You’ve probably heard that cholesterol is bad for you. But what exactly is cholesterol? And why do you care about it?
Cholesterol is a type of fat that’s found in your blood. In small amounts, it helps keep your nerves and muscles healthy. But too much can cause health problems like heart disease and stroke. Most of the time, eating too much saturated fat causes high cholesterol levels in the blood.
Your body needs some cholesterol to stay healthy, but if you eat too much of it, your body makes more than it needs and stores it in your bloodstream. That can cause plaque buildup on your artery walls, which increases your risk of heart attack or stroke.
If you’re worried about your cholesterol levels because you eat too much saturated fat or other foods high in cholesterol, here are some things you can try:
Food With Cholesterol To Avoid
The liver naturally creates cholesterol, which travels throughout the body using proteins in the bloodstream. Cholesterol is an essential building block for cell membranes.
Alongside its cell building role, cholesterol is necessary for producing hormones, vitamin D, and substances that work to digest fatty foods.
However, a person’s lifestyle and genetics can cause the body to produce too much cholesterol. When cholesterol builds up in the arteries, it can block blood flow, which can lead to coronary heart disease, heart attack, or stroke.
Following a nutritious, balanced diet is one way to help moderate cholesterol levels.
This article details the relationship between cholesterol and fats, looks at which foods have a high cholesterol content, and explores some dietary changes a person can make to lower their cholesterol levels.
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Cholesterol and fats
There are two types of cholesterol that differ depending on the type of protein that transports them through the bloodstream. They are low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol.
LDLs deposit one type of cholesterol throughout the body. This kind of cholesterol can build upTrusted Source in blood vessels and lead to serious complications. People often refer to this as “bad” cholesterol.
HDLs, on the other hand, collect LDL cholesterol from the arteries and bring it back to the liver for disposal. For this reason, people often refer to HDL cholesterol as “good” cholesterol.
Learn more about the differences between LDL and HDL cholesterol here.
It is worth noting that the Dietary Guidelines for Americans, 2015–2020 removed the recommendation to limit dietary cholesterol intake to 300 milligrams per day. The most recent understanding is that the cholesterol content of different foods has little to no impact Trusted Source on blood cholesterol levels.
Although avoiding foods with high cholesterol content may still be beneficial for some people, it may not be practical for everyone.
Instead, the American Heart Association (AHA)Trusted Source and Centers for Disease Control and Prevention (CDC)Trusted Source suggest prioritizing unsaturated fats over saturated and trans fats as the most effective dietary approach to cutting blood cholesterol.
Types of fat
In general, people should aim to eat a diet that promotes low levels of LDL cholesterol and high levels of HDL cholesterol. However, fat intake affects this balance Trusted Source because fatty acids bind to liver cells and regulate the production of cholesterol.
People should pay attention not only to the overall quantity of fat in their diet but also to where this fat is coming from.
- Saturated fats: These mostly occurTrusted Source in meat and dairy products. They instruct the liver to produce more LDL cholesterol.
- Unsaturated fats: These are more common in fish, plants, nuts, seeds, beans, and vegetable oils. Certain unsaturated fats can help increase the rate at which the liver reabsorbs and breaks down LDL cholesterol.
- Trans fats: These are solid vegetable oils. Manufacturers normally use an artificial process called hydrogenation to produce them. Fried foods, baked goods, and packaged foods often contain trans fats.
Learn more about the different types of fats here.
Trans fats
Trans fats increase levelsTrusted Source of LDL cholesterol and decrease levels of HDL cholesterol. For this reason, a high trans fat intake is also a risk factor for a range of health complications.
A 2015 literature review found that a 2% increaseTrusted Source in energy intake from trans fats is associated with a 25% increased risk of coronary heart disease and a 31% increased risk of death from the condition.
Researchers have also found links between increased trans fat intakes and increased all-cause mortality in the United States and China.
Bans on trans fat content in foods have proven positive. A 2017 study revealed a 6.2%Trusted Source reduction in hospital admissions for heart attack and stroke in the New York counties with a ban on trans fats.
Foods to avoid
The AHA advises reducing saturated fat intake to no more than 6%Trusted Source of one’s total daily calories.
It suggests limiting the intake of the following foods to achieve this:
- fatty beef
- lamb
- pork
- poultry with skin
- lard and shortening
- dairy products made from whole or reduced fat milk
- saturated vegetable oils, such as coconut oil, palm oil, and palm kernel oil
Avoiding trans fats is also important. Some foods high in trans fats includeTrusted Source:
- packaged cookies, cakes, donuts, and pastries
- potato chips and crackers
- commercially fried foods
- bakery goods that contain shortening
- buttered popcorn
- products containing partially hydrogenated or hydrogenated vegetable oils
Cholesterol in foods
The bloodstream absorbs dietary cholesterol poorly and has little effect on cholesterol levels after several hours.
A person may wish to avoid the following foods due to their saturated fat and sodium content:
- red meat
- sausages
- bacon
- organ meats, such as kidney and liver
Learn more about which foods can help lower cholesterol here.
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Foods to include
It is important to note that following a completely fat-free diet may have harmful effects. For example, excluding fats can impair childhood development and brain function, according to one older studyTrusted Source.
Choosing healthy fats can help a person lower their LDL cholesterol levels while managing their HDL cholesterol levels.
Fiber
Fiber is important for a healthy heart and is present in two main forms: soluble fiber and insoluble fiber.
Insoluble fiber is essential for digestive health. Soluble fiber binds to cholesterol in the bloodstream and helps remove it through stool. This type of fiber has the added benefit of helping control blood sugar levels.
Some cholesterol-friendly fiber options to consider include:
- nuts, seeds, and legumes
- oats and oat bran
- chia and ground flaxseeds
- beans
- barley
- psyllium
- oranges
- blueberries
- Brussels sprouts
Nontropical natural vegetable oils are also cholesterol-friendly due to their unsaturated fatty acid content. These oils include olive oil, avocado oil, canola oil, and safflower oil.
People may also find it beneficial to choose leaner cuts of meat, opt for smaller portions, and choose low fat or fat-free milk and yogurts.
Cooking techniques and tips
Specific cooking methods can change the saturated fat content in a meal. Some easy adjustments to make to cooking routines include:
- using a rack to drain off fat when broiling, roasting, or baking poultry or meats
- using wine in place of fat drippings to baste meat
- broiling or grilling meats instead of pan frying them
- cutting off all visible fat from meat, and removing the skin from poultry, before cooking
- skimming off the top layer of congealed fat after soup has been refrigerated
Combining these cholesterol cutting techniques with a balanced, plant-based diet and a sustainable exercise routine can reduce the risk of heart disease and promote a healthier life.
Summary
Cholesterol is a fat-like substance that the body produces optimum amounts of on its own. Limiting foods that contain trans and unsaturated fats can be an effective wayTrusted Source of managing one’s cholesterol levels.
Foods high in cholesterol and these types of fats include red meat, poultry with skin, and full fat dairy products.
Consuming a healthy diet rich in fiber, whole fruits and vegetables, and lean protein sources can help a person maintain optimum cholesterol levels and promote general health.
what foods cause high cholesterol
A report from Harvard Health has identified 11 cholesterol-lowering foods that actively decrease cholesterol levels:
- oats
- barley and whole grains
- beans
- eggplant and okra
- nuts
- vegetable oil (canola, sunflower)
- fruits (mainly apples, grapes, strawberries, and citrus)
- soy and soy-based foods
- fatty fish (particularly salmon, tuna, and sardines)
- foods rich in fiber
Adding these to a balanced diet can help keep cholesterol in check.
The same report also lists foods that are bad for cholesterol levels. These include:
- red meat
- full-fat dairy
- margarine
- hydrogenated oils
- baked goods
Various low cholesterol recipe books are available to purchase online.
Levels and ranges
In adults, total cholesterol levels less than 200 milligrams per deciliter (mg/dL) are considered healthy.
- A reading between 200 and 239 mg/dL is borderline high.
- A reading of 240 mg/dL and above is considered high.
LDL cholesterol levels should be less than 100 mg/dL.
- 100–129 mg/dL is acceptable for people with no health problems but may be a concern for anyone with heart disease or heart disease risk factors.
- 130—159 mg/dL is borderline high.
- 160–189 mg/dL is high.
- 190 mg/dL or higher is considered very high.
HDL levels should be kept higher. The optimal reading for HDL levels is of 60 mg/dL or higher.
- A reading of less than 40 mg/dL can be a major risk factor for heart disease.
- A reading from 41 mg/dL to 59 mg/dL is borderline low.
Preventing high cholesterol
People who wish to reduce their cholesterol levels or maintain a suitable level can make four major lifestyle decisions.
- eat a heart-healthy diet
- regularly exercise
- avoid smoking
- achieve and maintain a healthy weight
These actions will reduce the risk of coronary heart disease and heart attack.
Since 2013, guidelines on reducing or preventing high cholesterol have focused on addressing lifestyle risks, even at a young age.
Since 2018, new guidelinesTrusted Source published in the Journal of the American College of Cardiology also urged doctors also to discuss with individuals the following factors that may increase a person’s risk:
- family history and ethnicity
- certain health conditions that increase the risk of high cholesterol, such as chronic kidney disease or chronic inflammatory conditions
Taking these factors into consideration will lead to a more personalized approach to the treatment and prevention of high cholesterol levels.
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How can high cholesterol be treated?
There are a number of ways to treat high cholesterol; these include:
Lipid-lowering therapy
For a person with high cholesterol levels, drug treatment will depend on their cholesterol level and other risk factors.
Recommendatoins usually start with diet and exercise, but people with a higher risk of a heart attack may need to use statins or other medications.
Statins are the leading group of cholesterol-lowering drugs. The statins available on prescription in the United States include:
- atorvastatin (brand named Lipitor)
- fluvastatin (Lescol)
- lovastatin (Mevacor, Altoprev)
- pravastatin (Pravachol)
- rosuvastatin calcium (Crestor)
- simvastatin (Zocor)
Apart from statins, a doctor may prescribe:
- selective cholesterol absorption inhibitors
- resins
- fibrates
- niacin
In 2017, researchers notedTrusted Source that a new drug, ezetimibe, can significantly reduce the risk of a major cardiovascular event in people with a high risk of such events. Etezimibe reduces lipid levels by limiting the absorption of cholesterol in the intestine.
The authors of the updated also mentioned another new type of drug: pro-protein convertase subtilisin/kexin 9 (PCSK9) inhibitors. There is evidence that these drugs are effective at reducing cholesterol levels, especially when a person uses them with ezetimibe.
In 2018, new guidelinesTrusted Source recommended a stepped approach, depending on how high an individual’s risk is.
If a person has already had a cardiovascular event, such as a heart attack, a doctor may recommend using ezetimibe as well as a statin. For those at very high risk, the guidelines also recommend adding a PCSK9 inhibitor.
However, the guidelines also note that PCSK9 inhibitors are expensive, and insurance companies may not cover their cost. For this reason, this option is likely to be only for those with a very high risk.
Statin safety
The use of statins has caused some debate because, like all drugs, they can have side effects.
These include:
- statin-induced myopathy (a muscle tissue disease)
- fatigue
- a slightly greater risk of diabetes and diabetes complications, though this is hotly debated
A person should not stop taking a statin without speaking to a doctor, as they may increase their risk of cardiovascular problems.
A doctor might recommend:
- switching to a different medication
- increasing efforts to reduce cholesterol through lifestyle changes
Complications of high cholesterol
In the past, people have aimed to reduce cholesterol to a target level, for instance, below 100 mg/ dL, but this is no longer the case.
Randomized, controlled clinical trials have not produced enough evidence to support treatment to a specific target.
However, some physicians may still use targets to help guide therapy.
10-year risk of a heart attack
Cholesterol levels play a major part in an individual’s risk of having a heart attack within the next 10 years.
The National Heart, Lung, and Blood Institute provide an online calculator of cardiovascular risk.