The Red Herring of Cholesterol

  • 6 Jul 2011
  • Reading time 12 mins
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Back in 1913 a Russian scientist, Dr Anitschkov, thought he had found the answer to heart disease: he found that it was induced by feeding cholesterol to rabbits. What he failed to realise was that rabbits, being vegetarians, have no means for dealing with this animal fat.

I’ve kept an eye on studies ever since and they all show the same thing. Eating cholesterol doesn’t raise blood cholesterol. For example, here’s a more recent study, published in the European Journal of Nutrition in 2008. The researchers fed two eggs per day to overweight but otherwise healthy volunteers for 12 weeks while they simultaneously followed a reduced calorie diet.

A control group followed the diet but cut out eggs altogether. Both groups lost between 3 to 4kg (7- 9lbs) in weight and saw a fall in the average level of blood cholesterol. Research leader Professor Bruce Griffin stated: "When blood cholesterol was measured at both six weeks and twelve weeks, both groups showed either no change or a reduction, particularly in their LDL (bad) cholesterol levels, despite the egg group increasing their dietary cholesterol intake to around four times that of the control."

But what about if you have a high blood cholesterol level already?

A study in the Journal of the American College of Nutrition took 161 people with high cholesterol levels and fed them either two eggs a day or a cholesterol-free egg substitute. After 12 weeks those eating two eggs a day had a tiny non-significant increase in LDL cholesterol of 0.07mmol/l, and a significant increase in the ‘good’ HDL of 0.1mmol/l, and therefore no real change in the ratio of HDL to LDL cholesterol, which is the more important statistic. Having an LDL cholesterol below 1.8 is consistent with a low risk, while having a level above 3.4 is consistent with high risk. A tiny 0.07 increase is inconsequential. But what if there’s something special about eggs? Other foods rich in cholesterol include shrimps.

A more recent study from Rockefeller University, published in the American Journal of Clinical Nutrition, gave participants either three servings (300 grams) of shrimps or two large eggs a day, each providing 580mg of cholesterol. Researchers found that both groups had an increase in both the good HDL cholesterol and the less desirable LDL cholesterol, which they interpreted to mean that neither diet would be likely to make any significant difference to cardiovascular risk.

Does eating high cholesterol foods increase heart disease risk?
Surely eating lots of eggs or other high cholesterol and high fat foods must be bad news? Inuit people of North America (Eskimos) were always an enigma with regard to the cholesterol theory. Their traditional diet, high in seal meat, has among the highest cholesterol levels of any cultural diet, yet their rate of cardiovascular disease is among the lowest. However, we now know their diet of seal meat is exceptionally high in omega 3 fats, which confer protection. But what about people eating high cholesterol foods that aren’t high in omega 3 fats? In fact, as long ago as 1974, a British advisory panel set up by the government to look at ‘medical aspects of food policy on diet related to cardiovascular disease’ issued this statement: “Most of the dietary cholesterol in Western communities is derived from eggs, but we have found no evidence which relates the number of eggs consumed to heart disease.” The same still holds true today. Every study I’ve ever seen says the same thing. Study after study, such as in the journal Medical Science Monitor, has repeatedly failed to find any increased risk of heart disease from eating six eggs a week versus one.

One study, in the American Journal of Clinical Nutrition finds that seven eggs or more a week confers a very slight increased risk but this is not confirmed by other studies, while two studies find that risk is slightly higher in diabetics either eating lots of eggs or having a very high cholesterol intake in their diet. It is now evident that there is no clear relationship between intake of dietary cholesterol and cardiovascular disease. This said, however, a lot of high cholesterol foods also happen to be high in saturated fat and often fried. While this might not significantly raise cholesterol you might get more oxidized cholesterol, which is bad news.

It is therefore prudent not to go overboard on high cholesterol foods, while at the same time there is no need for cholesterol phobia. So, if you are not diabetic you can assume that it is certainly safe to have six eggs a week. If you are diabetic it may be wise to limit your total cholesterol by having no more than three eggs a week and less other cholesterol rich foods such as prawns, shrimps and shellfish. However, it is likely that if you overall diet is healthy, even this may be unnecessary.

Does a high fat diet increase heart disease risk?
But what about fat? We’ve all been told to eat low calorie low fat diets and supermarkets are full of low-fat foods often implied to reduce your risk of heart disease. There are a lot of inconsistencies here in that some countries with a high fat intake (for example Finland) have a high rate of heart disease while others (like Greece) have a very low rate of heart disease. Then, of course, we have the Inuit, and also Pacific and other islanders who eat loads of coconut ......

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