My approach to help people lower their LDL cholesterol levels focuses more on what you should eat. Avoiding certain foods is also important. However, if your diet is loaded with healthy foods then there won’t be room for the foods that raise cholesterol.

I am a big fan of a Mediterranean style diet. In reality there is no formal Mediterranean diet. But the diets of people living in southern Europe tend to share these features:

• Lots of fruits and vegetables
• More whole grain breads and cereals rather than foods made from refined flour
• Beans, nuts and seeds that are healthy source of protein
• Liberal use of olive oil and other unsaturated fats
• More fish than meat or poultry
• Moderate use of alcohol, primarily wine

The foods that can raise LDL cholesterol -- and the ones to keep to a minimum -- contain trans fatty acids (trans fats) or saturated fats.

Trans fats are the worst. They increase LDL and lower HDL cholesterol levels. Trans fats do not occur naturally. They are made by a process called fat hydrogenation. Foods containing trans fats should be avoided completely. Most food manufacturers and restaurants have eliminated the use of trans fats. But it’s still a good idea to check food labels and restaurant menus to make sure.

Saturated fats are found in so many foods that avoiding them is nearly impossible. The American Heart Association recommends eating a diet with less than 7% of calories from saturated fats. The effect of saturated fat intake on LDL cholesterol levels varies. In some people, eating foods with saturated fats raises LDL dramatically.

Saturated fats are mostly in foods from animals and high fat dairy products. Some oils, such as coconut oil and palm oil, also are high in saturated fat.

The influence of dietary cholesterol intake on LDL cholesterol levels is debated. But the official recommendation is to take in no more than 300 mg of cholesterol per day.