Is Pizza Bad for Cholesterol?

If you’ve had high cholesterol for years or just found out your LDL is high, you’re probably asking yourself: is pizza bad for cholesterol? 

If you’ve been googling what foods can help lower cholesterol and wondering whether pizza is off-limits, this article is for you.

Understanding Cholesterol and Diet

Understanding what cholesterol is, what it does in the body, and the impact that diet can have on it’s levels can help clear up some of the fear or confusion you might have, especially after a recent diagnosis.

What is Cholesterol and Why is it Important?

Cholesterol is a waxy fatty substance naturally made by the liver (80%) and the other 20% comes from food, mainly from animal foods like meat, dairy, eggs, and seafood.

Cholesterol is important for making hormones, absorbing fat soluble vitamins, and building cells.

The problem isn’t cholesterol itself, it’s when you have too much cholesterol circulating in your blood. Especially high levels of LDL or triglycerides. This can increase your risk of heart disease and plaque build up in the arteries. (1)

HDL is actually good to have because it collects excess cholesterol in the body and removes it. Think of HDL like a street sweeper that goes around collecting trash in the street. HDL is protective and when levels are low, it can reduce it’s protective effect.

Curious to know what your cholesterol levels mean? Read more here.

How Diet Impacts Cholesterol

Certain foods that we eat can either raise or lower cholesterol levels. While genetics, lifestyle, and other health conditions all play a role, diet has one of the biggest impacts on cholesterol.

Foods high in saturated and trans fats like fried foods, butter, palm oil, processed meats, and full-fat dairy can raise LDL cholesterol and lower HDL

It’s recommended to eat <10% of your total calories from saturated fat. Based on a 2,000 calorie diet, this is about 200 calories or 22 g per day. The American Heart Association recommends an even lower goal of <6% of total calories per day. This is about 120 calories or 13g per day. Read more about saturated fats here.

Eating more fiber-rich foods such as oats, beans, fruits, and vegetables can help lower cholesterol levels naturally.

Looking for more ways to lower your cholesterol naturally? I’ve got you covered.

• Plant Sterols: Lower Your Cholesterol Naturally
• Smoothies to Lower Cholesterol
• Quinoa vs Oatmeal: Is one better than the other?

A meta-analysis of randomized-controlled trials show that consuming 3g/day of beta-glucans, a type of soluble fiber found in oats and barley, can significantly lower LDL and total cholesterol. (2) No effects were found on triglycerides or HDL.

Adding heart-healthy fats high in omega 3 fatty acids from olive oil, avocados, nuts, seeds, and fatty fish can also improve HDL cholesterol

Making these dietary swaps consistently is one of the most effective ways to support healthy cholesterol and heart health overall.

A note on sugar: Diets high in sugar and consuming more calories than your body needs over time, can increase the risk of chronic diseases like obesity. Research has found that drinking more sugar-sweetened beverages is linked to dyslipidemia—abnormal levels of fats and cholesterol in the blood. (3)

Is Pizza Bad for Cholesterol?

So what does all of this mean for pizza?

Like many foods, pizza can either raise or lower cholesterol depending on the type, ingredients, how it’s made, frequency of consumption, and portion size.

A pizza loaded with processed meats like sausgae or pepperoni and extra cheese will be higher in saturated fat, which can increase LDL cholesterol.

But a pizza made with whole-grain crust, veggie toppings, and lighter cheese—or even dairy-free alternatives—can provide fiber, healthy fats, and antioxidants that actually support heart health.

In other words, pizza doesn’t have to be completely off-limits if you’re mindful about how it’s made, your portion size, and how frequency you eat it.

What to Watch Out For

Not all pizzas are created equal when it comes to how it impacts your cholesterol. Certain ingredients and preparation methods can raise LDL cholesterol and make pizza not the best choice for your heart.

Here’s what to watch out for:

1. High Saturated Fat in Cheese
   • Cheese is a main contributor to saturated fat. Pizza with extra cheese or full-fat varieties have more saturated fats than regular or low fat cheese pizza.
     
2. Processed Meats and Toppings
   • Pepperoni, sausage, and other processed meats are high in saturated fat and sodium, both of which can negatively affect cholesterol if consumed in large amounts.
     
3. Thick, Refined Crusts and Stuffed Crusts
   • Heavy, refined-flour crusts can contribute extra calories and fat, especially if stuffed with cheese or butter.
     
4. Large Portions and Frequent Consumption
   • Eating oversized slices or having pizza several times a week increases your overall intake of saturated fat and sodium, impacting cholesterol over time.

Key word here is over time. Eating a few slices of pizza once in a while is not going to send your cholesterol through the roof. I would not recommend giving up pizza entirely unless you are allergic or do not enjoy eating it.

Takeaway: Pizza doesn’t have to be off-limits, but being mindful of cheese, meat toppings, crust type, and portion size can help protect your cholesterol.

Can You Eat Pizza If You Have High Cholesterol?

Yes! You can eat pizza if you have high cholesterol. In fact, you don’t have to give up your favorite foods if you’re working on lowering your cholesterol.

The most important thing to consider is your overall dietary pattern. What you do consistently overtime is going to impact your cholesterol levels. Not what you did one night or one day.

There are no quick fixes or magic diets that make your cholesterol rise or drop over night.

That’s why it’s important to not only limit your intake of saturated fats, ultra processed foods, and excess calories, but to increase foods rich in fiber like fruits and vegetables, whole grains, and healthy fats.

Healthier Pizza Options for Better Cholesterol

Try these simple swaps and strategies for a healthier option while still enjoying pizza

• Go thin crust (or cauliflower crust)
• Pile on the veggies like spinach, peppers, mushrooms, and broccoli
• Choose lean proteins like grilled chicken or shrimp instead of pepperoni or sausage
• Lighten up on cheese or try part skim mozzarella
• Watch the size, stick to 1–2 slices and pair with a side salad
• Try making pizza at home, that means you control the ingredients and portion sizes

To make your pizza more heart-friendly, try pairing a slice with a big salad topped with grilled chicken, beans, or avocado for extra fiber and protein. This helps fill you up and balances out the meal.

Conclusion

So the takeaway here is, certain foods that are high in saturated fats can contribute to abnormal cholesterol levels if consumed frequently and in excess. Cholesterol is not bad, but it becomes problematic when certain levels are too high (LDL and total cholesterol) or too low (HDL) in the blood.

What matters most is your overall dietary pattern—the foods you eat regularly, how much of them you eat, how often you eat them, and even the way they’re prepared.

If you need more guidance on lowering your cholesterol, let’s chat! Schedule a 30-minute discovery video call and I’d be happy to discuss how I can help you further.

Written by Heather Krawsek, RD, LDN
Reviewed by Carrie Weitzel, RD