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). Cholesterol you gain from your diet is extra and unnecessary, like frosting on an already sugary cake.
Speaking of cake, there are certain foods (like sweets) that make your “bad” cholesterol (LDL) level higher than normal. On the other hand, other foods can help lower your LDL level.
The major nutritional source of cholesterol (called dietary cholesterol) is animal products. These include meats, cheeses and dairy products. Many of these foods and drinks also contain lots of saturated fat, which can raise your LDL (bad) cholesterol. In fact, scientists believe saturated fat is even more harmful than dietary cholesterol when it comes to your LDL level.
What foods should I eat to lower my cholesterol?
You can lower your cholesterol by eating foods that lower your LDL level and avoiding foods that raise it. But a quick search for “cholesterol diet” can leave you feeling more confused than when you began. So where do you start? How do you know what to eat?
Here are some steps you can take:
- Learn which ingredients are good for you and which ones are bad. Read food labels when you shop so you know what’s in the items you’re buying.
- Learn the five food groups and how to choose healthy foods in each group.
Ingredients that are good for you
Some ingredients help lower your LDL cholesterol. These include:
- Soluble fiber: A form of fiber (roughage) that blocks absorption of cholesterol. Aim for 10 to 25 grams per day. Ask your healthcare provider the amount that’s best for you based on your calorie needs.
- Plant stanols and sterols: Natural compounds that block absorption of cholesterol. Aim for 2 grams per day.
Try to eat foods that contain these ingredients. The chart below lists some healthy options.
|Sources of soluble fiber||Sources of plant stanols and sterols|
|Apples.||Almonds and almond butter.|
|Beans (especially lima and kidney).||Broccoli.|
|Brussels sprouts.||Brown rice.|
|Chia seeds.||Brussels sprouts.|
|Figs.||Juices and yogurts (some).|
|Onions.||Peanuts and peanut butter.|
|Peas.||Sesame oil and sesame seeds.|
|Prunes.||Soft margarines (some).|
|Sweet potatoes.||Wheat germ.|
Ingredients that are bad for you
Some ingredients raise your LDL cholesterol. These include:
- Saturated fat: Fat molecules that are solid at room temperature. Your body needs some saturated fat to be healthy. But it’s easy to eat too much if you aren’t checking labels. Aim to get no more than 7% of your daily calories from saturated fat. For most people, that’s about 11 to 15 grams of saturated fat per day.
- Trans fat: A combination of liquid vegetable oil and hydrogen, made by the food industry. It’s cheap and easy to use in fast foods and prepared snacks. Your body doesn’t need any trans fat. It harms your body and does nothing to help it. So try to completely avoid it (0 grams per day).
Try to limit or avoid foods that contain these ingredients.
|Sources of saturated fat (LIMIT these foods)||Sources of trans fat (AVOID these foods)|
|Bacon.||Anything with partially hydrogenated oil.|
|Cheese (made from 2% or whole milk).||Doughnuts.|
|Cocoa butter.||French fries.|
|Coconut and coconut oil.||Fried foods.|
|Cream and whipped cream.||Pastries.|
|Palm oil and palm kernel oil.||Pizza dough.|
|Pork.||Prepared snack and convenience foods.|
You can make or buy healthier versions of many of the foods in the trans fat list. For instance, when you make cookies, use soft margarine instead of stick margarine or shortening.
There are five main food groups:
- Protein foods.
You need foods from all five groups every day. But it’s not always easy to figure out which foods within each group are good for your cholesterol and which ones can be harmful. The charts below provide some general guidelines for what to choose and what to avoid.
If many of the foods you enjoy are on the “avoid” lists, it’s OK. Often, you can find healthier alternatives. For instance, many dairy products come in low-fat or nonfat (fat-free) versions. Read labels and compare the fat content in each product. Plus, treat yourself once in a while, like on the weekend. Doing so will make your new eating plan feel more manageable and realistic.
|Canned fruit without added sugar or syrup.||Fried fruits.|
|Fresh or frozen fruit without added sugar.||Fruits served with cream or whipped cream.|
|Fresh, raw vegetables.||Fried or breaded vegetables.|
|Fresh vegetables that are steamed or cooked in little or no oil.||Vegetables made with cheese or butter.|
|Frozen or canned vegetables without added salt.||Vegetables served with cream sauce.|
|Oatmeal.||Chips and cheese puffs.|
|Low-fat crackers or pretzels.||Croissants.|
|Whole-grain cereals.||Flavored (buttered) popcorn.|
|Whole-grain or whole-wheat pastas.||Most bakery items and pastries.|
|Beef, pork or lamb without much fat (lean).||Corned beef.|
|Chickpeas.||Deli meat that’s fatty.|
|Deli meat that’s lean (like turkey).||Duck or goose.|
|Egg whites or egg substitutes.||Egg yolks.|
|Fish (especially mackerel, salmon and herring).||Fried meat or fish.|
|Lima beans.||Hot dogs.|
|Nut butters.||Organ meats (like liver).|
|Nuts (especially walnuts and almonds).||Poultry with skin.|
|Poultry with skin removed.||Ribs.|
|Quinoa or farro.||Salami.|
|Seeds (like sesame, pumpkin, sunflower and chia).||Sausage.|
|Nonfat or low-fat cheese.||Cheese that isn’t low-fat.|
|Nonfat or low-fat cottage cheese.||Cream and half-and-half.|
|Nonfat or low-fat yogurt.||Cream cheese.|
|Skim or 1% milk.||Sour cream.|
|Whole or 2% milk or yogurt.|
Can I have snacks on a low-cholesterol diet?
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 melted cheese (1 ounce).
Keep in mind that many low-fat snacks or desserts you may buy at the store are 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 without all the sugar 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 for a low-cholesterol diet?
Cooking at home helps you take control of your diet. But just because something is home-cooked doesn’t mean it’s healthy. Keep in mind these tips to cook in ways that support your low-cholesterol eating plan. Your healthcare 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 or meats.
- Bake, broil or steam your foods: Use these methods instead of frying them.
- Check recipes for butter and oil substitutes: Many recipes will provide options like applesauce or bananas for baking.
- Hold the butter and high-fat sauces: Don’t add butter or high-fat sauces to your recipes.
- Find herbs and spices you enjoy: Use them in place of salt or butter for flavor.
- Make your own salad dressing: You can create your own dressing using extra-virgin 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 before eating: Put your pot of soup or stew in the refrigerator 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 skin: Remove the skin from chicken before cooking.
- Trim visible fat: Trim fat from meat before cooking.
- Use egg whites or egg substitutes: Use these options in place of whole eggs.
- Use oatmeal in your meatloaf: Use oatmeal instead of bread crumbs in your meatloaf. And use lean turkey instead of beef.
- Use soft margarine when baking: Use soft margarine (especially one with plant stanols and sterols) instead of butter when baking.
What is the TLC 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.
A few parts of this diet are still helpful, though. The TLC diet makes these recommendations:
- Saturated fat: Less than 7% of your total calories.
- Plant stanols or sterols: 2 grams per day.
- Soluble fiber: 10 to 25 grams per day.
The key is watching the types of fat you eat. Reducing your saturated fat (and trans fat) consumption can make a big difference in your LDL levels.
How do I calculate my saturated fat limit?
You first need to check how many calories you need each day. The number varies based on your age, sex assigned at birth and activity level. For many people, 2,000 calories per day is typical.
Once you know your calorie needs, you can figure out your saturated fat limit. It’s helpful to know that 1 gram of fat contains 9 calories.
Here’s a breakdown of the math for someone who needs 2,000 calories per day.
Since your saturated fat intake should be less than 7% of your total calories, use 6% in the calculation.
- Calculate 6% of your total calories: 2,000 calories x 0.06 = 120 calories
- Convert calories to grams of fat: 120 calories / 9 = 13 grams of fat
So a person who needs 2,000 calories per day should eat no more than 13 grams of saturated fat per day.
Here’s a quick reference chart with common daily calorie needs:
|Calories you need per day||Saturated fat limit|
Talk with your healthcare provider before starting any new diet to lower your cholesterol. Often, the best plan is a personalized one. Your provider may refer you to a dietitian who can help you make a customized plan that you’ll feel good about following.
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 healthcare 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 body 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 may not have the same impact at age 60 as they would at age 40.
Change takes time
If you’ve made changes to what you eat, you may 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 healthcare 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 may 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.
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