January 27, 2022

What’s the Best Diet for High Cholesterol?

An expert reveals the diets that work and the ones you should avoid

cooking healthy watching cholesterol

The results of your routine bloodwork came in, and you’ve got high cholesterol. Ugh. Now what?


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The first line of treatment is usually changing how you eat. But knowing which diet for high cholesterol will improve the condition is challenging — there are so many to choose from, and they all claim to make you healthier.

Registered dietitian Julia Zumpano, RD, LD, says: Follow a heart-healthy diet.

“High cholesterol clogs your arteries,” she says. “Eat in a way that keeps the arteries open and clear because restricted blood flow leads to heart attacks.”

Diet plans for high cholesterol

Your diet has a big impact on cholesterol levels. So choose a pattern of eating that’ll get your cholesterol into a healthy range. Zumpano shares her thoughts on a few of the commonly recommended diet plans for high cholesterol.

TLC diet plan

The therapeutic lifestyle changes (TLC) diet was developed in 1985 to help people lower cholesterol. It’s a low-fat diet where:

  • 60% of calories come from complex carbohydrates like whole grains, like brown rice and oats. You can also eat pasta and cereal made with whole grains.
  • 20% of calories come from lean proteins like chicken breast.
  • Up to 20% of calories come from healthier fats like olive and canola oils.

However, this diet is based on an outdated way of thinking.

“We used to believe that fat was the dietary enemy. But thinking has evolved,” says Zumpano. “The TLC diet is too low in fat and has too many carbohydrates, which could lead to elevated blood sugars and triglycerides. Only those who are very active can burn off all those carbohydrate calories.”

Mediterranean diet plan

The Mediterranean diet has fewer carbohydrates and protein than the TLC diet. But it includes more healthy fats from foods like olive oil and nuts. If you’re following the Mediterranean diet, expect to fill your plate with lots of whole grains, beans and fruits and veggies. You can also enjoy a limited amount of nuts, fish, lean poultry and dairy.


“The amount of research that supports the Mediterranean diet for cardiovascular health is phenomenal,” says Zumpano. “It’s been proven to be very effective for managing heart disease.”

It addresses the three main heart-disease risk factors by:

  • Including foods that suppress inflammation.
  • Reducing high cholesterol.
  • Being low-sodium and helping reduce high blood pressure.

Keto diet plan

The ketogenic (keto) diet aims to put your body in a state of ketosis, when your body burns fat for energy rather than carbohydrates. The diet is high in fat, moderate in protein and very low in carbohydrates.

“Ketosis has a tremendous amount of benefits,” says Zumpano. “But I don’t like that the keto diet is extremely high in saturated fat with foods like bacon, cheese and red meat.”

Instead, Zumpano recommends the protein-sparing modified fast (PSMF). It’s a diet that also creates ketosis but with less fat. Most of the calories come from lean protein with moderate amounts of healthy fats. Vegetables are the only source of carbohydrates.

Personalized diet plan

When it comes to diet, one plan doesn’t work for everyone. What’s easy for you can be challenging for someone else to stick to. The best diet is one that fits individual food preferences and lifestyle, says Zumpano.

She recommends working with a registered dietitian to create a cholesterol-lowering diet plan tailored to your likes and dislikes.

“For example, you might love cheese but don’t particularly like red meat,” she says. “Both have saturated fat. A dietitian can help you include the foods you enjoy on a regular basis and limit or avoid those that you are willing to remove. It’s important to create a plan that works for you.”


Multiple diets can help you lower high cholesterol. But a personalized plan is the best option since you’re more likely to sustain it. That’s important because managing high cholesterol — and keeping your ticker going strong — is a long-term commitment.

How food impacts cholesterol

The main culprits that cause high cholesterol are saturated fats and partially hydrogenated oil known as trans fat. These are commonly found in highly processed foods like:

  • Commercial baked goods like doughnuts.
  • Commercial snack foods like potato chips.
  • Deep-fried foods.
  • Fast food.

Keep in mind that trans fat can sneak into peanut butter, coffee creamers, frozen pizza and microwave popcorn. So read those labels. Even items that claim zero grams of trans fat may include partially hydrogenated oils. The fat in these items increases your bad cholesterol, lowers your good cholesterol and causes inflammation, the underlying cause of heart disease, explains Zumpano. Inflammation can contribute to plaque buildup in your arteries and cause blood clots to form around them, blocking blood flow.

Additionally, eating too many unhealthy foods can produce excess triglycerides, another form of fat found in your blood. High triglyceride levels result from having too many calories most often from too much fat or sugar in the diet. Triglycerides also stick to the walls of your arteries, worsening plaque buildup.

Which foods are highest in cholesterol?

Only animal products contain cholesterol. These include:

  • Cheese.
  • Eggs.
  • Meat.
  • Milk and dairy products.

Plant-based foods don’t have cholesterol. “You won’t find it in peanut butter or avocados,” says Zumpano. “However, dietary cholesterol doesn’t necessarily cause elevated blood cholesterol. The real problem lies with eating the wrong kind of fats.”

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