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Advice for people with diabetes and their families

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Cholesterol and diabetes

When we hear about cholesterol, we think of it building up in our arteries and contributing to long-term health problems, but it isn’t just the bad guy – its healthy levels are vital for our cells to function and to make vitamin D and some hormones. 

There are two main types – HDL (good cholesterol) and LDL (bad cholesterol). If the levels of your bad cholesterol become too high and the good cholesterol too low you are at increased risk of developing cardiovascular complications. There are also triglycerides, which can have bad effects on your health if levels are high, too.

For most people, eating a healthy, balanced diet and being physically active is enough to keep cholesterol levels healthy. But for people with diabetes, it is important that you have your levels checked every year. You can find out why it's important in our video.


Do you have high cholesterol?

So if you are told your levels are too high, what can you do? Firstly, ask your GP to refer you to a dietitian who can help. They will advise you to cut down on saturated fat and increase your intake of fibre.

There are natural foods you can eat to help protect your heart and products on the market than claim to lower your cholesterol – but do they work?

We looked into the best foods to eat and looked at the products you can buy.

Natural foods that help protect your heart

There is evidence that some foods can protect our heart, either by their effect on cholesterol, triglycerides or through other means. The way that you prepare all of these natural foods has a huge effect on your health. It’s better to boil, steam or grill them.

Oily fish

For example: herring, salmon, sardines and mackerel.
Eat 1–2 portions a week. They are good sources of omega-3 fats. For ideas on how to cook with oily fish, visit our recipe finder.

Fruit and vegetables

Evidence shows that eating fruit and vegetables lowers risk of CVD. They are low in saturated fat (many contain no fat at all), high in fibre and low in calories to help you control weight. Also, their phytochemicals (natural plant substances), vitamins, minerals and antioxidants help you maintain good health.


For example: walnuts, almonds and cashews.
Studies show that eating nuts more regularly can lower cholesterol, as well as your overall CVD risk. This is partly because, as well as unsaturated fats, nuts contain plant sterols and stanols, and are high in fibre. Opt for unsalted nuts.

Soluble fibre

For example: peas, beans, lentils, broccoli, apples, berries, prunes and sweet potato.
Wholegrains also contain good amounts of soluble fibre. This helps to regulate cholesterol.

Oats and barley

They are rich in a type of soluble fibre called beta-glucan, which forms a gel that binds cholesterol in the body, preventing it from being absorbed into the bloodstream.

Functional foods that lower cholesterol

Many branded products claim to have health benefits, and some are scientifically proven to work.

Probiotics, for example, promote growth of healthy gut bacteria, while adding plant sterols and stanols in larger amounts than you find in natural foods can help reduce cholesterol.

According to research, consuming 1.5–2.4g of plant sterols/stanols every day can lower cholesterol levels in two to three weeks. To work well, they need to be eaten regularly at meal times.

Clinical trials have also shown that sterols and stanols in fortified foods are effective in reducing cholesterol levels, and are safe to use alongside medications, such as statins or fibrates. However, even though plant sterols and stanols are proven to lower cholesterol, there is no data to say they directly reduce or prevent heart disease and stroke.


  • Some fortified foods may not be suitable for pregnant and breastfeeding women, or for children under five.
  • Check with your doctor before using these products, especially if you are taking medication to help lower your cholesterol.
  • If your particular medication works in the same way by inhibiting cholesterol absorption, there may be no additional benefit. But, if your medication acts on liver cells to reduce cholesterol production, foods containing sterols or stanols may help. Check with your doctor.

What’s in store?

There are many products you can buy that contain plant sterols or stanols. They can be expensive, but supermarket own-brands may be cheaper. If you choose to buy them, check how much you need per day (ie a serving) for them to be effective and go for low-fat versions, especially if you’re trying to manage your weight.

Here are some examples of what’s available:


contains plant stanols that help to lower cholesterol when consumed daily – the equivalent of 1 serving of Benecol yogurt drink or dairy-free drink per day or 2–3 servings of Benecol yogurt or spread.


contains beta-glucan, a soluble oat fibre. It works by forming a gel that binds cholesterol-containing bile acid in the stomach and transports it out of the body. One serving provides 3g beta-glucan, which can help maintain normal blood cholesterol levels. Beta-glucan also slows down the absorption of carbohydrate, which will help you manage your blood glucose levels, offering an extra benefit to people with diabetes.

Flora pro.activ

contains plant sterols that help to lower cholesterol when consumed daily, for example 1 serving of milk (250ml) and/or 3 servings of spread, or just 1 mini drink.

Keep up the healthy, balanced diet…

Although cholesterol-lowering functional foods offer benefits, they are not a substitute for healthy eating and lifestyle. You still need to:

  • be a healthy weight, taking steps to lose excess weight if necessary
  • eat a healthy diet based on more fruit and vegetables, nuts, oily fish and wholegrains
  • keep a check on how much alcohol you drink (even though evidence suggests that drinking alcohol in moderation can protect against heart disease, drinking an excessive amount can increase risk)
  • get support to quit smoking
  • keep active and sit less.
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