How much cholesterol should you consume daily?

Cholesterol, a fat-like substance often portrayed as the villain of the nutrition world, is both a blessing and a curse for our bodies. The “dark side” of cholesterol is not unfounded: high blood cholesterol levels are associated with an increased risk of cardiovascular disease and diabetes—two conditions that are becoming increasingly common in our society (Cleveland Clinic, 2022). But as with so many things in life, balance is key: a healthy cholesterol level is essential to maintaining our health. The other side of the coin is that cholesterol is indispensable for our bodies, as it is a vital component of our cell membranes and a precursor of essential hormones. This article explores the basics of cholesterol and answers the question: how much cholesterol should you really consume per day?

Table of Contents

• What is cholesterol?
• Types of cholesterol
• When is cholesterol elevated?
• Recommended cholesterol intake
• How does high cholesterol become noticeable?
• Risks and effects of high cholesterol
• Methods to lower cholesterol levels
• Dietary sources of cholesterol
• Summary

What is cholesterol?

Cholesterol is a fat-like substance found in every cell of the body and is important for many vital functions. For one, it plays a central role in forming cell membranes. Additionally, cholesterol serves as a fundamental building block in the production of certain hormones that regulate various processes in the body, such as sex hormones (estrogen or testosterone). Cholesterol is also necessary for the production of vitamin D, which is important for bone health and the regulation of calcium levels in the blood (CDC, 2024).

Most cholesterol is produced primarily in the liver, alongside some production in the intestines. The liver produces a substantial amount each day to meet the body’s needs. Cholesterol can also be absorbed through the diet, especially from animal-based products such as meat, eggs, and dairy (Heumann, 2024).

Types of cholesterol

Since cholesterol is not water-soluble, it cannot be transported through the bloodstream on its own. Instead, it is carried by special molecules called lipoproteins (composed of fat [lipid] and protein). These transport vehicles deliver cholesterol to the cells that need it and return excess cholesterol to the liver, where it is further processed or excreted. The main lipoproteins in the body are low-density lipoproteins (LDL) and high-density lipoproteins (HDL), each playing a different role in regulating cholesterol levels (Prof. Dr. Püschel, 2022).

• LDL cholesterol (Low-Density Lipoprotein)
  

LDL cholesterol is often referred to as “bad” cholesterol. LDL transports cholesterol in the blood from the liver to the tissues. However, if too much LDL cholesterol is present in the blood, it can accumulate on the walls of the arteries. These deposits, known as plaques, can narrow and harden the arteries—a condition known as atherosclerosis. This narrowing of the arteries reduces blood flow and can lead to serious health problems such as heart attacks and strokes.

• HDL cholesterol (High-Density Lipoprotein)

HDL cholesterol is known as “good” cholesterol. HDL transports excess cholesterol in the blood back from the tissues to the liver, where it is broken down and eventually eliminated from the body. In this way, HDL helps keep the arteries free of cholesterol buildup and reduces the risk of cardiovascular disease. A higher HDL level in the blood is therefore associated with a lower risk of cardiovascular problems.

Source: CDC, 2024.

When is cholesterol elevated?

An increased risk of cholesterol-related health complications arises when certain conditions or factors are present that increase the likelihood of cholesterol accumulating in the arteries and causing health problems. These risk factors can be divided into different categories: genetic factors, lifestyle-related factors, medical factors, and age-related factors:

Non-modifiable factors:

• Genes
• Age and sex

Modifiable factors:

• Lack of physical activity
• Unhealthy diet
• Smoking
• Overweight
• Stress
• Medical conditions
• Medications

Source: Cleveland Clinic, 2022

Genetic factors

According to studies, one in 200 to 400 people is affected by hypercholesterolemia, a hereditary condition that has a 50% chance of being passed on to offspring. In this condition, the body is unable to effectively break down LDL cholesterol, leading to high LDL levels. People with this genetic defect often have a significantly increased risk of developing atherosclerosis and cardiovascular disease at a young age (Toft-Nielsen, F. et al., 2022).

Lifestyle-related factors

Lifestyle habits play a key role in determining cholesterol levels and the associated risk of disease. Some of the most important lifestyle-related risk factors include:

• Unhealthy diet: A diet high in saturated fats and trans fats can increase LDL cholesterol levels. Foods such as fatty meats, full-fat dairy products, fried foods, and processed snacks contribute to elevated cholesterol.
• Smoking: Smoking lowers HDL cholesterol levels and damages blood vessels, increasing the risk of plaque formation and atherosclerosis.
• Lack of physical activity: Inactivity can raise LDL cholesterol levels and lower HDL cholesterol. Lack of exercise thus contributes to greater susceptibility to disease.
• Chronic stress: Chronic stress may also contribute to elevated cholesterol levels, as it affects hormone balance and can lead the body to produce more cholesterol.

Source: Cleveland Clinic, 2022

Medical factors

Certain medical conditions and diseases can also increase the risk of elevated cholesterol levels:

• Diabetes: People with diabetes often have high LDL and triglyceride levels and low HDL levels. They also tend to have high blood sugar levels, which contribute to plaque formation in the arteries.
• Overweight: Obesity is associated with higher triglyceride levels, higher LDL cholesterol levels, and lower HDL cholesterol levels, all of which can lead to additional health problems.
• High blood pressure: High blood pressure can damage arteries and increase the risk of cholesterol buildup.
• Kidney or liver disease: These conditions can affect cholesterol metabolism and excretion, leading to increased cholesterol levels.

Sources: CDC, 2024;  Hexal, 2024

Age- and sex-related factors

• Age: The risk of high cholesterol increases with age, as the body becomes less efficient at removing cholesterol from the blood over time.
• Sex: Until about age 55 (or menopause), women tend to have lower LDL levels than men. However, men generally have lower HDL cholesterol levels than women.

Source: CDC, 2024.

Recommended cholesterol intake

The body produces about 700 to 900 mg of cholesterol per day on its own, which is why caution is advised regarding dietary intake. The German Nutrition Society recommends consuming no more than 300 mg of additional cholesterol per day through food—an amount already contained in a single egg. Studies have shown that exceeding this limit is associated with an increased risk of complications such as cardiovascular disease, particularly in people who are already predisposed to these conditions.

How does high cholesterol become noticeable?

Elevated cholesterol itself does not cause direct symptoms. However, it is often associated with long-term diseases, which are described below.

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Risks and effects of high cholesterol

High cholesterol can lead to serious health problems, including:

• Arterial calcification (atherosclerosis): High LDL cholesterol levels can lead to the formation of plaques in the arteries. These deposits narrow the arteries and increase the risk of high blood pressure, cardiovascular disease, or can impair blood circulation in the legs and arms.
• Cardiovascular disease: Elevated cholesterol is one of the main risk factors for cardiovascular diseases. This includes heart attack, chest pain, and stroke.
• Diabetes risk: People with high LDL cholesterol levels have an increased risk of developing type 2 diabetes.

Sources: Müller, C. et al., 2024; Rehberg, C., 2024

Methods for lowering cholesterol levels

There are several ways to reduce cholesterol levels:

• Dietary changes:
  • Reduce saturated and trans fats: Saturated fats and trans fats increase LDL cholesterol in the blood more than other types of fats. Saturated fats are found in animal products such as meat, eggs, and full-fat dairy products. Trans fats are often found in processed foods and baked goods.
  • Eat cholesterol-lowering foods: Choose foods that help lower cholesterol, such as apples, which contain pectin that helps reduce LDL cholesterol. Also opt for foods rich in unsaturated fats (e.g., nuts, seeds, avocados, and fish), as these can positively affect total and LDL cholesterol levels.
• Regular physical activity:
  At least 30 minutes of moderate physical activity per day (e.g., walking, swimming, cycling) can help increase HDL levels and reduce LDL levels.
• Weight loss:
  Studies show that losing just 5–10% of body weight can significantly reduce triglycerides, total cholesterol, and LDL cholesterol (Brown, J. D., et al., 2016). 
• Medication:
  In some cases, cholesterol-lowering medication may be necessary to keep cholesterol levels under control. Talk to your trusted healthcare provider.
• Quitting smoking:
  Smoking damages blood vessels and lowers HDL levels. Quitting smoking can help maintain a healthy cholesterol level.

Sources: Müller, C. et al., 2024; Rehberg, C., 2024.

Dietary sources of cholesterol

Cholesterol is primarily found in animal-based products. Some common sources include:

• Meat and poultry: Especially fatty and processed varieties.
• Dairy products: Particularly whole milk, cheese, and butter.
• Eggs: Especially the yolk contains cholesterol.
• Fish and seafood: Some types also contain cholesterol but are often good sources of omega-3 fatty acids.

Since the body produces cholesterol on its own, these foods should be consumed in moderation. To ensure a balanced diet, foods with cholesterol-lowering properties should also be included. Cholesterol-lowering foods:

• Spinach
• Berries
• Avocado
• Citrus fruits
• Walnuts
• Fish
• Green tea
• Olive oil
• Apple

Source: Heilkraft der Natur, n.d.

Summary

Cholesterol is an essential substance in the body and plays a crucial role in various bodily functions. It is important to maintain a balance between LDL cholesterol (the "bad" cholesterol) and HDL cholesterol (the "good" cholesterol), as too much LDL cholesterol can lead to secondary conditions such as increased susceptibility to cardiovascular disease. Through a healthy diet, regular physical activity, and, if necessary, medical guidance, you can keep your cholesterol levels under control and actively contribute to maintaining your long-term health.