No Link between Dietary Cholesterol and Cardiovascular Risk

“Findings from observational studies have not generally supported an association between dietary cholesterol and CVD risk.”


According to a new Scientific Advisory from the American Heart Association (AHA), there is no association between dietary cholesterol and cardiovascular disease (CVD) risk. However, it cautioned that people should continue eating heart-healthy diets.

The Scientific Advisory was published in the journal Circulation.

Study’s first author Dr. Jo Ann S. Carson from the University of Texas Southwestern Medical Center in Dallas and her colleagues explained the recent changes in dietary guidelines for lowering the risk of CVD.

They said the recent guidelines from the AHA, the American College of Cardiology, and the “2015–2020 Dietary Guidelines for Americans” have not set a target for dietary cholesterol, which is against the “traditional grain of numerically limiting dietary cholesterol to no more than 300 milligrams (mg) per day.”

The Advisory noted that studies have not managed to find a conclusive link between dietary cholesterol and high LDL (bad) cholesterol.

The authors wrote, “Findings from observational studies have not generally supported an association between dietary cholesterol and CVD risk.”

Also, the studies did not find a link after adjusting other dietary factors, such as saturated fat, fiber, or energy intake, suggesting that it is not easy to extricate the effect of dietary cholesterol from other dietary components, including saturated fats.

Dr. Carson and colleagues concluded, “In summary, the majority of published observational studies do not identify a significant positive association between dietary cholesterol and CVD risk.”

“Consideration of the relationship between dietary cholesterol and CVD risk cannot ignore two aspects of diet. First, most foods contributing cholesterol to the U.S. diet are usually high in saturated fat, which is strongly linked to an increased risk of too much LDL cholesterol,” said Dr. Carson.

“Second, we know from an enormous body of scientific studies that heart-healthy dietary patterns, such as Mediterranean-style and DASH style diet (Dietary Approaches to Stop Hypertension), are inherently low in cholesterol,” she added. She recommends, “Eating a nutrient-rich diet that emphasizes fruits, vegetables, whole grains, low-fat or fat-free dairy products, lean cuts of meat, poultry, fish or plant-based protein, nuts, and seeds. Saturated fats — mostly found in animal products, such as meat and full fat dairy, as well as tropical oils — should be replaced with polyunsaturated fats such as corn, canola, or soybean oils. Foods high in added sugars and sodium (salt) should be limited.”