Doctor Decoded: Dietary vs. Blood Cholesterol

Does having high cholesterol … mean you shouldn’t eat cholesterol?

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Your doctor tells you to watch your cholesterol. Does that mean you should start counting up cholesterol grams from your morning eggs?

Cholesterol is deeply misunderstood, and that’s partially because there are two categories of cholesterol that are often conflated: blood cholesterol and dietary cholesterol. 

Blood cholesterol is what your doctor is talking about when they refer to high cholesterol. It’s the fatty substance that the blood carries around in the body. Your body naturally produces its own cholesterol, but certain factors can cause it to make too much. 

High blood cholesterol is dangerous because it can contribute to plaque buildup, which is a sticky substance that builds up on the sides of artery walls. Not only can this narrow the space for blood flow (contributing to high blood pressure), but plaque can harden over time. This makes the artery walls less flexible and more narrow, a condition known as atherosclerosis

Additionally, blood cholesterol can be further broken down into LDL (bad) cholesterol and HDL (good) cholesterol. The former contributes to atherosclerosis, whereas the latter can actually help protect against heart disease and stroke. (Learn more about what blood cholesterol numbers mean here.) 

Dietary cholesterol is the cholesterol found in some foods. Dietary cholesterol is exclusively found in animal foods: meat, dairy, eggs, fish, and seafood. That’s because—just like humans—animals produce their own cholesterol. 

Researchers used to think that cholesterol in food led to higher cholesterol levels in your blood (a logical conclusion, right?). However, this isn’t necessarily true. Instead, experts now know that it’s the saturated fat in food that increases blood cholesterol levels.

This distinction is blurry, though, since the same foods high in dietary cholesterol (that is, animal foods) also tend to be the foods high in saturated fat—with a few exceptions. For example, coconut is a plant food that is high in saturated fat, but has no dietary cholesterol.

So what does it mean if your doctor wants you to be mindful of your cholesterol? Eat a well-balanced diet with heart-healthy fats and plenty of fiber, quit smoking (or don’t start), and stay active. Here are more lifestyle tweaks to lower cholesterol naturally