Dining Out When You Have High Cholesterol

Avoid Saturated Fats and Limit Fatty Meats

The U.S. Department of Agriculture’s (USDA) latest Dietary Guidelines for Americans no longer include specific limits for dietary cholesterol, but that doesn’t mean that your cholesterol intake is not important. Although it is widely accepted that the amount of cholesterol a person eats has less impact on their blood cholesterol levels than previously thought, the USDA guidelines and other experts still advise people to eat as little cholesterol as possible.

One large study found that dietary cholesterol did appear to affect blood cholesterol levels. Researchers followed 30,000 men and women who did not have cardiovascular disease (CVD) at the start of the study. After more than 17 years of documenting their health, the researchers concluded that for every 300 milligrams of cholesterol that people added to their daily diet, their risk of CVD increased by 17 percent.

The cholesterol you eat does seem to impact your blood cholesterol levels, but it’s not the only factor. According to the USDA guidelines, following an overall healthy eating pattern is the most important part of managing cholesterol and your health.

Eating a diet that is low in meat, especially processed meats such as bacon, sausage, and lunch meat, is among the best ways to reduce CVD risk in adults.

The current thinking stems from an evolving understanding of what affects your blood cholesterol levels and what doesn’t. According to the Harvard T.H. Chan School of Public Health: “The biggest influence on blood cholesterol level is the mix of fats and carbohydrates in your diet, not the amount of cholesterol you eat from food.”

Many foods that are high in cholesterol, such as fatty meats, high-fat dairy, and bakery items, are also higher in saturated or trans fats, both of which raise blood cholesterol.

For that reason, both Dr. Collingwood and Dr. Kris-Etherton agree that when dining out when you have high cholesterol, your goal is to limit or avoid foods high in saturated fats. As a rule of thumb, dishes that have a lot of ingredients, such as pizza, casseroles, burgers, tacos, and sandwiches, tend to be higher in saturated fats, according to the USDA. This list also includes most cheeses — Kris-Etherton notes that cheese tends to be high in both saturated fat and sodium, so moderation is the best approach — as well as cream, butter, tropical oils like coconut and palm oil, cakes, cookies, and snack foods.

Dishes with lots of vegetables, whole grains, low-fat and fat-free dairy products, most oils, fatty fish, and lean cuts of meat and poultry are good choices that are typically low in saturated fat. Shrimp is high in cholesterol but low in saturated fat, says Kris-Etherton. Her advice is to enjoy it occasionally, maybe twice a month.

Choose Steamed Instead of Fried When Eating Chinese Cuisine

Chinese restaurants have lots of fried food options. But there are many ways to eat low-cholesterol meals at a Chinese restaurant. For starters, consider spring rolls that are steamed rather than deep-fried, Kris-Etherton suggests, adding that spring rolls with rice wraps are an even better choice. Steamed rice is best too, says Kris-Etherton, and ask for brown rice when possible, since that’s a better nutrition option overall compared to white rice. If you must have stir-fried rice, which is higher in fat, she recommends asking your server to prepare it with as little oil as possible.

For your main course, seafood can be a good choice, especially if you order it steamed, notes Kris-Etherton. Boiled or broiled seafood entrées are also good choices for minimizing added saturated fats, according to the American Heart Association. Just remember to eat shrimp in moderation and choose entrées with lots of vegetables — many menus have a vegetable entrée section, which makes it easy.

Ask for skinless chicken as a protein and try to resist the crispy noodles often found on the tables at Chinese restaurants, to save on both fat and calories.

Skip the Sour Cream When Eating Mexican

Fajitas are a good lower-cholesterol meal choice when eating at a Mexican restaurant, Collingwood says, because they are usually abundant in vegetables. Consider a side of black beans, too, since they are high in soluble fiber and can help lower cholesterol.

The Cleveland Clinic recommends choosing corn tortillas over white flour tortillas, since corn tortillas are significantly lower in calories, saturated fat, sodium, and sugar compared with flour tortillas. Grilled fish and chicken are both good lower-fat, high-protein options. For toppings, opt for salsa, cilantro, or pico de gallo over sour cream and cheese.

Resist ordering nachos as an appetizer, says Kris-Etherton. “Even if there are a lot of people at the table sharing, these are very caloric.”

Take a pass on the refried beans, too, which are higher in saturated fat.

RELATED: 9 Things Dietitians Wish You Knew About High Cholesterol

Go for Vegetables and Skip the Ghee When Eating Indian

Indian restaurants typically offer many vegetarian dishes that provide healthy options when you’re trying to eat lower-cholesterol restaurant meals, Kris-Etherton notes. Chickpeas, for example, also called garbanzo beans, are often used in Indian cooking and are a good, healthy choice.

Look for dishes with plenty of vegetables and tofu, Collingwood says. She also gives a thumbs-up to chicken tandoori, a grilled entrée.

Stay away from dishes heavy with ghee, though, Kris-Etherton says: It’s a clarified butter made from buffalo’s or cow’s milk.

And Collingwood says that when ordering certain Indian dishes, it’s crucial to ask if they can be made with minimal oil.

Order Grilled When Eating Italian, and Skip the Sausage

Plain pasta with marinara sauce is a good lower-cholesterol option when dining at an Italian restaurant, says Kris-Etherton. Also look for grilled chicken, fish, or roasted vegetable dishes, she adds.

Dishes with beans and legumes are high in fiber and can help lower cholesterol, Collingwood says. The Italian staple minestrone soup, for instance, has cannellini beans.

Other staples, though, are not so healthy. The ground beef and cheese in lasagna dishes can make the total saturated fat content soar, warns Kris-Etherton.

Beware also of the sausage-based entrées, which are high in saturated fat. Even if they have peppers — a low-cal vegetable — the sausage dishes can be high-fat overall, she says.

“With Italian food, what you really want to be careful about are the casserole dishes, like chicken parmigiana and lasagna,” Kris-Etherton says. “It’s usually a big serving, and very caloric.”

Additional reporting by Kaitlin Sullivan.