Thanksgiving dinner with high cholesterol

You can eat a full Thanksgiving dinner with high cholesterol. One meal doesn't change your LDL, and the turkey itself is one of the leanest things on the table. The saturated fat comes from the skin, the butter, the cream and the pastry. Here is where it hides and how to build a plate you can enjoy.

The turkey: breast, dark meat and skin

Roast turkey breast without skin is about as lean as meat gets. Dark meat has a bit more fat, and the skin is where most of the saturated fat sits.

Two slices of skin use more saturated fat than a whole plate of breast meat. If you love crispy skin, have a small piece and leave the rest. Dark meat is fine in normal portions. Roast on a rack so fat drips away, and baste with stock or a little olive oil rather than butter.

Cholesterol in the meat itself is modest (about 70 to 110 mg per 3 oz), and for most people dietary cholesterol has a much smaller effect on blood cholesterol than saturated fat does. See eggs and cholesterol, explained for the evidence.

The sides, one by one

Plain vegetables, cranberry sauce and baked sweet potato are close to zero. The sides to watch are the ones made with butter: stuffing cooked with a stick of butter, mash with cream, and casseroles with cheese or cream-of-soup toppings. The USDA figures above are for standard recipes, so a home recipe with extra butter will be higher. A single tablespoon of butter has about 7 g of saturated fat, more than half a day's target.

The pies

All three pies land at around 5 g of saturated fat a slice, so pick the one you actually want. Pecan is the most calorie-dense at over 400 kcal. The topping is where you can save: real whipped cream adds as much saturated fat as the pie slice again, and a spoonful of aerosol topping adds under 1 g. For lighter ideas, see desserts for high cholesterol and baking swaps.

Two plates compared

Classic plate: dark meat plus a piece of skin, stuffing, buttery mash, gravy, a buttered roll and a slice of pecan pie comes to about 22.1 g of saturated fat and 1295 kcal.

Lighter plate: breast meat, stuffing, baked sweet potato, green beans, gravy, cranberry sauce, an unbuttered roll and a slice of pumpkin pie comes to about 8.2 g and 982 kcal, and it still has a bit of everything. Most of the saving is the skin, the butter and the pie choice.

Neither plate is "right". If the buttery mash is the dish you look forward to all year, keep it and skip the roll butter instead.

Cooking tips that cut the saturated fat

• Roast on a rack and skim the fat from the pan juices before making gravy. A fat separator takes a minute.
• Mash with stock, a little olive oil and skimmed or plant milk rather than butter and cream. Add roasted garlic for flavour.
• Make stuffing with onion, celery, herbs and stock, and use olive oil for the softening. Add chestnuts or apple for texture.
• Roast vegetables with olive oil (Brussels sprouts, carrots, squash) instead of cheese or cream sauces.
• Add beans, nuts and oats. Soluble fibre helps lower LDL, so include a bean or lentil dish, or crumble pecans over the squash.
• Pie crust: use an oil-based crust or a crumble topping with oats, which also adds fibre.

Leftovers and the day after

Turkey leftovers are an excellent lean protein for sandwiches, soup and salads, which is a good reason to roast a bigger bird. Skip the skin when you make turkey soup, and add beans and vegetables. If you have a cholesterol test coming up, wait a few days after the holiday before testing so one unusual meal doesn't skew the result. See how long it takes to lower cholesterol for when to re-test.

This is general information, not medical advice. If you take cholesterol medication or have a heart condition, check changes to your diet with your doctor, dietitian or pharmacist.

Sources

• American Heart Association: Saturated fat (aim for under 6% of calories, about 13 g on 2,000 calories).
• NHS: Fat, the facts (saturates: up to 30 g a day for men, 20 g for women).
• USDA FoodData Central (SR Legacy), values per serving calculated from the per-100 g record: FDC 171496, 171091, 171082, 172693, 168555, 171568, 173961, 168483, 169141, 172793, 173410, 172788, 175012, 172786, 170860, 170859. fdc.nal.usda.gov
• Carson JAS, et al. Dietary cholesterol and cardiovascular risk: a science advisory from the American Heart Association. Circulation. 2020;141:e39–e53.

Frequently asked questions

Can I eat turkey with high cholesterol?

Yes. Turkey breast without skin is very low in saturated fat (about 0.5 g per 3 oz). Dark meat has a little more, and the skin carries most of the saturated fat, so leave the skin if you want to keep your total down.

Is Thanksgiving dinner bad for cholesterol?

A single large meal is unlikely to change your blood cholesterol in a lasting way. What counts is your regular pattern over weeks. You can lower the saturated fat of the day by skipping the turkey skin, using less butter and cream, and choosing a lighter pie topping.

Which Thanksgiving pie is best for high cholesterol?

The three classic pies (pumpkin, apple and pecan) are similar at about 5 g of saturated fat a slice. Pumpkin pie is the lowest in calories (about 200 kcal a slice, against about 265 for apple and about 410 for pecan). The bigger difference comes from the topping: whipped cream roughly doubles the saturated fat of the slice.

What is a low-cholesterol substitute for butter at Thanksgiving?

Use olive oil or a spread made from unsaturated oils for roasting and mash, and chicken or vegetable stock to moisten stuffing and potatoes. Butter has about 7 g of saturated fat per tablespoon, olive oil about 2 g.

Should I stop my cholesterol medication or change my diet drastically for the holiday?

No. Keep taking any prescribed medication, and treat the holiday meal as one meal. If you are unsure how to fit the day into your plan, ask your doctor or dietitian.

Related reading