New Dietary Guidelines, Cholesterol and Your Heart

The upcoming US Dietary Guidelines for Americans (currently under review for release of the 2015 version) are eliminating the guideline to limit dietary cholesterol. Interestingly, most dietitians have never focused on this guideline, so this is not news to us.

Photo courtesy of the Academy of Nutrition and Dietetics

Photo courtesy of the Academy of Nutrition and Dietetics

Often when a person receives a diagnosis of high blood cholesterol, the first thing that comes to mind is something like “I have to watch my cholesterol”. However dietary cholesterol does not have that big of an impact on blood cholesterol. The overall quality of the diet (particularly fiber, and the amount of plant-based foods), as well as total fat, are more important.

The idea that new guidelines are no longer considering dietary cholesterol as a “nutrient of concern” does not mean that your overall diet has no impact on your blood cholesterol and fat levels. The Dietary Guidelines recommendation for daily cholesterol had been 300 milligrams a day (and lower for DASH Diet guidelines). The average man consumes about 340 milligrams. So on that point, the idea of a recommendation may be a moot point – people generally aren’t over-consuming cholesterol in their diets. They never really have.

As these new guidelines continue to form, keep these tips in mind:

  • As I often tell patients, it’s easy to limit dietary cholesterol, but it’s more difficult to limit dietary fat.
  • Dietary cholesterol only comes from animal products.
  • Dietary fat may be delivered by animal or plant based products. Vegetable oils or vegetable-based margarine spreads are “cholesterol-free”, but are sources of fat. Some salad dressings may also be cholesterol-free but a source of fat. Meats can have varying amounts of fat. And of course, many snack foods and fried foods contain various sources and amounts of fat.
  • While there’s some debate about the link between saturated fat and heart disease, many news outlets publish headlines that often exaggerate or misinterpret studies they report on. A heart healthy diet limits the amount of butter, cream, cheese, and fatty meats consumed. You don’t have to avoid these foods, but it’s prudent to limit the portion of them, choose lean meats and fish, and balance out your plate with more vegetables and whole grains.
  • One benefit to the limiting guideline for dietary cholesterol is that this guideline helped encourage the intake of more plants. Adding more vegetables, fruit, and whole grains to your diet ensures that you include adequate fiber (which helps keep blood cholesterol levels healthy) and also adds important antioxidants and other minerals and vitamins to your diet.

Enjoy Some Eggs

Unfortunately, the previous dietary cholesterol limits seemed to target eggs. Over the past 70 years or so egg consumption has gone down, although egg intake has been increasing over the past several years as dietitians and clinicians have relaxed the weekly egg rules. Eggs are a great inexpensive source of protein (the white) and other important nutrients. Eggs are a great addition to your breakfast, or even as a high protein, mid-day snack.

  • Remember that the cholesterol in eggs come from the yolks, so if you do have heart disease, diabetes, or high blood cholesterol, you should probably not go overboard and have a 3-egg omelet every morning. You can create a delicious high protein omelet using 2 whole eggs, and 2 egg whites. Fold in fresh spinach, onions, mushrooms and some shredded cheese for a delicious breakfast or lunch.

Vegetables, Grains, and Beans

CerealADA-Stock-56_LODietary fiber from plant products is an important part of a healthy diet. Sources of fiber, such as fruit and vegetables, provide important nutrients including antioxidant vitamins A and C, as well as B vitamins. Whole grains such as brown rice, wild rice, barley or quinoa also contribute some fiber to the diet. Grains mixed with beans and vegetables can offer up a high fiber, high nutrient, high protein, low fat meal or side dish.

Of course, the DASH Diet incorporates all of these foods with guidelines to ensure your heart stays healthy, and your blood pressure or diabetes is well managed. While cholesterol is not a focus of the DASH Diet, the diet limits portions of meats and therefore cholesterol, and also some fats, while encouraging a high intake of fruits and vegetables, and low fat dairy products.

Bottom Line

While the government’s committee to revise the Dietary Guidelines for Americans may have removed a guideline to limit cholesterol, keep in mind that it’s still a good idea to be aware of the amount of animal fats in your diet. Incorporating the goals of the DASH Diet will help you add more medicinal nutrients and fiber to your diet, and limit the dietary components that aren’t.

 

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