Key Takeaways

• Fish can be a heart-healthy protein choice with high cholesterol, even though it contains some cholesterol.
• High cholesterol can form plaque in blood vessels, raising your risk of heart attack and stroke.
• Aim for at least two servings of fish weekly, especially omega-3-rich options like salmon, sardines, and trout.
• Avoid deep-frying fish or cooking it in butter; bake, broil, or grill instead.
• Lower cholesterol by cutting saturated fats, trans fats, and refined sugar, and eating more fiber-rich plant foods.

Meal planning gets more complicated once you are diagnosed with high cholesterol. As you figure out what foods best support your health goals, and which ones to cut back on, you’ll likely have a lot of questions.

If you’re wondering if you need to avoid fish when you have high cholesterol, the short answer is no. Lean protein sources like fish are good for your heart health, says Rohini Manaktala, D.O., an interventional cardiologist at Memorial Hermann in Houston, TX.

What exactly makes fish and some other types of seafood smart choices when you’ve got high cholesterol? Check out the insights from heart health experts, plus advice for making cholesterol-friendly choices at the store and when you’re cooking.

First, What Is High Cholesterol?

Cholesterol is a fatty substance that’s produced by your liver and travels through your bloodstream attached to particles called lipoproteins. Your body uses cholesterol for important jobs like hormone production and is usually able to make all the cholesterol you need naturally. There’s also cholesterol in many foods that you eat (that’s called dietary cholesterol).

Problems arise when you have too much cholesterol in your blood. It can start to form sticky deposits called plaques in your blood vessels, eventually clogging them up, explains the Centers for Disease Control and Prevention (CDC). Just like water can’t flow through a grease clog in your kitchen drain, blood can’t travel freely through plaque-narrowed arteries to and from your heart and other organs. That’s when your risk for a heart attack and stroke goes up. Cholesterol levels are measured by a blood test; anything above 200 mg/dL is considered abnormal.

A variety of factors contribute to high cholesterol levels, says Dr. Manaktala, including excess weight, medical conditions like diabetes and kidney disease, a lack of physical activity, your genes, and what you eat. When it comes to diet, though, it’s not as straightforward as you might think. While dietary cholesterol can affect your levels, in healthy people the bigger effect is from fat in your diet, according to the Harvard T.H. Chan School of Public Health. The reason: Eating lots of saturated and trans fats boosts your body’s production of low-density lipoprotein (LDL) cholesterol, the “bad” type of cholesterol. (There’s also high-density lipoprotein, or HDL cholesterol, also known as “good” cholesterol, which helps your body clear out LDL.)

Does Fish Contain Cholesterol?

So, back to the question about whether to avoid fish if you have high cholesterol. While fish does have some cholesterol, that doesn’t mean you have to ditch it from your diet, says Dr. Manaktala.

Pretty much any animal food contains some cholesterol, according to a chart of the cholesterol in various foods from the University of California San Francisco Health. When it comes to fish, the cholesterol amount per serving is lower than many other sources of animal protein, such as chicken and beef, making it a great swap for those foods.

And despite having some cholesterol, fish is still a net-positive for your heart health because it is low in saturated fat, says the AHA. Better yet, many types are high in heart-healthy unsaturated fats, meaning it can help lower your risk of heart disease and stroke.

Shellfish and Cholesterol

On the whole, shellfish are rich in nutrients like zinc, iron, and vitamin B12, according to the University of Washington. They’re also low in saturated fat, making them a good alternative to meat.

But shellfish are notorious for having the highest cholesterol count under the sea. Is that reputation warranted? Yes… and no. Some types of shellfish are better than others. Here’s how much cholesterol is in a 3.5 oz. serving of different types of shellfish, according to the USDA:

• Mussels: 28 mg

• Clams: 30 mg

• Scallops: 41 mg

• Oysters: 50 mg

• Shrimp: 161 mg

• Squid: 233 mg

The higher levels of cholesterol in shrimp don’t necessarily make it off-limits, however. Despite being high in cholesterol, it doesn’t appear to negatively impact blood cholesterol levels, finds research described in Mayo Clinic Proceedings. This may be due to the fact that unlike most foods high in dietary cholesterol, shrimp is low in saturated fat.

Another factor to consider: some types of shellfish, including squid, snow crab, and lobster, may contain higher levels of trimethylamine N-oxide (TMAO), a substance that can cause cholesterol to make plaques form more easily in the arteries, according to Michelle Routhenstein, R.D., a dietitian based in New York City who focuses on heart health.

How Much Fish Can You Eat With High Cholesterol?

Eat at least two servings of fish (6 ounces total) a week to boost your heart health, says the AHA. Focus on those that are high in omega-3s to get the biggest benefit. These are a type of unsaturated fatty acid that are anti-inflammatory and help combat cholesterol’s damaging effects on your arteries, says Routhenstein.

The Best Fish for High Cholesterol

If you’re working with your health provider to lower your cholesterol and risk for heart disease, the AHA suggests eating heart-healthy fish that are rich in omega-3 fatty acids, like these:

• Anchovies

• Black cod

• Herring

• Mackerel

• Salmon

• Sardines

• Striped bass

• Trout

• Tuna

• Whitefish

Since they’re all heart-healthy, which ones you choose are a matter of taste. Try rotating them into your meal routine in place of higher saturated fat options like steak and burgers.

Fish to Avoid With High Cholesterol

Fish in general are good for your heart, according to our experts. But how you cook it is important. Dipping fish in batter and deep frying will add unhealthy fat into your meals. Similarly, cooking seafood in butter will counteract some of its health benefits. Choose a healthier cooking method like baking, broiling, or grilling instead, advises the AHA.

Other Dietary Advice for High Cholesterol

Eating well with high cholesterol is all about making smart swaps you can stick with for the long haul. “In order to reduce your cholesterol levels, you want to focus on reducing saturated fat, trans fat, and refined sugar in your diet, while adding in more vegetables, fruits, whole grains, nuts, and legumes that are rich in soluble and insoluble fiber,” suggests Routhenstein.

To cut down on saturated and trans fats, the American Heart Association (AHA) suggests that you:

• Cook with vegetable oils like canola, safflower, and olive oils instead of solid fats like butter and lard.

• Eat less red meat—especially processed meats such as bacon, sausage, and hot dogs (fish is a great alternative!).

• Replace whole-fat milk, cream, and cheese with low-fat (1%) and skim versions.

Fiber-rich foods such as oatmeal, fruits like bananas and berries, Brussels sprouts, and beans are also important. Fiber binds to cholesterol in your intestine, which prevents your body from absorbing as much, according to a report on dietary fiber and cardiovascular disease in the journal Nutrients.

As for fish, the two weekly servings the AHA recommends should give you the omega-3 fatty acids you need to protect your heart. And by substituting fish for fattier protein sources, you won’t overload on the cholesterol and saturated fat you don’t need.

The Bottom Line

Eating fish is a great idea when you’ve got high cholesterol, provided you prepare it without adding unnecessary saturated fats. Aim for at least two servings a week as part of a heart healthy diet.

Source: https://www.healthcentral.com/condition/high-cholesterol/fish-to-eat-and-avoid-with-high-cholesterol

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