By Stephen T. Sinatra, M.D., F.A.C.C., F.A.C.N., C.N.S., C.B.T.
Not guilty…and it’s about time. That’s my take on the 2015 finding of the influential U.S. Dietary Guidelines Advisory Committee that cholesterol in food is “not a nutrient of concern for overconsumption.” Until now, the “official” position on cholesterol consumption has been to keep it below 300 milligrams a day because of the fear of contributing to so-called high cholesterol in the blood and therefore to heart disease. For perspective, one egg yolk contains 200 milligrams.
As a result people have avoided healthy animal foods like whole eggs, butter, dairy, meat, and seafood, all of which contain cholesterol. And, for decades, the “no cholesterol” claim on labels has dominated food packaging and marketing, and strongly influenced consumer food purchases.
Limit on Dietary Cholesterol Put to Rest
All that’s likely to change with the far-reaching decision of the expert panel that meets every five years and provides the scientific basis for official and medical establishment nutritional guidelines.
Precisely, the committee has now said that the previous limitation on dietary cholesterol for Americans will not be brought forward “because available evidence shows no appreciable relationship between consumption of dietary cholesterol and serum cholesterol.”
In other words, eating foods with cholesterol doesn’t significantly affect the cholesterol level in your blood.
I loudly applaud this overdue finding. It should help defuse the pervasive and nonsensical fear of cholesterol – a big piece of the cholesterol bugaboo has collapsed.
It means that now you can be freer in your food choices and not be fearful of foods containing cholesterol.
Up until now there has been widespread fear that the cholesterol you eat contributes to a so-called elevated blood cholesterol level, which in turn has long been feared as something akin to the mother of all heart disease causes.
The cholesterol conspiracy has stuck all these years. That’s because it’s hard to beat a good myth, and the fear that comes with it, especially when promoted by the mega food and pharmaceutical industries that reap high profit from selling low, as in low-fat and low-cholesterol foods and cholesterol-lowering drugs.
As I have been saying for years, that’s pure hooey. Inflammation is the cause of heart disease, and has been recognized as such for well over a decade.
For years I’ve badgered patients and readers of my newsletters and website articles to stop obsessing about cholesterol. Cholesterol only plays a supporting role in the process, and is far from being the perpetrator; it’s not the big bad monster, the instigator of heart disease, it has been made out to be. It is, in fact, an utterly essential fatty substance produced by your body in order to make cell membranes, neurotransmitters, vital hormones, and digestive acids called bile.
Never forget this: your body needs it; life can’t go on without cholesterol.
Cholesterol is found in all food from animal sources, including meat, fowl, fish, seafood, dairy, and eggs. It is not present in plant food. If you eat more animal food sources, your body makes less cholesterol. If you eat less cholesterol, your body will simply take up the slack and make more.
Back years ago, the classic Framingham Heart Study found virtually “no difference” in the amount of cholesterol consumed on a daily basis by those who went on to develop cardiovascular disease and those who did not.
That message, however, was effectively drowned out by the louder voice of the “cholesterol industry.”
I recall attending a hospital buffet luncheon years ago where beautiful shrimp were being served. I put some in my plate. A fellow cardiologist, in line next to me, questioned my choice.
“You can’t eat the shrimp,” he said.
“Why not?” I said.
“Because it has cholesterol,” he said.
Well, I don’t believe in the cholesterol theory of heart disease and I told him so. We were both cardiologists, however he believed one thing, and I believed another.
I also recall a meeting with a lawyer and businessman over breakfast in 2012. I ordered two poached eggs. The two ordered egg white omelets because of fear of cholesterol. I tried to explain the importance of cholesterol to them, but in vain. They had just heard a widely-publicized study in which a group of Canadian researchers claimed that lifelong egg yolk consumption leads to the development of carotid artery plaque and may be almost as bad as smoking.
The reported conclusion was that regular consumption of eggs was about two-thirds as harmful to the carotid arteries as smoking! You were supposedly at risk for slightly more carotid degradation if you ate three yolks vs. two in a week.
That’s the kind of nonsense that has gone on for years and has stopped a lot of people from eating a whole food as basic as the egg. Hopefully, this nonsense will stop now.
Shopping for a Heart-Healthy Diet
As far as your food purchases are concerned, ignore the “no cholesterol” labels on foods. What’s much, much more important is to eat a varied anti-inflammatory diet for optimum health.
Such a diet accommodates animal protein, including whole eggs. My preference is organic and free-range as much as possible. As for meat, I enjoy occasional grass-fed bison. Seafood, fish, and dairy, they are all fine.
What about saturated fat, you may be thinking? Do new guidelines say anything about the saturated fat found in animal food products?
Answer: the 2015 advisory panel says that saturated fat remains a nutrient of concern.
In 2013, nutritionist Jonny Bowden and I wrote The Great Cholesterol Myth, a book that became a bestseller. I suggest you give it a read if you have any concerns about cholesterol and saturated fat. In it, we explained how the public, everyday doctors in practice, and public health officials have been bamboozled with highly manipulated and skewed research about cholesterol and saturated fat. A follow-up book, The Great Cholesterol Myth Cookbook, provides practical guidelines for food purchases and cooking.
Here’s My Bottom Line
After nearly forty years of clinical practice in cardiology, and carefully following the research about all things related to cholesterol and fat: neither cholesterol nor saturated fat are your enemies. Your big enemies are excess sugar and carbohydrates, as well as stress. They are the perpetrators of weight gain and inflammation that lead to metabolic derangement, diabetes, and cardiovascular disease.
As far as saturated fat is concerned, skewed research years ago transformed it into some kind of a food Frankenstein to be avoided at all cost. Such research has been widely questioned and refuted. Saturated fat, in moderation, is in fact, quite healthy for cardiac health and the rest of you.
I expect the next time the advisory panel meets, in 2020, the members will change their tune on saturated fat as well. The rumblings of change are already in the wind, as indicated by the 2014 findings of an international group of researchers. The findings: no evidence that saturated fat consumption increases the risk of cardiovascular events like heart attacks. Additionally, researchers who published a 2015 study in the Journal of Nutrition reported no risk associated with saturated fat and additional heart disease problems, even among patients who already have documented coronary artery disease.
The new panel guidelines, unfortunately, still stick to the “official” view about the “danger” of high levels of so-called “bad” cholesterol in the body.
High cholesterol, bad cholesterol, what do these things really mean? Do they represent a danger to you? Please refer to my book and the links below for the clear answers. You will find that most of your fears about cholesterol are without merit as well.
- Scientific Report of the 2015 Dietary Guidelines Advisory Committee. Published online at http://www.health.gov/dietaryguidelines/2015-scientific-report/
- Puaschitz NG, et al. Dietary Intake of Saturated Fat Is Not Associated with Risk of Coronary Events or Mortality in Patients with Established Coronary Artery Disease. J. Nutr, 2015. Published online at http://jn.nutrition.org/content/early/2014/12/10/jn.114.203505.abstract?papetoc#aff-1
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