Foods to eat and avoid to lower cholesterol

High levels of LDL cholesterol in the blood can increase a person’s risk of developing CVD.

Although the liver creates cholesterol for the body to use, individuals can also find cholesterol in the foods they eat. This is called dietary cholesterol.

According to a 2019 article, health experts previously believed an intake of high dietary cholesterol increased a person’s risk of developing CVDs.

Until recently, public health recommendations, including those from the Dietary Guidelines for Americans and the American Heart Association (AHA), widely recommended limiting dietary cholesterol to 300 milligrams (mg) per day.

However, recent evidence suggests that this is not the case. The AHA published a study in 2020 indicating that the Dietary Guidelines for Americans 2015–2020 (DGA) removed the long-held recommendation to limit cholesterol to help prevent cardiovascular disease.

Heart UK, a charity in the United Kingdom, notes that eating foods that contain cholesterol is unlikely to make a significant difference to a person’s cholesterol levels in the blood.

To help reduce a person’s blood cholesterol levels, they need to cut down on foods that contain saturated fat. Saturated fat affects how the liver processes cholesterol, which can increase LDL levels in the blood.

Dietary cholesterol only has a small effect on a person’s levels of blood cholesterol. However, some health organizations still recommend limiting dietary cholesterol to no more than 300 mg of cholesterol daily.

The Centers for Disease Control and Prevention (CDC) note that many foods high in dietary cholesterol, such as red meat and other animal-derived foods, also tend to be high in saturated fat. This may contribute to the previous confusion about the impact of dietary cholesterol on blood cholesterol levels.

However, the AHA, the American College of Cardiology (ACC), and the DGA do not offer any specific guidance regarding dietary cholesterol.

However, they recommend that a person eats a diet that includes:

• fruits
• vegetables
• vegetable oils
• whole grains
• seeds
• lean protein sources
• low fat or fat free dairy products
• nuts

The CDC has similar recommendations. It suggests a person eat more foods with high amounts of fiber, such as beans, oats, and vegetables. The agency also recommends eating foods with high levels of unsaturated fats, such as olive oil, avocados, and nuts or seeds.

Learn more about 15 foods that lower cholesterol.

Both the CDC and AHA recommend that a person limit foods high in saturated fats.

Foods high in saturated fats include:

• red meats
• full fat dairy foods
• bacon, sausage, and other processed meats
• baked goods with large amounts of butter, such as biscuits and cake
• cured meats

The AHA states that the Dietary Approaches to Stop Hypertension (DASH) diet and the Mediterranean-style diet are generally low in cholesterol.

DASH diet

The DASH diet aims to lower a person’s blood pressure and reduces LDL cholesterol.

To follow this eating plan, people should aim to eat:

• vegetables
• whole grains
• fruits
• fish
• poultry
• beans
• nuts
• seeds
• vegetable oils
• fat free or low fat dairy products

Individuals should also avoid eating:

• fatty meats
• sugary beverages
• sweets
• sodium
• full fat dairy

Learn more about the DASH diet here.

Mediterranean style diet

A 2022 article notes that the Mediterranean diet is the term that describes the traditional dietary habits of those living in the Mediterranean region.

The AHA states that the Mediterranean diet can help prevent stroke and heart disease. It can also reduce the following risk factors for stroke and heart disease, including:

• obesity
• high cholesterol
• high blood pressure
• diabetes

According to a 2019 review, this eating plan can also improve a person’s cardiovascular health.

Those following the Mediterranean diet should aim to eat:

• green, leafy vegetables
• a variety of legumes
• nuts, such as walnuts, pistachios, and almonds
• fresh fruits
• whole grains
• olive oil
• fish

Learn more about the Mediterranean diet.

The CDC notes that some people could use dietary changes to help with high cholesterol. However, they also state that a person’s diet alone may not be enough to lower cholesterol levels.

In addition to making dietary changes, individuals should take the following steps to help lower LDL cholesterol levels:

• avoiding or quitting smoking, if applicable
• getting lipid profiles regularly, at least every 5 years
• taking part in regular exercise

Some people may also require medications. Those who may need medication for cholesterol include those with:

• diabetes
• CVD
• familial hypercholesterolemia, an inherited condition that can cause a person to have high levels of LDL cholesterol

A person could help reduce their cholesterol levels with dietary changes. However, they may also need to make additional changes, such as increasing the amount they exercise and quitting smoking, if applicable.

However, some people, such as those living with diabetes or CVD, may not be able to control their cholesterol with diet and lifestyle changes alone. They may require medication to help better manage their condition.