Rethinking cholesterol
For decades, we were warned to avoid foods containing cholesterol, such as eggs, shrimp, and many other types of seafood. The thought was that dietary cholesterol would contribute to high blood cholesterol. Now we know better.
Most of the cholesterol in your body is produced by your own liver. A diet high in saturated fats tends to promote the production of cholesterol by the liver. Dietary cholesterol, on the other hand, does not seem to have this effect. If anything, your liver will adjust its cholesterol production to compensate for the amount of cholesterol in your diet. That is, if you take in more dietary cholesterol, your liver will make a bit less.
So, isn't it time to put eggs and shrimp back on the heart-healthy menu? Although both foods contain a good amount of cholesterol, they are both low in saturated fat and rich in good-quality protein and other nutrients.
Contradictory advice?
Back in 2000, the American Heart Association (AHA) revised its recommendations in view of the new wisdom on cholesterol. For those without high cholesterol or heart disease, the AHA now countenances the consumption of an egg a day. However, their recommendations on cholesterol intake remain unchanged. For healthy adults, the AHA advises a limit of 300mg of dietary cholesterol per day. That seems unrealistic--and unnecessary--to me.
I can easily imagine a healthy diet, one that is well within the recommendations on saturated fat (less than 7-10% of total calories), exceeding this limit. For example, if you ate just one egg ( with 213mg of cholesterol) and a shrimp cocktail (90 mg) in the same day, you'd be over the limit for a healthy adut--even though these foods contain only about 2 grams of saturated fat.
Now that we know that dietary cholesterol is not the culprit in high blood cholesterol, I'm not sure what the justification is for this recommendation anymore--especially for those without cholesterol issues. It seems to me that there are more important things to focus on, such as keeping your saturated fat intake within recommended limits, and eating plenty of eating fiber- and nutrient-rich foods (i.e., veggies!).
For those with high cholesterol, the AHA's recommendations are even stricter...less than 200mg of dietary cholesterol per day, even though several studies have shown that netiher dietary cholesterol nor egg consumption appears to be the culprit in heart disease. I'm not saying that high cholesterol levels don't matter--they do. I'm just saying that I don't think dietary cholesterol is the reason that people have high cholesterol.
Usually, high cholesterol levels are brought on by a combination of genetics and lifestyle factors (such as not exercising, smoking, poor diet, etc.). The stronger the genetic component, the more likely that diet and lifestyle changes alone will not be enough to bring cholesterol levels down to safe levels. In this case, cholesterol-lowering medications (plus lifestyle modifications!) may be needed.
If you have high cholesterol, you obviously need to follow your doctor's advice, including his or her dietary recommendations. Limiting your intake of saturated fat, eating a diet high in antioxidants and fiber, exercising and avoiding cigarette smoke are all key factors in treating and preventing heart disease. But if you are doing all of this, and you miss eating eggs and seafood, it might be worth probing to see whether your doctor really feels that drastically limiting your intake of healthy foods that contain cholesterol is necessary.
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Posted by: Nigeepoo | Jan 4, 2009 4:24:37 PM
Steve Parker, M.D. said:-
"By coincidence, I blogged about egg consumption on May 8 elsewhere:
http://advancedmediterraneandiet.com/blog/?p=35
A recent Physicians' Health Study article suggested that men who ate 7 or more eggs per week suffered higher all-cause mortality. NOT the higher mortality from heart attacks, strokes, or other cardiovascular diseases that would have been predicted from the cholesterol-atherosclerosis theory. Even more worrisome, diabetics who ate almost any eggs at all had higher all-cause mortality.
There are so many contradictory studies that I have decided not to lose any sleep over it. Eggs are a cheap source of high quality protein.
-Steve Parker, M.D."
Association (in epidemiological studies) does not prove causation. Egg consumption is associated with higher mortality, especially for people with diabetes most likely because egg consumption is ALSO associated with toast consumption!
Posted by: Plod | Jan 3, 2009 12:49:20 PM
Regarding the egg argument - people can eat crap and still have a great cholesterol level. Your genes play a more important role. If you have lots of cholesterol receptors, your body is very efficient at processing cholesterol. If your genes are working against you - you can have a very healthy life style and still have a horrible cholesterol profile. My husband eats pizza at least once a week, hard cheese at least 4 times a week and lots of red meat. He does not excise very much and he has a wonderful cholesterol profile - his HDL is really high (in the 70's). On the other hand, I eat fish, whole meal bread and rice, soya milk, and cereal and excise every day - but my profile sucks. I have managed to reduce my total cholesterol over time (without meds), but the ratio has stayed the same...... (my HLD is under 40). I have tried everything - fish oil, green tea every day........
Posted by: Angelica | Aug 19, 2008 3:37:54 PM
I forgot to add:
Eating several meals a day as opposed to eating 2 or 3 larger meals is often effective in losing weight because it tricks your body into burning calories more consistently throughout the day. When you eat a big meal and then go several hours without eating - especially if much of that time is spent sitting down, like at work or watching TV - your body slows down the processes that burn calories so it doesn't use up its energy stores. But if you frequently refuel your body with small meals throughout the day, your body learns that it doesn't have to go into "energy-saving" mode. This way, more of the calories you eat are burned and less are stored away. So if you're on a reduced calorie diet to lose weight, not only will you burn the calories you eat, your body will also burn some of that excess fat stores, because your body's more focused on burning calories than storing them away. Make sense?
Posted by: Angelica | Aug 19, 2008 3:16:10 PM
To Pat: My mother is in the same boat as you. She's 73, a little overweight and has diet-related health concerns. I keep telling her to just stick at her recommended diet and exercise, and try not to get discourage that her weight isn't coming off as quickly as she had hoped. Unfortunately, weight loss at this age seems a pretty difficult challenge, and persistence is the key.
Another thing you could try is getting 2 LB dumbbell weights or resistance bands and doing some upper body resistance training (get a DVD, book or look online for exercises appropriate for your age and fitness level). My mother uses Leslie Sasone's "Walk Away The Pounds" DVDs, which combines easy cardio with resistance exercises. Resistance exercise builds more muscle mass, and the more muscle mass you have, more calories your body uses daily.
As for your LDL, try taking a fiber supplement like Metamucil daily. Alluim vegatables (onions, garlic, leeks and shallots) and celery contain effective LDL-lowering nutrients, so try to work these more into your daily diet, either cooked or raw. Also you can get garlic in supplement form, if you would prefer it that way. Fenugreek, a Middle Eastern spice, is also effective in lowering LDL and you can often find this in supplement form too. Chromium, an essential trace mineral supplement often taken to control high insulin and blood sugar levels, has also shown potential to lower LDL as well (recommended dosage is 200-400 mcg daily).
Eating "oily" fish (salmon, tuna, mackerel, sardines, herring) 3 times a week or taking fish oil (Omega 3 Fatty Acid) may help too. Fish oil is highly effective in lowering high triglycerides, a problem that often seen along side high LDL and can be equally as dangerous (fenugreek is also effective in lowering triglycerides). But be aware that fish oil supplements may raise you blood sugar, so it's advised that this supplement should be taken with 200-400 mg of Vitamin E to prevent that.
Lastly, if you're not already, you may wish to start taking a B-vitamin complex supplement every day. Be sure to get one that has vitamin C in it too. These vitamins - especially niacin, B5 and vitamin C - are important in controlling of LDL, and taking a supplement will assure you're getting the amount your need.
Disclaimer: before you (and anyone else) take any of my advice, please consult your doctor, a nutritionist, or legitimate online medical resources beforehand. I am not a medical professional of any kind, and all the information here comes my own layperson's experience with these issues.
Posted by: pat | Jul 29, 2008 11:56:41 AM
How can I loose weight and eat 4 or 5 times a day. My LDL is high. I eat around 900 calories per day, I walk for 1 hr. 5 days a week. The scales never move. Each morning the scales say the same. I don't eat red meat, or eggs. Eat a lot of chicken & veggies. I am 77 yrs. old and weigh 140, 5 ft. tall, would like to lose 15 lbs. and maintain it.
Posted by: MGOOD | Jul 16, 2008 9:58:07 AM
I’ve read that niacin is the only medication that has demonstrably reduced unwanted cardiovascular events. The 8341 patients, in the 15 year Coronary Drug Project (CDP), demonstrated the end-result effectiveness of niacin. There’s much about this at www.cholesterolscore.com
Posted by: Johnny | Jul 4, 2008 3:40:07 AM
There is a very simple solution to this for each of us. Stop eating eggs for awhile and get our cholesterol levels checked. Then start eating eggs everyday for the same amount of time, then get our levels checked again. If your levels are higher when your eating eggs, well then the answer is clear. If it's no higher, then you'll know you can eat eggs everyday and not worry. That's what I intend to do. I would also like to test and see if giving up carbs effects my cholesterol the same way.
Posted by: Joanne | Jun 9, 2008 3:48:59 PM
My husband recently had been told by our doctor that his high cholesterol will eventually be fatal, and that he needs to start lowering his cholesterol now. I've always thought that bad food = bad cholesterol. I never knew the liver produced the cholesterol in our bodies. Being the loving wife, I found some studies, one from the American Journal of Clinical Nutrition that Immunized Milk can help lower cholesterol and even blood pressure! We found some immunized milk supplements online and he makes sure to include it in his diet and I'm happy to say his cholesterol is now down to 198
Posted by: Phase | May 28, 2008 6:10:29 AM
Hey a source to prove the point on what is considered normal for cholesterol
http://www.americanheart.org/presenter.jhtml?identifier=183
total cholesterol under 200
LDL under 100
Posted by: Phase | May 28, 2008 6:04:50 AM
Yeah, the LDL (bad cholesterol) is supposed to be under 100, total cholesterol is supposed to be under 200 not 100. Total Cholesterol, if it's too low, is a serious threat.
Posted by: Dr. Dave | May 27, 2008 8:11:27 AM
Hate to disappoint some but total cholesterol should be BELOW 100, not 100 or 130 or 145. Those are unhealthy levels.
Posted by: Phase | May 20, 2008 6:51:04 PM
How retarded to think that eating cholesterol and fat will raise cholesterol levels in the body. It's elevated insulin that stimulates these issues, if you have a disorder of carb metabolism. I used to have a cholesterol level of 236 and three months into eating red meat, butter, animal skins and fat, and about 1/2 dozen eggs a day I had my levels rechecked and they had dropped to 186! Today they are at 180, and I eat coconut oil, butter, eggs, fatty beef, chicken skins, heavy cream and eat low gycemic fruits and veggies as well as some nuts and cheese. I eat very low-carb.
This is years later. I also have energy, healthier skin and hair, and have lost lots of weight. I have no intention of going back to my prior higher carb lower fat diet!
Posted by: Steve Parker, M.D. | May 15, 2008 12:39:10 AM
By coincidence, I blogged about egg consumption on May 8 elsewhere:
http://advancedmediterraneandiet.com/blog/?p=35
A recent Physicians' Health Study article suggested that men who ate 7 or more eggs per week suffered higher all-cause mortality. NOT the higher mortality from heart attacks, strokes, or other cardiovascular diseases that would have been predicted from the cholesterol-atherosclerosis theory. Even more worrisome, diabetics who ate almost any eggs at all had higher all-cause mortality.
There are so many contradictory studies that I have decided not to lose any sleep over it. Eggs are a cheap source of high quality protein.
-Steve Parker, M.D.
Posted by: EGGIE! | May 10, 2008 3:42:46 AM
THANKS Monica! I only eat egg whites off hard boiled eggs. That's why they call me EGGIE!
Posted by: Monica Reinagel | May 9, 2008 10:04:22 AM
On egg whites and biotin deficiency: Raw egg whites contain a protein called avidin, which binds tightly to the nutrient biotin. Eating large amounts of raw egg whites can create biotin deficiency. Cooking the egg whites completely solves the problem.
Posted by: EGGIE! | May 9, 2008 9:14:44 AM
Hello O. I had my cholesterol done. It is 145. I don't smoke or drink alcohol and am 90% vegetarian. I expected a low number. I just can't believe anyone eating so many eggs and having low cholesterol. How about that biotin issue posted by 'e'. That concerns me because I do eat a lot of egg whites. Anyone got anything on that?
Posted by: O | May 8, 2008 3:17:58 AM
EGGIE: i don't understand why you don't believe me. Do yourself a favor and go get your cholesterol levels checked now, with your current diet. Then start eating 3 or more eggs each day, and check your levels in about 2 months again and see for yourself.
Posted by: e | May 7, 2008 3:35:58 PM
I usually eat anywhere from 8-12 eggs a day (uncooked, they're easier that way) depending on if I'm on a weight gain or weight loss diet. 3+ years steady and my cholesterol levels have tanked; cut in half if I recall correctly. So I'm on O's side (as long as your not Oprah).
I've read articles that eating egg whites are bad for you. The white of the egg leeches on to biotin, which is why the yolk is so high in biotin. So, eating just egg whites can cause a biotin deficiency. The yolk is the most nutritious part of the egg. Does anyone have information on this claim?
Posted by: EGGIE! | May 7, 2008 7:33:40 AM
O: I don't believe you have low cholesterol. Not to tick you off! I just don't believe you.
Posted by: O | May 7, 2008 4:57:46 AM
Nutrition specialist trainee: if egg yolks are so bad for us, why do I, the 6 eggs/day Jonathan Benson, and numerous other people (do a Google search) have perfect cholesterol?
It is just sad to see so many brainwashed people here. Think with your own head and seak studies, research papers, and data. Start by reading the link I provided in my previous comment. Change your diet, do blood tests and see for yourself.
Remember science isn't advanced by consensus, but by the work of an individual. Think Gallileo, Einstein ... People believed the Earth was flat for many years.
Posted by: Nutrition specialists trainee | May 7, 2008 12:34:52 AM
Eggs are good for you but egg yolks are the most unhealthy part. But it all starts back with what your body is used too and how you eat it. Served with hollandaise sauce or pan cooked with butter is very unhealthy. Remember one meal isn't going to make you unhealthy but you should always think about moderations. Personally I think that if any food is consumed during breakfast time, you will have plenty of time to burn it off throughout the day, but if you eat chocolate and sugar or something hearty even a few hours before bed, your body will never have a chance to properly break down the foods that you just consumed. Don't criticize if you leave feedback remember I'm a trainee and have finished culinary school only a few months ago.
P.S. One cup of egg yolks have about 1000% of the total cholesterol your suppose to consume a day, which means about 12 large egg yolks (.6 oz each)
Posted by: O | May 6, 2008 7:07:34 PM
I am astonished as well how many people fail to read that the guy that eats 6 eggs per day has perfect cholesterol.
And as I said in an earlier post, I eat 3 whole eggs per day (they are the omega-3 kind) and have perfect cholesterol as well: total = 162, and total/HDL ratio = 2.35.
People, nutrition is a science, and like every science it constantly evolves. There in increasing evidence that the entire "cholesterol is bad" theory is wrong: http://www.spiked-online.com/Articles/0000000CAE78.htm
Posted by: Webzonk | May 6, 2008 4:07:15 PM
Looks like "EGGIE!" has the sanest head on his/her shoulders.
Posted by: Tito | May 6, 2008 9:46:00 AM
Hi Monica,
Please check out this article
about eggs from the US National Institute of Health:
http://www.nlm.nih.gov/medlineplus/news/fullstory_63277.html
"THURSDAY, April 10 (HealthDay News) -- A new study suggests that consuming more than six eggs a week seems to raise the risk of dying from all causes.
And diabetics seem to face an even higher mortality risk, according to the study that was limited to men."
Posted by: Lorna | May 6, 2008 6:17:05 AM
Why does it have to be so complicated to eat healthy? I recently read three books by Michael Pollan: 'The Botany of Desire', 'The Omnivore's Dilemma' and 'In Defence of Food'. The books were fascinating and Pollan's contention is that we are eating food 'products' rather than real food. The idea of eating the kind of meals my mother cooked fifty years ago is very appealing, and people were healthier.
Posted by: K | May 5, 2008 8:30:32 PM
I'm amazed by how many people completely missed the fact that the guy that eats 6 eggs a day says "My cholesterol levels have never been anything but perfect since starting." IOW, his cholesterol levels are good.
I eat 3 Eggland's Best eggs/day and my cholesterol stays around 180-190. There is a lot of good nutrition in a egg.
Posted by: EGGIE! | May 5, 2008 3:57:28 PM
Who would eat 6 eggs a day! What a nut. I guess the world is filled with dumb people. One egg every other day might be just enough or maybe too much for some. Stick with veggies (no butter!). You'll live longer.
Posted by: Roseann | May 5, 2008 2:14:27 PM
Interesting! People with total Cholesterol over 100 think they're doing great! Talk to a cardiologist. Ours is an interventionist and he's excellent. There is talk in the cardiology community that cholesterol should be in the 100 range! And, there is the A profile vs. the B profile -- you would have to have a VAP test to find that out. One is more likely to have heart disease related to cholesterol than the other. There's much more to this than just cholesterol. And the carb thing -- sure give up the processed, white and useless carbs, but those with lots of fiber like beans are irreplaceable in your diet! This concept of focusing on one issue and anything else is wrong, is the problem. It's always been about balance and it remains about balance. Fact is that today we know more about the details. So, we are able to fine tune. Balance is essential. Don't load up on one side and forget the rest. When you're 75 it will make a difference. Today you're fantastic with the high protein/low carb (no carb) diet, when you're 75 let's see what's up.
Posted by: Antonio | May 5, 2008 12:09:34 AM
Want to know the truth about cholesterol and why people wo eat lots of saturated fat and cholesterol are healthier, stronger and live longer than those who dont, especially vegetarians????
Check out You Tube: Big Fat Lies -and- Cholesterol Myths – Separating Fact from Fiction.
Also read 'Good Calories, Bad Calories' or anything by Sally Fallon or Nina Plank. The low cholesterol myth has been failing America for 70 years and the low fat diet has done nothing more than give an adult disease (type 2 diabetes) to kids.
Posted by: Nigeepoo | May 4, 2008 7:02:56 PM
I wonder how many years it'll be before "The bad: This food is high in Saturated Fat, and very high in Cholesterol." is deleted from ND's pages?
As some people seem to get their panties in a bunch about any increase in serum cholesterol level, it may be worth reading http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=2126116&blobtype=pdf as the group with *higher* total chol & LDL-c had one *quarter* the mortality from CHD. It's oxidised chol that clogs arteries.
It's also been known since 1979 that eating 2 large eggs a day made no significant difference to total chol & TGs compared to no eggs a day in healthy subjects. See http://www.ajcn.org/cgi/reprint/32/5/1051.pdf
Cheers, Nige.
Posted by: Egg's aren't gay thankyou | May 4, 2008 5:57:08 PM
"Why would you eat 6 whole eggs a day!!! thats waayy to many. of course your cholesterol isnt at a good level."
I know how stupid, I eat 10-16 a day.
Posted by: Jim Kent | May 4, 2008 2:13:15 AM
It may be that dietary cholesterol is something some people need to watch and others don't. Sort of like salt.
Posted by: EggsWhitesOnly! | May 2, 2008 11:17:27 PM
I HIGHLY disagree with this article! Egg yolks absolutely increase cholesterol levels. I am a vegetarian, and I eat extremely healthy (lots of veggies, fruits, nuts, etc), and I exercise daily. But even in spite of this because I was eating one egg per day my cholesterol began increasing (and I had no other sources of cholesterol). I now only eat the whites. I highly suggest (and most nutritionists agree) that yolks be eaten in moderation.
Posted by: EGGZRGAY | May 2, 2008 2:51:03 PM
Why would you eat 6 whole eggs a day!!! thats waayy to many. of course your cholesterol isnt at a good level.
Posted by: N | May 1, 2008 10:29:49 PM
Thanks, Monica. The information in this article was very helpful to me. I am a pregnant vegan with total chol. 91 and I recently began eating eggs (which I hate) because of the NIH study showing the risks of low cholesterol (<159) during pregnancy. I can stop eating eggs and instead enjoy peanut butter made with a vegetarian saturated fat like palm oil (in moderation, of course).
Posted by: Sam Hartman | Apr 28, 2008 1:17:06 PM
Gary Taubes' book "Good Calories, Bad Calories" suggests that cholesterol measured as a whole is meaningless and does not foretell any risks related to heart disease. He also gives examples of native peoples who ate high amounts of saturated fats (coconuts, for instance) who only began to have Western diseases when more carbohydrates were introduced into their diet through other civilizations. There is definitely more than one view on this cholesterol issue.
Posted by: Joseph Putnoki | Apr 26, 2008 7:10:19 AM
Innocent Cholesterol is made a scapegoat. It is NOT THE DISEASE but rather a symptom of something else when markedly elevated. It is known what triggers the cascade of events that ends in atherosclerosis. We get propaganda instead. The facts are available. We need to insist on facts and the con men to be run out of town!
Posted by: O | Apr 25, 2008 6:57:02 AM
I should add that I also eat 2oz nuts (almonds, pistachios), and 2 tbsp olive oul each day, salmon, and chicken with skin. This is where the rest of the fat comes from. I avoid polyunsaturated fats (all plan oils basically, except for olive) like a plague.
Posted by: O | Apr 25, 2008 6:49:20 AM
Each day I consume 3 whole omega-3 eggs each day, 8oz red meat and 3oz cheese. Out of the 2500 kcal/day, 41% come from fat. I have calculated I eat 30g saturated fat each day. I also eat low carbs, only about 120g carbs each day. I also exercise regularly, about 8hrs total each week. Result? Perfect cholesterol, at 162, and total/HDL ratio of 2.35.
It is not the saturated fat, but the carbs everyone should avoid.
Posted by: Jonathan Benson | Apr 25, 2008 4:50:16 AM
I consume on average 6 whole eggs a day, but as part of a natural paleo type diet which includes lots of good fats from nuts etc.
My cholesterol levels have never been anything but perfect since starting.
Posted by: Tess | Apr 25, 2008 12:44:35 AM
Hi, I am really enjoying your site and am reading your Inflammation Diet book. But no where have I been able to find information on the IF of rice protein powder. I am calculating all the foods I eat every day but this one item, I don't know if it is greatly helping me in my efforts or sabotaging me. How do I find the IF of brown rice protein powder? With protein powders such a large part of people's smoothies each day, I would think it would be listed somewhere, but I've yet to find it.
Thanks for your help.
