Consumers should continue to stick to heart-healthy diets for optimum cardiovascular health, according to the American Heart Association (AHA). There is no numerical recommendation of food intake of cholesterol, however, as the AHA does not find any link between dietary cholesterol and cardiovascular risk.
This is based on a new AHA Scientific Advisory that appears in the Circulation journal.
The first author is Jo Ann S. Carson, Ph.D.S
Carson is the immediate past chair and current member of the nutrition committee of the AHA and a professor of clinical nutrition at the Southwestern Medical Center at Dallas University of Texas.
She and her colleagues describe in the paper that their new research has been inspired by recent changes in dietary guidelines for reducing cardiovascular disease (CVD).
In other words, recent recommendations from the AHA, the American College of Cardiology, and the “American Dietary Guidelines for 2015–2020” have no longer explicitly set a dietary cholesterol target.
It stands in contrast to the “traditional” grain of numerically limiting dietary cholesterol to no more than 300 mg per day.

A meta-analysis of existing research is included in the advisory. It concludes that there is no conclusive association between dietary cholesterol and higher blood levels of low-lipoprotein (LDL) cholesterol also known as the “bad” form of cholesterol in the available studies and trials.
The researchers write:
“Findings from observational studies have not generally supported an association between dietary cholesterol and CVD risk,”
In addition, after adjusting for other dietary factors such as fiber. saturated fat, or energy intake, the findings of the studies that found an association were attenuated.
This indicates that methodological issues interfere with such research and that it is difficult to disentangle the effect of dietary cholesterol from other dietary substances, such as saturated fats.
Because in the former, most foods with high levels of the latter are also high.
Carson and colleagues says: “In summary, the majority of published observational studies do not identify a significant positive association between dietary cholesterol and CVD risk.”
Egg consumption is on average one quarter of the dietary intake of cholesterol in the United States, with one large egg containing about 185 mg of cholesterol.
Furthermore, different studies have provided different results about the correlation between the intake of eggs and the risk of CVD, depending on the subtype of CVD studied.
Another study also found that eating seven or more eggs a week had a lower risk of stroke compared to eating less than one egg a week.
A research in the U.S. and another one in Sweden, however, showed a 20-30 percent higher risk for heart failure in those who ate more than one egg per day, but the findings related only to men.
Overall, the researchers conclude, “The published literature generally does not support statistically significant associations with the risk with CVD for both dietary cholesterol and egg consumption.”
Still, they continue to notice certain limitations to this existing body of knowledge, such as the fact that nutritional epidemiology methods have changed significantly over time, or that different study populations have different dietary patterns that may have influenced the outcome.
For example, egg consumption in China is a healthy addition to the diet that is already rich in fiber, vegetables, and fruit, they write.
Jo Ann S. Carson said: “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.”


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