More than 1.5 million Australians now have high blood cholesterol, so chances are you know someone whose blood results have returned with a little asterisk when their GP or cardiologist checked their cholesterol levels.

In isolation, elevated cholesterol may not be cause for concern, but high cholesterol levels – in particular high LDL (low-density lipoprotein) cholesterol levels – are one of the risk factors for heart disease.

And with heart disease still Australia’s No.1 cause of death, especially for older Australians, why would you not make some dietary changes to help lower your risk?

What is cholesterol?

Cholesterol is a waxy substance made by the liver and plays a key role in hormone production as well as the natural function of the body’s cells and nervous system. While we need some cholesterol in our body for general health, when the natural levels become unbalanced as a result of genetic issues or lifestyle variables such as diet, there can be negative consequences for heart health.

Elevated LDL cholesterol, commonly referred to as the “bad” cholesterol, is associated with an increased risk of heart disease and stroke. High amounts of LDL cholesterol can result in fat accumulation in the walls of the arteries, which over time can cause atherosclerosis, where the artery walls harden and narrow, increasing the risk of a stroke or heart attack.

What do we know about diet and cholesterol?

While some individuals will require medication to help manage cholesterol levels, there is also strong evidence to show that specific dietary changes can help reduce cholesterol levels by as much as 10 per cent.

Healthy diets such as the Mediterranean style of diet can reduce the risk of developing heart disease by as much as 25 per cent. More recently, data suggests that plant-based diets (both vegetarian and vegan eating patterns) are associated with a 7 per cent reduction in total cholesterol levels.

The association between dietary patterns and cholesterol suggests that it is not individual foods that should be the focus when it comes to heart health; rather, it is the daily food choices we make to create strong dietary habits that have the biggest effect.

The key dietary patterns to focus on

To achieve the cholesterol-related benefits of both a Mediterranean and plant-based diet, the first thing to focus on in your diet is to increase your intake of brightly coloured fruits and vegetables.

Forget five a day. A minimum of seven to 10 serves, or two to three cups at lunch and dinner, will significantly increase your intake of key nutrients and dietary fibre, and lower your total calorie intake, helping to support weight control.

Next, get liberal with your intake of legumes, nuts, Australian extra virgin olive oil and oily fish such as sardines and salmon. Aim to include legumes and oily fish in your diet at least two to three times each week, plus a handful of mixed nuts each day, and extra virgin olive oil regularly in cooking and as a base for dressings and sauces.

Finally, cut back a little with the red meat. While red meat is a rich natural source of iron, zinc and protein, our servings tend to be way too large, so try swapping to a vegetarian-based meal or two each week, and keep your meat portions to just 100-150 grams, aiming for no more than 350 grams each week.

The superfoods to include in your diet

There are also a handful of foods that have specific cholesterol-lowering benefits that make a smart daily diet addition for those with slightly high cholesterol levels.

Plant sterols

Plant sterols are a molecule that can be found naturally in a range of plant-based foods in small amounts and, when concentrated to 2-3 grams, help to block cholesterol uptake in the body and naturally lower cholesterol levels. Seek out a daily serve of plant sterols in minimally processed foods with added sterols including breakfast cereals, oats and milks.

Foods packed with soluble fibre

Soluble fibre is naturally found in oats, legumes, vegetables, nuts, seeds and fruits, and 5-10 grams per day of soluble fibre is associated with significant reductions in LDL cholesterol levels. Adding a daily serving of at least two foods high in soluble fibre is an easy way to reap the benefits of this super nutrient.

Anti-inflammatory foods

An anti-inflammatory diet is closely associated with an improvement in HDL (high-density lipoprotein) or “good” cholesterol levels in the body. And there are a handful of foods that are exceptionally high in key nutrients and antioxidants that are associated with the key anti-inflammatory benefits. Extra virgin olive oil is one, as are brightly coloured green, orange and purple vegetables, which is why a daily serve or two of leafy greens and vegetable-based juices makes a smart dietary addition.

Oily fish such as salmon and sardines are important for increasing the amount of omega-3 in the diet. Or for those on a plant-based diet, walnuts, chia, pepitas and soy-based foods including tofu and edamame help to boost your intake of plant-based omega-3s. In addition, daily serves of onions, garlic, green and black tea will all work to reduce inflammation in the body, which can directly affect the health of the arteries and help to reduce heart disease risk.