High Cholesterol Foods: Food to Eat and Foods to Avoid
As the old saying goes, you are what you eat, and this is at least partially true when it comes to your cholesterol levels. “Our diet impacts about 20% to 30% of the cholesterol in our blood,” explains Amy Kimberlain, R.D.N., a Miami-based spokeswoman for the Academy of Nutrition and Dietetics. While other factors, including genetics, certain health conditions, age, and unhealthy lifestyle habits can also play a role, there are specific foods that can increase your “bad” or LDL cholesterol levels, and others that can lower these levels. Therefore, choosing the right foods can help you maintain healthy cholesterol levels and reduce your odds of blood clots, stroke, and heart disease.
How Can Food Impact Cholesterol?
Somewhat counterintuitively, the cholesterol in foods is not the main factor that drives up your blood cholesterol levels, explains Kimberlain. Rather it’s the saturated fat (and trans fat) in foods that can elevate your cholesterol levels, cause plaque to accumulate in your arteries, and potentially lead to heart disease, heart attacks, and stroke.
How so? Essentially, eating too much saturated fat—and too little of healthy unsaturated fats—overtaxes receptors in the liver so that they are less efficient at performing their crucial function of removing LDL “bad” cholesterol from your blood. Instead of this bad cholesterol being shuttled into the liver where it can be broken down, an increasing amount of it remains in the bloodstream.
Cholesterol itself is a waxy substance and the trouble comes when there is too much of it in the blood. Cholesterol can clump together to form plaques. These plaques can then either build up on the walls of your arteries, restricting or even eventually stopping blood flow, or they can break apart, potentially damaging blood vessels and causing them to clot.
The upshot: To keep your cholesterol levels in check, rather than focusing on which foods are high in cholesterol, it’s better to pay attention to how much saturated fat you are eating throughout the day, says Kimberlain. (More on which foods are high in saturated fat, below.)
It’s also important to note that there are several different cholesterol levels in your blood that affect your health. What is “normal” for you varies based on your age and sex. Here’s what you need to know about those cholesterol levels:
High-density lipoprotein (HDL) cholesterol, known as “good” cholesterol, can help protect you from heart attack or stroke, per the American Heart Association (AHA). HDL cholesterol helps remove other forms of cholesterol from your bloodstream, according to the Mayo Clinic. Higher levels of HDL cholesterol are associated with a lower risk of heart disease. Genetic factors, type 2 diabetes, smoking, being overweight, and having a sedentary lifestyle can all lower your HDL cholesterol levels. Medication, increasing physical activity, avoiding saturated fat and trans fats, and quitting smoking can help improve your HDL cholesterol levels.
Low-density lipoprotein (LDL) cholesterol is known as “bad” cholesterol. High levels of LDL cholesterol can build up in your blood vessels and narrow the passageways, sometimes leading to clots that can cause heart attack or stroke, according to the Mayo Clinic. The thing that makes LDL so “bad” is that it becomes oxidized and triggers inflammation in the body. A diet high in saturated and trans fat can raise your LDL cholesterol levels, so reducing these fats in your diet can help lower your LDL cholesterol levels. As your HDL levels improve, LDL levels will lower.
Triglycerides are the most common type of fat, or lipid, in your body. People who have high triglycerides often have a high total cholesterol level, including a high LDL cholesterol level and a low HDL cholesterol level, per the AHA. High triglycerides may contribute to the hardening of your arteries or thickening of your artery walls, which can increase your risk of stroke, heart attack, and heart disease.
Total Blood Cholesterol
Your total blood cholesterol is calculated by adding your HDL and LDL cholesterol levels, plus 20% of your triglyceride level, per the AHA.
The ‘Worst’ Foods for High Cholesterol
All food can find a place in a well-rounded diet, notes Kimberlain, but if you’re watching your cholesterol numbers, these are some of the biggest saturated fat offenders:
- Processed and cured meats. These include hot dogs, sausage, bacon, and pepperoni.
- Fatty cuts of meat. Watch out for ribs, poultry with the skin, and highly marbled meat.
- Organ meats. Liver, heart, brains, and intestines are all high in saturated fat.
- High-fat dairy. Though rich in calcium, heavy cream, cream cheese, sour cream, and butter are cholesterol no-gos.
- Coconut oil and palm oil. These oils are plant-based, but they have a high level of saturated fat.
- Fried foods. Fried chicken, fish and chips, chicken tenders, french fries, and onion rings fall into this category.
- Commercially prepared pastries. This includes pies, croissants, muffins, donuts, some cakes and frostings, baked goods, and cookies.
Ingredients to Avoid When You Have High Cholesterol
If you’re trying to improve your cholesterol levels, focus on reducing or avoiding foods high in saturated fat and trans fat—and keep an eye on your salt and sugar intake as well.
Reading labels can help you know how much saturated fat a product contains but this big-picture look will help you spot foods that contain it: “Saturated fat is predominantly found in animal products,” says Kimberlain. That’s why foods like fatty meats and whole-fat dairy made the “worst” list for cholesterol levels. An important caveat: Not all animal products are the same when it comes to levels of these fats; eggs and low-fat dairy, for instance, are healthier options.
Trans fats have been shown to not only increase LDL levels but to decrease HDL levels, says dietitian Jamie Mok, R.D.N., a Los Angeles-based spokesperson for the Academy of Nutrition and Dietetics. Trans fats have been banned from foods in the United States since 2020, but you still want to check nutrition labels for “hydrogenated oil” or “partially hydrogenated oil” to ensure no amount of trans fat is in the product you are consuming, says Kimberlain. Fast food, fried food, and commercially baked goods (cookies, doughnuts, and pastries) can be sources of trans fat—another reason those “worst” list foods should be limited, she adds.
If, in addition to watching your cholesterol, you are monitoring your blood pressure and/or have heart conditions, sodium (salt) should be monitored, says Kimberlain. Too much salt raises your blood pressure which, like high cholesterol, can lead to heart attacks and strokes. Cutting down on salt can lower these risks.
Eating too much added sugar, especially from processed foods, can contribute to elevated triglyceride levels, per the AHA. High triglycerides can also increase your risk for prediabetes, type 2 diabetes, and metabolic syndrome, which can further increase your risk for heart disease and stroke, explains Mok.
Refined carbohydrates include white bread, pasta made with white flour, and white rice. One study found that the consumption of refined carbs was linked to lower HDL “good” cholesterol levels. They can also increase triglycerides and in turn impact total cholesterol, says Kimberlain. Eating too many refined carbs can also lead to insulin resistance or prediabetes, which in turn increases your risk of heart disease, adds Mok.
Foods to Eat When You Have High Cholesterol
The good news is that there are some foods that you should eat more of to improve your cholesterol levels and heart health (and overall health). Luckily, some of the healthiest choices are also delicious.
A recent meta-analysis of 30 scientific trials, published in the European Heart Journal, found that vegetarian and vegan diets were associated with lower total cholesterol and LDL cholesterol. “Aim to add a vegetable at lunch and dinner at a few different meals throughout the week—ideally all, but start slowly and aim to increase from there,” Kimberlain says. Indeed, Mok recommends shifting some meals to be more plant-based (if not fully plant-based) more of the time. By doing this you’re not just reducing saturated fat, you’re also bumping up fiber, antioxidants, and phytonutrients.
Foods that come from plants contain natural substances called plant sterols and stanols. Eating foods rich in these substances may help lower your total cholesterol and LDL cholesterol, per the Cleveland Clinic. Plant sterols are found in vegetables, fruits, wheat germ, whole grains, beans, sunflower seeds, and many vegetable oils. You can also find plant sterols and stanols in plant-based proteins such as nuts, seeds, beans, tofu, tempeh, and edamame.
Plant Sterol-Enriched Foods
You may not eat enough plant foods in your diet to decrease your LDL, says Kimberlain. In order to get that extra boost, you may need to eat certain foods supplemented with plant sterols in order to get the recommended amount to lower your LDL. Some examples of plant sterol-enriched or fortified foods include spreads (such as plant-based butters), orange juice, bars, chews, and cereals.
Dietary fiber, found in plant foods such as fruits, vegetables, whole grains, nuts, seeds, beans, lentils, and all the legumes, is the part of a plant that you’re not able to digest, explains Kimberlain. While people mainly associate fiber with helping them stay regular, fiber (specifically soluble fiber) also helps to lower total cholesterol and LDL levels, she says. One recent meta-analysis of research, published in the Lancet, found that among the combined 4,635 study subjects, those with the higher intake of dietary fiber had significantly lower total cholesterol.
“Soluble fiber helps remove excessive cholesterol from our system,” explains Mok. “It binds to cholesterol via bile acid to be eliminated from the body in our stool. So diets higher in soluble fiber are recommended especially for those with high cholesterol for that purpose.” Foods higher in soluble fiber include oatmeal, oat bran, beans, strawberries, apples, pears, oranges, carrots, and brussels sprouts, she says.
Whole grains are a good source of fiber, so aim to make half of your grains whole, recommends Kimberlain. Examples include quinoa, rolled oats, and whole wheat bread (the first ingredient listed should be whole wheat).
A cholesterol-lowering diet should also include more unsaturated fats. “It’s not just remove, remove, remove, it’s more replace,” says Mok. “Studies have shown that if we replace these saturated fats with unsaturated fats, it can actually help decrease LDL cholesterol.” You can replace saturated fats with unsaturated fats by choosing healthy cooking oils—like olive oil, grapeseed oil, avocado oil, canola oil, safflower oil, and sunflower seed oil—instead of cooking with grease, butter, or lard, and replacing meat dishes like prime rib with seafood meals like salmon.
Meat and poultry choices should be lean or low-fat, like 93% lean ground beef, pork loin, and skinless chicken breasts. “Lean cuts of protein have less saturated fat,” says Kimberlain. When you’re buying protein, check the package for words like “loin” or “round,” she advises, which typically indicate leaner cuts.
It’s also important to pay attention to how much protein you’re consuming: portions depend on the individual person, but 3 ounces (the size of a deck of cards) is a good starting point, Kimberlain says.
Beans are a plant protein (meaning no saturated fat) and a good source of fiber. They also contain plant sterols and stanols. “All beans are healthy: Black beans, white beans, peas, lentils, the whole legume family,” says Mok. Ease your way into eating beans by reducing the amount of meat in a meal by half and supplementing with beans or lentils. Or go for a fully meatless meal, says Mok—just be sure to prepare your beans without the addition of saturated fat, whether it’s coming from animal fat, grease, or lard. In other words, refried beans are not a heart-healthy, cholesterol-lowering choice.
To bone up on calcium while watching your cholesterol, the Centers for Disease Control (CDC) recommends opting for fat-free or low-fat milk, cheese, and yogurt instead of whole milk and full-fat cheeses and yogurts. Some good options include low-fat cottage cheese, low-fat mozzarella, and nonfat cheddar.“These are good ways to reduce the impact of saturated fat by finding lower saturated fat alternatives,” says Mok, adding that there is no need to completely eliminate full-fat dairy if that’s something you enjoy, but just keep an eye on the amounts you consume and how often.
Omega-3 Rich Foods
High amounts of omega-3s have been shown to reduce triglyceride levels, so if you’re battling high cholesterol, these are your friends. One recent study in the Journal of Clinical Investigation suggested that omega-3s help lower triglycerides not only by increasing fatty acid oxidation and but also by creating substances that aid in the breakdown and absorption of fat.Omega-3s are essential fatty acids that your body cannot produce independently. Instead, you must get them from dietary sources, like salmon, trout, walnuts, ground flaxseed, or supplements like fish oil.“Omega-3 is a form of polyunsaturated fat that we can consume from food that has powerful anti-inflammatory properties,” says Mok.
Canned sardines, anchovies, or herring are also great options to boost your omega-3 intake, and they have a longer shelf life. You can also buy frozen fish or freeze fresh fish for later if it’s on sale. “These are ways to regularly keep omega-3 rich foods in your kitchen,” Mok says.
One quick note about choosing heart-healthy fish: Unlike other fish, you may have heard that shellfish are high in cholesterol. But, again, since shellfish are low in saturated fat, the key with enjoying them as part of a heart-healthy diet is to prepare them without frying or other such techniques that can turn up the saturated fat.
Nuts and Seeds
Nuts and seeds are plant proteins that are also a really good source of fiber, as well as plant sterols and stanols. “Nuts and seeds are great alternatives or replacements for animal protein such as meat or poultry,” says Mok. When choosing nuts and seeds, she recommends opting for ones that are rich in omega-3 fatty acids such as walnuts, ground flaxseeds, chia seeds, and hemp seeds.
Cooking Tips for High Cholesterol
Now it’s time to take your lessons to the kitchen. Follow these guidelines to help cook meals that will keep your cholesterol levels healthy.
- Grill fish, not burgers. Aim to add seafood to your meals twice a week (for a total of eight ounces weekly), recommends Kimberlain. Seafood contains omega-3 fatty acids and is also low in saturated fat. It’s also a high-quality source of protein to incorporate in your diet.
- Trim the fat. If you regularly prepare or order chicken or turkey with the skin on, Mok recommends removing it to help reduce saturated fat.
- Bake, don’t fry. “Avoid frying, breading, and deep frying fish or poultry,” suggests Mok. “Grilling, baking, broiling, or air frying are great, healthier ways to cook fish and poultry.”
- Toss in veggies to any dish. More veggies equal more fiber. Always add as many veggies as possible, says Kimberlain. Plus, eating a diverse variety of veggies will mean you enjoy more flavors and benefit from more nutrients, says Mok.
- Add seasonings instead of butter. If you’re beginning to omit saturated fats from your cooking, such as butter and high-fat sauces, you’ll want to incorporate flavor in another way—adding spices and herbs can do this, suggests Kimberlain.
- Choose non-fat flavor boosters. “When you think about cooking vegetables, add onions or garlic because they’re very flavorful,” says Mok. “Roasting your veggies instead of steaming can also bring out more flavor.”
- Upgrade to vegetable oils. Instead of cooking with butter and/or coconut oil, use vegetable oils such as olive oil, grapeseed oil, avocado oil, canola oil, safflower oil, and sunflower seed oil to cut saturated fat and boost your intake of unsaturated fats, says Mok.“Olive oil is a great heart-healthy oil, great for medium-temperature cooking,” she says. “For higher-temperature cooking, avocado oil is a great oil.”
- Use just a dash (of oil) in the pan. Because even healthy oils can be high in calories, pay attention to how much you’re using. “Excessive calories get packaged up into triglycerides,” warns Mok. Use just enough oil to keep the food from sticking to the pan, she advises.
Other Lifestyle Tips for Lowering Cholesterol Naturally
While healthy eating can help keep your cholesterol in check, other everyday habits have a role to play, too. The following lifestyle tips can help you lower your cholesterol and maybe even help you lose some weight while you’re at it.
Studies have shown that exercise can improve cholesterol by raising HDL cholesterol and in turn lowering LDL cholesterol. Work up to 30 minutes of exercise five times a week, or at least 150 minutes of moderate-intensity aerobic exercise to lower your cholesterol, per the AHA. Exercise may also help with weight management, and that too can help you lower your cholesterol levels: weight loss of as little as 5% to 10% can help improve your numbers, according to the AHA.
Add movement in small amounts as it all adds up, suggests Kimberlain. Take a walk during your lunch hour, ride your bike to work, find a friend that can help you to stay accountable and make the “exercise” more fun! (If you have a chronic condition or disability, talk with your health care provider about what types of exercise and how much of it you should do before you get started, advises the AHA.)
If You Smoke, Quit
Smoking and vaping lowers HDL cholesterol, notes the AHA. Also, if you have high cholesterol levels, smoking further increases your risk of coronary heart disease, per the National Heart, Lung, and Blood Institute. Quitting smoking will improve your HDL cholesterol level (thereby decreasing your LDL cholesterol). Find smoking cessation support from the American Lung Association’s quitline at 1-800-586-4872.
Avoid Overindulging in Alcohol
Drink alcohol only in moderation. One meta-analysis of 44 studies in the British Medical Journal (BMJ) found that moderate alcohol consumption was associated with increased HDL cholesterol. However, the benefits are not strong enough to recommend someone begin to consume alcohol, per the Cleveland Clinic. If you do drink, recommendations are one drink a day for women of all ages and men older than age 65, and up to two drinks a day for men aged 65 and younger. “Excessive alcohol may contribute to excessive caloric intake and can drive triglycerides and inflammation, and coupled with higher cholesterol it can increase the risk of heart disease and stroke,” says Mok. “Additionally, overloading the liver with a lot of work to process excessive alcohol as well as its function to process cholesterol is why we recommend to keep it in moderation if you choose to drink alcohol.”
Still, if lifestyle changes aren’t enough to make a difference in your cholesterol levels, medication may be recommended, says Kimberlain. Some people require medication to help them avoid accumulating too much LDL cholesterol. Talk to your health care provider about your cholesterol levels as well as your family history to see if medication is right for you.