specialist, to learn more about how to maintain cholesterol levels and maintain good heart health through plant-based diets. The Heart Smart Basics Fact Sheet has been helpful! This handout is helpful in situations where someone needs help understanding terms and risk factors in relation to their heart health.
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