Foods for Cholesterol and Heart Health: What Trials Found
What trials and official bodies found for oats, soy, nuts, beans, tea, cocoa and plant sterols on LDL cholesterol, and why foods do not replace cholesterol medicines.
Content last updated . This page has not been medically reviewed.
Safety first. Supplements can cause side effects and interact with medicines. Read mushroom safety and interactions before you use any mushroom product.
Read this first. Food changes in these studies were small to moderate, and they were measured as cholesterol numbers in the blood, not as heart attacks. Foods here are never a replacement for a medicine a doctor has prescribed. The UK National Health Service says that if you stop taking statins your cholesterol levels may be affected, and to talk to a doctor or pharmacist before stopping. [1] If you have a food allergy to any food named here, do not use it; for trouble breathing or swelling of the face or throat, call 911.
Several everyday foods lowered LDL ("bad") cholesterol a little in pooled trials: oats and barley (through beta-glucan fiber), soy protein, walnuts, beans and other pulses, black tea, cocoa and foods with added plant sterols. We did not find head-to-head trials that rank them, and this page does not rank them. This page covers foods only; fiber, omega-3 and sterol supplements are in Vitamins & Supplements.
What trials found
| Food or pattern | What the source found | Evidence label | Form and population |
|---|---|---|---|
| Oat beta-glucan | LDL down 0.25 mmol/L versus control at 3 g or more of beta-glucan a day; no change in HDL or triglycerides [2] | Established for a small LDL change | 28 trials; oat products with at least 3 g beta-glucan a day [2] |
| Soy protein | LDL down 4.76 mg/dL, about 3 to 4% [3] | Promising but limited | 43 trials the FDA had identified; median 25 g soy protein a day for about 6 weeks [3] |
| Walnuts | LDL down 5.51 mg/dL compared with control diets [4] | Promising but limited | 26 trials, 1,059 people [4] |
| Beans, chickpeas, lentils, peas | LDL down 0.17 mmol/L; the authors said longer, higher-quality trials are needed [5] | Promising but limited | 26 trials; median about 130 g a day (about 1 serving) instead of a diet without pulses [5] |
| Black tea | LDL down 4.64 mg/dL; no clear change in total or HDL cholesterol [6] | Promising but limited | 10 studies, 411 people [6] |
| Cocoa | LDL down 9.47 mg/dL [7] | Promising but limited (mixed forms) | 31 studies; cocoa extract or dark chocolate with at least 70% cocoa, so not chocolate alone [7] |
| Plant sterols and stanols | LDL down by 6 to 12% on average at 0.6 to 3.3 g a day [8] | Established for the LDL number | 124 studies; two authors were listed with a food company research unit [8] |
| Portfolio pattern (nuts, plant protein, viscous fiber, sterols together) | LDL down about 17% (0.73 mmol/L) versus a standard diet [9] | Promising but limited | 7 trial comparisons, 439 people with high blood fats [9] |
Details for single foods are on oats, walnuts, soy foods, legumes and plant sterols.
Swapping fats
A Cochrane review of 15 long trials (about 59,000 people) found that cutting saturated fat lowered combined cardiovascular events by 21% (risk ratio 0.79). [10] It said replacing that energy with polyunsaturated fat or carbohydrate appears useful, while the effect of replacing with monounsaturated fat was unclear. [10] The US Dietary Guidelines, 2020 to 2025, set a limit of less than 10 percent of calories a day from saturated fat starting at age 2. [11] For a whole eating pattern, the CORDIOPREV trial in Spain assigned 1,002 people with established coronary heart disease to a Mediterranean diet or a low-fat diet. Hazard ratios for major cardiovascular events ranged from 0.719 to 0.753 in favor of the Mediterranean diet, but there was no difference in the 175 women, and olive-oil foundations were among the funders. [12] See dietary patterns.
Frequently asked questions
Which food lowers cholesterol the most?
We did not find trials that compare these foods directly. In separate meta-analyses, oat beta-glucan lowered LDL by 0.25 mmol/L and soy protein by 4.76 mg/dL, with other foods in similar small ranges. [2][3]
Can food replace a statin?
Not on the evidence we read. The foods above changed cholesterol numbers modestly. Ask a doctor or pharmacist before stopping a prescribed medicine. [1]
Do oats really lower cholesterol?
In 28 trials, at least 3 g of oat beta-glucan a day lowered LDL by 0.25 mmol/L compared with control, with no effect on HDL or triglycerides. [2]
Is dark chocolate good for cholesterol?
A 31-study review found lower LDL, but it combined cocoa extract and chocolate with at least 70% cocoa, so it cannot tell you about chocolate alone. [7] See dark chocolate and cocoa as food.
Does swapping butter for other fats matter?
In the Cochrane review, reducing saturated fat lowered combined cardiovascular events, and replacing it with polyunsaturated fat or carbohydrate appeared useful. [10]
More details: evidence, limits and cautions
The details behind this page: cautions, limits of the evidence and where sources disagree. Open any note to read it.
How to read these studies
LDL is the cholesterol number most often used as a stand-in for heart risk. A change in LDL is a biomarker, not a clinical outcome such as a heart attack. Most food trials ran for weeks, not years. Many compare a food with another food ("instead of"), so adding a food on top of everything else may not give the same result. A result for a cocoa extract, a fiber powder or a sterol-enriched spread does not transfer to the plain food.
What regulators say
In the US, the FDA's health-claim rules allow a label to link soluble fiber and heart disease risk when a food supplies 3 g or more a day of beta-glucan from whole oats or barley. [13] Plant sterol and stanol claims are tied to 1.3 g or more a day of sterol esters or 3.4 g or more a day of stanol esters. [14] These are label rules read from the regulation text, not advice for any one person.
Limits and safety
- Proper evidence not found in the sources we read for any single food preventing heart attacks in a trial; the long-term outcome evidence we read is for fat swaps and a whole Mediterranean pattern.
- Some foods and drinks can change how medicines work or raise side-effect risk, according to the NHS statin page. [1] See grapefruit and medicine interactions and medication interactions.
- Ask a pharmacist or clinician before adding sterol-enriched products or large amounts of any one food if you take cholesterol medicines or have kidney, allergy or other conditions.
References
- NHS (UK). Statins. Read 2026-10-22.
- Whitehead A et al. Cholesterol-lowering effects of oat β-glucan: a meta-analysis of randomized controlled trials. Am J Clin Nutr 2014. Read 2026-10-22.
- Blanco Mejia S et al. A Meta-Analysis of 46 Studies Identified by the FDA Demonstrates that Soy Protein Decreases Circulating LDL and Total Cholesterol Concentrations in Adults. J Nutr 2019. Read 2026-10-22.
- Guasch-Ferré M et al. Effects of walnut consumption on blood lipids and other cardiovascular risk factors: an updated meta-analysis and systematic review of controlled trials. Am J Clin Nutr 2018. Read 2026-10-22.
- Ha V et al. Effect of dietary pulse intake on established therapeutic lipid targets for cardiovascular risk reduction: a systematic review and meta-analysis of randomized controlled trials. CMAJ 2014. Read 2026-10-22.
- Zhao Y et al. Black tea consumption and serum cholesterol concentration: systematic review and meta-analysis of randomized controlled trials. Clin Nutr 2015. Read 2026-10-22.
- Arisi TOP et al. Effects of Cocoa Consumption on Cardiometabolic Risk Markers: Meta-Analysis of Randomized Controlled Trials. Nutrients 2024. Read 2026-10-22.
- Ras RT et al. LDL-cholesterol-lowering effect of plant sterols and stanols across different dose ranges: a meta-analysis of randomised controlled studies. Br J Nutr 2014. Read 2026-10-22.
- Chiavaroli L et al. Portfolio Dietary Pattern and Cardiovascular Disease: A Systematic Review and Meta-analysis of Controlled Trials. Prog Cardiovasc Dis 2018. Read 2026-10-22.
- Hooper L et al. Reduction in saturated fat intake for cardiovascular disease. Cochrane Database Syst Rev 2020. Read 2026-10-22.
- U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025. 9th Edition, December 2020. Read 2026-10-22.
- Delgado-Lista J et al. Long-term secondary prevention of cardiovascular disease with a Mediterranean diet and a low-fat diet (CORDIOPREV): a randomised controlled trial. Lancet 2022. Read 2026-10-22.
- U.S. Government. 21 CFR 101.81: Health claims: soluble fiber from certain foods and risk of coronary heart disease. Regulation text as shown by Cornell Legal Information Institute. Read 2026-10-22.
- U.S. Government. 21 CFR 101.83: Health claims: plant sterol/stanol esters and risk of coronary heart disease. Regulation text as shown by Cornell Legal Information Institute. Read 2026-10-22.