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Revisiting Dietary Cholesterol Recommendations: Does the Evidence Support a Limit of 300 mg/d?

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Abstract

The perceived association between dietary cholesterol (DC) and risk for coronary heart disease (CHD) has resulted in recommendations of no more than 300 mg/d for healthy persons in the United States. These dietary recommendations proposed in the 1960s had little scientific evidence other than the known association between saturated fat and cholesterol and animal studies where cholesterol was fed in amounts far exceeding normal intakes. In contrast, European countries, Asian countries, and Canada do not have an upper limit for DC. Further, current epidemiologic data have clearly demonstrated that increasing concentrations of DC are not correlated with increased risk for CHD. Clinical studies have shown that even if DC may increase plasma low-density lipoprotein (LDL) cholesterol in certain individuals (hyper-responders), this is always accompanied by increases in high-density lipoprotein (HDL) cholesterol, so the LDL/HDL cholesterol ratio is maintained. More importantly, DC reduces circulating levels of small, dense LDL particles, a well-defined risk factor for CHD. This article presents recent evidence from human studies documenting the lack of effect of DC on CHD risk, suggesting that guidelines for DC should be revisited.

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Disclosure

Dr. Fernandez and her institution have received a grant from the American Egg Board. No other potential conflicts of interest relevant to this article were reported.

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  1. Department of Nutritional Sciences, the University of Connecticut, 3624 Horsebarn Road Extension, Storrs, CT, 06269, USA

    Maria Luz Fernandez & Mariana Calle

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  1. Maria Luz Fernandez
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  2. Mariana Calle
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Correspondence to Maria Luz Fernandez.

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Fernandez, M.L., Calle, M. Revisiting Dietary Cholesterol Recommendations: Does the Evidence Support a Limit of 300 mg/d?. Curr Atheroscler Rep 12, 377–383 (2010). https://doi.org/10.1007/s11883-010-0130-7

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