Weekly menu to lower cholesterol: 7 days and a shopping list

Who is this menu for, and who is it not for?

Who it is for. Adults with high total or LDL cholesterol on a blood test, without other complications. It is a good fit if you want a week of meals planned out that you can cook without too much effort.

Who it is not for. It has not been calculated for pregnancy or breastfeeding, or for anyone under 18. It is also not for people with diabetes treated with insulin or medicines that can lower blood glucose too much. It has not been calculated for people with chronic kidney disease or anyone who has or has had an eating disorder. If you have a condition with its own dietary plan (coeliac disease, a diagnosed allergy, heart failure or liver failure), follow that plan.

It does not include a fixed calorie count. A fixed figure for a general menu would be an artificial estimate. Adjust portions to your activity and hunger; if you need more volume, increase the vegetables and pulses.

The 7-day weekly menu to lower cholesterol

The week includes pulses in four meals, oily fish at least twice and wholegrain cereal in almost every breakfast.

For dessert, have fresh seasonal fruit. Between meals, have a handful of raw or roasted unsalted nuts, plain unsweetened yoghurt or a piece of fruit.

This week’s shopping list

The quantities are a guide for one person for seven days. If you are cooking for more people, multiply the quantities of fresh ingredients.

Vegetables

• 1 kg of potatoes and 1 medium sweet potato
• 1 small cabbage and 1 small cauliflower
• 2 artichokes and 1 bunch of asparagus (fresh or tinned)
• 1 bunch of chard, 2 courgettes and 500 g of green beans
• 250 g of mixed mushrooms and 1 tray of endives
• 6 onions, 3 leeks and 2 bulbs of garlic
• 1.5 kg of ripe tomatoes, 3 red peppers and 2 green peppers
• 500 g of carrots and 1 bunch of radishes

Fruit

• 4 red apples and 2 bananas
• 1 punnet of blueberries and 1 punnet of raspberries
• 1 medium avocado
• 1 kg of assorted seasonal fruit for desserts (oranges, pears, mandarins or kiwis)

Pulses, grains and bread

• 250 g of dried lentils (or 2 medium jars of cooked lentils)
• 1 medium jar of cooked chickpeas and 1 jar of cooked white beans
• 250 g of peas (fresh or frozen)
• 500 g of whole rolled oats and 1 packet of muesli with no added sugar
• 500 g of brown rice and 250 g of wholewheat pasta
• 2 good-quality wholemeal loaves (to slice and freeze)

Fish, meat and eggs

• 2 chicken breast fillets and 200 g of turkey breast fillets
• 1 fillet of fresh salmon
• 2 cleaned horse mackerel to bake
• 1 fillet of fresh or frozen hake
• 150 g of desalted cod
• 1 medium cleaned squid for cooking with onion
• 2 tins of tuna in spring water
• 3 eggs
• 100 g of extra-quality cooked ham (low in salt) or lean Serrano ham with the fat removed

Dairy products

• 1 litre of skimmed milk, or unsweetened soya drink or another plant-based drink with at least 3% protein (soya is an allergen)
• 12 plain, unsweetened, fat-free or semi-skimmed yoghurts
• 1 tub of fat-free fresh cheese or low-fat cottage cheese

Store cupboard and seasonings

• Extra virgin olive oil and apple cider or wine vinegar
• 150 g of shelled, unsalted walnuts
• 100 g of 100% peanut butter (with no added sugar or oils)
• 50 g of linseeds and chia seeds
• 50 g of pine nuts and 50 g of black olives
• 1 small tin of sweetcorn with no added sugar
• Spices and seasonings (sweet paprika, black pepper, cumin, parsley, fresh basil, coriander and classic mustard)

What the week includes and leaves out

This is the meal distribution we recommend in consultations for a week when you have high cholesterol.

• Pulses three or four times a week, to replace fatty meat.
• Fish at least three times a week, including oily fish twice.
• Eggs: AESAN recommends up to four a week for the general population. Eating up to one egg a day can also fit into a healthy dietary pattern. If you have high cholesterol, we suggest two or three whole eggs a week; egg whites are unlimited.
• Meat: up to three servings a week, prioritising skinless chicken, turkey or rabbit. Red and processed meat as little as possible. Lean cold cuts, such as cooked ham or turkey, are different from fatty processed meats.
• Fruit, two or three pieces a day, and vegetables at lunch and dinner.
• Extra virgin olive oil for cooking and dressing, along with walnuts, avocado or seeds.
• Dairy products: skimmed or semi-skimmed, plain unsweetened yoghurt and fresh cheese.

Fatty processed meats, pastries, very mature cheese, butter, fried and ready-made foods, soft drinks and alcohol are left out or reserved for occasional meals.

Use little salt; herbs, garlic, lemon and spices provide the flavour. If you also have high blood pressure, the diet for high blood pressure can help you adjust your salt intake.

Why does this menu help lower cholesterol?

According to the European dyslipidaemia guideline, LDL cholesterol is raised most by saturated fat, while trans fat raises it almost as much [1]. Dietary cholesterol has a much smaller effect [1]. That is why the menu keeps eggs while cutting back on processed meats, pastries and mature cheese.

When cholesterol is high, saturated fat should account for less than 7% of calories [1]. On the plate, that means less processed meat and butter, and fresh cheese instead of mature cheese. That fat is replaced with fat from olive oil, nuts and fish, or with fibre-containing carbohydrates such as pulses, whole grains, fruit and vegetables [2].

The second pillar is soluble fibre. The recommendation is 25 to 40 g of fibre a day, including at least 7 to 13 g of soluble fibre [1]. Oats, lentils, beans and apples contain it. In the gut, it forms a gel that carries away some bile salts. To replace them, the liver uses cholesterol, lowering the amount in the blood.

Soft drinks and excess refined flour raise triglycerides, another type of fat in the blood. Added sugar should account for no more than 10% of the day’s energy [1], and this menu contains no soft drinks or pastries. To see how these lipids are related, read the complete guide to high cholesterol.

This menu also follows the dietary pattern studied in a large Spanish trial involving people at high cardiovascular risk. The Mediterranean diet supplemented with extra virgin olive oil or nuts reduced heart attacks, strokes and cardiovascular deaths by around 30% compared with a low-fat diet [3].

What mistakes do we see in consultations?

When cholesterol is high, four stumbling blocks come up in consultations almost every week.

• Cutting out eggs while keeping processed meat. This is the first change almost everyone makes. Processed meat, pastries and mature cheese remain in the shopping basket, and that is where the saturated fat we should cut back on is found.
• Cutting out all fat and filling the gap with biscuits or white bread. Eating very little fat may lower HDL cholesterol, which is protective, while refined carbohydrates raise triglycerides [1].
• Having a perfect week and giving up in the second. The menu works if you repeat it. If one day does not go to plan, pick it up again at your next meal and repeat the dishes that worked best for you.
• Expecting to see a change in your blood test within a few days. Changes show when habits are maintained over time and accompanied by regular exercise.

How can you adapt this menu if you eat out or have little time?

During the week, time is often the main obstacle. The menu allows for shortcuts without losing quality.

• Use tinned pulses. They are just as nutritious as dried pulses. Rinse them under the tap for a minute to remove some of the salt in the liquid.
• Batch-cook on Sunday. Boil potatoes with their skins on, roast a tray of peppers, courgette and onion, and cook the lentils. They keep for three or four days in the fridge in sealed containers.
• When choosing the set menu, have grilled vegetables, salad or gazpacho for your first course, and grilled or oven-baked fish or poultry for your main course. Ask for extra virgin olive oil for dressing and fruit for dessert.
• Freeze bread in slices. Slice the wholemeal bread as soon as you get home and toast what you plan to eat each morning.