Cholesterol Flip-Flop

Advisory committee’s 2015 change on cholesterol
[published on]

by Lynn Prowitt


Have you heard the latest about-face in nutrition advice? It’s cholesterol this time. It seems dietary guidelines are highly susceptible to change. It happens in other disciplines: we once used leeches as a first line medical treatment; women used to wear corsets and men wigs; people thought the earth was flat. But when it comes to expert opinion on what we should and shouldn’t eat, it does seem there’s a higher than usual amount of flip-flopping.

dLife has long been saying that eggs (and seafood like lobster and shrimp) are good for you, yolks and all. Even if cholesterol and saturated fat were things to be avoided, the benefits of the extravaganza of nutrients in a whole egg would outweigh the negatives. It turns out that at long last the experts have seen the light and no longer recommend restricting dietary cholesterol.

Every five years the government releases a report called the “Dietary Guidelines for Americans.” It contains the latest, science-based nutrition recommendations for the general public. It’s written for nutrition and health professionals but trickles down to us via federal nutrition efforts, education initiatives, school lunch menus, and national food assistance programs. It also influences how food companies market products (e.g., “with whole grain!” and “zero grams of fat!”) and is the gospel behind most diet advice.

Who advises the government on what the guidelines should say? This year, it was a committee made up of fourteen nationally renowned experts in the fields of nutrition, medicine, and public health. They held seven public meetings and produced a 571-page report that they presented to the secretary of Health and Human Services and the secretary of Agriculture in February.

Some of the most respected voices in nutrition have publicly applauded the guidelines, calling them “courageous” (Marion Nestle, PhD, MPH, professor of Nutrition, Food Studies, and Public Health at New York University) and “excellent” (David L. Katz, MD, MPH, FACPM, FACP, founding director of Yale University’s Prevention Research Center). In addition to removing cholesterol from its previous designation as a “nutrient of concern for overconsumption,” other highlights of the report include:

–The advisors singled out added sugars as a major concern and suggest limiting it to no more than 10 percent of calories. In addition to the obvious sugar suitcases like candy, soda, and baked goods, added sugars are found in teas and juices, cereals (even the super healthy ones), yogurts, bread, ketchup, spaghetti sauce—almost everything.

–The advisors dropped the previous recommendation that Americans restrict their total fat intake to 35 percent of daily calories. This has been a long time coming, with previous versions having upped the limit. (Saturated fat is still designated a nutrient of concern.)

–Their summary recommendation: “A healthy dietary pattern is higher in vegetables, fruits, whole grains, low- or non-fat dairy, seafood, legumes, and nuts; moderate in alcohol (among adults); lower in red and processed meat; and low in sugar-sweetened foods and drinks and refined grains.”

(I predict we’ll see the dairy recommendation amended eventually and the meat wording might become more specific—e.g., perhaps they’ll say pasture-raised, organic beef is harmless in the context of a whole foods diet or get specific about what types of processing create the problems with “processed meat.”)

There’s a very important caveat to this change in cholesterol advice. Says Walter Willett, chair of the Harvard School of Public Health’s Nutrition Department and professor of Epidemiology and Nutrition, in an interview from the Harvard Gazette


“In the studies where we’ve seen overall no relation between eggs in the diet and heart disease, among people with diabetes, we do see an increased risk of heart disease with higher egg consumption. [Emphasis mine.] There is also quite a bit of evidence that higher egg consumption is related to a higher risk of diabetes itself. So for some people it’s still good to limit eggs.”

Bottom line: If you have diabetes, don’t eat a three-egg omelet every day. Be smart, be moderate, eat a variety of whole, natural foods with plants outweighing all the rest. And as for the guidelines, stay tuned to see if the government goes along with all of the advisors’ advice.

March 10, 2015
696 words