Confused About Cholesterol?

High cholesterol is prevalent in our society, and many people are confused about how to eat to control the levels in their blood. Cholesterol is made by the body in the liver, and it is also ingested through the consumption of animal protein, such as meat, eggs, and cheese.Our body needs cholesterol for many of the its metabolic processes. Cholesterol is a part of cell membranes, and it has a role in the production of vitamin D, hormones, and bile acids. Bile acids are used to break down fats during the digestive process. However, too much cholesterol in the blood can lead to plaque formation, whereby plaque sticks to the walls of the arteries and causes atherosclerosis. This may lead to coronary artery disease where the arteries are narrowed and blocked.When we have our dietary cholesterol taken, we usually look at the total cholesterol, HDL cholesterol (high density lipoproteins), LDL cholesterol (low density lipoproteins), VLDL (very low-density lipoproteins) cholesterol, and triglycerides. LDL cholesterol, also known as “bad cholesterol,” carries most of the cholesterol to your body cells, and when the level is high, it can cause a buildup of plaque and clog the arteries. HDL cholesterol (the “good” cholesterol) is responsible for transporting cholesterol from the body back to the liver, which then removes it from the body. VLDL cholesterol mainly carries triglycerides, which can also lead to a buildup of plaque in the arteries. Triglycerides are a type of fat found in the blood which are stored in fat cells for energy in the body, but they also can contribute to atherosclerosis.High cholesterol levels are usually caused by an unhealthy lifestyle including poor eating habits, lack of physical activity, and smoking. Additionally, cholesterol levels tend to increase with weight and age. High levels have also been associated with family history and race. Historically, the American Heart Association (AHA) has recommended restrictions on the intake of dietary cholesterol, trans fat and saturated fat (especially from eggs), which can potentially increase cholesterol levels in the blood. However, a study published in Circulation found that after reviewing 17 studies, there did not seem to be a significant association between dietary cholesterol and heart disease or egg consumption and heart disease. In fact, the new guidelines from The AHA do not limit daily cholesterol level anymore. The old standard was to consume less than 300 milligrams of cholesterol for the population at large and less than 200 milligrams for those with a history of high cholesterol.  Instead, now the focus has become focusing on the diet as a whole and choosing whole grains, vegetables, fruit, lean protein, and nuts rather counting the amount consumed every day.  https://www.ahajournals.org/doi/10.1161/CIR.0000000000000743. As far as eggs, two studies published in 2018 show that eggs do not raise the risk of heart disease and may even be protective. https://www.health.harvard.edu/heart-health/eggs-might-help-your-heart-not-harm-itThe AHA guidelines still restrict eggs to one per day for those with heart disease and two per day for those with normal cholesterol.Besides the research on eggs, some recent research has shown that saturated fat may not impact CVD risk as originally thoughthttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5577766/ and https://www.ncbi.nlm.nih.gov/pubmed/30084105The take home message is moderation. Eat a diet with healthy fats, plenty of fruits and vegetables and some lean protein. Exercise and maintain a healthy weight and don’t fixate on any one part of your diet or lifestyle – look at it as a whole. by Denise Groothuis, MS RD CFMP