High-Cholesterol Foods: Which Foods To Eat & Avoid
High-cholesterol foods have been vilified for years. In the very recent past, they were believed to cause heart disease, stroke, and other issues. Doctors then routinely suggested cutting back or avoiding them altogether for folks with high blood pressure or once reaching a certain age.
Yet cholesterol is a vital nutrient in the body. And many foods that are high in cholesterol are filled with nutrients missing from many nutrition plans.
In other words, cholesterol has been misunderstood and wrongly demonized for too long. And many high-cholesterol foods should neither be feared nor avoided. In fact, there are some foods that are high in cholesterol that you should eat. Others, of course, likely are best avoided or at least limited.
What is Cholesterol?
Cholesterol is a waxy substance naturally found in the body that is needed for cell building, as well as to create vitamins (e.g., vitamin D) and hormones (e.g., aldosterone, testosterone, and estrogen), as well as bile, to digest fat and fat-soluble vitamins (e.g., vitamins A, D, E, and K). An essential part of every cell, cholesterol is made by the liver and provides structural integrity and flexibility to cell membranes throughout the body. 1
You’ve likely heard that you want low LDL (“bad” cholesterol) and high HDL “(good” cholesterol). These initials stand for Low-Density Lipoprotein and High-Density Lipoproteins, and are how cholesterol is transported through the blood.
The reason they’re referred to as good or bad is because LDL is typically associated with a buildup of plaque in the arteries, which can lead to heart disease. HDL, on the other hand, helps the body get rid of extra cholesterol as well as decreasing inflammation and oxidation. 2 This is necessary as while cholesterol is essential for healthy cell function, abnormal concentrations can lead to problems like hypercholesterolemia, which increases the risk for cardiovascular disease.
While the body can produce all the cholesterol needed, it’s also found in foods like meats, poultry, and dairy products. Interestingly, however, the body naturally compensates for the cholesterol consumed by decreasing the amount it produces. If you consume less cholesterol, the body naturally produces more. 3 Typically, just 25% of cholesterol comes from the diet, with the liver producing the rest of what’s needed. 4
The Impact of High-Cholesterol Foods
In the past, doctors have recommended limiting high-cholesterol foods to people who had high cholesterol levels. For example, some recommended limiting egg yolks to no more than two to six per week because a single egg provides 186 mg of cholesterol or 62% of the recommended daily intake. 5
However, when researchers looked at the effects of eggs on cholesterol, they found that good HDL cholesterol tends to go up, while bad LDL cholesterol levels are unchanged or increase only slightly. One study, in fact, found that when three eggs were consumed per day as part of a carbohydrate-restricted diet, the risks from metabolic syndrome decreased significantly. 6
On the other hand, eggs—especially those enriched with omega-3—have been shown to lower blood triglycerides and increase levels of the carotenoid antioxidants lutein and zeaxanthin by a lot. 7 – 9
In addition, eating whole eggs was shown to improve lipoprotein profiles as well as insulin sensitivity in people with metabolic syndrome. 10
There are, however, individual differences. About 30% of people (known as “hyper responders”) are more likely to see a slight increase in LDL when they consume a lot of eggs. Even then, the data did not indicate a negative influence of LDL cholesterol. And in fact, there was a beneficial effect on the LDL to HDL ratio. 11
However, it’s important to note that not all high-cholesterol foods are created equal. Here are six to keep in the diet:
6 Healthy High-Cholesterol Foods
This should come as no surprise as eggs are loaded with nutrition. In addition to providing cholesterol, they are also rich in B vitamins, vitamin A, selenium, and quality amino acids. Research suggests you can enjoy up to three eggs per day as long as you’re healthy. 12
Another healthy high-cholesterol food to enjoy is cheese. Yes, that includes full-fat cheese. While cheese is high in calories and thus shouldn’t be eaten by the block, a one-ounce serving provides protein, calcium, and vitamins A and B. It’s also been shown that even when three ounces of cheese were consumed per day, LDL cholesterol levels and metabolic syndrome risk markers were unaffected. 13
3. Yogurt (full-fat)
While full-fat yogurt provides cholesterol, it’s also a rich source of protein, calcium, B vitamins, vitamin D, and vitamin K, magnesium, and other nutrients. In addition, it’s been found in research to help reduce LDL cholesterol as well as blood pressure. In turn, moderate consumption of full-fat dairy products, especially those that are fermented like yogurt or kefir, may even help promote cardiovascular health. 14
Sardines don’t get as much attention from the health-food world as other fatty fish, which is a mistake. These cholesterol-containing little fish can be included in a variety of dishes and provide a lot of protein along with vitamins D, B12, and E and minerals like calcium, iron, selenium, zinc, and magnesium.
Shellfish is included on the healthy foods list for good reason. Shrimp, crab, clams, and oysters are all great sources of protein, amino acids, iron, selenium, B vitamins, and antioxidants. But they can also be medium to high in cholesterol (up to 166 mg or over 50% RDI for a serving of shrimp). Yet in population studies, those who consume more seafood, including shellfish, have been found to have lower rates of heart disease and diabetes. They also are at a lower risk for arthritis and other inflammatory diseases. 15
6. Meat from Pasture-Raised Animals
There are many reasons to be wary of food from feedlots. These meats are lower in omega-3 fatty acids and higher in cholesterol and monounsaturated fat and also cause concern when it comes to sustainability, environment, and the ethical treatment of the animals.
Pasture-raised, grass-fed animals, on the other hand, can actually contribute to the health of the environment. And the meat (along with eggs and dairy) of the animals is also higher quality. It’s packed with protein, vitamin B12, zinc, iron, and selenium. 16
What about all the reports of eating red meat leading to heart disease? There is a connection between eating processed meats and heart disease as well as diabetes and strokes. However, research has not found a link between eating red meat (e.g., steak) in moderation and these diseases. 17, 18
If you enjoy them, cholesterol-rich organ meats can also be part of a healthy diet as they’re high in CoQ10, vitamin B12, iron, and zinc. 19
4 High-Cholesterol Foods to Avoid
The above high-cholesterol foods also come with the benefits of tons of nutrition. They’ve been associated with improved health. But again, not all high-cholesterol foods are created equal. Some, in fact, can have detrimental effects. Those to avoid include:
- Deep-fried foods, which are loaded with calories and trans fats and have been shown to increase the risk of heart disease, obesity, and diabetes. 20
- Fast foods, which are related to obesity, increased belly fat, increased inflammation, and metabolic and cardiovascular diseases. 21
- Processed meats, such as hot dogs and sausages, which have been associated with a 42% increased risk of heart disease for people who ate 50 grams or more per day. 18 Processed meats may also increase the risk of colorectal cancer. 22
- Desserts that are high in cholesterol and added sugars, like many cookies, cakes, ice creams, and other sweets, provide an abundance of calories as well as refined fats, which can lead to not only weight gain but obesity, diabetes, heart disease, and cognitive decline over time. 23
High-Cholesterol Foods: A Wrap-up
When it comes to high-cholesterol foods, it can seem complicated. There’s a lot of competing information telling us what to eat and what to avoid. Nutrition is ever evolving as we learn more about our bodies and how they react to the foods we eat.
Remember that you are an individual as well, and your body may be more or less responsive to dietary cholesterol. The advice is not black and white. Nuance in this (as in most things) is needed, and moderation (i.e., limiting rather than avoiding) is key.
For an even deeper dive into the truth about cholesterol and how to lower bad cholesterol, check out this article.