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Dec 27, 2019

Cholesterol Experts Recommend Focusing on a Healthy Overall Diet

Experts recommend choosing healthy foods, rather than cutting cholesterol from our diet, to promote heart health.

When it comes to heart health, we should focus on overall diet, not cholesterol intake, says a science advisory from the American Heart Association that addressed the role of dietary cholesterol and cardiovascular risk. The advisory was published in Circulation and concludes that a healthy dietary pattern—which is naturally low in cholesterol—should be the focus of efforts to promote better health.

Cholesterol is a waxy, fat-like substance found in the blood. In high levels, it can build up in the blood vessels and cause heart disease and life-threatening heart events. High cholesterol affects an estimated 29 million Americans and more than half of adults could benefit from treatment, according to the Centers for Disease Control and Prevention.

In the past, guidelines recommended limiting cholesterol intake from foods to keep cholesterol levels in check. However, research shows that cholesterol intake may not have as big of an impact on our heart risk as initially believed. Experts have decided to take a different approach.

In 2013, dietary guidelines from the American Heart Association and American College of Cardiology did not include a recommendation for dietary cholesterol, stating that there is not enough evidence to say whether lowering cholesterol intake reduces bad (low-density lipoprotein or LDL) cholesterol. Similarly, 2015 U.S. dietary guidelines also left out cholesterol recommendations, stating that dietary cholesterol is “not a nutrient of concern for overconsumption.”

As authors note, previous dietary guidelines recommended limiting cholesterol intake to no more than 300 mg a day. However, national data suggests that the average cholesterol intake is 293 mg a day among American adults, which is well within the previously recommended range.

In addition, limiting dietary cholesterol may not be the key to controlling cholesterol levels anyway. Authors note that eggs make up 25% of dietary cholesterol in the United States, but there’s little data suggesting that regular consumption of eggs has a negative effect on heart health. There is also little evidence that cutting eggs out of a diet would effectively lower cholesterol levels and risk for heart disease.

As a result, eating healthy foods—rather than cutting out foods high in cholesterol—should be the focus of public health efforts, experts state. Guidelines recommend a diet full of fruits, vegetables, and whole grains that includes low-fat dairy products, lean protein, nuts and seeds. These foods are naturally low in cholesterol and also promote a healthy weight, blood pressure and overall health.

Over time, experts believe that maintaining a healthy eating pattern will have the biggest impact on cholesterol levels and risk for heart disease—the leading killer of men and women in the United States.

Questions for You to Consider

  • What is a heart-healthy diet?

  • A heart-healthy diet is full of fruits, vegetables, beans and whole grains and includes low-fat dairy, fish and nuts as part of a balanced diet. It’s important to limit intake of added sugars, salt (sodium) and bad fats (saturated and trans fats).

  • What are the risks associated with high cholesterol?
  • High cholesterol can cause atherosclerosis, the build-up of plaque on artery walls. This accumulation of deposits can cause serious complications, such as chest painheart attack and stroke. High cholesterol is largely preventable and treatable, so getting screened and making healthy lifestyle choices can go a long way in controlling cholesterol levels.

Infographic: Cholesterol

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