The worst drinks for your cholesterol (and what to have instead)

 When it comes to cholesterol, we generally know which foods to avoid: the high-fat processed meats, cakes, fried foods, and pastries. But rarely do we think about what we drink.

“Drinks work in exactly the same way as food,” confirms Dr Mohssen Chabok, a consultant cardiologist at HCA Healthcare UK’s Harley Street Clinic. “If you drink a large full-fat latte, which is high in saturated fat, it will have a similar effect on your cholesterol levels as eating greasy foods.”

“The cornerstone of cholesterol-lowering advice remains to reduce your saturated fat intake,” says Dell Stanford, a senior dietitian at the British Heart Foundation, “and I think we’re all on the same page with that, given that about half of UK adults have cholesterol levels above the recommended amount, and the majority of UK adults exceed recommended intakes of saturated fat.”

This is because high intakes of saturated fat increase our artery-clogging LDL (low-density lipoprotein), also known as “bad” cholesterol, which can lead to heart attacks and strokes. However, our HDL (high-density lipoprotein), or “good” cholesterol, protects our hearts by reducing the activity of the bad cholesterol.

But it’s not just saturated fat that’s the issue: sugar in fizzy drinks and juices can also raise your cholesterol. This is because excess sugar can overwhelm the liver, causing it to convert sugar into bad cholesterol, while lowering good cholesterol.

Alcohol, meanwhile, can raise the amount of triglycerides, a type of fat in the blood that behaves almost like LDL. “It’s very common to find high levels of triglycerides in those who regularly drink more than the recommended levels of alcohol,” says Dr Chabok. “Triglycerides are a significant cardiovascular risk factor, independent of LDL levels.”

Here, Stanford and Dr Chabok reveal the drinks that will raise your cholesterol – and the healthy swaps to have instead.

High-fat coffee drinks

Most of us realise that regularly drinking milkshakes may contribute to raised LDL levels, but we may not be aware that ready-to-drink coffee products – such as a bottled frappuccino – are not dissimilar. Many bottled, ready-to-drink coffee products are very high in sugar and fat.

Frappés and mochas often combine large helpings of cream or whole milk with up to 10 or 12 teaspoons of added sugar. In fact, some contain more sugar than a 330ml can of Coca-Cola.

“Top of the list of drinks to avoid are sugary, creamy drinks that give you extra calories, saturated fat and added sugar with no fibre,” says Stanford. “These aren’t really drinks; they’re more like desserts. And over time, there’s a danger they will raise your bad cholesterol.”

Swap for: coffee with a splash of milk

“The healthiest way to drink coffee is a normal filtered coffee with a splash of milk in it – ideally semi-skimmed or skimmed if you’re looking to lower your cholesterol,” Stanford notes.

With some studies suggesting that French press coffee can raise cholesterol, should we throw away our cafetières in favour of filter or instant? “There is some evidence that unfiltered coffee contains a compound called cafestol, which may increase cholesterol levels more than filtered coffee,” Stanford says, “but if you’re drinking no more than three to five cups a day, as part of a balanced diet, it’s unlikely that it will have a detrimental effect on your cholesterol level.”

Sugary fizzy drinks

Given that one can of cola could contain up to 10 teaspoons of sugar, regular consumption can lead to weight gain, obesity, type 2 diabetes and fatty liver disease. “Drinks like this are relevant to cholesterol,” says Dr Chabok, “but more so to blood sugar. They can contribute to the development of diabetes.”

While sugar-free drinks (containing artificial sweeteners) might be a better option, especially for people who are overweight or have diabetes, research suggests that artificial sweeteners in drinks can negatively affect cholesterol levels and cardiovascular health. A 2022 study published in The BMJ discovered that regularly eating or drinking foods and drinks with artificial sweeteners is linked to greater risk of heart and circulatory disease. The study didn’t find why there’s a greater risk, but other studies suggest artificial sweeteners affect the ways our bodies control blood sugar levels, which could, in turn, lead to heart disease.

Swap for: kombucha

“Kombucha is basically fermented tea,” Stanford explains, “so it contains probiotics and polyphenols.” Both compounds have been linked to decreased LDL levels. “It does contain some sugar, but usually much less than regular soft drinks,” she adds.

Fruit juice

While fruit juice itself doesn’t significantly raise cholesterol, it’s high in what’s known as “free sugars”. These cause blood-sugar spikes, which trigger the liver to increase the production of LDL, while lowering HDL and raising triglycerides.

“If you eat an orange, there are no free sugars – the sugars are contained within the cell of the fruit,” Stanford explains. “But if you squeeze an orange to make juice, the sugar comes out of the cells, and you’re basically drinking sugary water that’s got some vitamin C and some orangey flavours in it.”

Swap for: a high-fibre smoothie

“If you regularly drink fruit juice,” says Stanford, “a smoothie could be a better option, especially if it’s made with whole fruits or vegetables and you add things like oats, nuts and seeds that will provide you with soluble fibre. We know that soluble fibre can help lower bad cholesterol levels: it binds to cholesterol in the gut and helps to remove it from the body.” Adding nuts or nut butters can also slow down the rate at which your body absorbs sugar, preventing sugar spikes.

“But there is a downside: like fruit juice, smoothies contain free sugars. The guidelines recommend limiting smoothie consumption to a maximum of 150ml per day. The biggest cholesterol-lowering benefits still come from eating whole fruits rather than consuming them in the form of fruit juices or smoothies. And it’s worth remembering that vegetables, oats, nuts and seeds will all deliver far more fibre.”

Hot chocolate

As with bottled ready-to-drink coffee products, it’s the sugar, full-fat-dairy and ultra-processed-foods ingredients in commercial hot chocolate that can damage your health and raise your levels of bad cholesterol, especially cheaper varieties, as they often add milk fat or other oils, increasing the amount of saturated fat and sugar. “Cocoa – and in particular cocoa butter – is high in saturated fat,” Stanford confirms. “Therefore, regularly drinking hot chocolate may contribute to raised cholesterol levels, especially if made with full-fat milk.”

She adds that there are certain ways to mitigate the ill effects: “If you make it with skimmed milk, you’ll reduce the amount of saturated fat. If you make it without sugar, then you’re going to be saving yourself some sugar and calories.”