Book Review: Lower LDL Cholesterol Naturally With Food By Dr Michael Greger

Dr Michael Gregers’ website nutritionfacts.org is an invaluable resource for all health related information. Dr Greger and his scores of volunteers read all the research and decode it for general public.

Though Greger can be controversial. First he is not a practicing doctor and he is just going by what is claimed in the research papers. Research papers can have conflict of interest and bias which are not declared or not obvious. In such a case, one should compare the information with some real expert.

For example, when it comes to Heart Disease, Dr Caldwell Esseltyn is an real expert who has used power of Low Fat Whole Food Plant Based diet to reverse heart disease in many people. His book ‘How to prevent and reverse heart disease’ and youtube videos are highly recommended if you want to access his knowledge and wisdom that can save your life!

In this book review, I am taking Gregers’ recommendations and cross checking them with Dr Caldwell Esselstyn’s point of view.

So first lets discuss how low should LDL cholesterol be? Dr Greger starts the book by stating the latest from the Medical Establishment that LDL cholesterol should be as low as possible.

I will use bold-italic in double quotes to quote Greger verbatim from the book as in following paragraph.

“LDL cholesterol, also known as “bad” cholesterol, is “unequivocally recognized as the principal driving force” in the development of atherosclerotic cardiovascular disease, our leading cause of death. Guidelines have shifted to lower and lower LDL cholesterol targets as more and more clinical trials have demonstrated that lower is better. They started with an LDL goal of 130 mg/dL* in the 1980s and went down to 100 mg/dL in the 1990s, then further still to 70 mg/dL in the 2000s for those at really high risk, and, over the last decade, even lower to 55, 40, or even 30 mg/dL.”

Dr Esseltyn’s original point of view was that if your total cholesterol is less than 150 mg/dl (and LDL less than 100 mg/dl) you can not have heart attack. In one of the recent youtube video Dr Essentyn states that no LDL number will cause you harm unless your Endothelium layer is damaged.

Gemini Summary Of Above YouTube Video: “Dr. Caldwell Esselstyn’s main point in this video is that strengthening the lining of your blood vessels is more critical than a specific cholesterol number for preventing and reversing heart disease.
He argues that a whole-food, plant-based (WFPB) diet achieves this by protecting the endothelial cells and their ability to produce nitric oxide (NO).
The Endothelial Fortress (The True Cause of Heart Disease)
Dr. Esselstyn shifts the focus from cholesterol numbers to cellular health:
* Numbers Don’t Cause Disease: He asserts that no single number (like cholesterol) has ever caused heart disease; the disease is caused by the food that damages the endothelial cells [00:45].
* Nitric Oxide (NO): The standard American diet destroys the ability of endothelial cells to make sufficient nitric oxide, which is necessary for blood vessel health and flexibility [00:55].
* Endothelial Fortress: The goal of the WFPB diet is to constantly strengthen the endothelial fortress [02:20]. If a patient is 100% compliant and has successfully protected their endothelium, they can’t injure themselves, even if their cholesterol is moderately high (e.g., 190 or 200), because the plaque-forming cholesterol cannot slip past the strengthened cell wall [02:35].
* Critique of Guidelines: He criticizes government cholesterol guidelines for completely missing the point by failing to mention the necessity of protecting the endothelial cells [03:52].
Dietary Caveats and Exclusions
Dr. Esselstyn outlines key food groups to avoid, especially for patients with established cardiovascular disease:
* Nuts and Seeds: For patients who are seriously ill with heart disease, he recommends avoiding nuts and seeds [05:10]. He states they contain a lot of saturated fat and are highly addicting, making compliance difficult [05:10]. (He clarifies that if a person has no heart disease, having them is acceptable [04:59]).
* Dairy Must Go: Dairy is highlighted as “one of the worst things” a person can consume for its role in tumor formation and atherosclerosis (artery hardening). He calls it “absurd” to suggest heart patients eat ice cream, cheese, or butter [06:27].
* Familial Hypercholesterolemia: For the small percentage of patients with familial cholesterol (levels over 300 or 400), diet alone may not be enough, and medication may be a necessary complement to the WFPB program [03:07].
The Seismic Revolution
* Broad Impact: He concludes by calling WFPB nutrition a “seismic revolution” in health [07:26].
* Annihilating Chronic Illness: This therapy is safe, inexpensive, and can “absolutely annihilate 80% of chronic illness” [08:39]. Beyond heart disease, he lists its benefits for hypertension, diabetes, stroke risk, Crohn’s disease, rheumatoid arthritis, and multiple sclerosis [07:37].”

Endothelium layer is a single cell lining in all of your 60,000 miles of blood vessels. When healthy it produces Nitric Oxide which is strongest blood vessel dilator. An unhealthy endothelium layer does not produce Nitric Oxide and it causes blood vessels to harden and not do their job properly. That further causes the person to become susceptible to cardiac artery disease. Key point from Dr Esselstyn’s video above is that Government guidelines that keep lowering LDL targets completely ignore the importance of protecting Endothelium layer.

As I mentioned before if there is a conflict between Greger and Esselstyn’s point of view, I trust Dr Esselstyn’s opinion more.

Dr Greger has an app called The Daily Dozen that helps you eat healthy. There are twelve main categories. You can learn about these in detail from Dr Greger’s website NutritionFacts.org or by downloading the Daily Dozen app from app store. For example Beans categories above has three squares implying you should have three servings of Beans every day.

Out of the above, and based on Esseltyne’s recommendation we can ignore the following:

• Nuts and Seeds : due to saturate fat in them and because it is very easy to overindulge. Just avoid Nuts and Seeds
• I further avoid Soybeans because it is goitrogenic and has phytoestrogens. Other Beans and Legumes are fine.
• Flaxseeds : flaxseeds also have phytoestrogens and are goitrogenic so avoid.
• Vitamin D: avoid supplement, just spend 30 minutes in sunshine every day
• DHA : avoid DHA and EPA supplementation, you don’t need it.
• Plant Sterols: My recommendation is to avoid Plant sterols as they are just like cholesterol.
• Coffee : Drink only decaf. Caffeine damages endothelium layer. Caffeine is also a vaso-constrictor. Also if you drink coffee whether caffeine or decaf, use paper filter to filter coffee as the paper filter is known to filter out cholesterol raising compounds.
• Green Tea, Cocoa powder: I avoid them because I am personally very sensitive to Caffeine. Might work for you.
• Mushrooms: I avoid them mainly due to personal preference. Read somewhere that they are not grown in very hygienic conditions. You decide for yourself.
• Bergammot, Taurine: I don’t believe in taking supplements. Only exception is Vitamin B12. I try to get all the nutrients from foood. You can try them. Bergammot can enhance efficacy of the medications you are taking so you need to keep your doctor in loop.
• Nutritional Yeast: I avoid it because it is a processed food. You can decide for yourself.

Rest of the stuff in Gregers’ infographic above is good and I encourage you to experiment with them. You can change quantities and consume more than Gregers’ recommendations.

In this section, I will include my experience and what I am doing these days.

I primarily eat a low fat, low salt whole food plant based diet.

But Indian parties and travel are a challenge. I probably make things worse by dropping my eating rules when I go to parties and when I travel. I need to be more careful going forward.

Because of these my LDL cholesterol came to 150 in Sep-2025. It was 92 in August-2024.

So now I am tightening the screws.

To lower LDL I have started drinking Amla tea. I got this organic Amla powder and I put half a teaspoon in one cup of hot water.

Also increased consumption of legumes and beans to at least three times a week.

Oats are also regular part of my diet. I eat them at least two to three times a week.

I have also introduced no-added-salt Sumac spice and barberries in my diet. These two are excellent salt replacement. These you can sprinkle over your pasta, dal, … etc.

I have also increased consumption of greens. I have a big salad at least couple of times a week. Need to make it a daily habit to consume 10 to 12 oz salad daily.

I also consume organic beet root juice. It is substitute for coffee as caffeine damages endothelium layer. Beet root juice helps endothelium layer by increasing production of nitric oxide which is a strong vaso-dilator. Decaf coffee is fine from endothelium layer protection point of view.

Salt-restriction also helps as salt is vaso-constrictor.

I am planning to repeat my cholesterol test again in a few months.

I also avoid nuts and seeds as they are high in saturated fats.

I will also recommend avoiding plant sterols. They lower LDL cholesterol by binding to cholesterol receptors. But they are essentially cholesterol like substance that can still harm endothelial layer.

Greger book also recommend eating dry apple rinds for reducing LDL cholesterol. I just slice apple and air fry it for 10 minutes. I like eating apple this way. Before starting to air fry apple slices, I had hard time eating apples. Now I am eating apples three to four times a week.

Psyllum Husk is a very potent LDL reducer. We add it to flour when we make Indian Rotis. We used the brand Isabgol from Indian stores. Important thing is that it should not be mixed with sweeteners as in general, sweeteners are not good for you.

Lately, I have become big fan of potatoes and sweet potatoes. Dr John McDougall who was an internal medicine doctor was big fan of potatoes and sweet potatoes. He said if you don’t know what to eat just eat potatoes and sweet potatoes. I air fry about 300 to 400 grams of potato/sweet potato after slicing them for about 10 minutes and eat them for breakfast. Potatoes are very rich in nutrients and they have high fiber. As a result they act as slow release energy pill. Eating lots of potatoes is best way to lose weight. But make sure you don’t add any fat or salt to them in preparation. Potatoes lower LDL cholesterol because of their high fiber content. The fiber binds with cholesterol and then cholesterol is excreted.