Cholesterol is a waxy, fat-like substance found in the body and in many foods. You need some cholesterol for your cells to function normally and for your body to make hormones, vitamin D and even break down food during digestion.

But cholesterol can become problematic. Skewed levels of “good” cholesterol (high-density lipoprotein, or HDL) and “bad” cholesterol (low-density lipoprotein, or LDL), for instance, can threaten heart health. Too much cholesterol, coupled with high levels of a closely related blood fat known as triglycerides, can lead to hyperlipidemia, a condition characterized by high cholesterol.

“(Hyperlipidemia) can lead to the harmful buildup of atherosclerotic plaque – or fatty deposits – in your arteries, which may eventually cause heart attacks and strokes,” says Dr. Brian Lima, national physician director for cardiothoracic surgery, heart failure and transplant at HCA Healthcare in Dallas.

Causes of High Cholesterol

There are two primary reasons why your cholesterol might be high: lifestyle choices and genetics. Some people have a combination of both factors that lead to their high cholesterol levels.

According to the Centers for Disease Control and Prevention, about 111 million American adults age 20 or older have total cholesterol levels that are considered too high (above 200 milligrams per deciliter). Nearly 25 million of these people have very high cholesterol levels (above 240 milligrams per deciliter) that put them at even higher risk for developing heart disease.

For a long time, lifestyle choices, such as diet and exercise, shouldered much of the blame for high cholesterol. More recently, however, there’s been some controversy about how much diet and exercise can affect cholesterol levels. Rather, some people appear to have high levels because of their genetics rather than environmental factors.

“It’s true that for most people, dietary cholesterol intake per se, has a relatively small effect on cholesterol,” notes Dr. Deepak L. Bhatt, director of Mount Sinai Heart and the Dr. Valentin Fuster professor of cardiovascular medicine at the Icahn School of Medicine at Mount Sinai Health System in New York.

But that doesn’t mean you can eat whatever you want. Bottom line: If you have high cholesterol, you should be following a low-cholesterol diet. Reducing your consumption of saturated fat and sugar, for instance, can help bring your hyperlipidemia under control.

Shopping for Foods to Lower Cholesterol

Some strategies to make low-cholesterol shopping a snap include:

Reading labels

Using diet to help control hyperlipidemia “starts with paying attention to what you’re eating by reading food labels,” says Lima, who also serves as surgical director of heart transplantation and mechanical circulatory support with Medical City Healthcare.

Be sure to check how much cholesterol is listed on the label and the amount of saturated and trans fats, which can be bad for heart health.

Saturated fats are “the kind of fat that is usually solid at room temperature, such as fats in meat, butter, coconut oil and full-fat dairy products, as well as a variety of packaged foods, snack foods and desserts,” explains Dr. M. Wesley Milks, a cardiologist and associate program director of the cardiovascular disease fellowship at the Ohio State University Wexner Medical Center in Columbus.

Trans fats are the unhealthy fats that are often found in fast foods and convenience foods, such as cookies, crackers, vegetable shortening, coffee creamer and other processed foods. Many food manufactures have already removed trans fats from their products, but be on the lookout for them. If the label contains the words “partially hydrogenated oil,” that’s a sign that the item contains trans fats.

If a food contains these fats, it’s best to put it back on the shelf.

Choosing fish and poultry

If you’re going to eat meat, make sure to select only the leanest cuts and opt for chicken or fish instead of red meat or pork. This helps reduce your saturated fat intake, Milks points out.

“In particular, fish such as salmon have a special kind of unsaturated fat, called omega-3 polyunsaturated fatty acids, which may have specific health benefits,” he notes.

Skipping added sugars

Added sugars can boost your triglyceride levels quickly, so you may want to limit how much you consume, Milks says. Examples of sugar-heavy foods include:

Reducing alcohol and tobacco use

The National Institutes of Health recommends reducing alcohol intake or avoiding it altogether to help lower your blood lipid levels. Similarly, if you smoke, you should quit as soon as possible.

“Smoking can reduce your good cholesterol, or HDL, and is extremely detrimental to your heart health,” Lima says.

Healthy Foods to Lower Cholesterol

The good news is there’s a whole rainbow of delicious, healthy foods that can be part of your low-cholesterol diet. These include high-fiber foods such as:

In addition, you should aim to consume unsaturated rather than saturated fats, like those with omega-3, as Milks pointed out. Examples of unsaturated fats include:

How to Lower Cholesterol Through Diet

Healthy lifestyle changes can help bring your cholesterol levels down. Some of the top tips for doing so include:

Paying attention to calories

Keep a close eye on the number of calories you’re consuming versus the number you’re burning.

“Especially for people who are overweight, the first thing you should do is reduce the number of calories you’re eating,” Bhatt says. “It’s less important which diet you follow – fads come and go – but the basics of weight loss are based on thermodynamics. If you’re putting more calories in than you’re burning, the first step is to cut down the number of calories.”

Choosing a plant-based diet 

Animal products often contain cholesterol, so opt for plant-based foods to eliminate some of that dietary cholesterol.

The data have been consistent for years, Bhatt says, that a plant-based, low-fat diet is good for heart health and can help you lower your cholesterol and triglyceride levels.

Upping your fiber intake

Milks notes that fiber helps remove cholesterol from the body by trapping it and carrying it out of the body via stool. Fiber can also help keep your system regular and is an important component of overall health.

Avoiding high-cholesterol and high-fat foods

A heart-healthy diet should contain “minimal amounts of saturated fats and sugary foods,” Lima says. Instead, try eating more fruits and vegetables, and opt for low-fat or fat-free dairy products.

Working with a dietitian

No single diet is best for everyone, and what foods to eat for optimal health depend on whether you have certain health conditions, such as heart disease, diabetes or digestive problems, Milks says. Therefore, it’s best to ask your doctor or a registered dietitian about what diet is best for you.