If you always swerve the cheese course out of concern for your cholesterol, then it might be time to change tactics. 

The long-standing fear has been that saturated fats in cheese increase the level of LDL (or “bad”) cholesterol in our blood, which is associated with an increased risk of heart attack and stroke. Now some experts believe cheese has been wrongly demonised and that it might actually be beneficial for health. Recent research suggests that the beneficial microbes and nutrients in cheese might inhibit the uptake of its unhealthier elements.

It’s not the only food that’s been re-evaluated after being long associated with raising bad cholesterol. Others include shellfish and eggs. 

What is cholesterol?

Cholesterol is the waxy substance found in your blood that is important in the making of certain hormones and healthy cells.

“We can make about two thirds typically of what we need and the last third comes from our diet,” explains dietitian Dr Duane Mellor of the British Dietetic Association.

The difference between HDL (high-density lipoprotein) cholesterol, sometimes called “good” cholesterol, and LDL (low-density lipoprotein) is that the former absorbs cholesterol in the blood and carries it back to the liver. The liver then flushes it from the body. High levels of HDL cholesterol can lower your risk for heart disease and stroke. LDL, on the other hand, takes cholesterol directly to your arteries.

Other fats can block your arteries, too

“In simple terms, LDL pushes cholesterol into the body and HDL is a way of getting it out of the body,” says Dr Mellor.

When measuring our risk of developing heart disease, the focus used to be on LDL cholesterol, HDL cholesterol levels and total cholesterol levels. But our blood also contains a type of fat called triglycerides (found in fat cells), which can also contribute to narrowed arteries.

“It’s now understood that as well as LDL, other types of “bad” fats are also important to consider when thinking about someone’s risk of developing cardiovascular disease,” says Bahee Van de Bor, a paediatric dietitian. 

Carrying excess weight, eating a lot of fatty and sugary foods or drinking too much alcohol can all lead to high triglyceride levels. This is because triglycerides are made to store extra calories.

Not all saturated fat is bad for your heart

The new research concerning cheese shows that not every saturated fat behaves the same. Dr Mellor says: “It’s possible that because dairy products come from herbivores they have all sorts of odd-chain fatty acids which may actually be good, so we can’t say all saturated fat is bad,” 

However, he adds: “What we can say is that too much of it and your calorie intake will be too high and that’s something to be mindful of. 

A healthier approach is to think about eating small amounts. “The main things that are going to drive cholesterol up are eating too many calories, gaining weight and putting on fat, because that’s what your body will then make the cholesterol from.” 

Reducing your meat intake will also make room for other foods on your plate, many of which have been shown to actually help lower your cholesterol level. As well as cheese, here are eight more to try…

They can be difficult to know how to cook well, but worth the effort from the perspective of both taste and health. Some animal studies suggest including aubergine may help lower low-density lipoprotein (LDL) cholesterol. These effects are likely to be because of the fibre as well as the antioxidant content of aubergine, including nasunin, the major component of the pigment in eggplant. “The soluble fibre in them is good. It stops you recycling your own cholesterol that would normally be reabsorbed in the gut,” says Dr Mellor. Soluble fibre binds cholesterol particles to it in the small intestine, preventing them from entering your bloodstream and travelling to other parts of the body. Instead, cholesterol will exit the body through the faeces.

For the most health impact, avoid frying them: “Doing that means you’re getting a lot of energy that way which isn’t good from the weight side of things.” Instead roast them with a sensible amount of oil.

Last eaten most likely in an Indian restaurant, this pointy green vegetable, also known as lady’s fingers or bhindi, is cultivated worldwide and available increasingly in mainstream supermarkets. Researchers have found that a gel in okra called mucilage can help lower cholesterol by binding to it during digestion. This helps cholesterol leave the body through stools.

Okra’s polyphenols content has also been shown to reduce the risk of heart disease. One four-year study in 1,100 people showed that those who ate a diet rich in polyphenols had lower inflammatory markers associated with heart disease.

A healthy food that doesn’t hurt your wallet. Human studies have found that lentils may improve cholesterol levels in people with diabetes. Rich in fibre that can help stop the reabsorption of cholesterol into the bloodstream they also contain folate, iron and vitamin B1, which support your heart health.

Dr Mellor advises opting for red lentils. “They’re easy to use and you can part-substitute the mince in a dish like bolognese, helping you to reduce meat consumption while maintaining protein and iron intake. As well as the dietary benefits there are the financial ones too, because they are much cheaper.”

If you’re looking for a healthy snack, then it has to be nuts. 

It’s not entirely clear why, but it’s thought that the “good” fats in nuts – both monounsaturated and polyunsaturated fats – lower bad cholesterol levels. They contain fibre as well as plant sterols, a substance that can help lower cholesterol. Nuts are also a source of L-arginine, which research suggests may lower blood pressure, improve cholesterol and improve overall blood vessel health.

“A lot of the research is sponsored by the almond growers of California, but it seems to be a class effect,” says Dr Mellor. “The only one that’s not going to be as good is a chestnut because that’s a starchy nut. It’s not a true nut.”

If you go for a hazelnut, walnuts, pecans and almonds, they’re all thought to have a similar effect, as do seeds like chia. “The key thing is not to have salted roast peanuts, because they’re not the healthiest. It’s best to have a fresh nut.”

A type of fibre called beta-glucan present in oats and barley has been found to lower blood cholesterol in studies, says Dr Stacey Lockyer, senior nutrition scientist at the British Nutrition Foundation.

When you eat beta-glucan, it forms a gel that binds to cholesterol-rich bile acids in the intestines. This helps limit the amount of cholesterol that is absorbed from the gut into your blood. Your liver then has to take more cholesterol out of your blood to make more bile, which lowers your blood cholesterol.

“The healthiest way to have them is as a simple porridge with a little bit of fresh or dried fruit,” says Dr Mellor. “The key thing is not to add lots of syrups and chocolate sprinkles and all sorts of things people do. Keep it as simple as possible.”

Tofu, made from condensed soy milk, may have been discovered during the Han dynasty (202 BC – AD 220) and became a popular choice for Buddhist monks who didn’t want to eat meat or fish. Modern researchers have studied soybeans to understand their effect on cholesterol, with scientists noting that soybeans with increased levels of the protein beta-conglycinin compared with the protein glycinin were better able to regulate cholesterol metabolism and inhibit fatty acid oxidation. It is thought that eating soybeans with higher levels of beta-conglycinin may help to maintain healthy liver and cardiovascular function.

“A harder one to sell to people,” says Dr Mellor, as tofu isn’t a traditional food in the UK. “You can scramble it like an egg that works quite well. Or you can toss it into a stir fry with a load of vegetables and serve it with noodles. It does taste better when fried, or you can put it into a curry sauce. The key thing is that you add it into a sauce early so it can take on the flavours of the sauce,” says Dr Mellor. 

Of the reason tofu is a cholesterol buster, he says: “It seems to be the phytoestrogens, these plant-like mimicking hormones that tend to alter the way the cholesterol is absorbed.”

It’s a myth that tofu has a feminising effect, he adds: “Otherwise vast swathes of the world that eat plots of tofu, would have different characteristics. But it does tend to have a beneficial effect on cardiovascular risks.”

The omega-3 fats found in oily fish can help lower harmful blood triglycerides. “It seems to be beneficial in helping lower triglycerides and increasing the good cholesterol,” says Dr Mellor. Oily fish includes herring, mackerel, pilchards, sardines, salmon, trout and fresh tuna. “I’d probably go for something simple and not too salty like sardines in tomato sauce which you can have on a piece of toast as a quick and easy meal,” says Dr Mellor. “It’s an alternative to a bacon sandwich and healthier.”

When it comes to having healthy cholesterol levels the vitamins and fibre in vegetables are key. “It’s not quite as simple as antioxidants, but they contain a range of things like Vitamin C and E, which help keep the cholesterol in its healthy state,” says Dr Mellor. 

The brassica family has been associated with healthy cholesterol because of its levels of soluble fibre. In particular, studies have shown a diet rich in high glucoraphanin broccoli reduces plasma LDL cholesterol. Other cholesterol-busting vegetables to consider include spinach, Brussels sprouts and collard greens.

“The science isn’t 100 per cent but it is thought that having a range of these different plants will nourish your gut microbiome that has a role in your body handling fats and lipids, not necessarily cholesterol but triglycerides.”