The effects of foods on LDL cholesterol levels: A systematic review of the accumulated evidence from systematic reviews and meta-analyses of randomized controlled trials

source extracted confidence: high 2026-04-09
#adult #biomarkers #cholesterol-ldl #diet #diet-healthy

The effects of foods on LDL cholesterol levels: A systematic review of the accumulated evidence from systematic reviews and meta-analyses of randomized controlled trials

Schoeneck et al., 2021 | Nutr Metab Cardiovasc Dis | Meta Analysis

Citation

Schoeneck Malin, Iggman David. The effects of foods on LDL cholesterol levels: A systematic review of the accumulated evidence from systematic reviews and meta-analyses of randomized controlled trials. Nutr Metab Cardiovasc Dis. 2021-May-06;31(5):1325-1338. doi:10.1016/j.numecd.2020.12.032

Abstract

AIMS: To systematically evaluate the evidence regarding the effects of foods on LDL cholesterol levels and to compare the findings with current guidelines. DATA SYNTHESIS: From inception through June 2019, we searched PubMed, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials for guidelines, systematic reviews, and RCTs (for coffee intake only) of at least 13 days duration. Additionally, we searched Trip database for guidelines from 2009 through Oct 2019. Language was restricted to English. The strength of evidence was evaluated using The Grading of Recommendations Assessment, Development, and Evaluation (GRADE). A total of 37 guidelines, 108 systematic reviews, and 20 RCTs were included. With high evidence, foods high in unsaturated and low in saturated and trans fatty acids (e.g. rapeseed/canola oil), with added plant sterols/stanols, and high in soluble fiber (e.g. oats, barley, and psyllium) caused at least moderate (i.e. 0.20-0.40 mmol/L) reductions in LDL cholesterol. Unfiltered coffee caused a moderate to large increase. Soy protein, tomatoes, flaxseeds, and almonds caused small reductions. With moderate evidence, avocados and turmeric caused moderate to large reductions. Pulses, hazelnuts, walnuts, high-fiber/wholegrain foods, and green tea caused small to moderate reductions, whereas sugar caused a small increase. Other identified foods were either neutral or had low or very low evidence regarding their effects. CONCLUSIONS: Several foods distinctly modify LDL cholesterol levels. The results may aid future guidelines and dietary advice for hypercholesterolemia.

Key Findings

Several foods distinctly modify LDL cholesterol levels. The results may aid future guidelines and dietary advice for hypercholesterolemia.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size 20
Age Range See abstract
Condition See abstract

MeSH Terms

  • Adult
  • Biomarkers
  • Cholesterol, LDL
  • Diet
  • Diet, Healthy
  • Down-Regulation
  • Female
  • Humans
  • Hypercholesterolemia
  • Male
  • Middle Aged
  • Nutritive Value
  • Randomized Controlled Trials as Topic
  • Risk Assessment
  • Risk Factors
  • Risk Reduction Behavior
  • Treatment Outcome
  • Young Adult

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Systematic Review
  • Vertical: curcumin

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09