The impact of dietary cholesterol on cardiovascular disease

The American Heart Association recently reviewed effects of dietary cholesterol on cardiovascular disease. The review highlighted a number of key points to consider regarding the impact of diet on supporting a healthy blood cholesterol concentration.

What is Dietary cholesterol?
Dietary cholesterol is found in foods such as eggs, meat, and diary products. When you break these foods down in your digestive system, some of the cholesterol is absorbed into your body and used for essential functions in the body. Your liver also produces and stores cholesterol for the body.

What is the effect of dietary cholesterol on cardiovascular health?
The review found that dietary cholesterol does not have a significant association with cardiovascular disease itself. The effect of dietary cholesterol on blood cholesterol is dependent on the amount saturated consumed in the diet alongside the dietary cholesterol. When saturated fat is high, dietary cholesterol can have a negative impact on cardiovascular health.

How much dietary cholesterol should I be eating and how do I know?
The current recommended guidelines conclude that your diet should contain less than 300mg/d of cholesterol per day. Dietary cholesterol can be hard to measure without knowing the cholesterol content of each food. An easier and more accurate way for us monitor daily dietary cholesterol consumption is through apps such as My Fitness Pal, allow us to look at the amount of saturated fat in our diet and ensure this fits within the guidelines.

What can we do in terms of nutrition to ensure healthy cholesterol levels?
Focusing on dietary patterns, such as the Mediterranean-style diet, which are high in fruits, vegetables, whole grains, low-fat or fat-free dairy products, lean protein sources, nuts, seeds, and liquid vegetable oils are more likely to improve overall diet quality and therefore promote cardiovascular health than if you focused on the amount dietary cholesterol in your food alone.

What foods could have a beneficial effect on cholesterol?
• Increase Viscous Dietary Fibre Intake
o 5-10g/day total
o Oats – beta glucan (3d/day)
o Eat more wholegrains, beans, pulses, veg and fruit
o Has shown a 5% reduction in LDL

• Plant Sterols
o 2g/day
o Benecol drink
o Plant sterol spread
o Vitabiotics – Ultra Plant Sterols
o Has shown a 10% reduction in LDL

• Oily fish (>2/wk)
o Salmon, mackerel, herring, tuna, trout
o Omega-3 – anti-inflammatory, anti-thrombotic, improves endothelial function
o Nut intake
o Choose a variety of nuts – approx 10-15 nuts per day will do it
o 7% reduction in cholesterol

• Reduce saturated fats
o Manage intake of cheese, cream, animal fat, processed meat, coconut
o 5-10% reduction in cholesterol

What about eggs?
Although eggs are higher in cholesterol, they’re an important component of our diet as a good source of protein and healthy fats. Current recommendations suggest we should eat up to 10 eggs a week. When eggs are eaten alongside your saturated fats such as those found in bacon and sausages, on regular occasions, this could become detrimental for our health. Instead of the bacon or sausage, try swapping in spinach (high in vitamin A) or smoked salmon (omega 3) with wholemeal bread (fibre) for your breakfast.

If you don’t want eggs for breakfast, below are a couple of alternative which are still high in protein, healthy fats and fibre
• yoghurt with some fresh fruit, nuts and seeds
• muesli or bran flakes
• As we enter the winter, porridge is a perfect breakfast as a slow release carbohydrate it will help maintain energy throughout the morning and is high in fibre