Study shows that frequent food can lower cholesterol: Q & A with Melissa Stevens, MS, RD, LD, Nutrition Program Coordinator for Preventive Cardiology and Rehabilitation

Is it possible that eating more frequently can lower your cholesterol? A recent study published in The British Medical Journal found that people who ate six small meals each day had an average cholesterol level that was five percent lower than people who ate only one or two big meals each day. The study, conducted at the University of Cambridge, found that eating more frequently also lowered levels of artery-clogging LDL cholesterol.

So does this mean you can eat fast food six times a day and lower your cholesterol? No. But you can lower your cholesterol if you eat more frequently, make healthy eating choices and control your portions, says Melissa Stevens, MS, RD, LD, Nutrition Program Coordinator for Preventive Cardiology and Rehabilitation at the Cleveland Clinic Heart Center in Cleveland, Ohio. Below, Ms. Stevens discusses how frequent eating can lower your cholesterol.

Q. First, what are the current standards for normal, borderline and high cholesterol?

A. The National Cholesterol Education Program, which is administered through the National Institutes of Health, released aggressive new cholesterol guidelines last year. For total cholesterol, 200 milligrams/deciliter is considered desirable; 200 to 239 is considered borderline; and greater than 240 is high. For low density lipoproteins, also known as LDL or bad cholesterol, under 100 is optimal; 100 to 129 is above normal; 130-159 is borderline high; over 160 is high and over 190 is very high.  For high-density lipoproteins, also known as HDL or good cholesterol, a higher number is good; 40 or below is low, while 60 or more is considered good.

Q. Why would eating six times --  rather than once or twice per day -- lower cholesterol levels?

A. About half of the patients I see skip breakfast and eat a light lunch, then eat a big dinner and snack throughout the evening. If you don’t eat regularly, your metabolism slows down and your body absorbs and stores more of the food you eat, including cholesterol and fat. But our bodies are incredibly adept at adapting. If you eat more frequently, your metabolism speeds up because your body “learns” that more food will be on the way, thus burning off calories instead of storing them and absorbing less cholesterol and fat. Eating breakfast is a great way to jumpstart your metabolism each day. It’s also a good idea to consume most of your food during daylight hours because that’s when you’re most active. For most people, eating after 7 p.m. is like putting gas into a car that isn’t going to be driven.

Q. Since cholesterol levels are somewhat hereditary, does what you eat play a critical role in controlling cholesterol?

A. Absolutely. For patients with high cholesterol, we recommend up to three months of dietary changes before we put them on cholesterol-lowering medications. A change in diet and lifestyle can result in a five to 25 percent reduction in total cholesterol. Patients achieve this by reducing saturated fat and cholesterol intake. Total daily fat intake should be between 25 and 35 percent of total calories. Saturated fat should be less than seven percent of total calories. About 20 percent of total calories should come from monounsaturated fat, which is found in foods such as olive oil, nuts, canola oil, avocados and olives. Another 10 percent of total calories should come from polyunsaturated fats, which are found in foods like corn oil and soybean oil. Cholesterol from animal products such as meat, eggs, cheese and milk should total less than 200 milligrams per day. Fiber also plays an important role in controlling cholesterol. We encourage patients to eat 20 or more grams of fiber each day, with at least half of that coming from soluble fibers such as oatmeal, fruits, vegetables, barley and dried beans.

Q. Are there any new foods that work specifically to lower cholesterol?

A. In addition to soluble fibers, which are found naturally in several foods, some manmade foods can lower cholesterol. For example, Benecol and Take Control are sterol-enriched margarines intended for use by people who have high cholesterol. They work by competing with cholesterol for absorption into the body. Two tablespoons per day can reduce cholesterol by about 14 percent.

Q. What types of food, what quantities and what schedule would you suggest if someone wants to eat six meals per day?

A. Here is a typical menu and schedule for a low saturated fat, low cholesterol, high fiber diet. This example would provide about 1800 calories.

• 7:30 a.m.—1/2 cup cooked oatmeal; one cup skim milk; one slice of whole wheat toast with one tablespoon peanut butter; one cup of blueberries
• 10 a.m.—8 ounces of non-fat yogurt with a tablespoon of walnuts or flax seeds
• 12:30 p.m.—Large spinach salad (two cups) topped with carrots, radishes, onion, cucumber and two ounces of tuna (packed in water), a teaspoon of olive oil and a tablespoon of vinegar; six whole-wheat crackers; one apple
• 3 p.m.—One cup of raw vegetables and one-quarter cup of hummus dip
• 6 p.m.—Three ounces of grilled, skinless chicken breast; one cup of brown rice; 1.5 cups of steamed broccoli; one piece of fruit
• 8 p.m.—One piece of fruit or three cups of light microwave or air popped popcorn

Q. Is eating more frequently a healthier way to eat, no matter your cholesterol levels?

A. Yes. This is a healthful eating pattern that can help lower the risk of cancer, hypertension, obesity, diabetes and other diseases.  You don’t have to eat six times per day. Four to six times per day is fine as long as you’re making healthful choices and controlling your portions.

For more information on a heart-healthy diet plan, please contact the Preventive Cardiology and Rehabilitation Program at 216.444-9353 (or toll-free at 800/223-2273, extension 49353) and we can schedule a nutrition consultation.