Cholesterol is hot in the news ever since a top nutrition advisory committee stated that people no longer need to be concerned about eating foods high in cholesterol earlier this year.
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This guideline caused confusion as people wondered:
- Is checking my cholesterol still important?
- Do I need to change my diet?
Do my numbers matter?
Yes – just because the emphasis on cholesterol in food is less – it does not mean that your blood cholesterol does not matter. If your blood cholesterol level is high and you are at risk for cardiovascular disease – it needs to be treated.
“There is still a clear association between blood levels of cholesterol and cardiovascular disease,” says Michael Rocco, MD, Medical Director of Cardiac Rehabilitation and Stress Testing, Section of Preventive Cardiology at Cleveland Clinic.
Initial confusion arose when the American College of Cardiology and American Heart Association released new cholesterol management guidelines in 2013, which eliminated target LDL-C goals and simply recommended intensive statin therapy to lower LDL-C by 50 percent or more in high-risk patients and 30 to 50 percent in medium-risk patients. The goal was to emphasize use of treatments proven to reduce cholesterol and adverse events such as heart attack and not to de-emphasize the importance of elevated cholesterol.
So, while specific optimal goals for blood cholesterol are not outlined, it is important for individuals to track blood cholesterol levels over time since blood levels remain an important component of risk assessment and targets for treatment.
“We see potential benefits for maintaining LDL-C target goals, including patient compliance and motivation. They also provide physicians with a means to ensure that the desired effect is achieved,” Dr. Rocco says.
Food for thought
Miss eggs? Get reacquainted at the breakfast table, if you’d like. According to new U.S. Dietary Guidelines, intake of cholesterol itself does not appear to significantly raise blood cholesterol and does not need to be restricted as much as once thought to maintain healthy cholesterol levels, Dr. Rocco says.
Since over 80% of cholesterol in blood is manufactured and regulated by the body, the contribution from food we eat generally has a small effect on total cholesterol levels. Although eggs and shellfish are high in cholesterol they are low in saturated fat.
Saturated fats and particularly trans-fat contribute to high blood cholesterol and should be avoided. Trans-fats often are labeled as hydrogenated oil or partially hydrogenated vegetable oil. Also from a public health perspective, dietary recommendations reinforce emphasis on reducing intake of refined sugars and carbohydrates (linked to the surge in obesity and diabetes in this country) and increasing intake of fruits, vegetables and whole grains, he says.
Updates to the U.S. Dietary Guidelines reflecting these shifts are expected this year.
“There has been considerable misinterpretation of these new recommendations. Although cholesterol in the diet takes a back seat, blood cholesterol levels remain important. If your cholesterol is high, it should be treated with a focus on limiting saturated fat, increasing fiber in the diet and taking medications such as statins when determined appropriate by a physician.”