A study examined the impact of a strict vegetarian diet on cholesterol levels of individuals who already had heart disease or serious risk factors for heart disease. Here are some facts to consider if you are toying with the idea of trying to go vegetarian in order to improve your overall health and specifically if you’d like to improve your heart health.
What affects coronary artery disease (CAD)?
A 2015 Morbidity and Mortality Report from the CDC (Centers for Disease Control) found that more than a third of Americans eligible for cholesterol treatment were not taking medication or attempting to modify their lifestyle, increasing their risks for coronary artery disease and stroke.
Regardless of the cause of CAD, diet and exercise can help to prevent it and also improve the health profile of someone who has been diagnosed with heart disease. Coronary artery disease can often progress to a full blown heart attack due to blockage of blood flow in one or more coronary arteries. Once you have a heart attack, you are also at risk of heart failure and rhythm abnormalities. Coronary artery disease has a number of risk factors including elevated total cholesterol and specifically LDL or the bad cholesterol. The CDC estimates that 71 million people in the U.S. have high cholesterol levels.
Typically patients with high cholesterol levels are prescribed statin medication. This often occurs because the level is quite high and immediate treatment is necessary. Another common reason that patients start statins is because they are not sufficiently motivated to change their lifestyle. If one’s diet is dramatically modified, as in the case of going vegetarian, you can gain profound benefits including reducing your total cholesterol level.
How does a vegetarian diet improve cholesterol levels?
An analysis in the Journal of the American Heart Association looked at how a strict vegetarian diet can impact risk factors for CAD and coronary artery disease. The analysis was actually a summary of eleven studies from countries including the U.S., Sweden, Finland, Czech Republic and Australia. In all of the studies reviewed, patients were randomized to receive some form of a vegetarian diet versus a control group that ate meat.
Vegan (no fish, meat, dairy) was the most commonly studied diet, followed by lacto-ovo vegetarian (includes dairy and eggs). The control diet included meat and plant-based products. Cholesterol levels of patients who participated in the studies were monitored for up to 74 months.
The results of the analysis were as follows:
- Total cholesterol was reduced by 13.9 mg/dL
- LDL (the bad cholesterol) was reduced by 13.1 mg/dL
- HDL (the good cholesterol) was reduced by 3.9 mg/dL
- Triglycerides levels were similar in nearly all studies regardless of which vegetarian diet was followed
- An additional benefit was that, on average, participants lost about 6.35 pounds
The impact of the diet on cholesterol levels
If you recognize that the average person who participated in these studies had a total cholesterol level over 200mg/dL, then the average response was a decline of 5 to 10 percent in total cholesterol levels. Unfortunately, HDL, the good cholesterol, did not improve but rather declined slightly. It’s important to realize that statins only modestly improve HDL levels.
A healthy cholesterol profile is defined as:
- A total cholesterol level of less than 200 milligrams (mg) per deciliter (dL)
- An LDL (bad cholesterol) level of less than 130 mg/dL and less than 100mg/dL if you have a history of or very high risk for heart disease
- An HDL (good cholesterol) level of more than 60 mg/dL
- A triglycerides level of less than 150 mg/dL
To raise your HDL level:
- Exercise with moderate intensity on a regular basis (lowers total cholesterol and improves HDL)
- Lose weight if you are diagnosed with obesity
- Embrace dietary habits like eating a portion of nuts daily and eat good fats like avocados and healthy oils on a regular basis.
Vegetarian diet choices include:
- Lacto-ovo-vegetarian: allows dairy and eggs
- Lacto-vegetarian: allows dairy products but no eggs
- Ovo-vegetarian: allows eggs but no dairy products
- Vegan: allows no meat, dairy, eggs, or fish
Other non-vegetarian diets to consider:
- Pescatarian: allows fish, eggs, and dairy
- Flexitarian: predominantly vegetarian dietary approach with occasional meals that include meat
Some people make a commitment to refrain from eating red meat and just eat poultry or white meats in order to take a first step towards some form of vegetarian diet, or simply to improve their diet (since red and white meats are often high in saturated fats). It is important to note that you should include certain foods to help improve your HDL level.
A final note
Diet and exercise can help you to achieve a healthier weight, an improved cholesterol profile, and help to reduce your risk of heart disease. It can also improve your health, even if you’ve been diagnosed with heart disease. Make sure that you track and consume enough protein from your non-meat sources.
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Known as The HealthGal, expert contributor Amy Hendel is a popular medical and lifestyle reporter, nutrition and fitness expert, columnist, and brand ambassador, as well as a health coach. Trained as a physician assistant, she maintains a health coach private practice in New York and Los Angeles. Author of The Four Habits of Healthy Families, you can find her on Twitter @HealthGal1103 and on Facebook at TheHealthGal. Her personal mantra is “Fix it first with food, fitness, and lifestyle.”