What Kind of Fish Should I Eat if I Have High Cholesterol?

November 25, 2025 •

4 min read

Heart disease, which is often linked to high cholesterol, remains a leading cause of mortality worldwide. Making strategic dietary changes, such as knowing what kind of fish should I eat if I have high cholesterol, can play a vital role in improving your heart health. The key is focusing on fish rich in omega-3 fatty acids while using healthy cooking methods.

Quick Summary

Fish rich in omega-3 fatty acids, like salmon and sardines, can help manage high cholesterol by lowering triglycerides and supporting heart health. Choosing baked, grilled, or broiled preparation methods is recommended.

Key Points

Prioritize Omega-3s: Choose fatty fish like salmon, mackerel, and sardines, which are excellent sources of heart-healthy omega-3 fatty acids.
Opt for Leaner Options: Include lean white fish such as cod, haddock, and tilapia, which are high in protein and low in saturated fat.
Cook Healthily: Avoid frying fish. Instead, bake, grill, broil, or steam to prevent adding unhealthy saturated and trans fats.
Monitor Mercury Intake: Be mindful of mercury levels, especially if consuming certain types of tuna or larger predatory fish like swordfish.
Shellfish in Moderation: While most shellfish are low in saturated fat, some like shrimp and squid are high in dietary cholesterol; moderation is key, and cooking methods should be healthy.

The Power of Omega-3s for Heart Health

Omega-3 fatty acids, particularly EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), are polyunsaturated fats found in fish that offer significant benefits for heart health. Our bodies cannot produce these essential fats, so we must obtain them from our diet. These fatty acids help reduce triglycerides, slightly lower blood pressure, and decrease the risk of abnormal heart rhythms and blood clots. Incorporating fish into your diet, ideally two servings per week, is a great way to boost your intake of these beneficial fats.

Top Fatty Fish Choices for High Cholesterol

These fatty fish are packed with omega-3s and are excellent options for a heart-healthy diet:

Salmon: A powerhouse of omega-3s, salmon is one of the most recommended fish for managing cholesterol. It's versatile and can be baked, grilled, or broiled.
Mackerel: Rich in omega-3s, mackerel is a flavorful and nutritious choice. It's also known for reducing triglycerides.
Sardines: Small but mighty, sardines are loaded with omega-3s, calcium, and vitamin D. They are also lower in mercury, making them a safe and healthy option.
Herring: Another small, oily fish, herring is an abundant source of omega-3s and can be found fresh, smoked, or pickled.
Trout: Especially freshwater trout, this fish offers a good balance of omega-3s and is low in saturated fat, making it a great heart-healthy choice.
Tuna: For canned options, choose light tuna packed in water over oil-packed varieties to minimize fat intake. Limit albacore tuna due to its higher mercury content.

Lean Fish Options for Your Diet

For those who prefer a milder flavor or want to further limit fat, lean white fish can also be a valuable part of a cholesterol-conscious diet. These fish are high in protein and low in saturated fat:

Cod: A very lean, high-protein whitefish with a mild flavor that works well in many dishes.
Haddock: Similar to cod, haddock is low in calories and saturated fat, making it an excellent alternative to fattier proteins.
Tilapia: A popular, low-fat fish that is easy to prepare.
Pollock: Another affordable and lean whitefish option.

Cooking Methods Matter

How you prepare your fish is just as important as the type you choose. Cooking techniques can drastically alter the final nutritional profile, especially concerning fat content.

Best Cooking Methods

Baking: A simple, clean method that requires minimal added fat. A drizzle of olive oil and some herbs is all you need.
Grilling: Adds a smoky flavor without extra fats. Marinating with lemon juice and spices enhances the taste.
Broiling: A fast way to cook fish with a crispy exterior. Use a rack to let any excess fat drip away.
Steaming: Excellent for retaining nutrients and flavor without any added oil.

Cooking Methods to Avoid

Frying: Deep-frying or pan-frying adds significant amounts of saturated and trans fats, which can counteract the heart-healthy benefits of the fish.
High-Fat Sauces: Be mindful of creamy, butter-based sauces that add unnecessary fats and calories.

Fish Type Comparison for High Cholesterol


Feature	Oily Fish (Salmon, Mackerel)	Lean White Fish (Cod, Haddock)	Shellfish (Shrimp, Oysters)
Omega-3 Content	High	Low	Variable, generally lower
Saturated Fat	Low to moderate	Very low	Very low
Dietary Cholesterol	Moderate	Low	Variable, can be high
Protein Content	High	High	High
Considerations	Highest omega-3 benefits.	Very low-fat protein source.	Moderation is key for higher-cholesterol types like shrimp.

Shellfish and Mercury Considerations

Shellfish and Dietary Cholesterol

Shellfish like shrimp and squid have a higher dietary cholesterol content compared to fin fish. However, research has shown that dietary cholesterol has a relatively small impact on blood cholesterol for most people, and shellfish are very low in saturated fat. For most, eating shellfish in moderation as part of a healthy diet is not a concern, but it is wise to consult a doctor if you are managing very high cholesterol. Some studies have noted that certain shellfish may contain TMAO, a substance that can contribute to plaque formation.

Mercury Levels

Larger, longer-living predatory fish tend to have higher levels of mercury. The FDA provides guidance on which fish are low in mercury and safe to consume regularly. For most people, the benefits of omega-3s from fish outweigh the risks of mercury contamination.

Low-mercury options: Salmon, sardines, trout, herring, cod.
Higher-mercury fish to limit: Swordfish, shark, king mackerel, tilefish.

Conclusion: Making Heart-Smart Fish Choices

Making informed choices about the fish you eat is a powerful step towards managing high cholesterol. By focusing on fatty fish rich in omega-3s like salmon and sardines, and preparing them using healthy methods such as baking or grilling, you can significantly support your heart health. Adding leaner white fish also provides low-fat protein, and understanding mercury levels helps ensure safe consumption. Combining these smart dietary choices with an overall healthy lifestyle is key to a healthier heart. For more guidelines on heart-healthy eating, refer to the resources from the American Heart Association.

Remember to consult with your doctor or a registered dietitian to create a personalized diet plan that fits your specific health needs.

Frequently Asked Questions

Yes, canned light tuna, packed in water, is a good source of omega-3s and is low in fat, making it suitable for a cholesterol-conscious diet. Choose water-packed to minimize fat and be mindful of mercury levels by limiting albacore tuna.

Shrimp is high in dietary cholesterol but low in saturated fat. For most people, the cholesterol in shrimp does not significantly raise blood cholesterol levels. Enjoy it in moderation, prepared healthily by baking, grilling, or steaming.

Yes, sardines are an excellent source of omega-3s and are very low in mercury, making them a superb choice for managing cholesterol. They are also rich in calcium and vitamin D.

Frying fish, especially deep-frying, is the worst option because it adds unhealthy saturated and trans fats from the cooking oil. This can negate the heart-healthy benefits of the fish.

Fish oil supplements are effective at lowering triglycerides but have mixed and sometimes minimal effects on LDL ("bad") cholesterol, and can even increase it in high doses. Eating whole fish is generally more beneficial for overall heart health.

The American Heart Association recommends eating at least two servings (3.5 ounces cooked) of fish, particularly fatty fish, per week. This helps ensure adequate intake of heart-healthy omega-3s.

You don't need to avoid all fish, but you should limit or avoid larger predatory fish like swordfish, shark, king mackerel, and tilefish due to their higher mercury content. Heavily processed and fried fish products should also be avoided.