Health Debunked: Should You Worry About Your Food’s Cholesterol Content?

For many years, nutritional guidelines recommended limiting the intake of foods high in dietary cholesterol, such as eggs, meat, and seafood. It was thought that dietary cholesterol from these foods was linked to increased blood cholesterol levels and an increased risk of heart disease.

But science evolves. The 2015-2020 Dietary Guidelines for Americans removed the long-held recommendation of restricting dietary cholesterol to 300 mg per day. And they had the science to support that decision. 

What is cholesterol?

In the medical world, cholesterol is a tricky term because it can refer to two things:

1. Dietary cholesterol: This kind of cholesterol is a substance found in the animal-based foods that we eat. Foods that contain high levels of dietary cholesterol include: egg yolk, shrimp, beef, pork, poultry skin, cheese, and butter. Cholesterol is only found in foods that come from animals, so there is no cholesterol in plant-based foods such as vegetables, grains, seeds, nuts, and beans. 

2. Blood cholesterol: This kind of cholesterol is a waxy substance made by the liver. When your provider measures your cholesterol levels, they are looking at how much cholesterol is found in your blood.  

Cholesterol in your blood is carried on lipoproteins, which there are two types of: 

1. Low-density lipoprotein (LDL): known as “bad” cholesterol, because it contributes to fatty buildups in arteries

2. High-density lipoprotein (HDL): known as “good” cholesterol, because it carries LDL (bad) cholesterol away from arteries and back to the liver to be expelled from the body

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When you get your blood cholesterol levels measured by your healthcare provider, you will learn what your levels of both LDL and HDL cholesterol are. You will also get suggestions for treatment if your LDL is too high or your HDL is too low. 

Claim: Eating foods that contain cholesterol will cause high blood cholesterol levels 

For many years, researchers believed that eating foods high in dietary cholesterol, such as red meat, cheese, and butter, causes high blood cholesterol levels. This may have been partly because many foods high in cholesterol are also high in saturated fats.

Interestingly, foods like eggs and shrimp are the exception to this rule. These foods are high in dietary cholesterol, but not high in saturated fat. There have been many studies on foods that are high in dietary cholesterol to determine the impact on blood cholesterol levels. So what did they find?

What does the science say?

Foods that contain cholesterol are not the cause of high blood cholesterol levels. 

Eggs account for about 25% of all the dietary cholesterol consumed in the U.S. As a result, they are often blamed for causing high blood cholesterol levels. But studies have disproven this. Eggs do not raise cholesterol levels or increase risk of heart disease. 

The 2015-2020 Dietary Guidelines for Americans dropped dietary cholesterol as a “nutrient of concern” and the previously recommended limit of 300 mg per day. This is supported by studies that demonstrate no appreciable relationship between dietary cholesterol and blood cholesterol.

But this doesn’t mean you shouldn’t be mindful of your intake. Your dietary cholesterol consumption should be as low as possible without compromising nutrition.

Saturated fat and cholesterol levels 

Diets high in saturated fat and trans fat do increase LDL cholesterol levels. That’s in part because saturated fats cause your liver to make more cholesterol than it usually would. 

As a result, it’s recommended that you limit saturated fat to less than 10% of your daily calories. But 77% of Americans get more than 10% of their daily calories from saturated fat, mostly from foods like deli sandwiches, burgers, tacos, burritos, grilled cheese sandwiches, and hot dogs. 

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Reducing saturated fat helps reduce blood cholesterol levels and lowers your risk of heart disease.  

What do the experts say?

“Most observational studies have found dietary cholesterol is not linked to an increased risk for heart disease and higher cholesterol levels,” says Justine Chan, MHSc, RD, CDE, a registered dietitian and certified diabetes educator. “It’s more the type of fat in your diet, namely saturated fats and trans fats, which can raise your blood cholesterol levels.”

Kelsie Ives, MS, RD, a dietitian specializing in cardiology, agrees. “Something I always say is that animal-derived cholesterol does not exactly translate to our blood cholesterol,” Ives says. “Our body will make cholesterol from saturated and trans fats.

Chan notes that age and genetics, an inactive lifestyle, smoking, and having an underlying history of diabetes can also cause high cholesterol. But there are things you can do to help manage blood cholesterol levels. 

“There are well-established heart-healthy eating patterns that can help people lower their blood cholesterol levels,” Chan says, pointing to the Mediterranean diet, “portfolio diet,” and DASH diet as dietary patterns that can lower LDL cholesterol. 

“The foods common in these diets include fruits, vegetables, whole grains, and nuts,” Chan explains. “Foods high in soluble fiber like oats, beans, barley, and psyllium have also been shown to reduce cholesterol.” 

Ives also recommends these eating patterns. She suggests consuming “a well-varied, balanced diet that includes fruits, vegetables, whole grains, and lean sources of protein.” 

She also recommends people start with small changes, such as using olive oil to cook with instead of butter. “Gradually identify items in your diet that are high in saturated fat and find a better alternative,” says Ives. “Seek out a registered dietitian if you would like help with this.” 

What does affect your cholesterol levels? 

The body makes cholesterol in the liver. And your body will make too much if your lifestyle includes: 

• An unhealthy diet that’s high in saturated fat, trans fat, and sugar

• A lack of physical activity

• Smoking

Other important causes of high cholesterol are genetics and family history. 

To lower blood LDL cholesterol levels, it helps to reduce foods that are high in saturated fat, including:

• Deep-fried foods

• Fast food, such as burgers and pizza

• Butter and lard

• Full-fat dairy products, such as cream and cheese

• Fatty meat, such as sausages and bacon

Eliminating trans fat is now less of a concern because it was banned from the U.S. food supply in 2015. Since some products can still contain trace amounts, it’s important to read your food labels. Avoid foods with the ingredient “partially hydrogenated oil,” a source of trans fat. Foods can have up to 0.4 grams of trans fat from this harmful ingredient and still have 0 grams trans fat listed on the Nutrition Facts label. 

Lowering cholesterol levels

As mentioned above, to lower cholesterol levels, you’ll want to limit your intake of saturated and trans fats, sweets, sugar-sweetened beverages, and red meats. When choosing fats, opt healthier fats like those in oils, nuts, and fatty fish, rather than saturated and trans fats.

The American Heart Association’s cholesterol guidelines recommend managing cholesterol by eating more whole, plant-based foods and reducing your intake of ultra-processed foods and fast food. The organization advises choosing a dietary pattern that emphasizes:

• Vegetables

• Fruits

• Whole grains

• Legumes (beans, chickpeas, lentils)

• Healthy animal-protein sources (low-fat dairy products, low-fat poultry preparations, fish, and other seafood)

• Vegetable oils 

It’s also smart to include more soluble fiber in your diet, which you can get from foods such as oats, barley, and psyllium. This ingredient moderately reduces LDL cholesterol. 

Some specific plant-based foods that help moderately lower LDL cholesterol levels include: 

• Soy

• Tomatoes

• Flax

• Almonds, hazelnuts, and walnuts

• Avocados

• Turmeric

• Green tea

In addition to diet, it’s important to include aerobic physical activity in your routine. You should try to do this kind of activity 3 to 4 times per week. Aim for an average of 40 minutes per session, doing moderate- to vigorous-intensity physical activity. This raises HDL cholesterol levels. 

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Written by:

Cara Rosenbloom, RD

Cara Rosenbloom, RD, has been a registered dietitian for 22 years. She began her career working as a dietitian at Toronto's Hospital for Sick Children (SickKids).

Edited by:

Kelsey Abkin

Kelsey Abkin has been working as a journalist since 2016. She has held many titles throughout her career, including editor, content strategist, digital strategist, and writer.

Reviewed by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

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