There are few health conditions that affect as significant of a portion of Americans as high cholesterol. One in 3 Americans, or 38% of the population, has high cholesterol, according to the American Heart Association. Perhaps a bigger problem is that you probably don't know it. High cholesterol has no symptoms, so many people don't know that their cholesterol is too high until they take a blood test, according to the CDC.
When you think about it, the pervasiveness of high cholesterol isn't that surprising. Some of the worst foods for high cholesterol—simple carbs, processed sugars, and saturated fat—are all staples of a Western diet.
But just because you don't feel any different with or without cholesterol doesn't mean you should blow off a diagnosis and stick to the bad habits that got you here in the first place. High levels of LDL cholesterol (low-density lipoproteins, a.k.a the "bad" kind of cholesterol) can lead to other health problems, namely heart disease and stroke: the two leading causes of death for people in the United States. You run the same risk if your good cholesterol, or HDL (high-density lipoproteins), is not high enough. HDL is responsible for removing excess cholesterol in your blood and helping break it down.
If you're thinking, "I gave up fried food already, I'm good," we have some news for you: there could be a dozen other things (many of which are seemingly healthy) you're doing that are wreaking havoc on your cholesterol levels. We asked dietitians for the 13 unhealthiest diet habits for people with high cholesterol you need to know about.
Not eating enough fiber
What does fiber have to do with cholesterol levels? A lot, as it turns out.
"Fiber binds to excess cholesterol and clears it from the bloodstream," says registered dietitian Danielle McAvoy, RD, senior manager of nutrition and culinary product for Territory Foods. She adds that people with high cholesterol should try extra hard to get the recommended 25 to 30 grams of fiber per day.
And if you really want to knock the socks off your high cholesterol levels, aim to make your fiber soluble (i.e. the kind that dissolves in water), says registered dietitian Sarah Rueven, MS, CDN, founder of Rooted Wellness. That means eating plenty of foods like beans, oats, barley, citrus fruits, apples, strawberries, Brussels sprouts, and potatoes.
Eating packaged snacks
Yes, on-the-go crackers, granola bars, and baked goods are convenient—but they're also empty calories more often than not, full of added…well, junk, to be honest.
"These foods often have hydrogenated oils added to extend the shelf life," reveals McAvoy. Many of these oils are of the saturated kind, which has been linked to high LDL levels.
Avoiding soy
If you've steered clear of soy because it gets a bad reputation for causing reproductive problems and even certain types of cancer, you might want to reconsider a full ban on the plant-based source of protein. According to McAvoy, the phytoestrogens in soy interfere with cholesterol absorption and can help lower LDL cholesterol.
The Harvard T.H. Chan School of Public Health acknowledges that studies about soy have been notoriously conflicting, but at this point, says there's not strong enough evidence to believe it's harmful in moderation.
Avoiding all fats
We know, we know…you thought you were supposed to stay away from fat if you have high cholesterol! But here's the thing: not all fat is bad and, in fact, some fat is actually good for you.
According to Lainey Younkin, MS, RD, LDN, weight loss dietitian at Lainey Younkin Nutrition, you should focus on swapping fats in your diet, not nixing them completely: "Research shows that replacing saturated and trans fats with poly- and monounsaturated fats is associated with healthy LDL and HDL cholesterol levels."
Rueven agrees, noting that it's always beneficial to think about what you can add to your diet versus what you should restrict—and adding healthy fats, in this case, can improve your health.
Frying your foods
The oils typically used to fry foods, like peanut oil and vegetable oil, are usually high in trans fats, which are notorious cholesterol-raisers.
"Fried foods are the absolute worst for cholesterol," says Amy E. Rothberg, MD, PhD, an obesity specialist and director of the weight management clinic at Michigan Medicine. "Steaming, grilling, broiling, and baking are far preferred over frying."
Eating processed foods
If you eat a bowl of breakfast cereal in the morning, pop open a can of soda with lunch, and finish off your day with one or two (okay, three) pieces of fun-size candy for dessert, that's a lot of processed food that could be contributing to your high cholesterol.
"Processed foods are often full of saturated fat and sodium while also being devoid of heart-healthy nutrients like fiber, vitamins, minerals, and antioxidants," says Rueven. "Studies show an association between higher intakes of ultra-processed foods and a greater risk for cardiovascular disease."
Overdoing it on dairy products
In moderation, cheese can be a healthy complement to a snack or meal (hello, calcium!), but many people have a misconception about its health food status.
"[People] eat cheese and consider it healthy because it's low in carbs [but] cheese is very high in saturated fat, the type of fat that clogs your arteries and increases your cholesterol levels," says Amy Shapiro, MS, RD, CDN, and founder of Real Nutrition.
You're also probably eating way more of it than you realize since cheese pops up in everything from eggs to sandwiches to burgers to salads, Shapiro warns.
Drinking too much alcohol
Lest you think your health issues are all about what you eat and not what you drink, we're here to remind you to mind your alcohol consumption, too—but it's not all bad news!
"Moderate alcohol consumption may actually have a protective effect on heart health and raise HDL levels," says Rueven.
What does "moderate" mean? One drink per day for women and two drinks per day for men. Once you go beyond that, Rueven warns, alcohol has the opposite effect on cholesterol, increasing the risk for heart disease and raising triglyceride levels.
Getting too many calories from animal products
Plant-based eating is usually associated with lower levels of LDL cholesterol, but you don't have to go full vegan to reap the benefits; many people choose to simply incorporate more plant-based meals into their diet, only eating animal products for one meal every day (like only at dinner, for example).
"Eating highly-processed meats and red meat contributes to worsening of cholesterol levels," says Dr. Rothberg. "People with high cholesterol should focus on getting more of their daily energy from plant sources rather than animal sources."
Eliminating carbs
If you went carb-free when your doctor told you that you have high cholesterol levels, this dietary choice could actually be making it harder for you to keep your LDL cholesterol down.
Why? Well, remember when we told you to eat more fiber? It's pretty hard to do that if you've eliminated carbs—including the good kind—from your diet.
"Whole grains, beans, and legumes are chock-full of fiber, which helps lower LDL cholesterol," says Younkin. "Instead of skipping carbs at meals, start the day with oatmeal and add beans, quinoa, farro, whole-wheat pasta or lentils to lunch and dinner."
Choosing lean fish
You should think twice before skipping the salmon in favor of a low-fat fish like tilapia; according to McAvoy, the omega-3 fats in fattier fish like salmon, tuna, and mackerel are especially effective at raising healthy HDL cholesterol levels.
Younkin agrees: "Eating more omega-3 fatty acids in particular, which are found in salmon, albacore tuna, chia seeds, and flaxseed, is associated with healthy cholesterol levels and lower inflammation in the body."
Substituting with coconut oil
Did you fall victim to the "superfood" trend like the rest of us? If so, you might still be using coconut oil in your recipes thinking it's better for you than vegetable oil…but that may not be the case.
"Coconut oil is touted as a superfood but it's actually about 90% saturated fat, the type that raises LDL cholesterol," explains Younkin. "In fact, a 2020 meta-analysis found that consumption of coconut oil raised LDL cholesterol by 10.5 milligrams per decilitre compared to nontropical vegetable oils."
Younkin adds that coconut oil may also raise HDL, the good cholesterol, but because of its effects on LDL it should be used in moderation (just like butter), with olive oil filling in as your cooking fat of choice whenever possible.
Leaving the fat on your meat
It's true that for meat-eaters, few foods are more indulgent than the crispy layer of fat on a well-cooked chicken thigh. But indulgent is the keyword there, because animal skin is not great for your cholesterol levels.
"People consider animal skin or fat to be healthy because it's carb-free, but it's pure fat," says Shapiro, who adds that it's saturated fat to boot (i.e. the kind that clogs your arteries).
Instead, Shapiro recommends removing as much fat as you can from your meat, buying grass-fed beef (which has a higher composition of omega-3 fatty acids in the fat), and purchasing lean cuts of other types of protein, like poultry.
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