Question: After recent blood tests, my GP told me I had high cholesterol and should review my diet. I’m an otherwise healthy 60-year-old, reasonably fit, light drinker, and eat healthily (very little red meat and no cheese). I immediately stopped my morning “bullet coffee”. What is the current thinking on diet and cholesterol management?
Answer: High cholesterol levels are linked to an increased risk of cardiovascular disease, so optimising your diet to lower your LDL (bad cholesterol) level is an essential preventive action for health.
Bullet coffees – black coffees made with butter and MCT oil – are marketed as a healthy beverage, but research suggests they may worsen cholesterol levels in some people.
High cholesterol is defined as having too much LDL (low-density lipoprotein) cholesterol, too little good HDL (high density lipoproteins) cholesterol, or both. So, the goal with dietary changes is to remove foods that increase LDL levels and add beneficial foods known to increase HDL cholesterol levels.
Bullet coffees are marketed as a healthy option that produces sustained energy, concentration and weight loss, and are popular with keto and paleo dieters despite a lack of scientific evidence to support these claims.
A clinical trial published in Current Developments in Nutrition in 2021 found no benefit from bullet coffee over regular black coffee for improving cognitive performance.
More worryingly, a 2015 article in the Journal of Clinical Lipidology detailed the case of a 59-year-old male diagnosed with high cholesterol who ditched his prescribed cholesterol medication and started drinking bullet coffee, significantly worsening his condition.
The patient’s blood cholesterol levels doubled after discontinuing his cholesterol-lowering medication (rosuvastatin). When he added bullet coffee to his diet, his LDL levels increased by a further third.
An earlier report about a 39-year-old patient noted similar effects on cholesterol levels from bullet coffee. In this case, the patient had no previous cardiovascular risk factors. But after adding a bullet coffee to his daily diet, subsequent blood tests revealed high cholesterol levels.
Bullet coffee contains high amounts of saturated fats, which scientific evidence suggests cause raised LDL cholesterol levels. So, ditching them is a wise step to manage high cholesterol.
In addition, the Heart Foundation recommends regular physical activity, not smoking, and eating a healthy diet. The foundation defines a heart-healthy diet as one that includes plenty of vegetables and fruit, some whole grains in place of refined grains, legumes, nuts, seeds and other sources of healthy fats, such as oily fish. You can also include lean meats, poultry and low-fat dairy products in this list.
Choosing certain foods within those groups can also maximise the impact on your cholesterol levels. For example, among the whole grains food group, oats and barley are known to have a particularly significant effect in lowering cholesterol levels. Scientists have identified a fibre in oats and barley called beta-glucan that is responsible for lowering bad LDL cholesterol.
Adding nuts rich in heart-healthy fats and fibre to your diet will also benefit your cholesterol levels. Clinical trials have shown that regular consumption of nuts lowers LDL cholesterol and triglyceride levels. Eating 3-4 small handfuls of nuts or seeds each week can help to reduce the risk of heart disease.
Other foods rich in heart-healthy fats, such as avocado, oily fish (such as mackerel, sardines and salmon) and vegetable oils, will also benefit your heart health. So, too, will legumes such as chickpeas and lentils, as well as beans, which are excellent sources of soluble fibre that can help to lower bad LDL cholesterol.
So keep up your active lifestyle, avoid the bullet coffees, and look to whole foods such as oats, nuts and seeds as close to their natural form as possible (ie, no added salt or sugar), to further improve your cholesterol levels, and benefit your health long-term.
