Where to Draw the Line on Cholesterol

Eggs are high in cholesterol but contain important nutrients.

By Heather Rasmussen

As a registered dietitian in a cardiology clinic, one of the most common questions I get asked relates to dietary cholesterol. Patients either state that they are avoiding dietary cholesterol as they know that it is “bad” for their heart, or they ask if the rumors that has been circulating about the dangers of cholesterol consumption are really true. As a researcher in the field of heart disease, I know the ins and out of cholesterol, and have a variety of responses in my arsenal.

First, it is true that in some people (approximately one-third), dietary cholesterol does increase your own circulating cholesterol. However, it raises both your good (HDL) and bad (LDL) cholesterol, so the ratio of the two does not change. Thus, it is thought that because of this simultaneous increase in both HDL and LDL cholesterol, dietary cholesterol does not greatly impact heart disease risk. However, there are a few caveats.  One, some research shows that eggs (containing dietary cholesterol) increase risk of heart disease in diabetics. In addition, there is some concern that if we measure our own circulating cholesterol after eating (not fasting as most of how cholesterol is measured), that dietary cholesterol may have a negative impact.

Something to also consider is the food source from which dietary cholesterol originates. Some foods that contain cholesterol include eggs, high-fat dairy (ricotta, whole milk, cheese), various meats and shrimp. But it’s important to look at food as a whole, rather than focusing attention on only one component such as cholesterol content. The table below highlights various components of three cholesterol-containing foods: shrimp, eggs and beef.

While some recommend cutting shrimp out of the diet due to its high cholesterol content, shrimp does possess several attributes that make it a reasonable selection. First, shrimp are high in protein and low in saturated fat. Second, they contain 235 mg of omega-3s per 3 ounces, while other sources of dietary cholesterol do not. Omega-3s are dietary fatty acids that are considered good for heart health, with the daily recommendation by the 2010 dietary guidelines being 250 mg omega-3 per day. Lean beefsteak has lower dietary cholesterol per serving, but does contain higher saturated fat, more calories and no omega-3 fatty acids. In addition, while eggs have almost as much cholesterol as is recommended for consumption over the entire day (≤200 mg per day recommended), they are relatively low in calories and saturated fat, and contain choline and leucine, two compounds that are important in the diet.

So depending on your health status, some foods such as shrimp and eggs can be consumed in reasonable portions, especially if they are used as a substitute for high saturated fat proteins or refined carbohydrates.

Shrimp

(3 oz)

Egg

(1 whole)

Beef Steak

(3 oz)

Calories

101

72

224

Protein (g)

19

6

23

Cholesterol

179

186

61

Saturated Fat (g)

0.5

1.6

6.0

EPA/DHA (mg)

235

29

0

Heather Rasmussen, PhD, RD, is an assistant professor with the Rush University College of Health Sciences.

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