Panel could scrap advice on dietary cholesterol

Liz Szabo | USA TODAY

Longstanding advice about avoiding cholesterol for heart health may be on the way out.

In a draft report issued in December, an influential federal panel — the Dietary Guidelines Advisory Committee — scrapped longstanding guidelines about avoiding high-cholesterol food. In the draft, cholesterol — found in foods such as egg yolks — is no longer listed as a "nutrient of concern."

The panel hasn't yet filed its final report, but it ncludes the same comment on cholesterol, according to a report in The Washington Post.

The committee is not reversing advice about the risks of having a high level of LDL cholesterol, the "bad" cholesterol, in the blood. People with high LDL levels are at greater risk of a heart attack.

The committee will send its final recommendations to the Department of Health and Human Services and the U.S. Department of Agriculture, which issue the dietary advice. Those departments are expected to issue Dietary Guidelines for Americans, 2015 later this year.

Spokesmen for the USDA and HHS declined to comment on the Post story. In a written statement, the USDA said, "The committee's activities are solely advisory in nature. We look forward to reviewing the recommendations from the advisory committee, as well as public comments and the views of other experts, as we formulate the 2015 Dietary Guidelines for Americans over the course of the next year."

The proposed change on cholesterol would be in line with the positions of other health groups, said Robert Eckel, past president of the American Heart Association. The heart association and American College of Cardiology issued dietary guidelines in 2013 and did not include advice about cholesterol. That's because there wasn't definitive evidence to tell the average person to reduce how much cholesterol they consume, Eckel said.

People with diabetes should still be careful about consuming too much cholesterol, which may increase their heart risks, Eckel says.

Other cardiologists agree it's time to stop telling people to limit cholesterol from food.

"It's the right decision," said Steven Nissen, chairman of cardiovascular medicine at the famed Cleveland Clinic. "We got the dietary guidelines wrong. They've been wrong for decades."

He noted that only 20% of a person's blood cholesterol — the levels measured with standard cholesterol tests — comes from diet. The rest comes from genes, he said.

"We told people not to eat eggs. It was never based on good science," Nissen said.

Advice to avoid foods high in fat and cholesterol led many Americans to switch to foods high in sugar and carbohydrates, which often had more calories. "We got fatter and fatter," Nissen says. "We got more and more diabetes."

Recent studies even suggest that longtime advice on saturated fat and salt may be wrong, Nissen says.

Marion Nestle, a professor in the department of nutrition, food studies and public health at New York University, noted that the federal government doesn't have to follow the committee's advice.

The last set of advice, the 2010 guidelines, advised Americans to consume less than 300 milligrams a day of dietary cholesterol, about the amount in one egg. Nestle said she has no inside knowledge of the committee's decision.

"If the committee is dropping this recommendation, it may be because so many people are taking statins that dietary cholesterol doesn't matter so much anymore," Nestle said. "In the last study I saw that exonerated eggs from raising heart disease risk, 90% of the study subjects were taking statins. But I think we need to wait and see what the committee actually says before saying too much about this."