Guide to Controlling Cholesterol

Tired of giving runny eggs the runaround, or scrimping on the shrimp? If you’ve been avoiding these foods because of their reputation as cholesterol monsters, you might need to rethink your strategy.

Nutrition experts note that while foods such as the incredible edible egg are high in cholesterol, the impact of dietary cholesterol for most people pales in comparison with the real villains: saturated fats and trans fats. And some high-cholesterol foods such as eggs are excellent sources of low-fat, inexpensive protein as well as many other nutrients.

Effect of Dietary Cholesterol

“The bottom line is that dietary cholesterol does increase blood cholesterol levels, but other factors are more important,” said Qi Sun, instructor in medicine at Channing Laboratory, Brigham and Women's Hospital and Harvard Medical School. “For most healthy people, in general, dietary cholesterol wouldn’t dramatically increase blood levels.”

But that’s not necessarily a green light to order the omelet. Overindulging in high-cholesterol foods could have other negative impacts, Sun said, including increased blood pressure in some people.

Cholesterol is a lipid, or fat, that is necessary for life and health in moderate amounts. The quantity of cholesterol in your blood is important because of the link between high blood cholesterol levels and cardiovascular problems, including heart disease. High blood cholesterol also can be harmful for people with conditions such as diabetes and kidney disease.

The National Cholesterol Education Program recommends that people older than 20 generally should have a total blood cholesterol level of less than 200 mg per dL. For LDL, or bad, cholesterol, the level should be less than 100 mg/dL, and for HDL, the “good” cholesterol, the level should be 60 mg/dL, which is considered helpful in protecting against cardiovascular disease.

Levels of triglycerides, another lipid, are also important. Most healthy people should have triglyceride levels below 150 mg/dL.

According to the American Heart Association, dietary guidelines for Americans suggest that healthy adults should eat less than 300 mg/dL of cholesterol per day. That’s why foods such as eggs and shrimp draw so much attention. One large egg has about 185 mg/dL of cholesterol, while a 3-ounce serving of shrimp has more than 100 mg/dL.

Focus on Total Fats

“Reducing dietary cholesterol alone is not the answer to reducing blood cholesterol levels,” said Heather R. Mangieri, spokeswoman for the American Dietetic Association and a Pittsburgh-based registered dietitian. “Pay attention to the whole diet, and focus your efforts on watching total fat intake.”

It is especially important to replace saturated fats, found in foods such as certain meats and cheese, with healthier monounsaturated and polyunsaturated fats.

Genetics and lifestyle can play significant roles in blood cholesterol levels. The body produces its own cholesterol, regardless of how much or how little cholesterol you eat. Some people are genetically predisposed to producing more cholesterol than others. Factors such as being overweight, avoiding exercise and smoking also contribute.

An Egg a Day?

While eggs have long been seen as public enemy No. 1 in the battle against high cholesterol, research is showing that moderate egg consumption -- up to one egg per day -- does not significantly increase the risk of heart disease in most healthy people. But Sun, of the Harvard School of Public Health, notes that research also has shown that eggs do increase heart disease risks for people with diabetes.

“If someone has other health issues, such as diabetes or high cholesterol, perhaps they should avoid eating the egg yolk, which is where most of the cholesterol is found, and instead eat egg whites,” Sun said.

In addition to their high cholesterol content, eggs are often served with foods such as sausage, cheese and butter, which are high in saturated fat. But eggs are high in other nutrients as well, including vitamins A and D, B complex vitamins and phosphorus. They also contain lutein and zeaxanthin, which may promote healthy vision.

“If you reduce your saturated fat intake, you can reduce your LDL cholesterol level by 8 to 10 percent,” said Janet de Jesus, a nutrition education specialist with the National Heart, Lung and Blood Institute. “The biggest way to reduce or control your cholesterol levels is to work on saturated fats and trans fats.”

The nutrition experts all say that focusing on one blood level, or one nutrient, is the wrong approach. “Moderation in everything” is their mantra.

“We all get into trouble when we eat too much of something,” Mangieri said. “Balance and moderation are key characteristics of a healthy diet.”