It is a common belief that adopting a vegan diet guarantees low cholesterol since it contains no animal products (the source of dietary cholesterol). While a whole-food, plant-based diet is strongly associated with lower cholesterol levels, the assumption that high cholesterol is impossible for vegans is misleading. A person following a vegan lifestyle can still have elevated serum cholesterol due to the types of plant foods consumed and several non-dietary factors. Understanding the difference between dietary and serum cholesterol is the first step in managing this risk.
The Difference Between Dietary and Serum Cholesterol
Cholesterol is a waxy, fat-like substance found in all body cells, necessary for producing hormones, Vitamin D, and digestive bile acids. It is discussed in two forms: dietary (exogenous) cholesterol, consumed through animal products, and serum (endogenous) cholesterol, which circulates in the blood. A vegan diet contains virtually no dietary cholesterol.
The body produces the vast majority of its own cholesterol, with the liver synthesizing about 75% to 80% of what is needed. This production is highly regulated; if a person consumes more dietary cholesterol, the liver generally produces less. The more significant factor influencing serum low-density lipoprotein (LDL) cholesterol—the “bad” cholesterol—is the intake of saturated fat. Saturated fat signals the liver to increase production and decrease its ability to clear LDL from the blood.
LDL and high-density lipoprotein (HDL) are lipoproteins that carry cholesterol through the bloodstream. LDL transports cholesterol from the liver to the rest of the body, and high levels contribute to plaque buildup in arteries. HDL, the “good” cholesterol, picks up excess cholesterol and returns it to the liver for removal. Saturated fat intake disrupts this balance by increasing the production of LDL particles in the liver.
Vegan Foods That Can Raise LDL Levels
While a vegan diet naturally excludes animal fats, certain plant-based ingredients contain high levels of saturated fat that can directly raise serum LDL cholesterol. Tropical oils, such as coconut oil and palm oil, are heavily saturated fats. Their inclusion in a vegan diet can negatively impact cholesterol; for example, one tablespoon of coconut oil contains about 12 grams of saturated fat, which can quickly exceed daily recommendations.
The rise of heavily processed vegan convenience foods also contributes to the problem. Many vegan cheeses, desserts, and processed meat alternatives use saturated tropical oils to create the desired texture. Regular consumption of these products results in a high saturated fat intake, even within a fully plant-based diet. This approach bypasses the protective benefits of a whole-food vegan approach.
Beyond saturated fat, a high intake of refined carbohydrates and sugars can lead to unhealthy blood lipid profiles. Excessive consumption of white flour products, sugary drinks, and processed snacks is linked to elevated triglycerides and very-low-density lipoprotein (VLDL). Since VLDL is the precursor to LDL, a diet rich in refined carbohydrates contributes to overall high cholesterol readings. The overall quality of the vegan diet matters significantly more than the simple absence of animal products.
Non-Dietary Factors Affecting Cholesterol
Several factors independent of diet play a role in a person’s cholesterol risk profile. Genetics is a significant, non-modifiable factor. Conditions like Familial Hypercholesterolemia (FH) cause high cholesterol from birth by affecting the body’s ability to remove LDL cholesterol from the blood, resulting in dangerously high levels regardless of dietary adherence.
Lifestyle habits beyond eating also influence the balance of lipoproteins. A lack of regular physical exercise is associated with lower levels of HDL cholesterol, which clears excess cholesterol. Exercise helps boost HDL and assists the body in moving LDL to the liver for processing. Chronic stress can also raise cholesterol by triggering the release of hormones, such as corticosteroids, that signal the body to produce more cholesterol.
Underlying medical conditions can further complicate cholesterol regulation, irrespective of diet. Conditions such as hypothyroidism and Type 2 diabetes are known to increase LDL and triglyceride levels. Managing cholesterol requires a comprehensive approach that includes exercise and stress management, alongside dietary vigilance, to address overall metabolic health.