The Blond Pharmacist
Scott Pelley reported in the CBS Evening News (2/10) that according to the Dietary Guidelines Advisory Committee, a government advisory panel, “we don’t have to worry so much after all about cholesterol in our diets.”
Dr. Jon Lapook noted that while “the amount of cholesterol in your blood is still important,” the panel found that “the amount of cholesterol in your food doesn’t necessarily translate to a higher level of cholesterol in your blood.”
While the current recommendations “say people should have less than 300 milligrams of cholesterol in their diet a day,” that number is “likely to change when the recommendations come out later this year.” Linsey Davis noted on ABC World News (2/10, ) that while the panel said that “eating some foods that are high in cholesterol like eggs and seafood may not be so bad after all,” foods like “meats and cheeses, because they contain saturated fats, are still on the list.”
The Washington Post (2/11) reported in its “Wonkblog” blog that this “does not reverse warnings about high levels of ‘bad’ cholesterol in the blood, which have been linked to heart disease,” adding that “some experts warned that people with particular health problems, such as diabetes, should continue to avoid cholesterol-rich diets.”
The blog stated that “a group from the American Heart Association and the American College of Cardiology who looked at the issue in 2013 said there is simply not enough evidence of danger to call for limiting cholesterol in diets.” USA Today (2/11, ) reports that “the committee will send its final recommendations to the Department of Health and Human Services and the U.S. Department of Agriculture, which issue the dietary advice.” HHS and the USDA “are expected to issue Dietary Guidelines for Americans, 2015 later this year.”
The AP (2/11, Jalonick) reports, however, that “it’s unclear if the recommendation will make it into the final guidelines.”
Blogfinger Medical Commentary by Paul Goldfinger, MD, FACC
The cholesterol story began in the 1960’s when it was found that high blood cholesterol levels were associated with heart disease. But we also found out that dietary cholesterol does not increase blood levels of “bad” cholesterol, unlike lab models where heavy intake of cholesterol leads to plaque formation.
When it came to dietary advice, early on in the cholesterol era, most experts favored diets low in saturated fats without stressing cholesterol so much. In our book, in the chapter called “Concepts: Cholesterol Risks and Treatment,” we did not even mention dietary cholesterol. As it turns out, many foods that are high in fats, such as red meats, are also high in cholesterol. But eggs, rich in yolk cholesterol, contain no fats and do not raise blood cholesterol.
What hasn’t changed is the fact that lowering bad blood cholesterol levels does save lives, but restricting dietary cholesterol is not the way to do it.
As time went by, we learned that even severe dietary fat restriction often doesn’t lower bad cholesterol levels enough to produce a clinical benefit, and that has led the prevention community to stress Mediterranean style diets which we discuss in depth in Prevention Does Work: A Guide to a Healthy Heart by Eileen and myself.
If the guidelines change, as described above, I don’t think it will make much of a difference in what people do or doctors advise. Maybe there will be a loosening of restrictions on eggs, lobsters or shrimp, but otherwise, not much change.