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What Do I Need to Know About My Diet and Cholesterol?
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High cholesterol is a fact of life for roughly one in every eight Americans, according to the Centers for Disease Control and Prevention. But there is a lot of confusion, especially when it comes to the effect dietary cholesterol and fat have on the levels of cholesterol in your blood.
Dietary guidelines issued by the Department of Health & Human Services and the Department of Agriculture used to recommend limiting daily consumption of dietary cholesterol to 300 milligrams (mg). The most recent 2015-2020 guidelines dropped that recommendation, concluding that cholesterol “is not a nutrient of concern for overconsumption” for most people.
To be clear, this does not mean that a high-cholesterol diet is good for you. The guidelines clearly state that individuals should consume “as little dietary cholesterol as possible.”
Our bodies use cholesterol to produce hormones, vitamin D, and bile acids, which aid digestion. But the body — specifically the liver — produces more than enough cholesterol on its own for these purposes. There’s no nutritional need for dietary cholesterol, which is found in animal but not plant foods.
The reason the cholesterol limit was removed from the dietary guidelines is that only a relatively small percentage of cholesterol in the blood is related to diet. “An overwhelming amount of research has shown that the cholesterol we eat doesn't significantly affect blood levels of cholesterol,” says Nicci Brown, RDN, a Chicago-based nutritionist.
Dietary cholesterol should not be ignored, however — especially if you already have high cholesterol. “People with high cholesterol levels may see their numbers decrease by avoiding cholesterol in their diets, but likely by only 10 to 20 percent,” says Pedro Cazabon, MD, section head of general internal medicine at Ochsner Health System in New Orleans.
As Dr. Cazabon points out, “decreasing dietary cholesterol can also result in increased liver production of cholesterol, so it may not be effective in keeping blood cholesterol levels down.”
“It turns out the liver does a really good job of regulating the balance between the cholesterol the body makes and the cholesterol we eat,” says Brown. “If we eat more cholesterol, the liver will produce less cholesterol, and vice versa.”
When it comes to diet and blood cholesterol, it's important to remember that foods high in cholesterol, like fatty meats and dairy, tend to also be higher in saturated fats. There are a few exceptions: Egg yolks, for instance, are higher in cholesterol but not saturated fat.
Consuming saturated fats raises levels of low-density lipoprotein (LDL) cholesterol. LDL is referred to as “bad” cholesterol because high levels lead to the formation of plaque that clogs arteries, raising the risk for heart attack and stroke.
Even foods containing healthy fats — like olive oil, nuts, and fish — contain some saturated fat. The key is to monitor how much saturated fat you are consuming. The Food and Drug Administration guidelines recommend that intake of saturated fats should be less than 10 percent of the calories you consume daily.
Another dietary culprit is trans fat, or trans-fatty acids, found in many processed foods. Trans fat not only raises levels of LDL cholesterol, but it also lowers levels of high-density lipoprotein (HDL) cholesterol. HDL is “good” because it helps carry LDL cholesterol to the liver, which breaks it down and removes it from your body.
On the other hand, consuming certain fats can actually be good for your blood cholesterol. Polyunsaturated and monounsaturated fats help reduce LDL levels. They're found in plant-based oils like olive, canola, and peanut oil, as well as in nuts, seeds, and fatty fish.
The government’s guidelines emphasize “optimizing” the types of fat you consume rather than total fat reduction. This is consistent with one of the keys to the Mediterranean diet’s success: Eating fat is not necessarily a bad thing — as long as it's the right kind of fat.
The bottom line, Cazabon says, is to “limit overall fat intake rather than cholesterol-specific foods.” Whether you have high cholesterol or not, pay attention to food labels listing information about different types of fats.
Do you have a health-related question for Dr. Gupta? You can submit it here. For more health news and advice, visit Health Matters With Dr. Sanjay Gupta.
PHOTO CREDIT: Shutterstock
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