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Expert’s Corner: Impact of dietary cholesterol ‘overrated’

Preventive cardiologist Ira Ockene tells patients to concentrate on saturated fats, not cholesterol, in food choices and preparation

By Sandra Gray

UMass Medical School Communications

February 12, 2015
  Preventive cardiologist Ira Ockene, MD, supports a new federal recommendation to lift the decades-old limit on cholesterol consumption from the government’s dietary guidelines.
  Ira Ockene, MD

The impact of cholesterol in an individual’s diet has long been “overrated,” according to preventive cardiologist Ira Ockene, MD, who supports a new federal recommendation to lift the decades-old limit on cholesterol consumption from the government’s dietary guidelines.

“Dietary cholesterol does not play a large role in blood serum cholesterol levels,” said Dr. Ockene, the David J. and Barbara D. Milliken Professor of Preventive Cardiology and professor of medicine. “Everybody is different, but for most people, dietary cholesterol is not as important as other factors.”

The nation’s influential Dietary Guidelines Advisory Committee recommends lifting the limit on dietary cholesterol, a proposal that is likely to be adopted in the 2015 edition of the United States Department of Agriculture’s Dietary Guidelines, which are updated every five years and impact everything from what’s in school lunches to what products food companies purvey.

The guidelines released in 2010 maintained the advice that Americans should consume less than 300 mg per day of dietary cholesterol—the amount of cholesterol in just one-and-a-half egg yolks. But Ockene cites studies that have shown consuming one egg a day, which has a fair amount of cholesterol, won’t raise blood cholesterol at all, and eating two eggs a day will raise it just slightly.

“In terms of what’s important in the diet, saturated fats and trans fats (a kind of saturated fat) are much more important and play a much larger role.”

Ockene does caution that individuals should avoid eating cholesterol-laden foods with abandon. “That is not to say that if someone decides to eat a dozen eggs a day that it doesn’t matter—there is a relationship between increased dietary and serum cholesterol, but it takes a lot of it,” he said.

More important than how much cholesterol a food contains is how it is prepared and served. “It’s not the shrimp but the batter and fat you coat and fry it in,” said Ockene. “It’s not the lobster but the butter you dip it in.”

There are nuances, especially for individuals with diabetes. “If you’re not diabetic, focus on saturated fats and trans fats,” Ockene noted. But if you are diabetic, then concentrate on shifting the diet to much more important reductions in simple carbohydrates and low fiber foods. Weight loss also becomes very important.”

For years, Ockene has been telling patients to focus on a diet low in saturated fats and trans fats and high in fiber. “I talk about diet with my patients a great deal—three dieticians work with me. Diet is very important.”

Related links on UMassMedNow:
Research piling up against use of multivitamins: Cardiologist Ira Ockene says most people get adequate nutrition from daily diet
Diabetes intervention proves effective in Lawrence