This article ( "11 High-Cholesterol Foods-- Which to Eat, Which to Avoid") was written by: Jillian Kubala, MS, RD on September 10, 2018.
Cholesterol is arguably one of the most misunderstood substances.
For decades, people avoided healthy yet cholesterol-rich foods like eggs due to the fear that these foods would increase their risk of heart disease.
However, recent research shows that — for most people — consuming healthy foods that are high in cholesterol won’t harm your health.
What’s more, some cholesterol-rich foods are loaded with important nutrients that are lacking in many people’s diets.
This article explains why cholesterol in foods should not be feared and lists healthy high-cholesterol foods.
What Is Cholesterol and Is It Unhealthy?
Cholesterol is a waxy substance found in your body and in animal products like meat, eggs and dairy.
It plays important roles in the production of hormones, vitamin D and the bile necessary for digesting fats.
Cholesterol is an essential component of every cell in your body, giving cell membranes strength and flexibility (1).
Your liver produces all of the cholesterol that your body needs to function, but cholesterol can also be introduced through the consumption of animal products.
Since cholesterol doesn’t mix well with liquids (blood), it’s transported by particles called lipoproteins, including low-density and high-density lipoprotein — or LDL and HDL.
LDL is often referred to as “bad cholesterol,” as it’s associated with the plaque buildup in arteries, while HDL (“good cholesterol”) helps excrete excess cholesterol from your body (2).
When you consume extra cholesterol, your body compensates by reducing the amount of cholesterol that it naturally makes.
In contrast, when dietary cholesterol intake is low, your body increases cholesterol production to ensure there is always enough of this vital substance (3).
Only about 25% of cholesterol in your system comes from dietary sources. The rest is produced by your liver (4).
Is Dietary Cholesterol Harmful?
Research has shown that dietary cholesterol does not significantly impact cholesterol levels in your body, and data from population studies does not support an association between dietary cholesterol and heart disease in the general population (5, 6, 7).
Though dietary cholesterol can slightly impact cholesterol levels, this isn’t an issue for most people.
In fact, two-thirds of the world’s population experience little or no increase in cholesterol levels after eating cholesterol-rich foods — even in large amounts (8).
A small number of people are considered cholesterol non-compensators or hyper-responders and appear to be more vulnerable to high-cholesterol foods.
However, hyper-responders are thought to recycle extra cholesterol back to the liver for excretion (9).
Dietary cholesterol has also been shown to beneficially affect the LDL-to-HDL ratio, which is considered the best indicator of heart disease risk (10).
While research shows that it’s unnecessary for most people to avoid dietary cholesterol, keep in mind that not all cholesterol-containing foods are healthy.
Here are 7 healthy high-cholesterol foods — and 4 to avoid.
1–7. Healthy Foods That Are High in Cholesterol
Here are 7 high-cholesterol foods that are incredibly nutritious.
1. Eggs
Eggs are one of the most nutritious foods you can eat. They also happen to be high in cholesterol, with one large egg delivering 211 mg of cholesterol, or 70% of the RDI (11).
People often avoid eggs out of fear that they may cause cholesterol to skyrocket. However, research shows that eggs don’t negatively impact cholesterol levels and that eating whole eggs can lead to increases in heart-protective HDL (12).
Aside from being rich in cholesterol, eggs are an excellent source of highly absorbable protein and loaded with beneficial nutrients like B vitamins, selenium and vitamin A (13).
Research has shown that eating 1–3 eggs per day is perfectly safe for healthy people (14, 15).
2. Cheese
A 1-ounce (28-gram) serving of cheese provides 27 mg of cholesterol, or about 9% of the RDI (16).
Although cheese is often associated with increased cholesterol, several studies have shown that full-fat cheese does not negatively impact cholesterol levels.
One 12-week study in 162 people found that a high intake of 80 grams or about 3 ounces of full-fat cheese per day did not raise “bad” LDL cholesterol, compared to the same amount of low-fat cheese or the equal number of calories from bread and jam (17).
Different types of cheese vary in nutritional content, but most cheeses provide a good amount of calcium, protein, B vitamins and vitamin A (18, 19).
Since cheese is high in calories, stick to the recommended serving size of 1–2 ounces at a time to keep portions in check.
3. Shellfish
Shellfish — including clams, crab and shrimp — are an excellent source of protein, B vitamins, iron and selenium (20, 21).
They’re also high in cholesterol. For example, a 3-ounce (85-gram) serving of shrimp provides 166 mg of cholesterol — which is over 50% of the RDI (22).
Additionally, shellfish contain bioactive components — such as carotenoid antioxidants and the amino acid taurine — that help prevent heart disease and lower “bad” LDL cholesterol (23, 24).
Populations that consume more seafood have demonstratively lower rates of heart disease, diabetes and inflammatory diseases like arthritis (25).
4. Pasture-Raised Steak
Pasture-raised steak is packed with protein, as well as important vitamins and minerals like vitamin B12, zinc, selenium and iron (26).
It’s lower in cholesterol than feedlot beef and contains significantly more omega-3 fatty acids, which have anti-inflammatory properties (27, 28).
A 4-ounce (112-gram) serving of pasture-raised steak packs about 62 mg of cholesterol, or 20% of the RDI (29).
Though processed meat has a clear association with heart disease, several large population studies have found no association between red meat intake and heart disease risk (30, 31).
5. Organ Meats
Cholesterol-rich organ meats — such as heart, kidney and liver — are highly nutritious.
For example, chicken heart is an excellent source of the powerful antioxidant CoQ10, as well as vitamin B12, iron and zinc.
It’s also high in cholesterol, with a 2-ounce (56-gram) serving providing 105 mg of cholesterol, or 36% of the RDI (32).
One study in over 9,000 Korean adults found that those with a moderate intake of unprocessed meat — including organ meats — had a lower risk of developing heart disease than those with the lowest consumption (33).
6. Sardines
Sardines are not only loaded with nutrients but also a tasty and convenient protein source that can be added to a wide variety of dishes.
One 3.75-ounce (92-gram) serving of these tiny fish contains 131 mg of cholesterol, or 44% of the RDI, but it also packs 63% of the RDI for vitamin D, 137% of the RDI for B12 and 35% of the RDI for calcium (34).
What’s more, sardines are an excellent source of iron, selenium, phosphorus, zinc, copper, magnesium and vitamin E.
7. Full-Fat Yogurt
Full-fat yogurt is a cholesterol-rich food packed with nutrients like protein, calcium, phosphorus, B vitamins, magnesium, zinc and potassium.
One cup (245 grams) of full-fat yogurt contains 31.9 mg of cholesterol, or 11% of the RDI (35).
Recent research shows that increased consumption of full-fat fermented dairy products is associated with reductions in “bad” LDL cholesterol and blood pressure, as well as lower risks of stroke, heart disease and diabetes (36).
Plus, fermented dairy products like yogurt benefit intestinal health by positively impacting friendly gut bacteria (37).
SUMMARY
Eggs, cheese, shellfish, pastured steak, organ meats, sardines and full-fat yogurt are cholesterol-rich, nutritious foods that make healthy additions to your diet.
8–11: High-Cholesterol Foods You Should Avoid
While certain cholesterol-rich foods are highly nutritious and beneficial to your health, others can be harmful.
Here are 4 high-cholesterol foods that can negatively impact your health.
8. Fried Foods
Fried foods — such as deep-fried meats and cheese sticks — are high-cholesterol and should be avoided whenever possible.
That’s because they’re loaded with calories and can contain trans fats, which increase heart disease risk and are detrimental to your health in many other ways (38).
Plus, high consumption of fried foods has been linked to an increased risk of heart disease, obesity and diabetes (39, 40).
9. Fast Food
Fast food consumption is a major risk factor for numerous chronic diseases including heart disease, diabetes and obesity.
Those who frequently consume fast food tend to have higher cholesterol, more belly fat, higher levels of inflammation and impaired blood sugar regulation (41).
Eating less processed food and cooking more meals at home is associated with lower body weight, less body fat and reductions in heart disease risk factors like high LDL cholesterol (42).
10. Processed Meats
Processed meats, such as sausages, bacon and hot dogs, are high-cholesterol foods that should be limited.
High consumption of processed meats has been linked to increased rates of heart disease and certain cancers like colon cancer (42).
A large review that included over 614,000 participants found that each additional 50-gram serving of processed meat per day was associated with a 42% higher risk of developing heart disease (43).
11. Desserts
Cookies, cakes, ice cream, pastries and other sweets are unhealthy foods that tend to be high in cholesterol, as well as added sugars, unhealthy fats and calories.
Frequently indulging in these foods can negatively impact overall health and lead to weight gain over time.
Research has linked added sugar intake to obesity, diabetes, heart disease, cognitive decline and certain cancers (43).
Plus, these foods are often devoid of the nutrients your body needs to thrive. These include vitamins, minerals, protein and healthy fats.
SUMMARY
It’s best to limit or avoid certain high-cholesterol foods, such as fast foods, processed meats, fried foods and sugary desserts.
Healthy Ways to Lower Your Cholesterol
Having high levels of “bad” LDL cholesterol can lead to cholesterol buildup in your blood vessel, which can increase your risk of developing heart disease (44).
Certain lifestyle and dietary changes can reduce LDL levels and create a more favorable LDL-to-HDL ratio.
Here are healthy, evidence-based ways to lower cholesterol levels:
Eat more fiber: Research shows that consuming more fiber — especially soluble fiber found in fruits, beans and oats — can help reduce LDL cholesterol levels (45).
Increase physical activity: Becoming more physically active is an excellent way to lower cholesterol levels. High-intensity aerobic exercise seems to be the most effective way to reduce LDL (46).
Lose weight: Dropping excess body weight is one of the best ways to lower cholesterol levels. It can reduce LDL while increasing HDL, which is optimal for health (47).
Cut back on unhealthy habits: Quitting unhealthy habits like smoking can significantly reduce LDL levels. Smoking raises LDL cholesterol levels and greatly increases your risk of cancer, heart disease and emphysema (48, 49).
Increase dietary omega-3s: Consuming more omega-3-rich foods like wild-caught salmon or taking omega-3 supplements like fish oil pills have been shown to reduce LDL and raise HDL levels (50).
Eat more produce: Research shows that people who consume more fruits and vegetables have lower LDL cholesterol levels and are less likely to develop heart disease than those who eat less (51).
There are many other ways to effectively reduce high cholesterol levels.
Trying just a few of the above suggestions could result in a significant reduction in cholesterol and lead to other health benefits, such as weight loss and better dietary habits.
SUMMARY
Increasing dietary fiber, engaging in regular physical activity and quitting unhealthy habits like smoking are proven ways to decrease cholesterol levels.
The Bottom Line
Cholesterol-rich foods are not all created equal — while some like eggs and full-fat yogurt are nutritious, others aren’t good for your health.
Though it’s safe for most people to enjoy the healthy, cholesterol-rich foods listed above, everyone should try to limit unhealthy, high-cholesterol foods like fried items, desserts and processed meats.
Remember, just because a food is high in cholesterol doesn’t mean it can’t fit into a well-balanced, nutritious diet.