Cholesterol and Nutrition

Does my diet impact my cholesterol?

Yes, what you eat can affect the amount of cholesterol circulating in your blood. Cholesterol is a waxy substance that your body needs to function. Your liver produces enough cholesterol to support your body’s processes. So, you don’t need to get it from food (and it’s not an essential nutrient). The cholesterol you gain from your diet is extra and unnecessary, like adding sand to a beach. That being said, your diet only affects about 20% to 30% of the cholesterol in your blood.

There are certain foods that cause your “bad” cholesterol (LDL) level to rise higher than normal. On the other hand, other foods can help lower your LDL level. Knowing which foods to eat and which foods to avoid can help you manage your cholesterol levels and lower your risk of heart disease.

Meeting with a dietitian can help you lower your cholesterol.

What is the major nutritional source of cholesterol?

The major nutritional source of cholesterol (called dietary cholesterol) is animal products. These include meats, cheeses and dairy products.

When it comes to lowering your cholesterol levels, research shows it’s not dietary cholesterol we should worry about. Instead, two types of unhealthy fats — saturated fat and trans fat — are the culprits behind elevated bad cholesterol. It just so happens that many of the foods high in dietary cholesterol also may contain these unhealthy fats.

How can I lower my cholesterol with diet?

Here are some steps you can take to lower your cholesterol with your diet:

• Add more soluble fiber to your diet.
• Limit your intake of saturated fat.
• Don’t eat trans fat.
• Eat balanced meals.

Add more soluble fiber to your diet

Some ingredients help lower your LDL cholesterol. The main one to know is soluble fiber. This is a form of fiber that’s water-soluble. Soluble fiber binds around bile (which is composed of cholesterol) and removes it with your body’s waste. Aim for 10 to 25 grams of soluble fiber per day. Ask your provider what amount is best for you based on your calorie needs.

Add more soluble fiber to your diet by eating:

• Dried beans, lentils and split peas.
• Apples, blackberries and citrus fruits.
• Oats and oat bran.
• Brown rice.

Limit your intake of saturated fat

Saturated fat is a type of fat that’s solid at room temperature. Common sources of saturated fat include:

• Processed meat, including hot dogs, sausage, bacon and pepperoni.
• Fatty cuts of meat, including ribs, poultry with the skin and highly marbled meat.
• Full-fat dairy products, including butter, heavy cream, cream cheese and sour cream.
• Coconut oil and palm oil.
• Fried food.

Your body needs some saturated fat to be healthy. But it can be easy to eat too much if you’re not checking nutrition labels. Learning how much saturated fat is in some of your usual foods can help you find ways to cut back.

You might wonder, how much is too much? Aim to get no more than 5% to 6% of your daily calories from saturated fat. The chart below offers suggested limits based on how many calories you need each day.

Keep in mind that these ranges are suggestions, not hard and fast rules. Being too focused on numbers and strict limits can lead to disordered eating habits, like orthorexia. Plus, dietitians caution that getting too caught up in the numbers can cause you to eliminate some foods that are actually more healthy than harmful.

For example, olive oil contains some saturated fat, but its health benefits make it worth adding to your diet in moderation (up to four tablespoons per day). Other foods with saturated fat that you want to keep in your diet include avocados and walnuts.

The key is looking at the food source. It’s OK if you slightly go over the suggested ranges for saturated fat if the fat is coming from otherwise healthy foods. When in doubt, speak with a dietitian to learn which sources of saturated fat you should eliminate and which you can keep in moderation.

Don’t eat trans fat

Trans fat is a combination of liquid vegetable oil and hydrogen. Traditionally, fast foods and processed foods had been major sources of trans fat in people’s diets. That’s because those foods contained partially hydrogenated oils, which gain trans fat through the manufacturing process. However, in 2018, the U.S. Food and Drug Administration (FDA) banned the use of partially hydrogenated oils in food.

While that’s good news, it still doesn’t mean fast foods and processed foods are harmless. They may be high in saturated fat. Plus, they may still contain trans fat due to their cooking method (like frying). Your body doesn’t need any trans fat. It harms your body, and its food sources have no health benefits. So, it’s best to completely avoid it, if possible.

To limit trans fat in your diet, avoid eating:

• Fast food.
• Fried food.
• Commercial baked goods, such as cookies, doughnuts and pastries.

Eat balanced meals

When trying to reach healthy cholesterol levels with your diet, it’s important to eat meals that contain a balance of:

• Fruits.
• Vegetables.
• Grains.
• Protein foods.
• Dairy/dairy alternatives.
• Fats.

The infographic below provides some general guidelines for what to choose and what to avoid.

Learning which foods to choose and which foods to avoid can help you plan balanced, heart-healthy meals.

Can I have snacks or desserts?

Eat snacks sparingly, and be careful about the ones you choose. Aim for snacks low in saturated fat, sugar and sodium. Here are some good options for healthy snacks and suggested portion sizes:

• Nuts like walnuts, almonds, pecans or pistachios (1/4 cup).
• Pumpkin seeds or sunflower seeds (1/4 cup).
• Roasted chickpeas (1/2 cup).
• Fresh fruit (a small orange or apple) with a handful of nuts.
• Celery (a few stalks) with peanut butter or almond butter that contains no added sugar.
• Popcorn (3 cups, popped) and a string cheese.
• Raw vegetables (1 cup) with hummus (1/4 cup).
• Greek yogurt (6 ounces) with whole grain cereal (1/2 cup).
• Steamed vegetables (1 cup) with cheese (1 ounce).

Be cautious when buying low-fat snacks or desserts at the store. Many of these treats are low in fat but high in sugar. Keep an eye on sugar content and talk with your healthcare provider about how much sugar is OK for you to eat. This is especially important if you have a history of high blood sugar or diabetes.

One way to have a treat that’s low-sugar and low-fat is to experiment in the kitchen with healthy dessert recipes. Many recipes have little or no sugar yet still taste great.

What are some cooking tips?

Cooking at home helps you take control of your diet. But just because something is home-cooked doesn’t mean it’s healthy or good for your cholesterol levels. Keep in mind these tips to cook in ways that support your healthy eating plan. Your provider or dietitian can provide you with many more tips, too.

• Add more fish to your meals. Try for at least 8 ounces per week, and don’t fry it!
• Avoid using butter, lard and shortening. Use a healthy cooking oil (like olive oil) instead, but only use a small amount. Try using low-salt vegetable stock instead of oil when sautéing or baking vegetables, fish or poultry.
• Bake, broil or steam your foods. Avoid frying them.
• Check recipes for butter and oil substitutes. Many recipes will provide options like applesauce or bananas for baking.
• Double the amount of veggies when making soup. This will increase the fiber content in your soup. To make room, cut the amount of rice or noodles in half.
• Find herbs and spices you enjoy. Use them to add flavor to your dishes and replace butter, salt or high-fat sauces.
• Make your own salad dressing. Use olive oil and balsamic vinegar (or a similar combination). Salad dressings are often hidden sources of saturated fat.
• Remove the fat from the top of soups or stews. Put your pot of soup or stew in the fridge for a few hours after it’s cooled down. When you take it out, you’ll see a layer of solid fat on top that’s easy to remove.
• Remove the skin from chicken before cooking. Add seasonings to the meat itself, rather than the skin.

What is the TLC diet vs. Mediterranean Diet?

The TLC diet is part of the Therapeutic Lifestyle Changes (TLC) Program. This is a three-part program that aims to lower your cholesterol through diet, physical activity and weight management. The U.S. National Institutes of Health created this program in 1985, and some people still follow it today.

But there’s a problem. This diet is too low in total fat and too high in carbohydrates, as the latest research has shown. So, it may raise your blood sugar and triglyceride levels, especially if you aren’t eating the healthy kind of carbs.

Dietitians instead recommend the Mediterranean Diet as a heart-healthy eating plan. This plan helps you manage your cholesterol levels while also supporting many other aspects of your health. If you follow the Mediterranean Diet, you’ll:

• Plan your meals around plant-based foods. These include fruits and veggies, whole grains and beans.
• Eat moderate amounts of fish, lean poultry, seafood, eggs and dairy.
• Avoid red meat, fried foods, desserts and anything made with white flour.

The key is watching the types of fat you eat. The Mediterranean Diet reduces your intake of saturated fat and trans fat, which can make a big difference in your LDL levels. It replaces those fats with healthy fats that support your overall heart health. Research shows that this diet can lower your risk for cardiovascular disease.

What if I change my diet and my cholesterol is still too high?

What you eat can either raise or lower the amount of cholesterol in your blood, especially the bad kind that leads to atherosclerosis. This knowledge can be empowering. Your choices can make a difference. But sometimes, even your best effort won’t lower your cholesterol to where it needs to be. There are a few reasons why.

Dietary choices aren’t always in your control

In a perfect world, everyone would have access to nutritious foods, time to cook and community resources to help them reach their goals. In reality, we have to make choices within the limits of what’s available to us.

We all face certain constraints or factors that affect the choices we can make. So, our individual choices are just a few pieces of a larger puzzle that our whole community puts together.

Don’t blame yourself if you face barriers to making all the ideal choices that support a low-cholesterol diet. Instead, do what you can and ask your provider to help you fill in the gaps.

Your genes play a role

Scientists believe that heredity (the genes you inherit) impacts your cholesterol. As a result, dietary changes help, but sometimes they can’t make a big enough dent to get your numbers in the healthy range.

Some people have very high cholesterol because their bodies can’t get rid of enough LDL cholesterol. This inherited condition is called familial hypercholesterolemia. So, it’s hard for those people to lower their cholesterol levels through diet alone. They may need statins or other medications, too.

Your cholesterol goes up as you get older

As we age, our cholesterol levels go up. So, dietary changes might not have the same impact at age 60 as they would at age 30.

Change takes time

If you’ve made changes to what you eat, you might hope to see changes in your cholesterol numbers right away. But your cholesterol numbers reflect patterns that develop over time.

Picture a huge chalkboard covered in writing. If you swipe over the board once with an eraser, you’ll erase some of the writing. But you need to keep swiping for a while to get rid of all the writing. Meanwhile, someone else is writing on the parts you just erased. (You’re probably still eating some foods that raise your LDLs, and your body is still producing cholesterol!)

Be patient and give your body time to adjust to your new nutritional plan. Meanwhile, build exercise into your daily routine. Also, ask your provider how long it may take to see changes and whether you’d benefit from medications along with your new eating plan.

A note from Cleveland Clinic

The foods you eat can have a powerful effect on your health, including your cholesterol levels. If you’re starting to make changes to your diet, be patient with yourself. Don’t expect to overhaul your eating plan overnight. Make small, simple changes, and gradually add more as you go along. You might miss some of your favorite foods. But try to focus on the new foods you’re exploring, rather than the ones you’re limiting.

Plus, involve your family and friends in your new plan. Explain why you’re making these changes and how they can support you. It’s a lot easier to stay with a nutrition plan when the people around you encourage you in reaching your goals.