the annual Dietary Guidelines Advisory Committee Report stated
that cholesterol was "not a nutrient of concern for
people celebrated, expecting once again to fill their bellies
with unlimited amounts of butter, cheese, sausage and steak.
But several notable doctors and scientists balked — and even
result has been a green light for people to eat unhealthful
foods," said Neal D. Barnard, founding president of the
Physicians Committee for Responsible Medicine, in his March 24
testimony before the advisory committee. "The committee
made a scientific error on cholesterol, and to carry that
mistake into the guidelines is not scientifically defensible
and serves only to perpetuate confusion."
conclusion that eating foods high in cholesterol like eggs
will not affect blood cholesterol levels is flawed science,
several critics have stated. Others raise concern that people
will use that pronouncement as license to eat as much
high-cholesterol foods as they want — all to the detriment
other components in foods containing cholesterol can pose
health risks, including saturated fat, they said.
of the members of the public don’t differentiate between
dietary cholesterol and blood cholesterol or the effects of
dietary cholesterol from the risk of foods that contain
it," Dr. Barnard said in his testimony.
Greger of NutritionFacts.com went a step further, stating that
dietary cholesterol not only raises blood cholesterol but
increases the risk of diabetes, cancers and liver disease,
including nonalcoholic cirrhosis, cancer and hepatitis C.
problem, Dr. Greger testified, is that cholesterol is
"correlated with other disease-promoting components in
the same foods," such as saturated fat. Removing limits
on cholesterol consumption will invite people "to consume
foods that should be minimized in lieu of healthier food
Department of Agriculture updates science-based dietary
guidelines every five years, with new guidelines expected
later this year. The committee wants to overturn the 2010
guidelines recommending fewer than 300 milligrams a day of
dietary cholesterol, with a national average of 340
milligrams. One egg yolk has about 185 mllligrams.
occurs only in animal-based foods, with high concentrations in
eggs, shellfish and organ meats including liver. While those
foods don’t contain high levels of saturated fat, certain
cuts of beef (ribs), lamb and pork (chops), and whole-dairy
products do contain elevated levels of cholesterol and
saturated fat. The draft guidelines say that limiting
saturated fat consumption "would further reduce the
population level risk of cardiovascular disease."
saturated-fat consumption increase once limits on dietary
cholesterol are removed?
H. Eckel, professor at the University of Colorado School of
Medicine and former American Health Association president,
co-authored the 2013 AHA/American College of Cardiology
evidence upon which the committee based its decision to remove
dietary-cholesterol limits. "The evidence we reviewed
indicated that dietary cholesterol independent from the intake
of saturated and trans fats alone caused no appreciable
increase in blood cholesterol levels."
said the committee statement should include an asterisk to
denote the need for definitive studies to decide the matter.
think the public’s completely confused," Dr. Eckel
said. "The right studies need to be done where the entire
diet is prescribed and the only modification is in cholesterol
"a waxy, fat-like substance that’s found in all cells
of the body," is needed to make hormones, vitamin D and
substances that help digest food. The body makes the amount of
cholesterol it needs, the National Institutes of Health
states. Cholesterol, found in animal-based foods but not
plants, travels in the blood with elevated low-density
lipoproteins (LDL) cholesterol levels responsible for the
buildup of plaque in arteries, resulting in cardiovascular and
in the blood courses back to the liver where it is removed and
discarded. But saturated fat in the liver prevent the liver
from removing cholesterol, allowing levels to build in the
blood, the NIH explains.
Kuller, professor emeritus at the University of Pittsburgh
Graduate School of Public Health, said famous research studies
from the 1950s through the 1970s clearly found dietary
cholesterol to raise blood cholesterol. But the advisory
committee, he said, relies only on research done since 1990.
Modern studies survey people about what foods they consumed,
as compared to the earlier studies that provided study
participants with specific diets to measure the impacts of
reason, Dr. Kuller, 81, who’s been studying the topic for
decades, said the committee’s statement "is
intake of dietary cholesterol has been reduced dramatically
(over the decades) primarily by efforts to convince the public
to reduce their intake of dietary cholesterol," Dr.
Kuller stated in a written response to the committee
guidelines. Those population-wide reductions in cholesterol
represent "a major public health advance." But that’s
now at risk if limits on dietary cholesterol are removed. An
increase in the nation’s average cholesterol rate of a mere
10 milligrams "can be interpreted to result in perhaps a
20 percent increase in the risk of coronary heart
dietary cholesterol intake also has been linked to other
health problems, including colon cancer, Dr. Kuller said.
Srinivasan, medical director of the Cardiovascular Institute
at West Penn Hospital, said he accepts the committee statement
that dietary cholesterol doesn’t affect blood levels.
said people should reduce saturated fat in the diet and follow
another guideline recommendation to adopt the Mediterranean
diet, with its emphasis on plant-based foods and oils, and
meat largely limited to fish.
focus should be on a balanced diet, regardless what the
guidelines say," he said.
cholesterol levels, he said, no longer represent the sole
determinate of whether the cholesterol-lowering statin drugs
should be prescribed. Nowadays, risk calculators are used to
gauge the need for statin drugs, based on age, gender, blood
pressure, diabetes and cholesterol levels.
the committee has to be clear about its recommendations.
tell someone they can have cholesterol, they think ‘steak,’"Dr.
Srinivasan said. "When you say cholesterol is not a
concern, the mistake is that they think they can eat fat. The
guideline must make it clear that eating cholesterol doesn’t
give license to eat unlimited amounts of saturated fats."