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Experts acknowledge dietary cholesterol has little impact on blood cholesterol


Scientific evidence shows no appreciable relationship between dietary cholesterol and blood cholesterol levels. Further, cholesterol is not a nutrient of concern for overconsumption.

These were the conclusions of the Scientific Report of the 2015 Dietary Guidelines for Americans Advisory Committee in the United States that recently made headlines throughout North America.1

Health Canada has long recognized that dietary cholesterol has little impact on blood cholesterol in the general population. Now, as was first announced by the Washington Post February 10 this year, it appears that the U.S. government may be poised to withdraw longstanding warnings about cholesterol.

For decades the U.S. Dietary Guidelines for Americans has recommended that Americans limit their dietary cholesterol intakes to no more than 300 mg per day. Advice to limit dietary cholesterol was first introduced by the American Heart Association about 50 years ago, leading to much confusion about cholesterol.

The reality is that scientific research shows the dietary cholesterol found in foods like eggs has relatively little impact on blood cholesterol.  Most of the cholesterol circulating in our blood is made by our liver.

This is consistent with decades of evidence showing no significant relationship between egg intake and heart disease, with many studies concluding that healthy adults can enjoy eggs without increasing their risk of heart disease.2-7

In response to current research, in 2013 the American Heart Association dropped their advice to limit dietary cholesterol, acknowledging the lack of evidence linking dietary cholesterol and heart health. Their latest diet and lifestyle guidelines for the prevention and management of cardiovascular disease no longer recommend a limit for dietary cholesterol.8

Also citing a lack of evidence, the Advisory Committee for the 2015 Dietary Guidelines for Americans stated they will not bring forward the longstanding recommendation to limit dietary cholesterol. These recommendations will be taken into consideration by the U.S. departments of Health and Human Services (HHS) and Agriculture (USDA) as they develop the 2015 edition of the Dietary Guidelines for Americans.

Research showing that eggs can be part of a heart healthy diet, makes sense since most of the fat found in eggs is unsaturated. In fact, eggs contain more monounsaturated fat (the type of fat found in olive oil) than saturated fat. And they have no trans fat.

In addition, eggs provide a wide array of nutrients that may actually help to protect heart health. These include antioxidants like the vitamins A, D and E and lutein, as well as B vitamins like folate, B6 and B12.

Plus, eggs are an excellent source of high quality protein, with only 70 calories in a large egg.

There is growing recognition that decades of advice to limit dietary cholesterol really missed the mark.  The U.S. advisory committee’s acknowledgement that dietary cholesterol is not a nutrient of concern for overconsumption is a good step forward. Now, what we need more than ever is dietary guidance that steers people back to eating wholesome foods that are naturally nutritious.

As a natural source of 14 essential nutrients, eggs simply make sense as part of a healthy diet.

Valerie Johnson is a Registered Dietitian and nutrition writer driven by a passion for inspiring people to eat well. She is a member of the College of Dietitians of Ontario, Canadian Nutrition Society and Dietitians of Canada. 

References:

¹ USDA. Scientific Report of the 2015 Dietary Guidelines Advisory Committee.
² Rong Y et al. Egg consumption and risk of coronary heart disease and stroke: dose-response meta-analysis of prospective cohort studies. BMJ 2013; 346 (e-pub).
³ Scrafford CG et al. Egg consumption and CHD and stroke mortality: a prospective study of US adults. Public Health Nutrition 2011, 14(2):261-70.Qureshi AI et al. Regular egg consumption does not increase the risk of stroke and cardiovascular disease. Med Sci Monit 2007; 13:CR1-8.
⁴ Hu F et al. A Prospective Study of Egg Consumption and Risk of Cardiovascular Disease in Men and Women. J Am Med Assoc 1999; 281:1387-94.
⁵ Dawber TR et al. Eggs, serum cholesterol, and coronary heart disease. Am J Clin Nutr 1982; 36:617-25.
⁶ Barraj L et al. A comparison of egg consumption with other modifiable coronary heart disease lifestyle risk factors: a relative risk apportionment study. Risk Anal 2009; 29(3):401-15.
⁷ Jones PJ. Dietary cholesterol and the risk of cardiovascular disease in patients: a review of the Harvard Egg Study and other data. Int J Clin Pract Suppl 2009; 163:1-8, 28-36. 8. AHA/ACC. 2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk.