Hawaii is packed with natural beauty, but it also has a wealth of superfoods that can help maintain healthy cholesterol levels, improve heart health, and support overall well-being.
Heart disease is one of the leading health concerns, but some Hawaiian local foods, considered superfoods, could be the key to better heart health. Total cholesterol levels are often connected to heart health. However, the size and number of LDL particles and triglyceride levels significantly influence cardiovascular risk. Studies show that individuals with minor, dense LDL particles are at a higher risk for atherosclerosis than those with larger, more buoyant LDL particles. Small LDL particles penetrate artery walls more efficiently, leading to plaque buildup. Processed foods high in trans fats and refined carbohydrates promote small LDL particle formation. Instead, choosing more monounsaturated fats (avocados, olive oil) and omega-3s (fatty fish, walnuts) can help encourage larger, less atherogenic LDL particles.
High triglyceride (TG) levels often indicate insulin resistance and an increased risk for heart disease. The TG/HDL ratio is considered one of the best predictors of cardiovascular risk. A ratio above 3.0 suggests a higher risk. Consuming fiber-rich foods, regular physical activity, and omega-3 supplements can also lower TG levels. Avoid added sugar, alcohol, and ultra-processed foods, which can spike triglyceride levels.
Lipoprotein(a) (Lp(a)) is a genetically determined cholesterol variant that contributes to arterial plaque formation. Supplementing Niacin (B3), increasing omega-3 intake, and maintaining a heart-healthy diet can help. On the other hand, high levels of oxidized LDL from fried and processed foods can compound Lp(a) risk.
Hawaii is home to numerous superfoods that provide essential nutrients and work synergistically to reduce inflammation, support metabolic health, and improve lipid profiles. Taro (Kalo) is a staple in Hawaiian cuisine and rich in dietary fiber, which helps lower cholesterol levels by binding to LDL in the digestive system and promoting its excretion. Additionally, taro contains resistant starch, which supports gut microbiome health and can indirectly improve insulin sensitivity, helping manage triglycerides.
Locally grown avocados are loaded with monounsaturated fats, which help raise HDL and lower LDL cholesterol. Research shows that regular avocado consumption reduces small, dense LDL particles while maintaining larger, protective LDL particles. Avocados are also rich in potassium, which helps regulate blood pressure.
Macadamia nuts are native to Hawaii and packed with monounsaturated fats and polyphenols that help reduce oxidative stress and inflammation. Studies have found that diets rich in macadamia nuts significantly lower LDL cholesterol levels by up to 10% while increasing HDL cholesterol. A handful of raw or lightly roasted macadamia nuts can support heart health without adding excess saturated fat.
Breadfruit (‘Ulu) is high in fiber and complex carbohydrates and can help stabilize blood sugar levels and reduce triglycerides. Studies here show that breadfruit’s unique fiber content promotes cholesterol excretion, making it a valuable food for maintaining heart health.
Coconut oil is sometimes considered controversial due to its saturated fat content, even though it contains natural and healthy fat sources. Coconut water, however, is a natural source of potassium and electrolytes that support heart function and blood pressure regulation. Drinking fresh coconut water instead of sugary drinks can help maintain a healthy lipid profile.
Heart-healthy local fish contain omega-3 fatty acids essential for reducing inflammation and improving heart health. The waters surrounding Hawaii offer plenty of fish rich in omega-3s. Ahi (tuna) is an excellent source of omega-3s, and grilled or seared ahi with a light soy-ginger glaze makes for a heart-healthy main course. Mahi mahi is another favorite, low in fat but high in protein and omega-3s. Baking mahi-mahi with a citrus-herb crust brings out its natural flavors without adding unhealthy fats. Opah (moonfish) is rich in omega-3s and protein and can be grilled or sautéed with olive oil and fresh herbs.
Here’s a couple recipes:
Avocado &Ahi
Poke Bowl:
• 1 cup steamed brown rice or quinoa
• 4 oz fresh ahi (cubed)
• 1 ripe Hawaiian Avocado (diced)
• 1/4 cup seaweed salad
• 1 tbsp low-sodium soy sauce (or Coco Aminos)
• 1 tsp sesame oil
• Sesame seeds and green onions for garnish
Combine the ahi, soy sauce, and sesame oil. Layer rice/quinoa, marinated ahi, avocado, and seaweed salad. Top with sesame seeds and green onions. Enjoy a heart-healthy, omega-3-rich meal!
Roasted ‘Ulu &
Taro Salad:
• 1 cup roasted breadfruit (cubed)
• 1 cup steamed taro (cubed)
• 2 cups mixed greens
• 1/4 cup macadamia nuts (chopped)
• 2 tbsp olive oil
• 1 tbsp lemon juice
• Salt and pepper to taste
Combine ‘ulu, taro, and mixed greens in a bowl. Drizzle with olive oil and lemon juice. Top with macadamia nuts, salt, and pepper. Serve as a nutrient-dense side or light main dish.
A healthy lifestyle, of course, is always the best prevention. Stay active outdoors and take advantage of the beautiful swimming or hiking. Regular physical activity is key to maintaining heart health. Practice mindful eating, which means enjoying meals slowly and appreciating local flavors, as this also helps with digestion and portion control, both essential for heart health. And finally, lower stress naturally with outdoor yoga, meditation, or simply relaxing by the ocean, all of which can lower stress and support heart health.
References
Berneis, K., & Krauss, R. M. (2002). Metabolic origins and clinical significance of LDL heterogeneity. Journal of Lipid Research, 43(9), 1363–1379.
Garg, A. (2018). High triglyceride/HDL ratio and cardiovascular disease risk. Current Opinion in Lipidology, 29(4), 313–317.
Nordestgaard, B. G., Chapman, M. J., et al. (2010). Lipoprotein(a) as a cardiovascular risk factor. European Heart Journal, 31(23), 2844–2853.
Wang, L., Bordi, P., Fleming, J. A., Hill, A. M., & Kris-Etherton, P. M. (2015). Effect of avocado on LDL particle size and subclass distribution. Journal of the American Heart Association, 4(1), e001355.
Garg, M. L., Blake, R. J., et al. (2007). Macadamia nut consumption lowers LDL cholesterol levels. Journal of Nutrition, 137(3), 550–556.
American Journal of Clinical Nutrition (2017). Omega-3 fatty acids and cardiovascular disease prevention: current evidence and future directions. Am J Clin Nutr, 106(1), 120–129.
University of Hawaii Research (2020). The dietary fiber content in Hawaiian breadfruit and its role in cholesterol management. Pacific Health Journal, 35(4), 212–225.
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Ayda Ersoy is a nutritionist (Dip.C.N., Dip.S.N.); master trainer (CPT ACE, NCSF, CanfitPro); registered yoga teacher; founder, Health Angel Nutrition, Fitness and Wellness; and founder, SMS (Stability, Mobility Strength) Intuitive Training System.
