U.S. Advisers Rethink Cholesterol Risk From Foods: Report

Trans fats are a bigger threat to heart health, doctors and dietitians say

Tuesday, February 10, 2015

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TUESDAY, Feb. 10, 2015 (HealthDay News) -- Decades-old advice to Americans against eating foods high in cholesterol likely will not appear in the next update of the nation's Dietary Guidelines, according to published reports.

The U.S. Department of Agriculture panel assigned the task of revamping the guidelines every five years has indicated that it will bow to new research that has undermined the role that dietary cholesterol plays in a person's heart health, the Washington Post reported Tuesday.

The Dietary Guidelines Advisory Committee plans to no longer warn people to avoid eggs, shellfish and other cholesterol-laden foods, the newspaper reported.

One of America's top cardiologists endorsed the move.

"It's the right decision," Dr. Steven Nissen, chairman of cardiovascular medicine at the Cleveland Clinic, told USA Today. For years, "we got the dietary guidelines wrong. They've been wrong for decades."

Nissen said recent research has found that diet influences only about 20 percent of a person's blood cholesterol levels. The rest is governed by genetics.

However, dietitians and other heart doctors noted that saturated fat plays a direct and more important role in blood cholesterol levels than dietary cholesterol -- or cholesterol consumed through foods. And they expect the forthcoming federal guidelines to maintain their strict stance on limiting such fats.

"I have long recommended to my clients that the type of fat they eat is a much bigger issue to their blood cholesterol level than the amount of cholesterol they consume," said registered dietitian Connie Diekman, director of university nutrition at Washington University in St. Louis.

That means that, while a person might be able to eat more eggs, shrimp and lobster under the new guidelines, they would still need to limit foods heavy in saturated fat like prime rib, bacon, cheese and butter, she said.

"The challenge for the Dietary Guidelines has been the fact that they need to relate to all Americans and they need to convey a broad message," Diekman said. "The potential elimination of a cholesterol recommendation isn't a concern in terms of health but is a concern in that many will view this as, 'Good, I can eat what I want.' "

The federal panel discussed its cholesterol decision in December, the Post reported. The group's final report is due within weeks.

High levels of "bad" LDL cholesterol in a person's blood have long been linked to the formation of arterial plaques that can impede the flow of blood and contribute to heart attacks or strokes, according to the American Heart Association (AHA).

But many nutritionists and heart doctors now believe that for a healthy adult, cholesterol consumed at mealtimes does not significantly affect blood cholesterol and, thus, the risk of heart disease.

Instead, they have focused on the body's natural ability to produce cholesterol. This type of cholesterol is used for a wide variety of purposes -- to create hormones, to produce bile acids, to make vitamin D and to maintain healthy cell membranes.

Some people seem genetically predisposed to create unhealthy levels of this cholesterol in their bodies, experts say. But as many as one in four people still may be more vulnerable to diets high in cholesterol, and these people will need to continue watching what they eat, the experts said.

However, this does not mean that people can start eating foods high in saturated fat, which are a major source of "bad" LDL cholesterol, warned Dr. Robert Eckel, chair of atherosclerosis for the University of Colorado Anschutz Medical Campus and a spokesman for the AHA.

"Saturated fat is still bad for your blood cholesterol," as are trans fats, he said.

Eckel noted that the AHA itself has remained ambivalent regarding dietary cholesterol intake, neither condemning nor approving it.

"It just means the types of studies and the inadequacies of the data makes us uncomfortable," he said, arguing that there needs to be new, well-designed studies that compare dietary cholesterol intake against diets heavy in saturated fats.

The Dietary Guidelines Advisory Committee's proposed cholesterol recommendations run counter to dietary directives promoted for decades by a wide range of federal health agencies, including the National Institutes of Health and the Centers for Disease Control and Prevention.

In fact, the panel now poised to shrug off dietary cholesterol had deemed it a public health concern just five years ago, when the panel last convened.

The last federal Dietary Guidelines, produced in 2010, advised Americans to limit their cholesterol intake to less than 300 milligrams a day -- about the amount in one egg.

Members of the Dietary Guidelines Advisory Committee told the Post said they wouldn't comment until the publication of their report later this year.

The Dietary Guidelines serve a major role in American life. They influence meals served at schools, affect the decisions made by food manufacturers, and guide consumer decisions at the supermarket.

SOURCES: Connie Diekman, M.Ed., RD, CSSD, LD, FADA, registered dietitian and Director of University Nutrition at Washington University, St. Louis; Robert Eckel, M.D., chair of atherosclerosis for the University of Colorado Anschutz Medical Campus and a spokesman for the American Heart Association;Washington Post; USA Today

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