How to Lower LDL Cholesterol on a Lacto-Ovo Vegetarian Diet - Nutrition

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How to Lower Low-Density Lipoprotein Cholesterol on a Lacto-Vegetarian Diet


Hello, Nutritionist: A few days ago, my mother was informed by her endocrinologist that she has high low-density lipoprotein cholesterol (LDL-C=160, HDL-C=46.5).
However, during the consultation, my mother forgot to mention that she switched to a lacto-vegetarian diet over six months ago and no longer consumes meat; she only mentioned that she eats a lacto-vegetarian diet.
I am unsure if this is the reason why the doctor advised her to consume egg yolks to improve her cholesterol levels, stating that they would reassess the situation in three months to decide whether to prescribe medication.
However, we found many articles online suggesting that one should limit egg yolk intake to lower LDL cholesterol, which has left my mother confused about how to consume egg yolks and what quantity would be appropriate.
Additionally, should my mother follow the same dietary principles for lowering LDL cholesterol as those recommended for omnivores, such as reducing saturated fatty acids and high-cholesterol foods, and increasing the intake of high-fiber foods, or are there other considerations she should be aware of? Thank you for your guidance.

elaine, 30~39 year old female. Ask Date: 2020/07/16

Dr. Cai Xiuwen reply Nutrition


Hello! Regarding the issue of high low-density lipoprotein (LDL) cholesterol, increasing research indicates that egg yolks are not the primary cause of elevated blood cholesterol levels.
Most cholesterol in the blood is produced by the body itself, while saturated fatty acids in the diet contribute to increased cholesterol levels.
Therefore, it is the saturated fat in foods that should be limited, rather than egg yolks.

For lacto-vegetarians, foods that contain saturated fatty acids include cooking oils such as coconut oil, palm oil, butter, and ghee.
Baked goods like cakes, bread, and cookies also contain significant amounts of saturated fats.
Additionally, the high-fiber foods you mentioned should not only come from fruits and vegetables but also from whole grains such as brown rice, multigrain rice, and oats to increase dietary fiber intake.
Overall caloric intake and weight management are also crucial; reducing weight can help lower cholesterol levels.
As for how to consume egg yolks, it is advisable to limit intake to 1-2 yolks per day in the context of high cholesterol levels.
A varied and balanced diet is recommended, and vegetarians can obtain protein from sources such as tofu, soy products, and edamame, which are also high in protein and fiber.

In addition to dietary control, exercise is an important factor.
Cholesterol is an essential component synthesized by cells, so it is important to provide appropriate nutrients and engage in physical activity.
Staying well-hydrated is also key to preventing cholesterol from negatively impacting health.
Wishing you peace and health.
This response is provided by a dietitian from the Nantou Hospital, Ministry of Health and Welfare.

Reply Date: 2020/07/16

More Info


To effectively lower LDL cholesterol levels on a lacto-ovo vegetarian diet, it is essential to understand the relationship between dietary choices and cholesterol levels. Your mother's recent transition to a lacto-ovo vegetarian diet, which includes dairy and eggs but excludes meat, can indeed influence her cholesterol levels. However, it is crucial to approach this dietary change with a clear understanding of how different foods impact cholesterol.

Firstly, it is important to clarify the role of dietary cholesterol in relation to blood cholesterol levels. Recent research indicates that dietary cholesterol, such as that found in egg yolks, does not significantly impact blood cholesterol levels for most people. Instead, the primary contributors to elevated LDL cholesterol are saturated fats and trans fats found in various foods. Therefore, while your mother may have been advised to consume egg yolks, it is essential to balance this with an understanding of her overall dietary fat intake.

In terms of egg consumption, moderation is key. Current guidelines suggest that consuming up to one egg per day is generally safe for most individuals, including those with elevated cholesterol levels. However, if your mother has specific concerns about her cholesterol, it may be prudent to limit her intake to a few eggs per week, focusing on the egg whites, which are cholesterol-free and high in protein.

To further lower LDL cholesterol, your mother should focus on the following dietary principles:
1. Limit Saturated and Trans Fats: Foods high in saturated fats include full-fat dairy products, coconut oil, palm oil, and processed foods like baked goods and snacks. Instead, she should opt for healthier fats, such as those found in avocados, nuts, seeds, and olive oil.

2. Increase Fiber Intake: High-fiber foods can help lower cholesterol levels. Encourage her to consume a variety of fruits, vegetables, whole grains (like oats, brown rice, and whole grain bread), legumes (beans, lentils, and peas), and nuts. Soluble fiber, in particular, found in oats and beans, is effective in reducing LDL cholesterol.

3. Incorporate Plant Sterols and Stanols: These compounds, found in fortified foods and supplements, can help block the absorption of cholesterol in the intestines. Foods such as certain margarines, orange juice, and yogurt drinks may be beneficial.

4. Maintain a Healthy Weight: If your mother is overweight, losing even a small amount of weight can help lower cholesterol levels. Encourage her to engage in regular physical activity, which can also improve HDL (good cholesterol) levels.

5. Stay Hydrated and Limit Sugars: Drinking plenty of water and reducing the intake of sugary foods and beverages can also contribute to overall heart health.

6. Regular Check-ups: Since your mother has elevated LDL cholesterol, regular follow-ups with her healthcare provider are essential. They can monitor her cholesterol levels and make recommendations based on her progress.

In summary, while your mother can include eggs in her diet, it is crucial to focus on overall dietary patterns rather than singling out specific foods. By limiting saturated fats, increasing fiber intake, and maintaining a balanced diet rich in whole foods, she can effectively manage her cholesterol levels. Additionally, incorporating regular physical activity and maintaining a healthy weight will further support her cardiovascular health. If her cholesterol levels do not improve after three months of dietary changes, her healthcare provider may consider medication as an option.

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