Should people with high cholesterol avoid eating fish?

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Cholesterol is a waxy substance that the body needs to make hormones and vitamins and build healthy cells. However, having too much of the wrong type of cholesterol is a risk factor for cardiovascular disease.

The two types of cholesterol are low-density lipoprotein (LDL) cholesterol, which doctors consider “bad” cholesterol, and high-density lipoprotein (HDL) cholesterol, which is beneficial (“good”) cholesterol.

Lipoproteins carry cholesterol throughout the body via the bloodstream. As a result, LDL cholesterol can accumulate in the blood vessels, become oxidized, and form dangerous plaques in the arteries.

The lipoproteins that form HDL cholesterol carry the cholesterol back to the liver, which then processes it and stops it from accumulating in the arteries.

Diet is one factor that can affect cholesterol levels. Other factors include genetics, medications, and physical activity levels.

However, current evidence does not show that dietary cholesterol is a risk factor for cardiovascular disease. Instead, people should try to understand their saturated fat intake.

The National Heart, Lung, and Blood Institute advises that eating too many foods high in saturated fats or trans fats increases LDL cholesterol.

The American Heart Association (AHA) recommends a whole foods diet, rich in fiber and vegetables, to reduce the risk of heart disease and manage cholesterol levels. The diet should emphasize fish and poultry while limiting red meat and full-fat dairy.

If someone removes the skin from poultry, trims visible fat from meat, and broils meat and fish rather than frying, they can also reduce their saturated fat intake.

Both fatty and lean fish are low in saturated fat, making them a healthy addition to the diet. This means people who are trying to reduce their cholesterol levels do not need to avoid any particular kind of fish.

Fish and seafood also contain omega-3 fatty acids, which are anti-inflammatory and have many beneficial health effects, including reducing the risk of cardiovascular disease.

People who aim to reduce their cholesterol levels or improve their cholesterol profile can eat fish without worrying about adverse effects.

The AHA recommends eating more fish and seafood to lower cholesterol, and advises people to eat at least 8 ounces of fish a week.

In order to keep saturated fat intake low, a person can use an alternative cooking method to frying with oil, such as baking, poaching, or grilling.

People can choose leaner fish such as bass or cod, or fatty fish high in beneficial omega-3 fatty acids such as salmon, mackerel, and herring.

Another consideration when choosing which fish to eat is mercury levels, as these may be higher in some fish and seafood than others.

Some of the best choices of low-mercury fish highlighted by the Food and Drug Administration (FDA) are as follows:

• anchovy
• Atlantic mackerel
• black sea bass
• cod
• flounder
• haddock
• hake
• herring
• plaice
• salmon
• sardine
• tuna
• freshwater trout

Fish are a source of good fats and protein and contain no carbohydrates or fiber. In addition, fish with bones are rich in calcium, and all fish contain beneficial vitamins such as selenium and vitamin B12.

The following are some examples of healthy fish, their nutritional profiles, and ideas for preparing or cooking them.

Salmon

Nutritional profile per 100 grams (g)

• Calories: 206
• Protein: 22.1 g
• Saturated fat: 2.4 g
• Cholesterol: 63 milligrams (mg)

Healthy ways to cook salmon include poaching, broiling, and baking in the oven in foil. To keep saturated fats to a minimum, avoid using butter and instead use olive oil and flavorings such as citrus, garlic, and soy sauce. For extra flavor, try adding fresh herbs such as parsley, basil, or coriander.

People can use salmon in Asian recipes, salads, or with eggs for breakfast.

Trout

Nutritional profile per 100 g

• Calories: 168
• Protein: 23.8 g
• Saturated fat: 1.65 g
• Cholesterol: 70 mg

To keep saturated fats to a minimum, try grilling or broiling trout or poaching it in a pan with aromatic vegetables and stock. Or, try using trout in salads, fish pies, or en papillote (baked in parchment) with fresh herbs.

Sardines

Nutritional profile per 100 g (canned in oil)

• Calories: 208
• Protein: 24.6 g
• Saturated fat: 1.53 g
• Cholesterol: 142 mg

Choose fresh sardines canned in oil or tomato sauce for a lower fat option. For a quick lunch, top whole grain toast with sardines in tomato sauce and accompany this with a green salad.

If using fresh sardines, try marinating them for 30 minutes in chopped garlic, olive oil, lemon juice, and paprika, then grilling or baking them. When cooked, serve with chopped parsley and lemon wedges.

Anchovies

Nutritional profile per 100 g (canned in oil)

• Calories: 210
• Protein: 28.9 g
• Saturated fat: 2.2 g
• Cholesterol: 85 mg

A tin of anchovies is a versatile ingredient for adding to pizzas, salads, and sauces, lending a meaty umami flavor. Try adding anchovies to whole grain bread with sliced tomatoes and basil for an open sandwich, or include them in tomato, garlic, and olive pasta sauce.

People who want to manage their cholesterol or have received a diagnosis of high cholesterol from their doctor can include fish in their diet.

Fish are low in saturated fat, and experts recommend eating fish regularly for heart health.

Omega-3 fatty acids found in oily fish can help prevent cardiovascular disease.

To manage cholesterol levels and cardiovascular health, it is important for people to eat a varied, balanced diet and get regular exercise.