A scientific advisory from the AHA indicates there is no proven link between the risk of cardiovascular disease (CVD) and dietary cholesterol.
However, a heart-healthy diet and lifestyle may help a person maintain optimum cardiovascular health. Individuals can work with their doctor to manage any personal factors that could affect their cholesterol levels.
Blood cholesterol and dietary cholesterol
Generally, the body makes enough cholesterol to satisfy its needs. However, a person’s diet may contribute additional cholesterol, depending on the food included in the diet.
Types of cholesterol
There are two different types of cholesterol:
Low-density lipoprotein (LDL) cholesterol: This is sometimes called “bad cholesterol.” It is made by the body and exists in some food sources such as red meat and dairy products. It helps carry cholesterol through the bloodstream. If there is too much LDL cholesterol in a person’s blood, it may attach to the walls of the blood vessels and form plaques. These plaques may narrow the usable space in the blood vessel and reduce blood flow.
High-density lipoprotein (HDL) cholesterol: This is sometimes called “good cholesterol” and may have a protective effect on the heart. It picks up extra cholesterol to carry it out of the bloodstream and back to the liver, where it may be recycled or eliminated.
Dietary cholesterol comes from some foods, such as eggs, dairy products, meat, and shellfish.
In the past, dietary guidelines recommended limiting the consumption of dietary cholesterol to 300 mg/day. However, a review of current research shows no evidence that dietary cholesterol increases the risk of heart disease in healthy individuals.
Although dietary cholesterol has no proven effect on cardiovascular health, a person’s doctor may advise them to reduce their intake of saturated fat, and increase their intake of fruits, vegetables, and fiber.
Limiting dietary cholesterol
The Centers for Disease Control and Prevention (CDC) note that the body makes all the cholesterol it needs, which is a reason why medical professionals generally recommend a healthy diet with a minimum of dietary cholesterol. Such a diet may reduce the risk of CVD.
According to the AHA science advisory, diets such as the DASH or Mediterranean diet are examples of healthy eating patterns as they are low in dietary cholesterol. Such diets emphasize the following food groups:
- whole grains
- low or fat-free dairy
- lean proteins
- liquid vegetable oils
Routine blood tests are recommended to measure cholesterol levels because high cholesterol may not cause symptoms but can lead to health complications. For example, high blood cholesterol can lead to atherosclerosis, which is a condition that develops when plaque builds up inside the blood vessels, causing the arteries to become narrow and hard.
Over time, atherosclerosis may mean a person is at higher risk for heart-related conditions, such as:
- heart attack
- carotid artery disease
- coronary heart disease
- chest pain (angina)
- sudden cardiac arrest
A person’s lifestyle, including diet, can affect their cholesterol levels, although there may be other factors, according to the National Heart, Lung and Blood Institute (NIH).
According to the NIH, risk factors for high blood cholesterol can include the following:
- a person’s age
- family history
- ethnicity or race
- biological sex
In some cases, doctors may recommend prescription medications to lower cholesterol.
Cholesterol-lowering medications, such as statins, may be necessary for people with certain conditions including:
- Familial hypercholesterolemia (FH), which is a genetic condition. It can start at a young age and may lead to high LDL cholesterol levels.
- Type 2 diabetes, which can affect cholesterol levels and may increase the risk of stroke or a heart attack.
- Cardiovascular disease, which may raise the risk of heart attack or stroke.
A person should consult with their doctor to make sure they are getting the correct medication.
A person can make lifestyle or diet changes that may lower high cholesterol levels, or maintain healthy ones. For example:
- eating a healthy diet, including limiting foods high in saturated fats
- getting regular physical activity
- maintaining a healthy weight
- avoiding tobacco use
- limiting alcohol
Getting regularly tested for cholesterol levels can also help monitor change and track long-term progress.
When to contact a doctor
If a person is unaware of their cholesterol levels, they can visit their doctor to get tested. Otherwise healthy adults should get their cholesterol levels checked every 4 to 6 years, according to the CDC.
Anyone concerned with symptoms may also want to arrange a visit with their doctor. Although high cholesterol does not usually produce symptoms, there may be complications that do.
The body makes all the cholesterol it needs, so a person does not need to get any additional cholesterol from their diet. However, dietary cholesterol does not appear to impact overall cholesterol levels as was previously thought.
Many experts recommend heart-healthy diets and other lifestyle changes that may help reduce cholesterol levels. Anyone concerned about their cholesterol should consult their doctor.