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Q: My blood test shows prediabetes and a cholesterol score of 208 mg/dl (5.4 mmol/l). I’m finding it difficult to know what to eat because the recommended diets for these conditions seem contrary. For example, fruit is said to be acceptable on a low-cholesterol diet but not on a low-blood-sugar one, while meat is the opposite. How can I balance this out?

Many people who have high blood sugar also have high cholesterol levels. However, both can be managed with a healthy diet. What’s more, for some, it’s possible to reverse prediabetes through diet and lifestyle changes (1).

It’s common to see misinformation about what foods are bad for certain conditions, including high cholesterol, prediabetes, and diabetes. Nevertheless, the overall quality of your diet is most important.

The three macronutrients — carbohydrates, proteins, and fats — have different impacts on both blood sugar and cholesterol levels.

For example, sources of carbs like bread, pasta, and fruit affect blood sugar more than sources of protein or fat. On the other hand, cholesterol-containing fat sources, such as dairy and meat, have a greater effect on cholesterol than on blood sugar.

Still, food sources of cholesterol only significantly affect blood levels in people deemed cholesterol hyper-responders. In fact, two-thirds of the population experience little to no change in their levels after eating cholesterol-rich foods (2, 3).

Regardless, decreasing blood sugar and cholesterol levels through your diet doesn’t have to be difficult, and many foods help lower each of these markers. For instance, consuming more nutrient-dense, fiber-rich foods — such as vegetables and beans — reduces both blood sugar and cholesterol levels (4, 5).

Additionally, increasing protein intake and decreasing consumption of refined carbs — including white bread and sugary sweets — may also lower blood sugar, decrease LDL (bad) cholesterol levels, and increase HDL (good) cholesterol (6, 7).

Here are a few tips to effectively reduce high blood sugar and cholesterol levels:

  • Eat healthy fats. To reduce cholesterol levels, many people cut out sources of fat from their diets. However, research shows that eating healthy fats like avocados, nuts, seeds, fatty fish, and olive oil can help reduce LDL (bad) cholesterol, increase HDL (good) cholesterol, and improve blood sugar control (8, 9).
  • Reduce your intake of added sugars. Added sugars — such as those found in candy, ice cream, baked goods, and sweetened beverages — negatively affect both cholesterol and blood sugar. Cutting added sugar out of your diet is one of the best ways to improve overall health, including decreasing blood sugar and cholesterol levels (10).
  • Consume more vegetables. Increasing your intake of both fresh and cooked vegetables can significantly improve blood sugar and cholesterol. Try adding veggies like spinach, artichokes, bell peppers, broccoli, and cauliflower to your meals and snacks (11).
  • Eat mostly whole, nutritious foods. Relying on packaged foods or fast-food restaurants can damage your health, potentially raising cholesterol and blood sugar levels. Prepare more meals at home using whole, nutrient-rich foods that support metabolic health — such as vegetables, beans, fruits, and healthy sources of protein and fat, including fish, nuts, seeds, and olive oil (12).

Other healthy ways to reduce both blood sugar and cholesterol levels include increasing physical activity and losing excess body fat (13, 14).


Jillian Kubala Newsletter

Jillian Kubala is a Registered Dietitian based in Westhampton, NY. Jillian holds a master's degree in nutrition from Stony Brook University School of Medicine as well as an undergraduate degree in nutrition science. Aside from writing for Healthline Nutrition, she runs a private practice based on the east end of Long Island, NY, where she helps her clients achieve optimal wellness through nutritional and lifestyle changes. Jillian practices what she preaches, spending her free time tending to her small farm that includes vegetable and flower gardens and a flock of chickens. Reach out to her through her website or on Instagram.