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Cholesterol: an about-face

A recent (February, 2015) report by the Advisory Panel to the US Departments of Health and Human Services (HHS) and Agriculture (USDA) has removed dietary cholesterol as “a nutrient of concern”, thereby overturning decades of stern and adamant advice. They did this unapologetically.

Nevertheless, the science has been around for a while now – dietary cholesterol does not have a significant impact on overall blood cholesterol. The important distinction here is between dietary cholesterol (that you eat) and blood cholesterol (that is in your bloodstream).

Consistent with their decision that dietary cholesterol is no longer a health concern, the Advisory Panel has removed any recommendation for limiting its daily intake – a total capitulation.

2013-10-17 11.11.52The proclamation to limit dietary cholesterol to less than 300mg (about 1.5 eggs) a day appeared in the 1960’s and has been trumpeted ever since. It led to a 30% per capita reduction in egg consumption in the US (the advice was effective at a population level). The result? Egg producer’s livelihoods were affected (presumably artisan producers were the first to go, leaving mass-producers with cost-cutting methods in business); people who liked eggs but listened to the advice missed out; people who liked eggs and ignored the advice felt guilty, defiant or, (ideally) indifferent; a nutritious source of food was demonised and; it was all for nothing.

Where does the body get its cholesterol?

It is too important to take any chances with – the body manufactures it. In fact, nearly every cell can manufacture cholesterol, but the main source (and sink) of blood cholesterol is the liver. The brain makes its own ‘in-house’.

When we eat cholesterol,  the liver compensates by reducing the amount of cholesterol it manufactures. Hence, there is little overall effect on blood cholesterol level.

What triggered this dietary revision and what happens next?

The responsible US organisations (HHS and USDA) are required by law to re-examine their advice every 5 years (2015 is such a year). They start with an independent Scientific Advisory Panel (AP) that looks at the scientific evidence and makes recommendations (which are not binding). The AP report was finalised in February this year. The report then went through a public submission process that has just ended. The HHS and USDA are now formulating their final recommendations, which are due in August. So, assuming that their decision is evidence-based (there will be other pressures), it seems certain that dietary cholesterol will officially go off the radar this coming August.

In the meantime – perhaps a soft-cooked sous vide egg in a nest of deep fried corn silk?

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Then again, maybe not. The AP is still wagging its collective finger at saturated fat. The evidence is clear that this too doesn’t matter. Revisit this space in a decade or two…