High Cholesterol Diet: What to Eat and Avoid

Knowing what to eat for high cholesterol (hypercholesteremia) is important for your heart health. A high cholesterol diet is specifically designed to lower your cholesterol levels.

Not all cholesterol is the same:

• High-density lipoprotein (HDL) can help your body remove cholesterol from your blood.
• High levels of low-density lipoprotein (LDL) can cause plaque buildup (atherosclerosis) to occur.

When you have high cholesterol, the diet recommended to you will involve foods that help increase HDL (good) cholesterol and decrease LDL (bad) cholesterol.

In this article, you'll learn how to change your diet, and what foods to eat, limit, or avoid if you have high cholesterol.

What to Eat for High Cholesterol

Focus on foods high in soluble fiber, phytosterols, and protein. Swap foods high in saturated or trans fats for those with unsaturated fats.

Fruits and Vegetables

Plants don't contain any dietary cholesterol. You won't have to limit fruits and vegetables in your diet. Fruits and veggies are nutritious and packed with fiber and phytosterols (healthy chemicals that help control LDL levels).

Salads are typical go-to's, but be mindful of what you add on top. To give a salad lipid-lowering power, skip the dressing and extras like bacon. Go for a mix of leafy greens, lean protein, and seeds.

Whole Grains

Soluble fiber can reduce the amount of cholesterol you absorb and lower LDL. Whole-grain foods (bread, flours, rice) are typically higher in fiber than their refined counterparts. Oats and oat bran are particularly great choices.

However, check food labels for the fiber, total carbohydrate, and sugar content. Some already-prepared grains may contain added sugars.

Lean Protein

You can eat meat on a lipid-lowering diet, but be careful about the types you include.

Previously, recommendations were to avoid red meat and choose lean white meat instead. However, a 2019 study published in the American Journal of Clinical Nutrition found that red and white meat didn't differ much in their effect on cholesterol levels.

Fish, such as halibut, tilapia, and cod, are low in fat and carbohydrates and high in protein. Tuna and salmon also contain omega-3 fats, a type of healthy fat that can help reduce triglyceride levels.

Nuts and Seeds

All fats are not equal. Saturated fats, especially those high in LDL, can negatively affect lipid levels. Healthy fats (like nuts and avocados), can help lower cholesterol levels by boosting your HDL.

Nuts, seeds, and oils high in linolenic acid (a type of omega-3 fat) can reduce lipid levels. Walnuts, pecans, almonds, and pistachios are high in omega-3 fats and fiber.

These foods are high in calories, so include them in moderation.

Beans and Legumes

Legumes such as beans are high-protein, low-fat foods that can have a powerful impact on your lipid levels. They're versatile and nutritious. Also, the protein they contain tends to be filling. 

Most legumes have a fairly neutral taste and are suitable for different dishes, including soups, salads, sides, dips, and entrées.

Dairy

Choose non-fat milk and yogurt rather than whole milk. Cheese is generally high in saturated fat, but small portions of low-fat cheese such as mozzarella are healthy choices. Single-serve cheese slices or sticks work well, especially as a quick snack.

Dessert

Avoid sweets made with full-fat milk, butter, and sugar. Many packaged cakes, cookies, and snacks contain trans fats. These fats can raise “bad” cholesterol and lower “good” cholesterol. Instead, bake your own low-cholesterol desserts using fruit, egg whites, and oats. 

Beverages

Herbal teas and green teas may help lower cholesterol. Citrus juice may also have a beneficial impact on cholesterol levels.

Alcoholic drinks, especially mixed drinks and cocktails, can be sources of extra calories and sugar, and increase triglycerides.

Cooking Tips for High Cholesterol

As you’re preparing meals, you can reduce the fat content of meat by: 

• Selecting lean cuts of meat with no visible fat
• Trimming remaining fat or gristle from meat and removing the skin before serving
• Grilling, broiling, or roasting meat rather than frying it with high-fat butter or oil

With fruits and vegetables, avoid excess adding salt, sugar, butter, or canola oil. To avoid diminishing their nutritional power, avoid adding sweet sauces, fat, or grease to beans and legumes.

Instead, add flavor with spices. Aside from being tasty, many popular herbs and spices have properties that can change how LDL cholesterol interacts with free radicals—particles that can make the molecules in LDL unstable, causing inflammation and further impacting your cardiovascular health. The antioxidants in some fresh herbs and spices may prevent these harmful interactions. Garlic is another healthy and versatile option for savory meals that can help lower cholesterol and triglyceride levels.

When baking, try adding ginger, allspice, and cinnamon. These are all high in antioxidants. Instead of making baked goods using lard, butter, or oil, try using substitutes like applesauce, banana, or avocado. 

What Times to Eat

Research suggests that people who eat more at night may have higher LDL cholesterol levels than people who eat most of their food during the day. In a 2019 study, people who consumed what would normally be their late-day calories earlier in the day instead had lower cholesterol levels.

Another group of researchers looked at whether skipping meals had an effect on cholesterol levels. The research found people who skipped breakfast had higher LDL cholesterol, and people who skipped dinner had more triglycerides and a higher ratio of total and HDL cholesterol.

How Long to Stay on a High-Cholesterol Diet

Once you've changed how you eat to help manage your cholesterol, you'll likely need to keep those changes long-term. Going back to your previous diet may encourage your levels to rise again.

It may help to think about your new way of eating as a permanent lifestyle modification rather than a temporary diet.

Lifestyle Modifications

Your dietitian or healthcare provider will tailor your high cholesterol diet based on your condition and overall health profile. For example, they may suggest a stricter plan if you have several compounding risk factors.

Even still, sometimes changing how you eat may not be enough to lower your cholesterol. Adding other lifestyle modifications like increasing your physical activity and losing weight may also prove insufficient.

Your healthcare provider may prescribe statins (high cholesterol medications) if your levels are still high on a high cholesterol diet. You would take these medications as you continue with your diet for high cholesterol.

Considerations

If you’re planning to make changes to your diet, consider the parts of your life that might be affected. Your lifestyle, responsibilities, and preferences also influence your ability to make and stick to your changes. 

General Nutrition

Compared to diets that heavily restrict which foods you can eat, a high cholesterol diet can be varied and balanced. Fresh produce, lean meats, and low-fat dairy are all approved on this plan and are part of a healthy diet for anyone.

Many foods you may want to avoid or limit on a low-cholesterol diet are high in fat, sugar, and calories. Limiting or avoiding these foods can have health benefits beyond managing cholesterol, such as controlling your blood sugars or lowering your blood pressure. 

Flexibility

Though you may need to expand your typical shopping list and modify some favorite recipes, the wide range of foods to eat for high cholesterol make the plan quite flexible.

Many restaurant menus highlight heart-healthy or low-fat selections, which may be appropriate. You can also ask to make simple swaps like a whole-grain wrap instead of a bun, or grilled chicken instead of fried.

Dietary Restrictions

If you’re not sure how to make your dietary needs and preferences work with a low-cholesterol diet, you may want to talk with a registered dietitian or nutritionist. They can guide you through creating a lipid-lowering meal plan. 

This advice can be particularly helpful if you're also managing a gastrointestinal issue worsened by fiber or roughage, or if you need to avoid gluten (millet, teff, and quinoa are gluten-free choices packed with fiber).

Side Effects

A cholesterol-lowering diet shouldn't have any side effects. Whenever you make changes to how you eat, it's possible you will experience temporary bowel symptoms such as constipation, but these are usually temporary and get better as you adjust.

If you are starting a cholesterol-lowering drug as well, remember that any side effects you experience could also be the result of your medication. For example, muscle pain and weakness are common side effects of statins. Speak to your healthcare provider about anything you're experiencing that is of concern.

General Health

The recommended foods to eat for high cholesterol provide many other health benefits. Two in particular—helping you maintain a healthy weight and improving your energy—can make other changes, like exercising more, easier to adopt.

This can obviously help your cholesterol-lowering efforts, but it will also help reduce your risk of issues beyond cardiovascular ones, including cancer.

A Word From Verywell

Eating a heart-healthy diet full of fresh produce, whole grains, and lean protein while avoiding foods that are heavily processed and high in trans fat can improve your cholesterol and triglyceride levels and may even help you address other risk factors for heart disease, such as your weight.

You’ll want to discuss the different cholesterol-lowering approaches with your healthcare provider. While making changes to your diet can help, you may also need medications to help get your levels under control.