What Foods Should You Avoid If You Have High Cholesterol?

Foods to avoid if you have high cholesterol include tropical oils (coconut oil and palm oil), fatty meats, processed meats, red meat, full fat dairy products, egg yolks, fried foods, fast foods, frozen foods, salty foods (foods high in sodium), sugar-sweetened foods, and sugar-sweetened beverages.

Cholesterol is a waxy substance that works in the body to help support cell membranes, manufacture hormones, aid in digestion, and convert vitamin D in the skin.

The American Heart Association recommends limiting saturated fat in the diet to less than 6% of daily calories and minimizing consumption of trans fats.

Foods to avoid if you have high cholesterol include: 

• Tropical oils such as coconut oil and palm oil
• Fatty meats
• Processed meats
• Red meat
• Full fat dairy products
  • Whole milk
  • Butter
  • Cheese ice cream
• Egg yolks
• Fried foods
• Many fast foods and frozen foods
  • Frozen pizzas
• Salty foods (foods high in sodium)
  • Canned soups
  • Cold cuts
  • Salty snack foods
• Sugar-sweetened foods 
  • Cookies
  • Candy
  • Cakes
  • Donuts
• Sugar-sweetened beverages

Foods That Lower Cholesterol

Foods to eat if you have high cholesterol include fruits, vegetables, whole grains, poultry, fish, nuts, and nontropical vegetable oils.

The DASH (Dietary Approaches to Stop Hypertension) eating plan promoted by the National Heart, Lung, and Blood Institute is considered a heart-healthy approach. 

High cholesterol usually has no symptoms. It is detected with a blood test. 

The body naturally produces cholesterol in the liver, which makes up about 75% of the cholesterol in the body. For most people, elevated cholesterol levels come from foods we eat and an unhealthy lifestyle. 

Lifestyle factors that can negatively affect cholesterol levels include:

• Unhealthy diet
• Sedentary lifestyle
• Being overweight or obese
• Smoking, exposure to secondhand smoke, or vaping

In some cases, high cholesterol is genetic. Familial hypercholesterolemia (FH) runs in families and increases the risk for premature atherosclerotic heart disease.

The American Heart Association recommends adults 20 years and older have their cholesterol levels checked every four to six years. 

Cholesterol levels are checked with a blood test, which may be a “fasting” or “non-fasting” lipoprotein profile. A fasting test usually means not eating, drinking certain beverages, or taking medications between 9 and 12 hours before the cholesterol test.

Cholesterol scores usually contain three measurements:

• Low density lipoproteins (LDL)
  • “Bad” cholesterol
  • Too much LDL can build up in the artery walls and form plaque that narrows arteries and restricts blood flow, which lead to coronary artery disease
  • High levels of LDL cholesterol mean a person has an increased risk of stroke and heart attack
• High density lipoproteins (HDL) 
  • “Good” cholesterol
  • HDL removes LDL cholesterol from the bloodstream and the artery walls
  • A higher HDL score is desirable 
• Triglycerides 
  • The most common form of fat in the body
  • Can be an energy source
  • A high triglyceride level can mean a higher risk of developing coronary artery disease

People who do not have heart disease should aim for the following cholesterol levels:

• Total cholesterol below 200 mg/dL
  • Levels above 200 mg/dL are considered high and mean a higher risk for developing heart disease
• LDL cholesterol below 130 mg/dL
  • Or much lower for those at risk of heart attacks or stroke
• HDL cholesterol above 60 mg/dL
  • HDL levels of 60 mg/dL and higher can help reduce the risk for heart disease
  • HDL levels of 40 mg/dL and lower are considered a risk factor for developing heart disease
• Triglycerides below 150 mg/dL
  • Levels higher than 150 mg/dL increase the risk of developing heart disease and metabolic syndrome, which is also a risk factor for heart disease, diabetes, and stroke 
• Non-HDL cholesterol below 160 mg/dL
  • This is the total cholesterol minus the HDL cholesterol
  • Or lower for those at risk of heart attacks or stroke

Treatment for high cholesterol begins with lifestyle changes. 

• Eat a heart-healthy diet
• Exercise regularly
• Don’t smoke or vape
• Lose weight if you are overweight

Medications used to treat high cholesterol include: 

• Statins (HMG CoA reductase inhibitors)
  • Atorvastatin (Lipitor) 
  • Fluvastatin (Lescol) 
  • Lovastatin (Mevacor, Altoprev) 
  • Pravastatin (Pravachol) 
  • Rosuvastatin calcium (Crestor)
  • Simvastatin (Zocor)
• Ezetimibe (cholesterol absorption inhibitors)
• Bile acid sequestrants (also called bile acid-binding agents)
  • Cholestyramine (Questran, Questran Light, Prevalite, Locholest, Locholest Light)
  • Colestipol (Colestid)
  • Colesevelam HCl (WelChol)
• PCSK9 inhibitors to lower LDL (bad) cholesterol
  • Alirocumab (Praluent)
  • Evolocumab (Repatha)
• Adenosine triphosphate-citrate lyase (ACL) inhibitors
  • Bempedoic acid (Nexletol)
  • Bempedoic acid and ezetimibe (Nexlizet)
• Fibrates
  • Gemfibrozil (Lopid) 
  • Fenofibrate (Antara, Lofibra, Tricor, and Triglide) 
  • Clofibrate (Atromid-S) 
• Niacin (nicotinic acid), a B vitamin 
• Omega-3 fatty acid ethyl esters
  • Lovaza
  • Vascepa
  • Epanova
  • Omtryg
• Marine-derived omega-3 polyunsaturated fatty acids (PUFA)