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Over the years, the messages about cholesterol have changed. Until recently, the standard advice was to watch the amount of cholesterol in your food. We now know the relationship between the cholesterol we get from our diets and our bodies’ cholesterol levels is a lot murkier than it once seemed.
So let’s take a closer look at what cholesterol is, the factors affecting it, some examples of high cholesterol foods (and what that means for your health), and tips for lowering cholesterol levels.
What is cholesterol?
Cholesterol is a waxy substance made of lipids (a type of fat). It’s both produced by cells in the body and brought into the body through the food you eat. Your body uses cholesterol to form healthy cell walls, hormones, and vitamins, including (Huff, 2021):
- Vitamin D
- Bile salts
When your healthcare provider tests your cholesterol levels, they’re testing the number of lipoprotein particles in your blood because these carry cholesterol around your body. When your lipid profile is tested, you’ll typically see these different markers included in the results:
- Very-low-density lipoprotein (VLDL): This type primarily carries triglycerides.
- Low-density lipoprotein (LDL): This type carries around most of the cholesterol in the body. It’s often referred to as “bad” cholesterol because too much of this type can build up in the blood vessels and increase your risk for heart disease.
- Intermediate-density lipoprotein (IDL): This type transports cholesterol and triglycerides.
- High-density lipoprotein (HDL): This type absorbs cholesterol and brings it back to the liver. It’s often called “good” cholesterol because high levels of this type lower heart disease risk.
- Total cholesterol: This is the total amount of all lipoproteins in the blood.
Why cholesterol is too important to ignore
Does diet affect cholesterol?
Diet can impact your blood cholesterol levels. But it’s not the only factor because genetics and how much cholesterol your body produces also affect your levels.
New research has been emerging on how diet impacts cholesterol. Researchers used to believe the amount of cholesterol in foods was one of the main drivers of the body’s total cholesterol and LDL cholesterol levels. However, newer research shows dietary cholesterol may not be what’s impacting your levels.
A 2019 study found that high levels of saturated fat, not cholesterol, in foods were associated with higher triglyceride and LDL levels (Cha, 2019). It’s recommended to keep your total intake of saturated fat to 7–10% of your diet because higher levels may increase your risk of heart disease.
Some foods may help lower your cholesterol levels, especially plant sterols and soluble fiber. Fiber is the harder substance that gives plant foods structure and texture. The body isn’t able to break down fiber fully. Instead, fiber often has important roles as it moves through the digestive system, like keeping your bowel movements regular.
Fiber holds onto water and other substances in the intestines, including bile salts. The bile salts and other substances bound to soluble fiber leave the body in stool. Without fiber, your body would reabsorb most of the substances and reuse them for future digestion. Instead, your liver will create new bile salts using the cholesterol in your body, which helps lower your cholesterol levels (Soliman, 2018).
It’s recommended to focus on eating unsaturated fats and plant foods to help lower bad cholesterol and raise good cholesterol (Harland, 2012).
High cholesterol food examples
Since cholesterol is produced by animal cells, it’s only found in animal products. Here are some foods that are high in cholesterol:
- Eggs: Many people avoided eggs for years because they’re high in cholesterol. However, eggs are also a good source of protein, unsaturated fat, vitamin A, vitamin D, vitamin B12, choline, lutein, zeaxanthin, and other micronutrients.
- Meat: Many types of meat are higher in cholesterol, including fish, poultry, and beef.
- Dairy products: Milk, yogurt, cheese, and other dairy products all contain cholesterol.
- Organ meats: Animal liver, heart, and kidney are loaded with cholesterol, iron, zinc, vitamin B12, and other nutrients.
Although these foods are high in cholesterol, research suggests the cholesterol in foods has a lower impact on your cholesterol levels than other nutrients (Soliman, 2018).
How to lower cholesterol: medication and lifestyle
Foods to avoid if you have high cholesterol
Instead of looking at the amount of cholesterol in foods, it may be more useful to look at the type of fat in your food. Foods high in saturated fat and trans fat seem to negatively impact LDL levels in most people (Cha, 2019).
Here are some foods higher in saturated fat to avoid for high cholesterol:
- Full-fat dairy products
- Lard and shortening
- Fried foods
- Fatty cuts of beef, lamb, and pork
- Fast food
- Processed meats
- Saturated oils, like palm oil and coconut oil
- Rich desserts, like ice cream and candy bars
Saturated fat does have some important functions in the body and shouldn’t be completely eliminated from the diet. Still, it’s easily found in a wide variety of foods.
Most people can meet the recommended 7–10% of total calories from saturated fat by consuming leaner meats and high unsaturated fat foods. Most types of foods with fat contain a mixture of unsaturated and saturated fats.
Foods beneficial for high cholesterol
Fiber and unsaturated fats may help lower your LDL levels and increase HDL cholesterol, which helps your heart health and lowers cardiovascular disease risk. Here are some foods high in unsaturated fats and leaner proteins that may benefit high cholesterol:
- Fatty fish, like salmon, trout, mackerel, sardines
- White meat from chicken and turkey
- Eggs and egg yolk
- Greek yogurt
- Olives and olive oil
- Seeds, like pumpkin and sesame seeds
- Nuts, like almonds, cashews, pecans, hazelnuts
- Lean cuts of red meat
Here are some foods high in soluble fiber:
- Oats, oatmeal, and cereals
- Flax seeds
- Brussels sprouts
- Beans and legumes, like black beans, garbanzo beans, kidney beans, lentils
- Sweet potatoes
- Seeds, like sunflower seeds, hazelnuts
- Plant sterol spreads and margarine
Cholesterol medication: types, benefits, and side effects
Tips to help lower your cholesterol
High levels of bad cholesterol and lower good cholesterol can increase your risk for plaques that build up in your arteries. This increases your risk for coronary artery disease, atherosclerosis, heart attack, and stroke (Huff, 2021).
If you have high cholesterol levels, be sure to follow your healthcare provider’s recommendations for medications because some of these can help with the amount of cholesterol your body produces.
Other healthy lifestyle changes can help to lower cholesterol levels, such as:
- Healthy eating: Focus on eating heart-healthy foods like fruits, vegetables, whole grains, lean proteins, and healthy fats (Schoeneck, 2021).
- Weight loss: Losing weight (if needed) can help to lower the risk for heart disease and lower triglyceride levels (Clifton, 2019).
- Increasing physical activity and exercise: Regular exercise helps lower the risk for heart disease, high blood pressure, and high cholesterol (Huff, 2021).
- Quitting smoking: Stopping tobacco use may help to reduce cholesterol levels, in addition to all the other health benefits of quitting smoking (Huff, 2021).
While dietary cholesterol probably doesn’t impact our cholesterol levels the way researchers once thought, it’s still important to be mindful of what foods you’re eating and your overall health. Speak with your healthcare provider if you’re unsure about dietary changes.
- Cha, D. & Park, Y. (2019). Association between dietary cholesterol and their food sources and risk for hypercholesterolemia: the 2012⁻2016 korea national health and nutrition examination survey. Nutrients, 11(4), 846. doi: 10.3390/nu11040846. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6520795/
- Clifton, P. M. (2019). Diet, exercise and weight loss and dyslipidemia. Pathology, 51(2), 222–226. doi: 10.1016/j.pathol.2018.10.013. Retrieved from https://pubmed.ncbi.nlm.nih.gov/30528924/
- Harland, J. I. (2012). Food combinations for cholesterol lowering. Nutrition Research Reviews, 25(2), 249–266. doi: 10.1017/S0954422412000170. Retrieved from https://pubmed.ncbi.nlm.nih.gov/23069003/
- Huff, T., Boyd, B., & Jialal, I. (2021). Physiology, cholesterol. [Updated 2021, Mar 2]. In: StatPearls [Internet]. Retrieved on Oct. 19, 2021 from https://www.ncbi.nlm.nih.gov/books/NBK470561/
- Schoeneck, M. & Iggman, D. (2021). The effects of foods on LDL cholesterol levels: A systematic review of the accumulated evidence from systematic reviews and meta-analyses of randomized controlled trials. Nutrition, Metabolism, And Cardiovascular Diseases, 31(5), 1325–1338. doi: 10.1016/j.numecd.2020.12.032. Retrieved from https://pubmed.ncbi.nlm.nih.gov/33762150/
- Soliman, G. A. (2018). Dietary cholesterol and the lack of evidence in cardiovascular disease. Nutrients, 10(6), 780. doi: 10.3390/nu10060780. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6024687/
Dr. Steve Silvestro is a board-certified pediatrician and Senior Manager, Medical Content & Education at Ro.