Recently, the Dietary Guidelines Advisory Committee has re-evaluated its longstanding guidance about the avoidance of high-cholesterol foods, and has compiled a draft report that states cholesterol is no longer a nutrient of concern. This updated guidance is expected to be submitted to the Department of Health and Human Services, and these departments will issue the Dietary Guidelines for Americans, 2015 later this year.

As an organization committed to the practice of lipid management and improved patient outcomes, the National Lipid Association is concerned that this updated guidance may cause confusion among patients. We maintain that the ongoing evaluation of lipid (cholesterol) levels is an important component of prevention of heart disease and stroke and proper modification of diet remains an important first approach in addressing increased risk.

Most of the blood lipids are controlled by the liver, and cholesterol is made by all cells, thus it is not a dietary essential. However, in some people with genetic influence, high dietary cholesterol intake can result in higher LDL cholesterol levels, which is a major risk factor for heart disease. Along with saturated and trans fat intake, dietary cholesterol can have a significant effect on lipid levels in some individuals.

It is our belief that in the patient treatment paradigm, lifestyle factors such as diet and exercise must be a part of the equation to ensure patients take actionable steps to improve and safeguard heart health. It is imperative to advise patients that increasing cholesterol consumption especially from high-calorie foods or foods high in saturated fat that often accompany eggs (e.g., sausage, bacon, butter, cheese, and fried potatoes) may lead to complications such as weight gain as well as elevated blood pressure and glucose levels, which are all significant factors that increase risk of a cardiovascular event. We want patients to engage in an ongoing conversation with their healthcare provider about their cholesterol levels.

We encourage all Americans to set goals to reduce their cholesterol levels through diet and exercise to ensure optimal heart health. Furthermore, it is our recommendation that healthcare providers still advise their patients to make heart-healthy dietary choices and educate them about the distinction between blood cholesterol and dietary cholesterol. With the news that dietary cholesterol is being de-emphasized, it is important that patients remain diligent about decreasing their total and LDL cholesterol levels. There is compelling evidence that lowering blood cholesterol levels decreases the risk of heart disease.

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