The following is excerpted from the following article:

Nutrients. 2018 Jun; 10(6): 780.

Published online 2018 Jun 16. doi: 10.3390/nu10060780

PMCID: PMC6024687

PMID: 29914176

Dietary Cholesterol and the Lack of Evidence in Cardiovascular Disease

Ghada A. Soliman

Cardiovascular disease (CVD) is the leading cause of death in the United States.  For years, dietary cholesterol was implicated in increasing blood cholesterol levels leading to the elevated risk of CVD.  To date, extensive research did not show evidence to support a role of dietary cholesterol in the development of CVD.  As a result, the 2015–2020 Dietary Guidelines for Americans removed the recommendations of restricting dietary cholesterol to 300 mg/day. This review summarizes the current literature regarding dietary cholesterol intake and CVD. It is worth noting that most foods that are rich in cholesterol are also high in saturated fatty acids and thus may increase the risk of CVD due to the saturated fatty acid content. The exceptions are eggs and shrimp. Considering that eggs are affordable and nutrient-dense food items, containing high-quality protein with minimal saturated fatty acids (1.56 gm/egg) and are rich in several micronutrients including vitamins and minerals, it would be worthwhile to include eggs in moderation as a part of a healthy eating pattern… The landmark of CVD is atherosclerosis, which is a chronic inflammatory condition instigated by deposition of cholesterol and fibrous tissues in the arterial walls which build up and eventually lead to narrowing and thickening or blocking of the arterial lumen. The inflammation regulates the plaque formation as well as the thrombotic complications of atherosclerosis [3]. The hypothesis that dietary cholesterol contributes to the risk of heart disease was initially suggested in 1968 and based on the research literature at the time [4,5]. Subsequently, the American Heart Association adopted a recommendation of limiting dietary cholesterol intake to 300 mg/day for healthy individuals in the United States, and with recommendations of restricting egg consumption to a maximum of three whole eggs per week [6]. However, the totality of scientific evidence and experimental data did not validate the hypothesis that dietary cholesterol increases blood cholesterol, and by extension increases the risk of CVD. Investigators have reported that increased intake of dietary cholesterol (exogenous) is associated with decreased synthesis of endogenous de novo cholesterol, possibly as a compensatory mechanism that keeps cholesterol homeostasis constant… In fact, eggs are the only dietary source of cholesterol that is low in saturated fatty acid but is also nutrient-dense, economical and affordable. The average large whole egg (50 g), contains only 1.56 g of saturated fat, 1.83 g monounsaturated fat and 0.96 g polyunsaturated fat (Table 1). Egg yolk is also rich in dietary choline (147 mg) [14], which is an essential nutrient for human liver and muscle functions… and is also rich in vitamin A (270 International Unit IU), and 80 µg Retinol Activity Equivalents (RAE) i.e., 9% RDA for adult male, 11% RDA for adult female, lutein and zeaxanthin (252 µg), folate (24 µg Dietary Folate Equivalents (DFE) i.e., 6% RDA for adult male and female), phosphorous (99 mg, i.e., 15% RDA for adult male and female), potassium (69 mg, i.e., 1% AI for adult male and female) and calcium (28 mg, i.e., 2.8% RDA for adult male and female), [16,29]. In addition to these micronutrients, the egg is also rich in high-quality animal protein (6.28 g, i.e., 11% of the recommended RDA) (Table 1)… For decades, the notion that elevated blood cholesterol is resultant from dietary intake cholesterol and saturated fatty acids were universally accepted. However, several follow-up studies showed no association between dietary cholesterol (egg consumption) and serum cholesterol, all-cause death, total coronary heart disease, or other heart disease problems such as angina pectoris or myocardial infarction [48]. Nevertheless, the recommendations of decreasing dietary cholesterol remained in effect… The following is the journal article conclusion The current literature does not support the notion that dietary cholesterol increases the risk of heart disease in healthy individuals. It is vitally important that we advocate for our own health and not just blindly follow the advice of those who should know better (but don’t), or know better, and hide the truth.

Yours for Better Health,