Nutrition-wise blog

Cholesterol — the controversy continues

By Katherine Zeratsky, R.D., L.D. February 20, 2015

The headlines are saying cholesterol may not be a "nutrient of concern." To understand what that means, you have to look beyond the headlines.

What the 2015 Dietary Guidelines for Americans Committee meeting minutes actually say is that "cholesterol is not a nutrient of concern for overconsumption." Separating it from saturated fat, sodium and added sugar — the nutrients that Americans do consume in amounts that are worrying.

What's changed? Some experts are saying that dietary cholesterol was mistakenly connected to heart disease. There was a rise in coronary artery disease leading up to the 1977 recommendation to reduce cholesterol intake. However, a closer look at the science reveals that there is more evidence to suggest that dietary cholesterol may not play a significant role for most healthy Americans and their risk of heart disease.

In addition, it appears that Americans are eating less cholesterol, approximately 80-100 mg less a day compared with the 1970s. This data comes from the National Health and Nutrition Examination Survey (NHANES), a series of studies that began in the 1960s to assess health and nutritional status in the U.S.

That perhaps provides more support for the argument that dietary cholesterol intake is not connected to blood (serum) cholesterol levels. But the reality is that heart disease is still a major health concern. Many people take medications to reduce their serum cholesterol levels.

Let's review what we know about cholesterol:

  • Cholesterol is an essential part of every cell in the body
  • Dietary cholesterol is the cholesterol we eat. It's found in foods of animal origin, such as meat, eggs, fish and dairy products.
  • Cholesterol is also produced by the body (in the liver). It's thought that a diet high in saturated fat signals the liver to make more cholesterol.
  • High serum levels of low-density lipoprotein (LDL) and very-low-density lipoprotein (VLDL) cholesterol are associated with increased risk of cardiovascular disease, whereas a high level of high-density lipoprotein (HDL) cholesterol is thought to be protective.

What does this mean for you? You should talk with your health care provider about your heart health. This conversation should include your serum cholesterol levels, your personal and family history of cardiovascular disease, and your weight and lifestyle habits, including your diet.

Your diet does matter. You can enjoy eggs, lean meats, shellfish and dairy products. However, it's still important to balance these foods with high-fiber, lower-calories foods like fruits and vegetables, which also help lower serum cholesterol levels. Whole grains and healthy fats, like nuts and seeds, should find their way to your plate as well.

Feb. 20, 2015