What to Eat if You Have Borderline High Cholesterol? A Diet Guide

January 6, 2026 •

4 min read

According to the CDC, nearly 94 million US adults have borderline or high cholesterol, a condition that can often be improved with dietary changes. Understanding what to eat if you have borderline high cholesterol is the crucial first step toward better heart health.

Quick Summary

A heart-healthy diet focusing on soluble fiber, healthy unsaturated fats, and omega-3s is key to managing borderline high cholesterol and improving lipid levels.

Key Points

Increase Soluble Fiber: Found in oats, beans, apples, and citrus fruits, soluble fiber helps reduce LDL cholesterol levels by preventing absorption in the gut.
Embrace Healthy Fats: Replace saturated fats with monounsaturated fats from olive oil and avocados, and polyunsaturated fats from fatty fish, walnuts, and seeds.
Limit Saturated and Trans Fats: Significantly reduce consumption of fatty red meat, butter, processed foods, and baked goods to lower 'bad' cholesterol.
Eat More Omega-3s: Aim for two servings of oily fish like salmon or mackerel weekly to benefit from their triglyceride-lowering properties.
Consider Plant Sterols: Incorporate foods fortified with plant sterols to help block cholesterol absorption, which can further lower LDL.
Choose Whole Grains Over Refined Carbs: Swapping white bread for whole grains and limiting added sugars can help manage triglycerides.
Moderation with Alcohol: Excessive alcohol intake can increase triglyceride levels, so it is best to limit consumption.

Understanding Borderline High Cholesterol

Borderline high cholesterol, generally defined by a total cholesterol reading between 200 and 239 mg/dL, often signals a need for proactive lifestyle changes, with diet being the most impactful factor. While your doctor may not prescribe medication at this stage, adopting a strategic eating plan can prevent your levels from climbing into the high-risk category. The primary goal is to lower low-density lipoprotein (LDL), often called 'bad' cholesterol, and increase high-density lipoprotein (HDL), or 'good' cholesterol. The following guide outlines a dietary approach focusing on wholesome foods that can make a significant difference.

The Power of Soluble Fiber

Soluble fiber is a type of dietary fiber that dissolves in water to form a gel-like substance in your digestive tract. This gel binds to cholesterol, preventing its absorption and carrying it out of your body. By incorporating more soluble fiber into your meals, you can directly influence your LDL cholesterol levels. The American Heart Association recommends aiming for 10 to 25 grams of soluble fiber per day.

Foods High in Soluble Fiber

Oats and Barley: Starting your day with oatmeal or adding barley to soups is an easy way to boost your intake. Beta-glucan, the soluble fiber in these grains, is particularly effective.
Legumes: Beans, lentils, chickpeas, and peas are versatile and packed with soluble fiber. They can be added to salads, stews, or mashed into hummus.
Fruits: Apples, pears, oranges, and berries are rich in pectin, a type of soluble fiber. Pears and apples are especially beneficial, with a medium fruit providing a good dose of fiber.
Vegetables: Okra, eggplant, Brussels sprouts, and carrots are excellent sources of soluble fiber and can be incorporated into various dishes.
Nuts and Seeds: Flaxseeds and chia seeds are rich in soluble fiber. Ground flaxseed can be sprinkled on cereal or yogurt, while chia seeds can be added to smoothies.

Choosing Healthy Fats Over Unhealthy Ones

Not all fats are created equal. The type of fat you consume has a profound effect on your cholesterol. Replacing saturated and trans fats with healthier unsaturated fats is a cornerstone of a cholesterol-lowering diet.

Beneficial Unsaturated Fats

Monounsaturated Fats: Found in olive oil, canola oil, and avocado oil, these fats help lower LDL while maintaining or even raising HDL. Avocados and almonds are also great sources.
Polyunsaturated Fats: Found in sunflower, corn, and soybean oils, these also help lower LDL. Omega-3 fatty acids, a type of polyunsaturated fat, are particularly important.

The Importance of Omega-3 Fatty Acids

Omega-3 fatty acids are a specific type of polyunsaturated fat known for their heart-protective properties. They can help lower triglycerides and have anti-inflammatory effects.

Oily Fish: Aim for at least two servings per week of fatty fish like salmon, mackerel, herring, and sardines.
Plant-Based Sources: Walnuts, flaxseed, and chia seeds also provide plant-based omega-3s, though in smaller amounts than fish.

Incorporating Plant Sterols and Stanols

Plant sterols and stanols are naturally occurring plant compounds that help block the absorption of dietary cholesterol in the intestine. You can find these in small amounts in nuts, seeds, and vegetable oils, but fortified foods offer a more concentrated dose. Fortified options include certain margarines, yogurts, and orange juices. It’s important to eat these with a meal to maximize their effect.

Foods to Limit or Avoid

To effectively manage your cholesterol, it's equally important to know which foods to limit. Excessive consumption of these items can counteract the benefits of a heart-healthy diet.

Saturated Fats: Found in fatty cuts of red meat, full-fat dairy products (like butter, cheese, and cream), and some processed foods. Trim all visible fat from meat and remove the skin from poultry.
Trans Fats: These are particularly harmful for cholesterol levels and are often found in processed foods like cookies, pastries, and fried items. Look for "partially hydrogenated oil" on food labels, as this indicates the presence of trans fats.
Refined Carbohydrates and Sugary Foods: Excessive intake of added sugars and refined carbs (white bread, white rice) can raise triglycerides, another type of fat in your blood linked to heart disease. Focus on whole grains instead.
Excessive Alcohol: Heavy alcohol consumption can raise triglyceride levels and blood pressure, negatively impacting your cardiovascular health.

Comparing Healthy vs. Unhealthy Fats


Feature	Healthy Fats (Unsaturated)	Unhealthy Fats (Saturated & Trans)
Cholesterol Impact	Lowers LDL ('bad') cholesterol; may increase HDL ('good') cholesterol.	Increases LDL ('bad') cholesterol significantly.
Common Sources	Olive oil, avocado, nuts, seeds, fatty fish.	Fatty red meat, butter, full-fat dairy, processed foods.
Physical State	Liquid at room temperature (most often).	Solid at room temperature (most often).
Associated Health Benefits	Anti-inflammatory properties; improved heart rhythm; blood pressure stabilization.	Can increase risk of heart disease and stroke.
Key Message	Replace unhealthy fats with these sources to see positive changes in lipid levels.	Limit or avoid these fats for better heart health.

Conclusion: A Lifelong Commitment to Heart Health

Addressing borderline high cholesterol through diet is a powerful and proven strategy for safeguarding your cardiovascular health. The key is to make consistent, long-term changes rather than seeking a quick fix. By focusing on incorporating fiber-rich whole grains, fruits, vegetables, and healthy unsaturated fats while minimizing saturated and trans fats, you can steer your cholesterol levels in the right direction. Remember that diet is just one piece of the puzzle; combining these eating habits with regular exercise and maintaining a healthy weight will further support your efforts. Always consult with your healthcare provider or a registered dietitian before making significant changes to your diet to ensure they align with your specific health needs.

For additional heart-healthy resources, visit the American Heart Association website.

Frequently Asked Questions

Borderline high cholesterol is typically defined as a total cholesterol reading between 200 and 239 mg/dL. While not as severe as high cholesterol, it indicates a need for dietary and lifestyle adjustments to prevent further increases.

Yes, for most people, eggs can be consumed in moderation as part of a heart-healthy diet. It is more important to limit saturated fat intake than dietary cholesterol from sources like eggs and shellfish, which have a less significant impact on blood cholesterol levels.

Instead of butter, lard, or coconut oil, which are high in saturated fats, opt for heart-healthy vegetable oils. Good choices include olive oil, canola oil, sunflower oil, and avocado oil.

Soluble fiber creates a gel in the digestive system that binds to excess cholesterol, preventing it from being absorbed into the bloodstream. This process helps your body excrete cholesterol, effectively lowering your LDL levels.

Yes, nuts and seeds are excellent for heart health. They contain healthy unsaturated fats, fiber, and plant sterols that contribute to lowering LDL cholesterol. Just be mindful of portion sizes as they are also high in calories.

Focus on lean proteins such as skinless poultry, fish (especially fatty fish like salmon), beans, lentils, and tofu. These are much lower in saturated fat than fatty red meats.

Yes, consuming 1.5 to 3 grams of plant sterols or stanols daily in fortified foods has been shown to reduce LDL cholesterol by up to 12% in a few weeks. They work by blocking cholesterol absorption.

A diet high in refined carbohydrates, added sugars, and excessive alcohol can increase triglyceride levels. To manage them, focus on whole grains, fruits, vegetables, and fish rich in omega-3 fatty acids.