Cholesterol
is a waxy substance produced by the body which uses it to create hormones,
produce bile acids for digestion, make vitamin D and maintain healthy cell
walls. In the diet, it is found in fish, chicken, meat, eggs, and dairy
foods. Advice to limit dietary
cholesterol dates back 50 years but over the last 10 years recommendations have
been gradually changing and now neither the Dietary Guidelines for Americans
nor the American Heart Association set limitations on cholesterol intake. It is still thought that a small percentage
of persons with genes that predispose them to increased blood cholesterol will
see blood cholesterol levels significantly increased by dietary intake. However, a recent study that included a large
percentage of carriers of a gene called apolipoprotein E type 4 (Apoe4) which
significantly impacts cholesterol metabolism and puts carriers at higher risk
for heart disease, found that even in this group heart health appeared
unrelated to dietary cholesterol intake.
In
this study researchers tracked for 21-years the dietary habits and heart health
of 1,032 middle-aged Finnish men, one-third of which had the Apoe4 gene. All were heart healthy at the study's start
but by the end of the tracking period over 20% had experienced at least one
heart attack. Participants averaged
about 400mg of daily cholesterol intake with an average intake of one egg per
day. Among the study sample as a whole as
well as among Apoe E carries, the results revealed no association between egg
intake or overall cholesterol intake and heart attack. They also found no association between cholesterol
intake and carotid artery thickness, a marker of ischaemic heart disease and
stroke risk.
One
of the reasons that cholesterol intake had been thought to be linked to heart
disease is that many foods that are rich in cholesterol are also rich in
unhealthy saturated fats and intake of saturated fats does significantly impact
blood cholesterol and heart health. For
example, fatty meats, chicken skin, and creamy dairy are all high in both. But, some foods such as egg yolks, shellfish,
and liver are low in saturated fat but high in cholesterol. Moderate intake of these foods does not appear
to damage heart health in most individuals.
Still, researchers caution it is still unknown whether very high intake
of cholesterol such as an average of three eggs daily negatively impacts heart
health. There is also some data suggesting diabetics may be vulnerable to
negative cardiovascular effects of high dietary cholesterol intake.
What to do: When making changes to your diet, always
discuss what is right for you with your care provider, but the research appears
to indicate that for most individuals intake averaging about 1 egg per day is healthy. Eggs are nutritional powerhouses -- good
sources of protein, essential fats, iron, B vitamins, vitamin D, and
anti-oxidants lutein, zeaxanthin. To
control blood cholesterol, recommendations to limit saturated (the fats found
in meat, chicken skin, and dairy) and completely avoid trans fats (artificial
fats used to manufacture baked goods, frosting, and spreads) are still in
place. Also, high intake of sugar and refined flours is emerging as
another important driver of heart disease risk.
So, to control blood cholesterol avoid trans fats and limit saturated
fats, sugar, and refined carbohydrates.
Instead, eat a healthy diet rich in plant-derived fats (i.e. olive oil,
nuts, avocado), fruits and vegetables, whole grains, and lean proteins.
Emphasize foods high in soluble fiber such as beans, oats, barley,
and gummier fruits and vegetables including avocado, okra, plums, apples,
oranges, green beans, and carrots. Control your weight, exercise
regularly, and take cholesterol lowering medicine as prescribed by your
provider.
Sources:
Berger
S, Raman G, Vishwanathan R et al. Dietary cholesterol and cardiovascular
disease: A systematic review and meta-analysis.
American Journal of Clinical Nutrition.
2015; 102: 276-294. First published online June 24, 2015. DOI:10.3945/ajcn.114.100305
Eckel,
RH. Eggs and beyond: is dietary
cholesterol no longer important? American
Journal of Clinical Nutrition. 2015; 102: 2 235-236; First
published online July 15, 2015. DOI:10.3945/ajcn.115.116905
Virtanen J, Mursu J, Virtanen H, et al. Associations
of egg and cholesterol intakes with carotid intima-media thickness and risk of
incident coronary artery disease according to apolipoprotein E phenotype in
men: The Kuopio Ischaemic Heart Disease Risk Factor Study. American Journal of Clinical Nutrition, 2016. DOI:10.3945/ajcn.115.122317
Adapted from
articles available at:
http://www.medicaldaily.com/cholesterol-eggs-heart-health-374040
https://www.nlm.nih.gov/medlineplus/news/fullstory_157281.html
https://www.sciencedaily.com/releases/2016/02/160211083044.htm
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