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Cholesterol¹ is a molecule in the human body that is essential for life. It is a fat-like waxy compound with multiple roles in maintaining normal cell functioning. For example, cholesterol keeps the outermost layer of your cells healthy.
It is also used in producing vitamin D, steroid hormones (like the stress hormone cortisol), and sex hormones like testosterone and estrogen.
Cholesterol moves through your body inside molecules called lipoproteins which carry it through the bloodstream. There are two main cholesterol-carrying lipoproteins in your body: low-density lipoprotein (LDL) and high-density lipoprotein (HDL).
Low-density lipoprotein (LDL) is often referred to as “bad” cholesterol because it carries cholesterol from the liver through the bloodstream to the body, and when it’s present in excessive amounts, it can accumulate inside the vessels’ walls, causing them to become narrow and stiff.
This can lead to a condition called atherosclerosis, reducing the blood flow to the organs and increasing the risk of blood clots, heart attack, and stroke.
On the other hand, high-density lipoprotein (HDL) is often referred to as “good” cholesterol, which takes cholesterol from the body tissues and blood, and moves it to the liver, where it is metabolized and eliminated from the body.
Your diet influences your cholesterol levels. Unhealthy diets high in fats, especially saturated and trans fats and cholesterol, are known to increase levels of low-density lipoproteins (LDL), the “bad cholesterol,” in your bloodstream.
Diets high in full-fat dairy, red meats, and processed meats will increase your cholesterol levels.
Choosing healthier options high in fiber, healthy fats, and vegetables is beneficial for people with cholesterol concerns. An example of this is the Mediterranean diet, which can help you lower your cholesterol levels.
The Mediterranean diet is low in red meats and high in fish, vegetables, legumes, nuts, and fruits.
The low levels of saturated fats in this diet mean less fat is available for your body to turn into cholesterol. In addition, the high levels of fiber from fruits and veggies slow digestion, keeping you fuller for longer and reducing the amount of fat absorbed from your meal.
Additionally, the Mediterranean diet is high in healthy fats, such as monounsaturated and polyunsaturated fatty acids, which have been found to reduce² total cholesterol levels and improve the LDL/HDL ratio.
Some strict diets low in saturated fats can decrease cholesterol levels in your bloodstream by up to 37% — an effect comparable to some medications. If you’re interested in changing your diet to lower your cholesterol, speak to a healthcare provider about the best diet.
All kinds of fish, both fatty and lean, are low in saturated fats, making them a suitable addition to most diets. All fish contain some cholesterol, as it’s essential for an animal to function properly; however, the levels are low enough not to cause concern.
Additionally, studies³ show that dietary cholesterol has minimal to no impact on worsening blood cholesterol levels, while saturated and trans fats are the main contributors to high blood cholesterol.
Fish and seafood also contain omega-3 fatty acids. Your body cannot make omega-3 and must obtain it from food or supplements. These fatty acids are anti-inflammatory and have a range of beneficial effects, such as reducing blood pressure and the risk of heart disease.
Omega-3 fatty acids can help lower triglyceride levels in your bloodstream and help increase the levels of “good cholesterol,” high-density lipoprotein, HDL.
Omega-3s don’t affect LDL levels, but because of their other benefits, it’s advisable to include them in your diet.
If you’re watching your cholesterol, including fish in your diet is a great idea. It’s a good substitute for red meats, which are high in saturated fats and cholesterol.
Some healthcare professionals may recommend limiting shrimp, which contain 161mg of cholesterol per three-ounce serving.
However, there’s evidence⁴ that moderate shrimp consumption increases both levels of LDL and HDL in the body, with more significant increases in HDLleading to an overall improvement in the LDL/HDL ratio, so it should not negatively affect cholesterol levels.
Recommended guidelines⁵ for the consumption of fish is at least twice per week, including one serving of oily fish, such as salmon, sardines, trout, or mackerel. Tuna does not count as an oily fish. A serving of fish should weigh around 4.9oz. On average, aim for two to five servings of fish per week.
If you’re pregnant or breastfeeding, you may want to limit your consumption of some kinds of fish. Mercury and other pollutants can be found in some fish, including tuna and cod. These pollutants can build up and impede your baby's development.
When choosing a type of fish to include in your diet, you should consider how to prepare it.
Using a low-fat preparation method like grilling or baking is better. Deep frying your fish adds cholesterol and saturated fat. If you choose to pan-fry your fish, selecting an oil low in saturated fats, like avocado oil, will help.
Fish are generally low in saturated and trans fats, but their cholesterol levels can vary.
Some fish that include the most cholesterol per 100 grams are:
Squid - 231mg
Shrimp - 194mg
Lobster - 71mg
Salmon - 63mg
Some fish that include the least amount of cholesterol per 100 grams:
Tuna - 47mg
Snapper - 47mg
Grouper - 47mg
Canned tuna - 42mg
Scallop - 41mg
Fish are an excellent source of protein and good fats. They have low levels of saturated fats and contain important nutrients like vitamin B12 and selenium.
Some meal ideas with fish that are low in cholesterol and healthy for your heart include:
Salmon tacos with pineapple salsa: Ready in under 20 minutes, this dish is super easy and convenient to make.
Charred shrimp, pesto, and quinoa bowls: A quick dinner with limited cooking, this is the perfect busy weeknight dinner. Keep it simple by switching out the vegetables for whatever’s in your pantry.
Brazilian fish stew: A hearty soup from South America, this dish blends spices, canned tomatoes, and any type of white fish.
Tuna casserole: If you’re a casserole lover, this health-conscious version of a classic dish will take you back to your childhood.
High cholesterol is a common condition that may not cause obvious symptoms. Having high cholesterol increases your risk of heart disease and stroke. Fortunately, through healthy lifestyle choices, you can decrease the cholesterol levels in your blood, reducing your risk of heart-related complications.
Adding fish to your diet can help you achieve your cholesterol goals. Fish are low in saturated fats and high in omega-3 fatty acids and proteins, so they’ll keep you fuller for longer and help decrease your risk of heart disease.
When deciding which fish to eat, be aware of the difference in cholesterol among different types. While it can improve cholesterol levels, a diet high in certain types of fish is not suitable for pregnant women.
Incorporating fish into your diet at least twice a week can help reduce your consumption of red meats and keep your cholesterol down. You should speak to a medical professional if you’re concerned about your cholesterol levels.
Physiology, cholesterol | NIH: National Library of Medicine
Fish and shellfish | NHS
The nutrition source | Harvard T.H. Chan
Picking healthy proteins | Heart Attack and Stroke Symptoms
Jerk salmon tacos with pineapple salsa | Heart UK
Charred shrimp, pesto & quinoa bowls | Eating Well
Brazilian fish stew | Better Homes and Garden
Modern tuna casserole | Taste of Home