Published by PMR of NY & CT
If your doctor has mentioned your cholesterol, your first instinct may be to cut out every food that contains it. It's an understandable reaction, but it isn't the most effective one. For most people, the cholesterol in food has a smaller effect on blood cholesterol than the type of fat that comes with it.
That's why many foods high in cholesterol are fine in moderation, while some foods with no cholesterol at all can push your numbers up. This guide explains which foods contain the most cholesterol, why saturated fat matters more and how to make sense of eggs, shellfish and other common questions.
Dietary cholesterol and blood cholesterol aren't the same
Cholesterol is a waxy substance your body needs to build cells and make certain hormones. Your liver makes most of the cholesterol in your blood. Dietary cholesterol is the cholesterol in food, and only animal foods contain it.
When you eat more cholesterol, your liver usually makes less, so for many people the effect on blood levels is modest. Some people respond more strongly, though, and your genes play a large role. That's one reason the American Heart Association no longer sets a strict daily number for dietary cholesterol and focuses instead on an overall heart-healthy eating pattern.
Foods high in cholesterol
Cholesterol is found only in animal products. The richest sources include:
- Organ meats such as liver, kidney and sweetbreads
- Egg yolks (egg whites contain none)
- Shellfish such as shrimp, squid and lobster
- Fatty and processed meats such as sausage, bacon, salami and hot dogs
- Full-fat dairy such as butter, cream, whole-milk cheese and ice cream
- Fried fast food and many baked goods made with butter, lard and eggs
Notice that this list splits into two groups. Some foods are high in cholesterol but fairly low in saturated fat, such as eggs and shrimp. Others are high in both, such as fatty meats, butter and cheese. The second group deserves more of your attention.
Saturated fat matters more for your LDL cholesterol
For most people, saturated fat raises LDL cholesterol, the type that builds up in artery walls, more than dietary cholesterol does. The Dietary Guidelines for Americans advise keeping saturated fat to no more than 10% of daily calories, and the American Heart Association recommends aiming for less than 6%.
Saturated fat isn't limited to animal foods. Coconut oil, palm oil and palm kernel oil are high in it, even though they contain no cholesterol. Trans fats raise LDL and lower HDL, the protective type of cholesterol, so they're the worst of all. The FDA no longer allows partially hydrogenated oils, their main source, to be added to foods, though small amounts of trans fat occur naturally in meat and dairy.
How to fit eggs, shrimp and meat into your diet
You don't have to give up foods high in cholesterol entirely. A few practical guidelines:
- Eggs: For most healthy people, the American Heart Association says up to one whole egg a day can fit a heart-healthy diet. If you have high LDL, diabetes or heart disease, ask your doctor how many fit your plan, and remember that egg whites are cholesterol-free.
- Shrimp and shellfish: They’re high in cholesterol but low in saturated fat. Steamed, grilled or broiled shrimp can be part of a healthy diet; fried shrimp or shrimp in butter sauce adds saturated fat.
- Meat: Choose lean cuts and skinless poultry, keep portions modest and eat processed meats rarely.
- Organ meats: Liver is nutritious but very high in cholesterol, so keep it occasional.
When to check your cholesterol and see a doctor
High cholesterol causes no symptoms, so a blood test is the only way to know your levels. Ask your primary care doctor how often you should be tested. Family history matters, too. If close relatives had very high cholesterol or early heart disease, you may have an inherited form called familial hypercholesterolemia, which often needs medicine, sometimes starting in childhood.
Cholesterol problems can show up as a heart attack or stroke, so know the warning signs. Call 911 for chest pain or pressure, shortness of breath, pain spreading to the arm, jaw or back, or sudden face drooping, arm weakness or slurred speech.
Frequently asked questions
Are eggs bad for your cholesterol?
For most people, eating eggs in moderation has a small effect on blood cholesterol. A large egg contains about 186 mg of cholesterol, all in the yolk, but eggs are low in saturated fat and provide protein and other nutrients. The bigger concern is often what comes with them, such as bacon, sausage and buttered toast. If you have diabetes or heart disease, ask your doctor how many eggs fit your plan.
Does coconut oil raise cholesterol?
Yes, it can. Coconut oil is mostly saturated fat, and research shows it raises LDL cholesterol compared with liquid plant oils such as olive or canola oil. It contains no cholesterol itself, which is why it's sometimes marketed as heart healthy, but the American Heart Association advises limiting it. Use it occasionally for flavor rather than as your everyday cooking oil.
Which foods have no cholesterol?
All plant foods are cholesterol-free, including fruits, vegetables, whole grains, beans, lentils, nuts, seeds and plant oils. That doesn't automatically make every plant food heart healthy, since coconut oil, palm oil and many packaged snacks are high in saturated fat, sugar or salt. Fresh produce, whole grains, beans and unsalted nuts are the plant foods that support healthy cholesterol levels.
Stay active with PMR
Your primary care doctor or cardiologist can interpret your cholesterol numbers and decide whether you need medicine. A registered dietitian can help you plan meals. If pain keeps you from regular activity, Physical Medicine & Rehabilitation of NY & CT (PMR) offers chiropractic care and physical therapy to help you move comfortably. Request an appointment and our team will contact you to schedule your visit.
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