What Is a Low-Cholesterol Diet? A Detailed Beginner’s Guide
If you’ve been diagnosed with or are at risk for high cholesterol (meaning you have too much of this waxy substance in your blood), your doctor may recommend a low-cholesterol diet.
Learn what a low-cholesterol diet involves, the benefits, foods to eat and avoid, and a seven-day low-cholesterol eating plan.
A low-cholesterol diet is an eating pattern that can help reduce levels of triglycerides (a type of fat in the blood) and low-density lipoprotein (LDL) cholesterol, also known as “bad cholesterol,” in the body.
A cholesterol-lowering diet limits saturated fat, an unhealthy fat found in butter, deep-fried foods, and high-fat cuts of meat that can raise LDL cholesterol. It also includes plenty of fiber — particularly soluble fiber (a type of fiber that forms a gel in the digestive tract to slow its digestion) — and omega-3 fatty acids (a type of healthy fat), which help lower triglycerides and LDL cholesterol.
Dietary cholesterol is found in animal foods like meat, eggs, and dairy, while blood cholesterol (which is what’s measured via a blood test at your doctor’s office) is made by your body (primarily your liver) and circulated through your blood.
Until 2015, the U.S. Dietary Guidelines for Americans recommended keeping dietary cholesterol intake below 300 milligrams (mg) per day to support healthy cholesterol levels. But evolving research suggests that limiting cholesterol in your diet doesn’t have a significant impact on cholesterol levels for most people.
“Every person metabolizes and processes cholesterol differently, resulting in different LDL levels,” says Rohit Vuppuluri, DO, an interventional cardiologist at Chicago Heart and Vascular Specialists.
The most recent dietary guidelines don’t specify dietary cholesterol limits but instead recommend focusing on an overall healthy diet that limits saturated fat to support healthy cholesterol levels.
“The most popular diets shown to help lower LDL cholesterol and promote overall healthy cholesterol levels are the DASH diet and Mediterranean diet,” says Patricia Kolesa, RD, a registered dietitian in private practice in Edison, New Jersey. “Both diets are high in fruits, vegetables, lean proteins, nuts, and seeds, while minimizing sodium, added sugars and saturated fats.”
Plant-based diets, including vegetarian and vegan diets, are also associated with improved cholesterol levels, since they naturally limit saturated fats by eliminating many or all animal products, says Angela Konegni, RD, a registered dietitian at Fresenius Medical Care in Coeur d'Alene, Idaho.
Here is a closer look at common types of low-cholesterol diets.
Mediterranean Diet
The Mediterranean diet is a flexible eating pattern based on the traditional eating habits of countries that border the Mediterranean Sea. While eating styles vary from one country to another, there are common factors.
In general, the Mediterranean diet emphasizes whole, minimally processed foods, including fruits, vegetables, whole grains, beans, nuts, seeds, and lean proteins like fish and poultry. Cheese and yogurt are consumed daily in low to moderate amounts, while red meat is eaten infrequently.
DASH Diet
The DASH (Dietary Approaches to Stop Hypertension) diet generally emphasizes the same foods as the Mediterranean diet but has more specific recommendations. Here are some of the serving suggestions for various food groups, according to the DASH diet.
Fruits 4 to 5 servings per day
Vegetables 4 to 5 servings per day
Whole Grains 6 to 8 servings per day
Nuts, Seeds, and Beans 4 to 5 servings per week
Meat, Poultry, and Fish 6 servings or less per day
Low-Fat or Fat-Free Dairy 2 to 3 servings per day
Plant-Based Diets
Plant-based diets focus on fruits, vegetables, beans, grains, seeds, and nuts. While there are many types of plant-based diets, common ones include:
Vegan A vegan diet excludes all animal products, including meat, dairy, eggs, and honey.
Lacto Vegetarian A lacto vegetarian diet excludes most animal foods, with the exception of dairy.
Lacto-Ovo Vegetarian A lacto-ovo vegetarian diet includes eggs and dairy products.
Here are a few of the benefits of following a low-cholesterol diet.
May Help Lower LDL Cholesterol
Studies show that limiting saturated fat and eating plenty of healthy fats, soluble fiber, and plant sterols and stanols (natural compounds found in plant foods that block cholesterol absorption during digestion) can reduce LDL cholesterol levels.
Older research shows that people who followed a low-saturated fat diet for six months lowered their LDL from 171 milligrams per deciliter (mg/dL) to 163 mg/dL on average. The results were even better when people also received regular nutrition counseling, which lowered LDL to 145 mg/dL on average over the same period. Optimal LDL levels are about 100 mg/dL.
May Help Lower Blood Pressure
High cholesterol and high blood pressure are linked. A buildup of cholesterol in your arteries causes them to narrow, forcing your heart to pump harder to circulate your blood. This raises your blood pressure and increases your risk of heart disease. Therefore, lowering your cholesterol may also lower your blood pressure.
The DASH diet is a low cholesterol eating pattern that was designed to lower blood pressure, and research shows it’s effective. The Mediterranean diet has also been shown to lower blood pressure, though more research is needed to understand how significant its effect is. Plant-based diets, even those that allow for some animal products, are associated with lower blood pressure levels, as well. This is likely because these diets are naturally low in sodium and saturated fat, both of which are linked to high blood pressure.
May Improve Brain Health
While more research is needed, studies have shown that Mediterranean and DASH diets may help protect against Alzheimer’s disease and cognitive decline. And one study of older adults found that plant-based diets are associated with better cognition and executive function (the mental skillset we use to get through everyday life, like time management, prioritization, organization, focus, and impulse control).
This area of research is still relatively new, so researchers don’t know exactly why diet impacts brain health. Some research suggests that following Mediterranean and DASH diets can lower inflammation and help important neurotransmitters (chemical messengers in the brain) function.
May Boost Mood
Following a cholesterol-lowering diet may improve mood. Research shows that healthy adults who eat a Mediterranean diet tend to have a better overall mood than those who follow other diets. Meanwhile, one review suggests that following a Mediterranean diet may alleviate depressive symptoms in adults with major or minor depression.
Researchers don’t know for sure why this might happen. High levels of polyphenols in fruits and vegetables and omega-3 fatty acids in fish and nuts (common in the Mediterranean diet) might lessen depressive symptoms by reducing inflammation, but more research is needed.
May Improve Digestive Health
Cholesterol-lowering diets are often high in fiber, a nutrient that supports digestive health. Eating enough fiber — about 14 g per 1,000 calories, according to the U.S. Dietary Guidelines for Americans — helps prevent constipation and supports a healthy and diverse gut microbiome (the ecosystem of microorganisms that live in your intestines).
“It is possible for a cholesterol-lowering diet to aid in weight loss,” Kolesa says.
A cholesterol-lowering diet often emphasizes dietary fiber, which digests slowly and can promote satiety and fullness. “This can reduce instances of overeating, resulting in weight loss,” Kolesa says.
Limiting processed foods and decreasing daily caloric intake may also help you lose weight on a low cholesterol diet, Dr. Vuppuluri says.
Still, long-term weight loss can be difficult to sustain, no matter which diet you follow. One review of more than 100 studies on 14 popular diets — including the Mediterranean and DASH diets — found that most people who lose weight typically regain it after one year.
Following a low-cholesterol diet has potential drawbacks. For example, those who follow a plant-based diet (like a vegan or vegetarian diet) may struggle to eat enough protein every day. In addition, cutting or limiting animal sources can increase your risk of deficiency in iron, calcium, zinc, or vitamin B12.
In addition, limiting all types of fat (not just saturated fat) could impair your body’s absorption of fat-soluble vitamins A, D, E, and K, Kolsea says.
It’s best to talk to your doctor or a registered dietitian before making any drastic changes to your diet. They can recommend foods and supplements to help you get the nutrients you need to stay healthy.
A low-cholesterol diet tends to be flexible and includes a variety of whole foods. When following the diet, it’s important to include foods that you like instead of forcing yourself to eat things that you don’t, Kolesa says.
Also, note that no food is off-limits. If you love cheeseburgers, you don’t need to avoid them completely because they’re high in saturated fat, though you should eat them less often and prioritize foods with little to no saturated fat most of the time. “A restrictive diet may bring on stress, frustration or a sense of deprivation, which can impact cholesterol levels, especially if it conflicts with personal or cultural food preferences,” Kolesa says.
With that in mind, here are the foods to emphasize and avoid on a low cholesterol diet.
Top 10 Foods to Eat
Whole grains
Beans and lentils
Nuts
Fatty fish like salmon and mackerel
Fruits
Vegetables
Avocado
Olive oil
Soy products like tofu and tempeh
Seeds
Top 10 Foods to Limit or Avoid
Fried foods
Processed meats
Butter
Cream
Fatty meats like ribeye, ground beef, and skin-on poultry
Tropical oils like coconut oil and palm oil
Animal fats like lard and tallow
Full-fat cheese
Baked goods
Processed snacks like chips and crackers
A low-cholesterol diet is flexible and includes plenty of variety. Because so many foods are encouraged, it’s easy to create meals and snacks using foods you like. If you need inspiration, here’s a sample seven-day meal plan from Konegni and Kolesa.
Want to give a low cholesterol diet a try? Here are some beginner tips.
1. Watch for Saturated Fat, Sodium, and Added Sugar
Vuppuluri recommends checking nutrition labels to see how much saturated fat and sugar are in different foods, since both of these nutrients are linked to higher blood cholesterol levels.
He also recommends checking for sodium, which doesn’t have a direct impact on your cholesterol levels but does affect your blood pressure (and blood pressure impacts overall heart health).
The U.S. Dietary Guidelines for Americans recommend getting less than 10 percent of your daily calories from saturated fat (which is about 13 g or less per day for most people), less than 10 percent of your calories from added sugar (36 g or less per day for men and 25 g or less per day for women), and no more than 2,300 mg of sodium per day.
2. Choose Carefully When Ordering Food
When ordering food from restaurants, choose lean proteins that are typically prepared with less oil, Kolesa says. She recommends skipping fried foods and fatty meats, because both tend to be high in saturated fat. Instead, she recommends choosing items that are baked, grilled, or sautéed, and opting for chicken or fish over steak, bacon, and burgers.
3. Stock Up on Healthy Snacks
If you tend to get hungry between meals, keep whole-food snacks in the fridge, at your desk, and in your car so you always have nutritious options on hand. Konegni recommends fruit, nuts, seeds, crunchy veggies, hummus, and whole-wheat crackers.
The Takeaway
A low-cholesterol diet limits saturated fats and emphasizes fiber and healthy fats.
Foods like fruits, vegetables, whole grains, nuts, seeds, lean meats, and fatty fish are all good options for a low-cholesterol diet.
In addition to lowering LDL cholesterol, a low-cholesterol diet may improve mood, brain health, digestion, and blood pressure.
