Abstract
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. This recommendation is particularly relevant when individual’s intakes of nutrients are suboptimal, or with limited income and food access, and to help ensure dietary intake of sufficient nutrients in growing children and older adults.
Highlights
Cardiovascular disease (CVD) is a leading cause of death in the US with approximately one in every four deaths occurring from heart diseases [1]
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
The current literature does not support the notion that dietary cholesterol increases the risk of heart disease in a healthy individuals
Summary
Cardiovascular disease (CVD) is a leading cause of death in the US with approximately one in every four deaths occurring from heart diseases [1]. 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]. 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]. 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. The 2015–2020 Dietary Guidelines for Americans removed the recommendations of setting a limit to the maximum intake of 300 mg/day cholesterol. The following review will summarize the current literature regarding dietary cholesterol, blood cholesterol, saturated fatty acids and the risk of cardiovascular disease (CVD)
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