Worried about your cholesterol levels? How you’ve been eating (combined with your genes) may have gotten you there, but the good news is that how you eat going forward can help you get out of this fix. In fact, you can lower your cholesterol by as much as 20 percent through diet alone. While perhaps a challenge, this doesn’t have to be painful — and it can even be delicious.

Forget the Fads
There’s a lot of information out there on heart-healthy diets, and not all of them agree on the best way to keep your ticker tocking. Steven Nissen, MD, chief of cardiovascular medicine at the Cleveland Clinic and coauthor of the “Cleveland Clinic Healthy Heart Lifestyle Guide and Cookbook, cautions against the latest fad diets, and instead emphasizes choosing a diet that works for you long-term.

So, just as those double-cheeseburger-hold-the-bun plans won’t sustain you, neither will uberstrict diets that take the joy out of eating. As with everything in life, think moderation. When trying to find a diet that works for you, keep the following guidelines in mind.

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Focus on fats for the week. Clean out your cupboards of all baked goods and processed foods with trans fats. Then work on reducing saturated fat by replacing beef and chicken with heart-healthy fish and beans. Swap out butter and corn oil for olive and canola oils.

It’s All Greek to Us
Dr. Nissen, the Cleveland Clinic and many other health professionals advocate a Mediterranean-style diet, which is based on the traditional cuisines of southern Italy and Greece.

This way of eating typically includes a bounty of plant-based foods like fruits, vegetables, beans and whole grains. Corn oil and butter are replaced with healthier, monounsaturated ones — most notably olive oil. Protein comes from eating fish several time a week, as well as beans, nuts and lean cuts of poultry.

Limiting your intake of processed foods, drinking red wine in moderation and eating red meat monthly rather than weekly are other important aspects of the diet.

Chew the (Good) Fat
Best news in the heart department this decade: Fat is okay to eat! Researchers compared the effects of a low-fat diet and a Mediterranean diet on heart attack survivors and found that people eating Mediterranean-style had a 50 to 70 percent lower risk of recurrent heart disease. The reason: heart-healthy fats.

Monounsaturated fats (found in olives and olive oil, canola oil, nuts and avocados) and omega-3s — think fish, flaxseed and walnuts — can boost your “good” HDL cholesterol.

Why is that great news? Because HDL protects the heart and actually helps remove LDL from your arteries. Of course, all fat is not created equal, so don’t go reaching for the french fries just yet. Saturated fat, which comes from processed food, meat and dairy products, can increase your “bad” LDL cholesterol, and is still a no-no.

  • Play the numbers. To get your cholesterol numbers on track, aim for roughly 25 to 35 percent of your calories to come from fat. Of that, 7 percent or less should be saturated. Avoid trans fats and hydrogenated fats, both of which increase LDL cholesterol. Trans fats also decrease HDL. The rest of the fat in your diet should come primarily from monounsaturated fat and omega-3s.
  • Fish for a solution. Fish oil is particularly important to heart health. It can lower triglycerides, another kind of fat in your bloodstream that is a risk factor for coronary heart disease. Get plenty of omega-3s from grilled salmon, tuna or sardines three times a week, or by taking a daily supplement. If you’re on blood thinners, consult your physician first.

The White Stuff Ain’t the Right Stuff
A Mediterranean diet does not mean all pasta all the time. In fact, Steven Gundry, MD, author of “Dr. Gundry’s Diet Evolution,” blames a great deal of heart disease on “healthy” low-fat diets, “because what most people end up eating are fairly concentrated, refined carbohydrates,” he states. The connection: Foods high in sugar, white flour or other refined carbohydrates can push your triglycerides levels up. Triglycerides can cause LDL and HDL molecules to shrink, which may make LDL more dangerous and HDL less protective.

The answer: Do a color swap, replacing “white” carbs with “brown.” For instance, choose whole-grain bread, whole-wheat pasta or brown rice instead of white versions, and experiment with other whole grains like quinoa, bulgur and barley.

Fill up on Fiber
Soluble fiber contains no vitamins, minerals or nutritional value, and your body can’t digest it for energy. So what good is it? A whole lot if you’re worried about cholesterol: Soluble fiber can help lower your LDL count — after turning into a gummy substance in your gut, soluble fiber binds to cholesterol-containing bile acids there, and then flushes the bile (and its LDL) from your body as the whole mess moves out your intestine. Your body then draws out more cholesterol from your bloodstream to make more bile, and the whole cycle repeats. While it sure doesn’t sound very pretty, it’s quite an amazing system for keeping your bad cholesterol down.

To pull off this disappearing act, try to eat at least 10 grams per day. Here are some fiber-rich foods in your daily menu that would get you to that number: 1/2 cup of oatmeal with six prunes for breakfast, a medium pear for a snack, 1/2 cup of cooked black beans in your salad at lunch, a cup of raw broccoli in the afternoon and a medium orange after dinner.

Plant One on Me
Diets high in fruits, vegetables and other plants are associated with a lower risk of heart disease. Researchers continue to work to figure out how and why, but they do know that eating plenty of produce means you get plenty of phytochemicals (a fancy word for plant chemicals) like flavonoids and sterols, which can help reduce inflammation and possibly even reduce plaque formation.

  • Get plant sterols from fortified products like Smart Balance spread and Minute Maid Heart Wise orange juice. A recent study showed that getting two to 2.5 grams of sterols may lower LDL by 10 to 14 percent.
  • Green and black tea, Concord grapes, dark chocolate (no more than 1.65 ounces a week), cranberries and pomegranates are some of the heavy hitters suspected of keeping LDL from turning into plaque.
  • Mix it up: Eating a wide variety of fruits and vegetables (think nine servings a day) is the best way to stay healthy.

—by Jill Provost