Is pasta bad for cholesterol?

There is no evidence that it is, and almost no evidence about pasta on its own. The main pasta meta-analysis looked for randomized trials and found no comparison that tested pasta alone. All 32 comparisons it did find, in 2,448 people, tested pasta inside low-glycemic diets, and the review measured only body weight and fat, not cholesterol. Those low-glycemic diets, where pasta is a typical staple, lowered LDL cholesterol slightly: by 6.6 mg/dL (0.17 mmol/L) in people with diabetes and by 5.8 mg/dL (0.15 mmol/L) across 25 trials in 1,973 people.

Unsettled. Whether a plate of ordinary pasta raises or lowers cholesterol has not been tested directly. A 2017 systematic review said exactly that: pasta raises blood sugar less than bread or potato, and evidence was lacking on how eating pasta affects cardiometabolic risk. Everything below is indirect, from diets that include pasta, from grain foods in general or from people who report eating it.

What the trials found

Low-glycemic and whole-grain diets

In a meta-analysis for the European diabetes guidelines, low-glycemic dietary patterns lowered LDL cholesterol by 6.6 mg/dL (0.17 mmol/L) against higher-glycemic diets, with a confidence interval from 0.08 to 0.25, across 29 trial comparisons in 1,617 people with diabetes. The paper graded that LDL result low certainty, and results varied a lot between trials. A 2026 meta-analysis of 25 randomized trials in 1,973 people aged 12 to 75 found LDL 5.8 mg/dL (0.15 mmol/L) lower on low-glycemic diets, with no clear change in total cholesterol, triglycerides or HDL.

Across 24 randomized comparisons, whole-grain foods lowered LDL cholesterol by 3.5 mg/dL (0.09 mmol/L) against refined-grain foods, with oats doing best. That is whole grains in general, and the review does not single out whole-wheat pasta.

Pasta itself

The trials that served pasta all changed what was in it or used it as the comparison. In 62 adults with high cholesterol, a daily 2.8 oz (80 g) serving of pasta made with soy germ lowered LDL by 14 mg/dL (0.36 mmol/L) more than ordinary pasta over 8 weeks, a fall of 8.6 percent from baseline. In a 3-month double-blind trial of 298 people with metabolic syndrome, pasta enriched with plant sterols and fiber lowered non-HDL cholesterol more than conventional pasta, and the abstract does not give the size. In both cases the added ingredient did the work.

When both groups ate whole-grain pasta, one plain and one with barley fiber and a probiotic, a serving a day for 12 weeks did not change the blood lipid profile of 41 overweight adults. Both arms ate pasta, so this trial cannot say what pasta does against no pasta.

People who eat more pasta

Among 2,562 Italian adults with type 2 diabetes, eating more pasta was not linked with LDL cholesterol or triglycerides, and was linked with lower HDL. That is one point in time, and the pasta eaters also ate less fat and protein. In about 6,000 older Spanish adults at high cardiometabolic risk, pasta intake was not linked to HDL or triglycerides, and replacing potato with pasta went with better HDL. Average pasta intake there was very low, about 9 g dry a day.

Across 17 cohorts with over 875,000 people, refined grain intake was not linked with cardiovascular disease, with a hazard ratio of 1.08 and a confidence interval from 0.99 to 1.18. The result held when the analysis kept only staple grains such as bread, pasta and white rice. The abstract gives no absolute risk, and the authors note probable unmeasured confounding.

Unsettled. Pasta has not been shown to raise LDL cholesterol. No trial has tested it directly, and among people with diabetes who eat more of it, LDL was no different. That is an absence of harm in weak data, which is not the same as proof that pasta is harmless for blood lipids.

Who should be careful

The signal that does show up is in HDL and triglycerides, the other half of the lipid panel. In a 6-week trial of 166 Chinese adults with high cholesterol, HDL fell in the group eating 3.5 oz (100 g) a day of wheat flour noodles compared with the group eating oats. The noodles were the control food, and the abstract does not give the size of the change. Among people with type 2 diabetes, those eating more pasta had lower HDL.

Not for everyone. A meta-analysis of 60 controlled feeding trials found that replacing dietary fat with carbohydrate raised fasting triglycerides. That is carbohydrate in general, not pasta, and the abstract does not give the size of the rise. If your triglycerides or HDL are already a concern, this is the finding that applies to a pasta-heavy plate.

We found no evidence on pasta and cholesterol in pregnancy, in children or with cholesterol-lowering drugs.

What expert bodies say

The American Heart Association's 2021 dietary guidance lists choosing whole grain foods and products as the third of its recommendations for a heart-healthy pattern. It says nothing about pasta specifically. We found no position on pasta and cholesterol from the AHA, the NHS or EFSA.

How we searched

What would change this answer

• A randomized trial of ordinary pasta against another staple such as bread, rice or potato, with LDL cholesterol as the outcome. We found none, and none registered in the local ClinicalTrials.gov layer.
• A trial of whole-wheat against white pasta on blood lipids. The whole-grain evidence today is about grain foods in general.
• Larger data on HDL and triglycerides in people eating a lot of pasta. The HDL signal comes from one noodle trial and one cross-sectional study, and the cohort with the best data ate very little pasta.

For what a serving of pasta holds and how it compares with other staples, see the pasta page.

Sources

1. ev-pacho-01 · Meta-analysis or systematic review · systematic review and meta-analysis of randomized controlled trials (GRADE) · n = 2448
   We identified no trial comparisons of the effect of pasta alone and 32 trial comparisons (n=2448 participants) of the effect of pasta in the context of low-GI dietary patterns.
   
   Who: adults in randomized trials of 3 weeks or longer, pasta alone or within low-GI dietary patterns
   Effect: 0 trial comparisons of pasta alone; 32 of pasta in low-GI patterns (adiposity outcomes only, no lipid outcomes)
   Certainty: Lipids were not an outcome; the point here is the absence of pasta-alone trials.
   BMJ Open, 2018 · checked 2026-10-07 · we read the abstract
2. ev-pacho-02 · Meta-analysis or systematic review · systematic review with meta-analysis of postprandial glucose · n = —
   Pasta meals have significantly lower postprandial glucose response than bread or potato meals, but evidence was lacking in terms of how the intake of pasta can influence cardio-metabolic disease risk.
   
   Who: prospective cohorts and randomized dietary trials on pasta and pasta-related fiber and grain intake
   Effect: lower postprandial glucose than bread or potato; no usable evidence on lipids or other risk factors
   Certainty: Pooled only postprandial glucose; risk-factor evidence summarized qualitatively and judged lacking.
   Nutr Metab Cardiovasc Dis, 2017 · checked 2026-10-07 · we read the abstract
3. ev-pacho-03 · Meta-analysis or systematic review · systematic review and meta-analysis of randomized controlled trials (GRADE), for EASD guidelines · n = 1617
   Low GI/GL diets showed moderate reductions in non-HDL-C (mean difference −0.20 mmol/L (95% confidence interval −0.33 to −0.07), P=0.002; substantial heterogeneity, I2=70%, P<0.001); small important reductions in LDL-C (−0.17 mmol/L (−0.25 to −0.08), P<0.001; substantial heterogeneity, I2=70%, P<0.001), ...
   
   Who: 1617 people with type 1 or type 2 diabetes, mostly middle aged and overweight, in trials of 3 weeks or longer
   Effect: LDL-C MD -6.6 mg/dL (95% CI -9.7 to -3.1; metric: -0.17 mmol/L, -0.25 to -0.08), I2 70%; non-HDL-C -7.7 mg/dL (-0.20 mmol/L); triglycerides -8 mg/dL (-0.09 mmol/L)
   Certainty: Dietary patterns, not pasta alone; LDL-C graded low certainty in the paper.
   BMJ, 2021 · checked 2026-10-07 · we read the fulltext
4. ev-pacho-04 · Meta-analysis or systematic review · systematic review and meta-analysis of randomized controlled trials · n = 1973
   Low-GI diets significantly reduced fasting blood glucose (FBG; -0.19 mmol/L, p = 0.04), glycated hemoglobin (HbA1c; -0.22%, p < 0.01), and low-density lipoprotein cholesterol (LDL-C; -0.15 mmol/L, p < 0.01) compared with control diets.
   
   Who: participants aged 12 to 75 in randomized trials of low-GI vs control diets, searched to April 2025
   Effect: LDL-C -5.8 mg/dL (-0.15 mmol/L) (p < 0.01); total cholesterol, triglycerides and HDL-C not significantly changed
   Certainty: Diet patterns, not pasta; confidence interval not in the abstract.
   Curr Diabetes Rev, 2026 · checked 2026-10-07 · we read the abstract
5. ev-pacho-05 · Meta-analysis or systematic review · systematic review and meta-analysis of randomized controlled trials · n = 24 studies
   Overall, whole-grain intake lowered LDL cholesterol (weighted difference: -0.09 mmol/L; 95% CI: -0.15, -0.03 mmol/L; P < 0.01) and TC (weighted difference: -0.12 mmol/L; 95% CI: -0.19, -0.05 mmol/L; P < 0.001) compared with the control.
   
   Who: adults in randomized controlled comparisons of whole-grain vs non-whole-grain foods
   Effect: LDL-C -3.5 mg/dL (95% CI -5.8 to -1.2; metric: -0.09 mmol/L, -0.15 to -0.03); total cholesterol -4.6 mg/dL (95% CI -7.3 to -1.9; metric: -0.12 mmol/L, -0.19 to -0.05)
   Certainty: Whole grains in general, not whole-wheat pasta specifically.
   Am J Clin Nutr, 2015 · checked 2026-10-07 · we read the abstract
6. ev-pacho-06 · Meta-analysis or systematic review · meta-analysis of controlled feeding trials · n = 60 trials
   Replacing fats with carbohydrates increased fasting triacylglycerol concentrations.
   
   Who: participants in 60 controlled feeding trials of dietary fat and carbohydrate
   Effect: fasting triacylglycerol higher when carbohydrate replaced fat; total:HDL ratio unchanged when carbohydrate replaced saturated fat
   Certainty: Carbohydrate in general, not pasta; size of the triglyceride rise not in the abstract.
   Am J Clin Nutr, 2003 · checked 2026-10-07 · we read the abstract
7. ev-pacho-07 · Randomized controlled trial(s) · randomized controlled parallel trial · n = 62
   Soy germ pasta reduced serum total and LDL cholesterol by 0.47 +/- 0.13 mmol/L (P = 0.001) and 0.36 +/- 0.10 mmol/L (P = 0.002) more than conventional pasta, representing reductions from baseline of 7.3% (P = 0.001) and 8.6% (P = 0.002), respectively.
   
   Who: adults with hypercholesterolemia on a Step II diet with one 2.8 oz (80 g) serving of pasta a day, 8 weeks
   Effect: total cholesterol -18 mg/dL (-0.47 mmol/L) and LDL-C -14 mg/dL (-0.36 mmol/L) vs conventional pasta (-7.3% and -8.6% from baseline)
   Certainty: Effect comes from the soy isoflavones added, not pasta; ordinary pasta was the control.
   J Nutr, 2007 · checked 2026-10-07 · we read the abstract
8. ev-pacho-08 · Randomized controlled trial(s) · randomized double-blind controlled trial · n = 298
   The participants who consumed the experimental pasta exhibited a significantly greater reduction in serum non-HDL-C levels compared to the control group (p = 0.001).
   
   Who: adults with metabolic syndrome, with and without major psychiatric disorders, experimental or conventional pasta for 3 months
   Effect: greater reduction in non-HDL-C vs conventional pasta (p = 0.001); size not in the abstract
   Certainty: Effect of the added phytosterols, arabinoxylans and unsaturated fats; mmol/L change not in the abstract.
   Eur Psychiatry, 2025 · checked 2026-10-07 · we read the abstract
9. ev-pacho-09 · Randomized controlled trial(s) · single-blind parallel randomized placebo-controlled trial · n = 41
   RESULTS: INN or CTR pasta consumption had no effect on primary and secondary outcomes over time, except for a significant increase in plasma γ-glutamyltransferase (GGT) after 12 wk of CTR pasta consumption.
   
   Who: healthy sedentary overweight or obese adults aged 30 to 65, one serving a day of whole-grain control or synbiotic pasta, 12 weeks
   Effect: no effect on fasting lipid profile over time in the whole group; LDL/HDL ratio lower only in an obese subgroup on synbiotic pasta
   Certainty: Both arms ate pasta; no non-pasta control.
   J Nutr, 2019 · checked 2026-10-07 · we read the abstract
10. ev-pacho-10 · Randomized controlled trial(s) · randomized controlled parallel-arm trial · n = 166
    HDL-cholesterol decreased significantly in the control group versus the oat group.
    
    Who: adults with mild to moderate hypercholesterolemia in Beijing, 100 g/day instant oats (n = 85) or wheat flour noodles (n = 81), 6 weeks
    Effect: HDL-C decreased in the noodle group vs the oat group; total and LDL-C fell with oats vs noodles
    Certainty: Noodles were the control food; size of the HDL change not in the abstract.
    Nutr J, 2012 · checked 2026-10-07 · we read the abstract
11. ev-pacho-11 · Observational data · cross-sectional analysis · n = 2562
    No relation was found with LDL cholesterol and triglycerides, but there was an inverse relation with HDL-cholesterol.
    
    Who: adults with type 2 diabetes in Italy, EPIC food questionnaire, sex-specific quartiles of pasta intake
    Effect: no relation with LDL-C or triglycerides; inverse relation with HDL-C
    Certainty: Association at one time point; pasta eaters also ate less fat and protein.
    Nutrients, 2019 · checked 2026-10-07 · we read the abstract
12. ev-pacho-12 · Observational data · longitudinal analysis within a randomized trial cohort · n = about 6000
    Replacing potato with pasta was associated with improvements in diastolic BP and HDL-cholesterol.
    
    Who: older PREDIMED-Plus participants with overweight or obesity at high cardiometabolic risk, food questionnaires over 2 years
    Effect: no association of pasta with HDL-C or triglycerides at 1 year; substituting pasta for potato associated with improved HDL-C
    Certainty: Observational; very low mean pasta intake (about 9 g dry a day).
    J Am Nutr Assoc, 2025 · checked 2026-10-07 · we read the abstract
13. ev-pacho-13 · Observational data · meta-analysis of prospective cohort studies · n = over 875,000
    The lack of association between refined grain intake and CVD risk was observed in meta-analyses of studies that restricted analyses to only staple grain foods (e.g., bread, cereal, pasta, white rice), as well as for meta-analyses of studies that included both staple and indulgent grain foods (e.g., cakes, cookies, doughnuts, brownies, muffins, pastries).
    
    Who: adults in 17 prospective cohort studies
    Effect: CVD HR 1.08 (95% CI 0.99 to 1.18), I2 70%; same null result when limited to staple grain foods
    Certainty: Observational; probable unmeasured confounding noted by the authors.
    Trends Cardiovasc Med, 2024 · checked 2026-10-07 · we read the abstract
14. ev-pacho-14 · Position of an expert body · scientific statement · n = —
    Evidence-based dietary pattern guidance to promote cardiometabolic health includes the following: ... (3) choose whole grain foods and products; ...
    
    Who: general population, cardiometabolic health
    Effect: recommendation 3 of 10: choose whole grain foods and products
    Certainty: Pattern-level advice; no statement on pasta specifically.
    American Heart Association, Circulation, 2021, Dietary Guidance to Improve Cardiovascular Health: A Scientific Statement From the American Heart Association · checked 2026-10-07 · we read the abstract