What to Know About Cholesterol and Sodium When Reading Food Labels

Week 3 of my 6-Week Label Reading Series: A deep dive into sodium and cholesterol

Hello, readers! Welcome to Week 3 of our 6-week label reading series. This week, we’re tackling two sections of the Nutrition Facts table: sodium and cholesterol. These are two nutrients that have been polarizing over the years (eggs, anyone?), so today we’ll break down the updated science on these nutrients, what the real risks are, and how much is actually too much. Plus, as always, I’ll show you how to apply this information to food labels so you can make more informed choices.

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Relevant resources

If you’re just joining us or need a refresher, you can catch up on previous posts here:

• Week 1: Calories: Why they’re not the most important number

• Week 2: Fats: types to limit, avoid, and which ingredients matter

You may also find these related posts helpful as you build your label-reading skills:

• Decoding serving sizes: What you need to know

• Percent Daily Value: the average 2,000-calorie diet, reference values, and how to use it

And if sodium is a priority for you, don’t miss my Complete Low-Sodium Grocery List (linked below) - a full walkthrough of low-sodium options available across each aisle of the grocery store 👇.

Your Complete Low-Sodium Grocery List

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Here’s what you can expect in today’s post:

• Cholesterol

  • The basics: what it is, sources, and role in the body

  • Why has cholesterol been so controversial?

  • How much is too much, and when we need to be concerned

  • Tips for label reading (with real product examples) 🔒

• Sodium

  • The basics: what it is, sources, and role in the body 🔒

  • Sodium and health 🔒

  • How much is too much, thresholds for products, and tips for label reading (with real product examples) 🔒

Let’s get started.

Cholesterol

What cholesterol is and where it comes from

Cholesterol is a waxy, fat-like substance found in every cell of the body. Despite its overwhelmingly negative reputation, it has many essential roles in the body, including building cell membranes, producing hormones, and helping the body digest fat.

There are two main sources of cholesterol for the body:

• Your liver, which produces all the cholesterol your body needs

• Your diet, specifically animal-based foods like eggs, meat, shellfish, and full-fat dairy

We don’t actually need to eat cholesterol to meet our body’s needs - our liver makes enough on its own. For years, it has been thought that eating too much dietary cholesterol would directly raise blood cholesterol levels. And since high blood levels of cholesterol, especially LDL (“bad” cholesterol), are a key risk factor for atherosclerosis (clogged arteries), many heart health organizations have historically advised limiting cholesterol-rich foods. But more recent research shows that the link between dietary cholesterol and blood cholesterol isn’t as straightforward as we once thought.

Why has cholesterol been so controversial?

The relationship between dietary cholesterol and heart health has been debated for decades, and much of that controversy stems from inconsistent research findings.

Some studies suggest that eating cholesterol-rich foods raises blood cholesterol levels and increases the risk of heart disease. While others show no association. This inconsistency has made it difficult to offer clear public health recommendations, and has led to changing guidelines over time. It’s also the reason why at times there have been contradictory media headlines about cholesterol popping up on a weekly basis.

But we now understand that there is important context to consider when looking at how cholesterol impacts our health:

• Most people don’t eat high amounts of cholesterol. Population intake (for U. S and Canada) tends to fall below the previous upper limit of 300 mg per day.

• Cholesterol usually comes packaged with saturated fat. Because the two are found together in many foods (like eggs, meat, and dairy), it’s hard to isolate the effect of dietary cholesterol from that of saturated fat, which is more strongly linked to heart disease.

• Some people respond differently to dietary cholesterol. A portion of the population, called hyper-responders, shows greater increases in blood cholesterol when they consume more cholesterol from food. These individuals may benefit from keeping cholesterol intake low. The problem is, there’s no easy way to identify who these people are.

• Dietary context matters. Someone eating cholesterol as part of a diet high in saturated fat and ultra-processed foods may see different effects than someone who includes cholesterol-rich foods like eggs or shrimp in an otherwise heart-healthy dietary pattern.

This context helps to explain why research findings on dietary cholesterol and health have been so inconsistent. Because of these factors, many health organizations have shifted away from setting strict cholesterol limits and instead focus on reducing saturated fat and improving overall diet quality. For example:

• The U. S., dietary guidelines surrounding cholesterol are to “keep dietary cholesterol intake as low as possible without sacrificing diet quality”.

• The 2013 AHA/ACC Guidelines on Lifestyle Management to Reduce Cardiovascular Risk did not include a recommendation for dietary cholesterol and concluded, “There is insufficient evidence to determine whether lowering dietary cholesterol reduces LDL”.

• The Heart and Stroke Foundation of Canada recommends limiting saturated fat intake, as this has more of an impact on cholesterol levels than dietary cholesterol.

So, how much dietary cholesterol is too much?

Past guidelines recommended keeping cholesterol intake under 300 mg per day, but that specific cap has since been removed. Not because cholesterol is harmless, but because it’s not the most meaningful target for reducing heart disease risk in the general population.

That said, the old 300 mg/day upper limit still shows up on food labels, as this is what the percent daily value for cholesterol is based on.

Rather than tracking cholesterol milligrams, it’s more useful to focus on your overall dietary pattern. A diet rich in whole grains, vegetables, fruit, legumes, nuts, and fish, and lower in saturated fat, will naturally keep dietary cholesterol in check, without having to micromanage it.

If you have high cholesterol, heart disease, or a family history of either, or other related risk factors, it’s worth discussing dietary cholesterol with your healthcare team. Some individuals (especially hyper-responders) do benefit from limiting high-cholesterol foods more strictly.

Label reading tips: Cholesterol