The nation’s top nutrition advisory panel has decided to drop its caution about eating cholesterol-laden food, a move that could undo almost 40 years of government warnings about its consumption.
The group’s finding that cholesterol in the diet need no longer be considered a “nutrient of concern” stands in contrast to the committee’s findings five years ago, the last time it convened. During those proceedings, as in previous years, the panel deemed the issue of “excess dietary cholesterol” a public health concern. The most current finding was discussed at the group’s last meeting.
The new view on cholesterol in the diet does not reverse warnings about high levels of “bad” cholesterol in the blood, which have been linked to heart disease. Moreover, some experts warned that people with particular health problems, such as diabetes, should continue to avoid cholesterol-rich diets.
But the finding, which may offer a measure of relief to breakfast diners who prefer eggs, follows an evolution of thinking among many nutritionists who now believe that for a healthy adult, cholesterol intake may not significantly impact the level of cholesterol in the blood or increase the risk of heart disease. The greater danger, according to this line of thought, lies in foods heavy with trans fats and saturated fats.
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The panel laid out the cholesterol decision in December, at its last meeting before it writes a report that will serve as the basis for the next version of the Dietary Guidelines, a federal publication that has broad effects on the American diet.
Members of the panel, called the Dietary Guidelines Advisory Committee, said they would not comment until the publication of their report.
The Dietary Guidelines, which are due later this year from the Department of Health and Human Services and the Department of Agriculture, help determine the content of school lunches, impacts how food manufacturers advertise their wares, and often serve as the foundation for reams of diet advice. Some foods that are high in cholesterol — such as liver, lobster and shrimp — may find more takers.
Walter Willett, chairman of the nutrition department at the Harvard School of Public Health, called the turnaround on cholesterol a “reasonable move.”
“There’s been a shift of thinking,” he said.
But the change on dietary cholesterol also shows how the complexity of nutrition science and the lack of definitive research can contribute to confusion for Americans who, while seeking guidance on what to eat, often find themselves afloat in conflicting advice.
Cholesterol has been a fixture in dietary warnings in the U.S. at least since 1961, when it appeared in guidelines developed by the American Heart Association. Later adopted by the federal government, such warnings helped shift eating habits — per capita egg consumption dropped about 30 percent — and harmed egg farmers.
Yet even today, scientists are divided.
Some nutritionists said lifting the cholesterol warning is long overdue, noting that the United States is out of step with other countries, where diet guidelines do not single out cholesterol. Others support maintaining a warning.
The forthcoming version of the Dietary Guidelines is expected to navigate myriad similar controversies. Among them: salt, red meat, sugar, saturated fats and the latest darling of food-makers, Omega-3s. As with cholesterol, the dietary panel’s advice on these issues will be used by the federal bureaucrats to draft the new guidelines.
The publication offers Americans clear instructions — and sometimes down-to-the-milligram prescriptions. But such precision can mask sometimes-tumultuous debates that surround these issues.
Even as contrary evidence has emerged, the campaign against dietary cholesterol has continued. In 1994, food-makers were required to report cholesterol values on the nutrition label. In 2010, with the publication of the most recent Dietary Guidelines, the experts again focused on the problem of “excess dietary cholesterol.”
Yet many have viewed the evidence against cholesterol as weak, at best. As late as 2013, a task force arranged by the American College of Cardiology and the American Heart Association looked at the dietary cholesterol studies. The group found that there was “insufficient evidence” to make a recommendation. Many of the studies that had been done, the task force said, were too broad to single out cholesterol.
“Looking back at the literature, we just couldn’t see the kind of science that would support dietary restrictions,” said Robert Eckel, the co-chairman of the task force and a medical professor at the University of Colorado.
The current U.S. guidelines call for restricting cholesterol intake to 300 milligrams daily. American adult men on average ingest about 340 milligrams of cholesterol a day, according to federal figures. That recommended figure, Eckel said, is “ just one of those things that gets carried forward and carried forward even though the evidence is minimal.”
Other major studies have indicated that eating an egg a day does not raise a healthy person’s risk of heart disease, though diabetic patients may be at more risk.
The persistence of the cholesterol fear may arise, in part, from the plausibility of its danger.
As far back as the 19th century, scientists recognized that the plaque that clogged arteries consisted, in part, of cholesterol, according to historians.
It would have seemed logical, then, that a diet that is high in cholesterol would clog arteries.
What early scientists may not have foreseen is how complicated the science of cholesterol and heart disease could be: that the body creates cholesterol in amounts much larger than diet provides; that the body regulates how much is in the blood; and that there is both “good” and “bad” cholesterol.
Adding to the complexity, the way people process cholesterol differs. Scientists say some people — about 25 percent — appear to be more vulnerable to cholesterol-rich diets.
“These reversals in the field do make us wonder and scratch our heads,” said David Allison, a public health professor at the University of Alabama-Birmingham. “But in science, change is normal and expected.”
What is changing?
The nation’s top nutrition advisory panel, which shapes the Dietary Guidelines, decided that consuming cholesterol-laden foods does not rise to the level of a public health concern. The panel is dealing with diet and consuming cholesterol; it is not downgrading the dangers of high levels of cholesterol in the blood.
Rather than cholesterol, many scientists now see the danger in foods that are laden with saturated fats, such as cheese, pizza and burgers, as well as trans fats.
It’s OK to eat more eggs?
In general, for healthy adults, nutritionists increasingly say that an egg a day is fine.
These scientists say that eating cholesterol-laden foods doesn’t necessarily lead to higher levels of cholesterol in the blood. In fact, most of the cholesterol in your blood comes not from what you eat but from what your liver produces.
Where does cholesterol come from in American diets?
Eggs, liver, shrimp and lobster are among the foods with the highest cholesterol content. But federal figures show that Americans actually get a lot of their cholesterol intake from foods such as beef, burgers and cheese simply because they eat a lot more of those items.