For decades, we have been advised to limit our cholesterol intake and stay away from foods with a high cholesterol content like eggs, shrimp and lobster. In February, however, the Dietary Guidelines Advisory Committee (DGAC) rocked the nutrition and medical worlds by changing their tune.
In its report, the committee states: “Previously, the Dietary Guidelines for Americans recommended that cholesterol intake be limited to no more than 300 mg/day. The 2015 DGAC will not bring forward this recommendation because available evidence shows no appreciable relationship between consumption of dietary cholesterol and serum (blood) cholesterol. … Cholesterol is not a nutrient of concern for overconsumption.”
The committee doesn’t make that claim lightly.
Every five years since 1985, the Department of Health and Human Services and the Department of Agriculture together publish dietary guidelines for Americans. The DGAC is composed of 15 experts appointed from the fields of nutrition, public health and medicine. These dietary guidelines affect everything from the composition of lunches served at schools across the country to how doctors talk to their patients about nutrition.
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So why can cholesterol in our food suddenly be deemed benign?
According to Ann Marie Navar-Boggan, M.D, Ph.D., a cardiology fellow at Duke University Medical Center: “Foods high in dietary cholesterol have not been shown to lead to higher levels of serum cholesterol in the general population. There’s a lot of research that shows a poor correlation between how much cholesterol we eat and the cholesterol levels in our blood.” Indeed, about 85 percent of the cholesterol in your blood comes from what is produced in your liver and only 15 percent from the food you eat.
However, that doesn’t mean we can all play fast and loose with cholesterol. Navar-Boggan says that the new guideline is designed for the general population and certain adults with abnormally high cholesterol levels may need to continue to limit cholesterol intake. Some individuals are diagnosed with familial hyperlipidemia, or abnormally elevated cholesterol in the blood, a disorder that is inherited and caused by a genetic abnormality that makes the liver incapable of removing excess cholesterol. People with this condition often need medication to keep cholesterol levels within normal ranges.
Other individuals do not have a genetic disorder, but may have high, hard-to-control cholesterol. But in the absence of these conditions, Navar-Boggan says that most adults can feel good about eating shrimp for dinner and an egg for breakfast because dietary cholesterol has so little effect on blood cholesterol.
So what’s the best treatment for high cholesterol? The first step is regular exercise of moderate intensity, such as brisk walking, for 30-40 minutes a day, at least three days per week. A healthy diet is also important, and it may surprise you to know that cutting back on sugar may be more important to your heart health than how much cholesterol you are eating. The DGAC report states that Americans eat an excessive amount of sugar in processed foods, and sugar intake should be less than 10 percent of the overall nutrients in your daily diet.
Susan DeLaney, N.D., a naturopathic physician in Chapel Hill, takes it one step further when making dietary recommendations for those with elevated cholesterol. She advises clients to eliminate sugar altogether. Why? Sugar is quickly turned to fat in the body, and fructose, found in high fructose corn syrup, is converted to fat more quickly than any other type of sugar. Research has also shown a positive relationship between sugar and both obesity and heart disease.
The American dietary trend toward reducing fats, which enhance flavor, has resulted in a food supply that is heavy on added sugar. It is important to read labels, particularly on foods like sauces and condiments where you might not expect to find sugar.
And perhaps it’s time to reevaluate eggs – they may be an egg-cellent choice after all!
If you have questions concerning your diet or cholesterol levels, please talk to your doctor and/or a nutritionist. For more information on the new dietary guidelines, visit health.gov/dietaryguidelines/2015.asp.
Holly Hough, Ph.D., works with the Clergy Health Initiative at the Duke Divinity School. You can contact and follow her at facebook.com/drhollyhough.