The liver naturally creates cholesterol, which then travels throughout the body using proteins in the bloodstream. Cholesterol is an essential building block for cell membranes.

It is also necessary for producing hormones, vitamin D, and substances that work to digest fatty foods.

However, a person's lifestyle and genetics can cause the body to produce too much cholesterol. When cholesterol builds up in the arteries, it can block blood flow, which can lead to coronary heart disease, heart attack, or stroke.

Following a nutritious, balanced diet is one way to help moderate cholesterol levels.

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Choosing foods that contain HDL cholesterol can make all the difference in preserving cardiovascular health.

There are two types of cholesterol.

These are based on the type of protein that transports it through the bloodstream:

  • Low-density lipoproteins deposit one type of cholesterol throughout the body. As this kind of cholesterol is likely to build up, people often refer to it as "bad" cholesterol.
  • High-density lipoproteins (HDL) collect bad cholesterol from the arteries and bring it back to the liver for disposal. For this reason, people refer to HDL cholesterol as "good" cholesterol.

While avoiding foods with high cholesterol content may be beneficial for some, the American Heart Association (AHA), National Heart, Lung, and Blood Institute (NHLBI), and Centers for Disease Control and Prevention (CDC) agree that the most effective dietary approach to cutting blood cholesterol is choosing foods that contain unsaturated fats over those that contain saturated or trans fats.

Aim to eat a diet that promotes low levels of bad cholesterol and high levels of good cholesterol. Fat intake affects this balance because fatty acids bind to liver cells and regulate the production of cholesterol.

Pay attention not only to quantities of fat in the diet, but also to which types are entering the body. Each form of fat influences cholesterol levels differently:

  • Saturated fats: These mostly occur in meat and dairy products. They instruct the liver to produce more bad cholesterol.
  • Unsaturated fats: These are more common in fish, plants, nuts, seeds, beans, and vegetable oils. Certain unsaturated fats can help increase the rate at which the liver reabsorbs and breaks down bad cholesterol.
  • Trans fats: These are solidified vegetable oils. Manufacturers normally use an artificial process called hydrogenation to produce them. Fried food, baked goods, and packaged foods often contain trans fats.

While avoiding foods with high cholesterol content may be beneficial for some, the American Heart Association (AHA), National Heart, Lung, and Blood Institute (NHLBI), and Centers for Disease Control and Prevention (CDC) agree that the most effective dietary approach to cutting blood cholesterol is choosing foods that contain unsaturated fats over those that contain saturated or trans fats.

Trans fats

Trans fats not only increase levels of bad cholesterol, but they also lower levels of good cholesterol. For this reason, they are the most harmful fats.

A study paper that appears in The American Journal of Clinical Nutrition followed 344,696 participants for 4–10 years after they changed which types of fats they ate.

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Processed food often contains harmful trans fats.

The participants who cut their saturated fat intake by 5 percent and replaced it with polyunsaturated fats had significantly fewer incidences of coronary illness or coronary-related death.

It is best to cut trans fats out of the diet completely. In 2013, the United States Food and Drug Administration (FDA) announced that they no longer recognize partially hydrogenated oils, the major commercial source of trans fats, as safe because of their strong links to coronary heart disease.

In 2018, the U.S. will undergo a national ban on trans fats, and several cities have already banned them from use in restaurants.

While nationwide cardiovascular disease incidences have recently fallen, the results of a recent study that appears in JAMA Cardiology revealed an additional 6.2 percent decrease of heart attack and stroke in the New York counties where trans fats are banned.

Foods to avoid

The AHA advise reducing saturated fat intake to no more than 6 percent of the total daily calories. They suggest limiting the following foods to achieve this:

  • fatty beef
  • lamb
  • pork
  • poultry with skin
  • lard and shortening
  • dairy products made from whole or reduced-fat milk
  • saturated vegetable oils, such as coconut oil, palm oil, and palm kernel oil

Avoiding trans fats is also important. Foods to stay away from include:

  • packaged cookies, cakes, donuts, and pastries
  • potato chips and crackers
  • packaged frosting
  • commercially fried foods
  • bakery goods that contain shortening
  • buttered popcorn
  • any products that contain partially hydrogenated or hydrogenated vegetable oils

Cholesterol in foods

Only animal products contain cholesterol itself, as a liver is needed for its production. However, cholesterol content should be less of a concern than fat content.

The bloodstream absorbs swallowed cholesterol poorly and has little effect on cholesterol levels after several hours. It may absorb some of this cholesterol, however, and it might reach the arteries. Limiting high-cholesterol foods might still be beneficial.

Foods that contain cholesterol and may be best avoided include:

  • red meat
  • sausage
  • bacon
  • organ meats, such as kidney and liver

It is important to note that a completely fat-free diet can also be harmful because it would deplete the levels of good carbohydrates, impair normal nerve and brain function, and possibly increase inflammation.

Choosing healthful fats can help lower bad cholesterol levels while maintaining and in some cases increasing good cholesterol levels.

Fiber

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Fiber can help support heart health.

Fiber is equally important for a healthy heart. Fiber is present in two main forms: soluble and insoluble. Insoluble fiber is important for digestive health.

Soluble fiber binds to cholesterol in the bloodstream and helps remove it through stool. This type of fiber has the added benefit of helping control blood sugar levels, as well.

Some cholesterol-friendly fiber options to consider include:

  • fatty fish, such as salmon, trout, albacore tuna, and sardines
  • nuts, seeds, and legumes
  • the skins of fruit
  • nontropical natural vegetable oils, such as olive oil, avocado oil, canola oil, and safflower oil
  • oats and oat bran, chia and ground flaxseeds, beans, barley, psyllium, oranges, blueberries, and Brussels sprouts

Choose leaner cuts of meat and smaller portions, as well as low-fat or fat-free milk and yogurts. Medical professionals do not recommend nonfat cheese, as it is highly processed and cannot be called a whole food.

Cooking methods can also change the saturated fat content in a meal. Some easy adjustments to cooking routines include:

  • using a rack to drain off fat when broiling, roasting, or baking poultry or meats
  • using wine in place of fat drippings to baste meat
  • broiling or grilling meats instead of pan-frying them
  • cutting off all visible fat from meat before cooking, and removing the skin from poultry
  • skimming off the top layer of congealed fat after soup has been refrigerated

Combining these cholesterol-cutting techniques with a balanced, plant-based diet and an exercise routine can reduce the risk of heart disease and promote a healthier life.