The 10 Worst Foods for High Cholesterol, and What to Eat Instead

01Why

Why some foods raise cholesterol

The liver makes most of the body’s cholesterol. Saturated fat and trans fat make the liver produce more LDL cholesterol and clear less of it from the blood. Dietary cholesterol, from eggs and shellfish, has a smaller effect for most people. Trans fats are particularly harmful: a review in the New England Journal of Medicine found they raise LDL, lower HDL (“good” cholesterol) and increase heart disease risk more than any other fat per calorie. The NHS advises eating less saturated fat to lower cholesterol.

02Top 10

The top 10 worst foods for high cholesterol

• 1. Processed meats: sausages, bacon, salami, ham and hot dogs; high in saturated fat and salt.
• 2. Fatty cuts of red meat: marbled steaks, lamb chops, minced beef with high fat content.
• 3. Butter, ghee and lard: very high in saturated fat.
• 4. Cream and cream-based foods: double cream, creamy sauces, ice cream.
• 5. Large amounts of hard cheese: high in saturated fat; small portions are fine.
• 6. Pastries, cakes and biscuits: often contain butter, palm oil or other saturated fats.
• 7. Fried foods and fast food: chips, fried chicken, burgers.
• 8. Coconut oil and palm oil: despite health claims, both are high in saturated fat.
• 9. Foods with partially hydrogenated oils: some margarines, snack foods and baked goods in countries where trans fats are not banned.
• 10. Sugary foods, refined carbs and excess alcohol: raise triglycerides and can lower HDL.

03Evidence

What the evidence shows

An American Heart Association presidential advisory reviewed randomised trials and concluded that replacing saturated fat with polyunsaturated vegetable oils reduced cardiovascular disease by about 30%, similar to the effect of statins, whereas replacing saturated fat with refined carbohydrates and sugars did not reduce risk. A Cochrane review found that reducing saturated fat intake for at least two years lowered the risk of combined cardiovascular events by around 17%, with greater benefit when saturated fat was replaced with polyunsaturated fat or starchy foods.

04Eggs

What about eggs and shellfish?

Eggs and shellfish contain cholesterol but are low in saturated fat. For most people, they have a relatively small effect on blood cholesterol, and eggs can be part of a healthy diet. People with diabetes, familial hypercholesterolaemia or very high LDL may be advised to be more cautious. How eggs are cooked and served matters: a fried breakfast with bacon and sausages has far more saturated fat than a boiled egg on wholegrain toast.

05Swaps

Healthier swaps

• Processed meat → chicken, fish, beans or lentils.
• Fatty red meat → lean cuts, trimmed of fat, in smaller portions.
• Butter → olive, rapeseed or sunflower oil, or a plant-based spread.
• Cream → plain yoghurt or reduced-fat crème fraîche.
• Pastries and biscuits → fruit, nuts or oat-based snacks.
• Fried foods → baked, grilled or air-fried versions.
• White bread and sugary cereal → wholegrain bread and oats.

06Lower

Foods that help lower cholesterol

• Oats and barley, rich in soluble fibre (beta-glucan).
• Beans, lentils and chickpeas.
• Nuts, such as almonds and walnuts.
• Oily fish such as salmon and mackerel.
• Olive oil and rapeseed oil.
• Soy foods.
• Fruit and vegetables.
• Foods with added plant sterols, for some people.
• A full plan is in diet for lowering cholesterol.

07Labels

Reading food labels

• Check saturated fat per 100 g: more than 5 g is high; 1.5 g or less is low (UK guidance).
• Look for “partially hydrogenated” oils in the ingredients.
• Watch for palm oil and coconut oil in snacks and baked goods.
• Compare similar products and choose the lower saturated fat option.
• Be wary of “low cholesterol” claims on foods high in saturated fat or sugar.

08Eating out

Eating out and takeaways

• Choose grilled or baked dishes over fried.
• Ask for sauces and dressings on the side.
• Pick tomato-based sauces rather than creamy ones.
• Share desserts or choose fruit.
• Choose thin-crust pizza with vegetable toppings and less cheese.

09Cases

Three common situations

• Bacon and sausages most mornings: switch to porridge or eggs on wholegrain toast most days.
• Cooking everything in butter: swap to olive or rapeseed oil.
• Daily biscuits and pastries at work: replace with fruit and a handful of nuts.

10Family

Inherited high cholesterol

Some people have very high cholesterol because of an inherited condition called familial hypercholesterolaemia, even with a healthy diet. Clues include very high LDL levels, a family history of heart attacks at a young age, or cholesterol deposits around the eyes or tendons. People with this condition usually need medicines in addition to diet, and family members may need testing. Talk to your doctor if you are concerned.

11Summary

Key points to remember

• Saturated and trans fats raise LDL cholesterol most.
• Processed meats, butter, cream, pastries and fried foods are key foods to limit.
• Replacing them with unsaturated fats and fibre-rich foods lowers risk.
• Get your cholesterol checked; diet alone may not be enough for everyone.