When most people become conscious of the negative health effects of high cholesterol, they start paying attention to the nutritional labels on their food, checking carefully to see if an item is high or low in cholesterol. And while it certainly makes sense to do that, there’s more that you should know about how foods can cause your blood cholesterol levels to rise. Focusing on cholesterol content to the exclusion of other food ingredients could leave you zeroed in on a relatively insignificant factor and not paying enough attention to food contents that play a greater role in cholesterol levels.

When cholesterol-conscious people make this mistake, they’re likely laboring under the misunderstanding that our blood lipid levels rise only when we put too much cholesterol into our bodies through food. To be clear, eating high-cholesterol foods may indeed drive up blood cholesterol levels, but there are other, more significant, ways this can happen.

Consider the following food types and their effects on cholesterol levels:

  • Foods high in cholesterol………………………… Raise blood cholesterol
  • Foods high in saturated fats……………………..Raise blood cholesterol
  • Foods high in sugars and carbs…………………Raise blood cholesterol
  • Foods high in unsaturated fats…………………Lower blood cholesterol
  • Foods high in fiber…………………………………..Lower blood cholesterol

While that may seem like a lot to remember, you can avoid cholesterol-elevating foods while taking in more foods that lower cholesterol by adopting a Mediterranean-style diet. Or simply go by the US Department of Agriculture’s MyPlate program, which suggests you divide your plate at each meal, filling half with fruits or vegetables, a quarter with whole grains and a quarter with lean protein. Most of us are well aware when we’re consuming sugar, although sometimes it sneaks into our diets in the form of sweetened beverages.

The latest on dietary cholesterol

It seems like a no-brainer that eating cholesterol would result in having more cholesterol in your bloodstream. But surprisingly, for most people dietary cholesterol is not the strongest driver of blood lipid levels. However, there are some people whose bodies are unusually susceptible to converting dietary cholesterol into circulating cholesterol. We call such people “responders.” Unfortunately, there’s no way to know whether or not you’re a responder except through trial and error. When responders stop eating foods high in cholesterol, their blood levels drop.

Certainly if you know you have high cholesterol, and especially if you have cardiovascular disease, you’ll want to limit the amount of cholesterol you take in through diet. Foods to avoid with high cholesterol include eggs, butter, and processed meats. Note, though, that experts now say people with normal cholesterol levels may eat an egg a day without worrying about it causing their cholesterol levels to rise.

But there’s another reason for all of us to pay attention to the amount of cholesterol in a food…Very often, foods high in cholesterol are also high in saturated fats, which are a key driver of increased blood cholesterol (Eggs, along with shellfish, are an exception. Both are high in cholesterol but not in saturated fat, which is what makes them safe for most people).

How saturated fats raise cholesterol

The liver doesn’t just produce cholesterol in the human body, it also traps and disposes of circulating LDL (“bad cholesterol”). When we consume saturated fats, which come from animal products, we’re introducing substances that effectively tell the organ to stop clearing LDL out of the blood. Someone who eats a diet high in animal fats (especially if they also consume a lot of sugars and carbohydrates) is likely to see their lipid levels go up and up.

Foods high in saturated fats

Most animal products are high in saturated fats. That includes:

  • Beef
  • Lamb
  • Poultry with skin
  • Processed meats (hot dogs, sausages, meatballs, etc.)
  • Bacon
  • Cold cuts
  • Whole milk
  • Cream
  • Butter
  • Cheese
  • Ice cream

Better fats

The solution is not to avoid fats altogether, since fat is a crucial nutrient. The fats found in plant-based foods, called unsaturated fats, have been associated with lower cholesterol levels and better cardiovascular health. Simply by making a conscious effort to get your fats from plant rather than animal sources can be a key to improving your lipid profile.

The healthy unsaturated fats include the omega-3 and omega-6 fatty acids. Foods high in such fats include avocadoes, walnuts, flaxseeds, soybean, sunflower, salmon, and olive oil. As you may know, olive oil is a key element of the Mediterranean diet. A 2022 Harvard-led study of more than 90,000 adults found that eating just half a tablespoon per day was associated with a 19% lower risk of death during the study period.

A special word on dairy

Although nutritionists have for decades urged people to cut down or eliminate full-fat dairy, newer research calls such recommendations into question. “About 90% of emerging evidence points to whole-fat dairy as being at least the same if not better than reduced-fat for most health outcomes,” says Dariush Mozaffarian, MD, a cardiologist and dean emeritus of the Tufts Friedman School of Nutrition Science and Policy.

Researchers have begun looking closely at the milk fat globule membrane, which appears to bind to cholesterol so that it’s expelled rather than absorbed. And solid research shows that compounds called menaquinones, whose richest source is cheese, are linked to lower diabetes risk.

A large international study published in The Lancet in 2018 found that, compared to people who ate no dairy, those who consumed two or more servings per day had a 22% lower risk of cardiovascular disease and 17% lower risk of death.

While federal guidelines have not yet caught up with the science, Dr. Mozaffarian now recommends eating a serving of yogurt and a serving of cheese each day, either whole-fat or low-fat. Butter and milk, he says, are optional. Just make sure you’re not getting extra calories by consuming too much of it, or by purchasing sweetened products.  

A place for fiber

There are good reasons behind MyPlate’s suggestion that three-quarters of your plate be covered by whole grains, fruits, and vegetables. One major such reason is that those foods are high in fiber. This substance, sometimes called “roughage,” is the portion of a plant food that can’t be absorbed by your body and gets excreted as waste. Fiber is thought to be anti-inflammatory, meaning that it helps tamp down the body’s harmful overreaction to irritants and thus helps protect against the negative outcomes associated with artery disease caused by high cholesterol. More than that, though, when you swallow soluble fiber, it binds with cholesterol in your digestive tract, carrying it along to be expelled as waste rather than letting it be absorbed into your bloodstream. This can bring down both your LDL (“bad”) and total cholesterol. Sources of soluble fiber include:

  • Whole grains such as oats, barley, quinoa, and brown rice
  • Nuts and seeds including peanuts, almonds, flaxseeds, and chia seeds
  • Vegetables such as kale, broccoli, Brussel sprouts, sweet potato, and carrot
  • Fruits including pears, bananas, apples, oranges, berries, and dried figs

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