• Most of the cholesterol in your body is produced by your liver.
  • The amount of cholesterol you have depends on many factors, including genetics, diet, age, activity, and other elements.
  • Managing cholesterol levels may include dietary changes, lifestyle changes, medication, or a combination.

Despite the negative press cholesterol often gets, this fatty substance isn’t entirely bad for you. Whether cholesterol is friend or foe to your health depends largely on the type and amount in your body.

Cholesterol is a fatty substance that travels through your blood. Your liver makes all the cholesterol your body needs, but you can also take in cholesterol through the foods you eat.

You need some cholesterol to produce hormones and substances your body uses to digest foods. But too much of it can build up in your arteries and lead to a heart attack or stroke.

The kind of cholesterol you have matters, too.

Low-density lipoprotein (LDL) cholesterol is nicknamed “bad” cholesterol because it can clog your arteries.

High-density lipoprotein (HDL) cholesterol, nicknamed “good” cholesterol, transports cholesterol to your liver, which removes it from your bloodstream. It’s like a drain cleaner for your arteries.

The ideal equation is to have high HDL “good” cholesterol and low LDL “bad” cholesterol. Knowing which foods are high in fat and cholesterol can help you make more heart-friendly dietary choices.

Cholesterol in your body comes from two main sources: your liver and your diet.

Your liver, other organs, and other cells in your body produce about 80 percent of the cholesterol in your blood.

The other 20 percent of cholesterol in your body is affected by the foods you eat. Foods high in trans and saturated fats can contribute to unhealthy cholesterol levels.

As you take in more of these fats, your liver compensates by reducing its own production of cholesterol and removing excess cholesterol. However, not everyone makes and removes cholesterol with the same efficiency.

Some people have genes that tell their liver to make extra cholesterol or to slow their body’s cholesterol removal process. If you’ve inherited these genes, you may have high cholesterol even if you don’t eat foods that are rich in fat or cholesterol.

Which foods raise LDL cholesterol?

Animal foods and products contain cholesterol, but it’s actually the types of fats in foods that can have a more dramatic effect on blood cholesterol levels.

Decades of research has shown that saturated fats can raise your LDL “bad” cholesterol and increase your risk for heart disease.

A study from 2015 showed a decrease in saturated fats could lead to a “small but potentially important reduction in cardiovascular risk.”

The researchers also found evidence that when saturated fat is replaced with polyunsaturated fats, not carbohydrates, heart disease risk decreases.

Foods that are high in saturated fats encourage your liver to make more LDL “bad” cholesterol. You should limit these foods:

  • full fat dairy products
  • red meat, including beef, veal, lamb, and pork
  • deli meats, sausage, bacon, and hot dogs
  • baked goods
  • processed foods

Foods that are high in trans fats also increase LDL “bad” cholesterol. These foods include:

  • cakes
  • cookies
  • crackers
  • fried foods
  • margarine
  • microwave popcorn

Which foods raise HDL cholesterol?

Other foods have a more positive effect on your cholesterol level. These foods can help improve the HDL-to-LDL ratio:

  • fatty fish like salmon, sardines, herring, mackerel, and sea bass
  • tofu and other soy-based foods
  • flaxseeds and chia seeds
  • walnuts and other nuts
  • green leafy vegetables
  • foods high in soluble fiber, like oats, fruit, vegetables, and legumes
  • olive oil

When you eat, cholesterol and fats from the food get broken down in your small intestine. They combine with bile salts, then lipases, and eventually get repackaged with other components before entering the bloodstream as lipoproteins.

Though some cholesterol components are stored in the liver and gallbladder, the main storage area for excess lipoproteins is in fat cells called adipocytes.

When you have too much cholesterol, these cells swell up and you gain weight. Too much cholesterol can be caused by eating too much unhealthy fat or carbohydrates.

Your body also uses some cholesterol to make bile, the greenish-brown fluid your liver produces to aid in food digestion. Bile is stored in your gallbladder.

Cholesterol isn’t entirely bad for you. In fact, your body uses it to make a few essential hormones, including:

  • sex hormones, such as estrogen and progesterone in women, and testosterone in men, which help the sex organs develop and are involved in reproduction
  • cortisol, which helps your body respond to stress
  • aldosterone, which balances the number of minerals in your body
  • vitamin D, which helps your body absorb calcium to strengthen your bones

Cholesterol is also a component of bile, a substance your body needs to digest foods. And it’s used to build the membrane that surrounds cells.

Cholesterol becomes a problem when you have too much LDL, and too little HDL. LDL “bad” cholesterol builds up in arteries and forms a sticky goo called plaque.

Over time, plaque hardens blood vessels, making them so rigid that less blood can flow through them. This is called atherosclerosis.

When your arteries are stiff, your heart has to work harder to force blood through them. Over time the heart can get so overworked that it becomes damaged.

Plaques can also break apart, and blood clots can form on the surface.

If a clot becomes lodged in a blood vessel, the clot can cut off your heart’s blood supply and cause a heart attack. If a clot instead blocks a blood vessel that supplies your brain, you can have a stroke.

A 2019 update to cholesterol guidelines advises healthcare professionals to look at more than just cholesterol levels.

The update recommends taking into account other risk factors to more effectively treat and manage heart disease risk.

This means that your doctor will consider:

  • your activity level
  • your diet
  • your weight
  • your age
  • your sex
  • any conditions you have, such as Type 2 diabetes
  • whether you smoke
  • any medications you take for cholesterol

The ideal cholesterol ranges that were previously recommended are:

Total cholesterol<200 mg/dL
LDL “bad” cholesterol<100 mg/dL
HDL “good” cholesterol>60 mg/dL

Your doctor will likely still check your HDL, LDL, and total cholesterol levels with a blood test called a lipoprotein panel.

If your cholesterol is high, you can start taking steps to lower it with lifestyle changes and possibly medication.

If your cholesterol level is high, you may be able to successfully manage it with a few lifestyle changes.

Here are some recommendations:

  • Try to limit or cut out foods that are high in saturated and trans fats. Aim for no more than 6 percent of your daily calories to come from saturated fats, which are found in foods like red meat, margarine, cookies, cake, and fried foods.
  • Replace unhealthy fats with heart-healthy, plant fats whenever possible. Some sources of heart-healthy fats include avocados, nuts, seeds, and olive oil.
  • Reduce intake of refined carbohydrates, like those made with white flour and added sugars as often as possible. These types of easily digested carbs can increase weight gain and contribute to developing or worsening certain health conditions, including diabetes and heart disease.
  • Try to eat more plants like whole grains, fruits, vegetables, and legumes to increase your fiber and plant fats intake. These foods reduce the amount of LDL “bad” cholesterol in your bloodstream.
  • Aim to increase the amount omega-3 fatty acids in your diet. The omega-3 fatty acids found in fish, flaxseeds, chia seeds, and walnuts help protect your heart.
  • Try to exercise every day. Aim for at least 150 to 300 minutes of aerobic exercise a week.
  • Combining regular exercise with eating a nutrient-dense diet as much as possible can help in managing your weight.
  • If you smoke, consider quitting. Talk with your doctor about smoking cessation programs and other resources to help you quit and find support. Quitting smoking can dramatically improve your heart health.

If you try diet and exercise and they’re not enough to lower your cholesterol, your doctor may add medications to your treatment plan.

Cholesterol-lowering drugs include:

  • statins
  • bile acid sequestrants
  • nicotinic acid
  • fibrates