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Dietary Cholesterol
The Gale Encyclopedia of Diets. 3rd ed. 2019.
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Page 347

Dietary Cholesterol

Definition

Cholesterol is a soft, white, waxy substance found in the lipids of the bloodstream and in the cells of the body. There are two sources of cholesterol. The first is the body, mainly the liver, which produces typically about one gram per day. The second are cholesterol-containing foods from animal sources, especially egg yolks, meat, poultry, fish, seafood, and whole-milk dairy products. Cholesterol in foods is called dietary cholesterol.

Purpose

Cholesterol is found in every cell of the body. It has several important functions in maintaining health, such as:

  • keeping cell membranes intact
  • boosting mental performance
  • helping digestion
  • building strong bones
  • building muscle
  • maintaining energy, vitality, and fertility
  • regulating blood sugar levels
  • repairing damaged tissue
  • protecting against infectious diseases

Dietary cholesterol

Food

Cholesterol (mg)

Beef liver, cooked, 3 oz.

331

Beef sweetbreads, cooked, 3 oz.

250

Squid, cooked, 3 oz.

227

Egg, whole, large

212

Shrimp, cooked, 3 oz.

166

Ice cream, gourmet, 1 cup

90

Salmon, baked, 3.5 oz.

87

Lamb chop, cooked, 3 oz.

75

Chicken breast, cooked, 3 oz.

72

Beef, round, cooked, 3 oz.

71

Beef, sirloin, cooked, 3 oz.

71

Pork chop, cooked, 3 oz.

71

Chicken, dark meat, cooked, 3 oz.

70

Beef, rib eye, cooked, 3 oz.

65

Ham, regular, cooked, 3 oz.

50

Tuna, water packed, drained, 3.5 oz.

42

Milk, whole, 1 cup

33

Butter, 1 tbsp.

31

Ice cream, light, 1 cup

31

Cheese, cheddar, 1 oz.

30

Scallops, cooked, 3 oz.

27

Hot dog, beef, 1 frank

24

Cheese, reduced fat, 1 oz.

6

Yogurt, part skim, 1 cup

6

However, excess cholesterol has been shown to accumulate in the bloodstream and on the walls of arteries, forming “plaques” that can clog the blood vessels (atherosclerosis) and lead to heart attack or stroke. Because high blood cholesterol is one of the major risk factors for heart disease, dietary cholesterol has been the focus of much debate over what constitute healthy or unhealthy levels of cholesterol in the blood and how to lower cholesterol in the diet.

Description

Dietary cholesterol is found in animal food sources such as meat, poultry, seafood, and dairy products. Foods from plants, such as fruits, vegetables, vegetable oils, grains, cereals, and nuts and seeds do not contain cholesterol. Major sources of dietary cholesterol include meats and poultry (beef, chicken, pork, lamb), seafood (squid, salmon, tuna), and dairy products (eggs, ice cream, cheese, milk, butter).

Cholesterol does not dissolve in blood. It has to be transported to and from the cells by special carriers called lipoproteins, which are present in blood plasma. The most important forms of lipoproteins are:

  • Very high-density lipoprotein (VHDL). VHDL consists of proteins and a high concentration of free fatty acids.Page 348  |  Top of Article
  • High-density lipoprotein (HDL). HDL helps remove fat from the body by binding with it in the bloodstream and carrying it back to the liver for excretion in the bile and disposal. High levels of HDL may lower chances of developing heart disease or stroke.
  • Intermediate-density lipoprotein (IDL). IDLs are formed during the degradation of very-low-density lipoproteins; some are cleared rapidly into the liver and some are broken down to low-density lipoproteins.
  • Low-density lipoproteins (LDL). LDL transports cholesterol from the liver and small intestine to tissues outside the liver (extrahepatic) and other parts of the body. High LDL levels may increase chances of developing heart disease.
  • Very low-density lipoprotein (VLDL). VLDLs carry triglycerides from the intestine and liver to fatty (adipose) and muscle tissues. A high VLDL level can cause a buildup of cholesterol in the arteries and increase the risk of heart disease and stroke.
  • Chylomicrons. Chylomicrons are proteins that transport cholesterol and triglycerides from the small intestine to tissues after meals.

Generally speaking, LDL levels should be low because LDL deposits cholesterol in the arteries and causes them to become clogged. HDL levels should be high because HDL helps clean fat and cholesterol from arteries, carrying it to the liver for removal from the body. This is why HDL is often called the “good cholesterol” and LDL the “bad cholesterol,” although studies conducted in 2012 began to challenge this belief.

American Heart Association recommendations

The American Heart Association (AHA) endorses the following dietary recommendations for people with high blood cholesterol:

  • total fat: 25% of total calories
  • saturated fat: less than 7% of total calories
  • polyunsaturated fat: up to 10% of total calories
  • monounsaturated fat: up to 20% of total calories
  • carbohydrates: 50%–60% of total calories
  • protein: about 15% of total calories
  • cholesterol: less than 200 mg/dL
  • plant sterols: 2 g
  • soluble fiber such as psyllium: 10–25 g

Categories of appropriate foods include:

  • lean meat or fish: less than 5 oz/day
  • eggs: less than two yolks per week (whites unlimited)
  • low-fat dairy products (1% fat): 2–3 servings/day
  • grains, especially whole grains: 6–8 tsp/day
  • vegetables: less than 6 servings per day
  • fruits: 2–5 servings per day

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QUESTIONS TO ASK YOUR DOCTOR
  • What is the connection between cholesterol and heart disease?
  • Do I need to take medication to lower my cholesterol?
  • Are there any precautions I should take with, or side effects to be expected from, cholesterol-lowering medications?
Tips for preventing high cholesterol

Making smart dietary choices can prevent cholesterol levels from being too high. Some fats, such as mono- and polyunsaturated fats, may lower LDL cholesterol levels. Other fats, such as saturated and trans fats, raise cholesterol. Sources of fats include:

  • monounsaturated fats (lower LDL, raise HDL): olives, olive oil, canola oil, nuts, avocados
  • polyunsaturated fats (lower LDL, raise HDL): corn, soybeans, safflowers, cottonseed oils, fish
  • saturated fats (raise both LDL and HDL): whole milk, butter, cheese, ice cream, red meat, chocolate, coconuts
  • trans fats (raise LDL): most margarines, vegetable shortening, partially hydrogenated vegetable oil, deep-fried chips, many fast foods, most commercial baked goods

Other suggested guidelines include:

  • Select lean meats and poultry. Choose chicken and turkey without skin or remove skin before eating. Dry peas, beans, and tofu are low in saturated fat and cholesterol and can be eaten as alternatives to meat.
  • Egg yolks are high in dietary cholesterol (213 mg per yolk). They should be limited to no more than two per week, including the egg yolks in baked goods and processed foods. Egg whites have no cholesterol and can be substituted for whole eggs when baking.
  • Choose low- or reduced-fat dairy products (milk, cheese, yogurt, ice cream) over those made with whole milk.Page 349  |  Top of Article
  • Limit butter, lard, and solid shortenings.
  • Eat lots of fruits and vegetables, which are low in fat and high in fiber.
Cholesterol-lowering foods

Some foods may actually lower a person's cholesterol. Soluble fiber has been shown to help reduce LDL cholesterol levels when eaten as part of a healthy diet. Specific cholesterol-lowering foods include:

  • oatmeal
  • fish high in omega-3 fatty acids, such as salmon
  • nuts
  • olive oil

Plant sterols and stanols, found in trace amounts in plant-based foods, have been found to reduce LDL cholesterol levels by up to 15%. Because the amounts obtained through dietary sources are low, foods fortified with plant sterols are available.

Precautions

The National Heart, Lung, and Blood Institute (NHLBI), through its National Cholesterol Education Program (NCEP), recommends that adults begin cholesterol screening at age 20 and repeat the screening every five years. People who have one or more risk factors for developing heart disease (for example: diabetes, kidney disease, high blood pressure, vascular disease, or a history of elevated cholesterol levels) should have their cholesterol levels checked more often.

Simple blood tests are done to check blood cholesterol levels. A lipoprotein test, also called a fasting lipid test, is commonly performed as part of a routine medical examination. A cholesterol test measures lipid levels and usually reports on four groups:

  • total cholesterol (normal: 100–199 mg/dL)
  • LDL (normal: less than 100 mg/dL)
  • HDL (normal: 40–59 mg/dL)
  • triglycerides (normal: less than 150 mg/dL)

Complications

If dietary cholesterol intake is excessive, it can lead to an elevation of lipid levels in the bloodstream, a condition known as hyperlipidemia. These lipids include cholesterol, phospholipids, and triglycerides (fats). Hypercholesterolemia is the term for high cholesterol levels, and hypertriglyceridemia is the term for high triglyceride levels. Because cholesterol-rich foods are also usually high in saturated fat, hypercholesterolemia is often combined with hypertriglyceridemia. Hyperlipidemias have been shown to represent a major risk factor for heart disease, a leading cause of death in the United States.

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KEY TERMS
Artery—
A blood vessel that carries blood from the heart to the body.
Atherosclerosis—
Clogging, narrowing, and hardening of the large arteries and medium-sized blood vessels. Atherosclerosis can lead to stroke, heart attack, eye problems, and kidney problems.
Blood plasma—
The pale, yellowish, protein-containing fluid portion of the blood in which cells are suspended. 92% water, 7% protein and 1% minerals.
Extrahepatic—
Originating or occurring outside the liver.
Fatty acid—
Any of a large group of monobasic acids, especially those found in animal and vegetable fats and oils, having the general formula CnH.
Heart attack—
A heart attack occurs when blood flow to the heart muscle is interrupted. This deprives the heart muscle of oxygen, causing tissue damage or tissue death.
Lipids—
Group of chemicals, usually fats, that do not dissolve in water, but dissolve in ether.
Omega-3 fatty acid—
Any of several polyunsaturated fatty acids found in leafy green vegetables, vegetable oils, and fish such as salmon and mackerel, capable of reducing serum cholesterol levels and having anticoagulant properties.
Saturated fat—
A type of fat that comes from animals and that is solid at room temperature.
Stroke—
The sudden death of some brain cells due to a lack of oxygen when the blood flow to the brain is impaired by blockage or rupture of an artery to the brain.
Triglyceride—
A fat that comes from food or is made up of other energy sources in the body. Elevated triglyceride levels contribute to the development of atherosclerosis.
Unsaturated fat—
A type of fat derived from plant and some animal sources, especially fish, that is liquid at room temperature.

See also Fats; Hyperlipidemia; Hypertriglyceridemia; Low-cholesterol diet; Omega-3 and omega-6 fatty acids; TLC diet; Trans fats; Triglycerides.

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Resources

BOOKS

American Heart Association. American Heart Association Healthy Fats, Low-Cholesterol Cookbook: Delicious Recipes to Help Reduce Bad Fats and Lower Your Cholesterol. 5th ed. New York: Harmony Books, 2015.

Duyff, Roberta Larson. Academy of Nutrition and Dietetics Complete Food and Nutrition Guide. 5th ed. Boston: Houghton Mifflin Harcourt, 2017.

Freeman, Mason W., and Christine E. Junge. Harvard Medical School Guide to Lowering Your Cholesterol. New York: McGraw-Hill, 2005.

Goldberg, Anne C., and Vera A. Bittner, eds. 100 Questions & Answers about Managing Your Cholesterol. The National Lipid Association. Burlington, MA: Jones & Bartlett Learning, 2011.

Mihaly, Mary. The Complete Guide to Lowering Your Cholesterol: Your All-in-One Resource for a Heart-Healthy Life. New York: St. Martins Paperbacks, 2011.

Truswell, A. Stewart. Cholesterol and Beyond: The Research on Diet and Coronary Heart Disease 1900–2000. New York: Springer, 2010.

PERIODICALS

AbuMweis, S. S., and P. J. Jones. “Cholesterol-Lowering Effect of Plant Sterols.” Current Atherosclerosis Reports 10, no. 6 (December 2008): 467–72.

Kolata, Gina. “Doubt Cast on the ‘Good’ in ‘Good Cholesterol’.” New York Times, May 16, 2012, A1. http://www.nytimes.com/2012/05/17/health/research/hdl-good-cholesterol-found-not-to-cut-heart-risk.html (accessed March 23, 2018).

Sabaté, Joan, Keiji Oda, and Emilio Ros. “Nut Consumption and Blood Lipid Levels: A Pooled Analysis of 25 Intervention Trials.” Archives of Internal Medicine 170, no. 9 (2010): 821–27. http://dx.doi.org/10.1001/archinternmed.2010.79 (accessed March 23, 2018).

WEBSITES

American Heart Association. “Whole Grains and Fiber.” http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyDietGoals/Whole-Grains-and-Fiber_UCM_303249_Article.jsp (accessed March 23, 2018).

Centers for Disease Control and Prevention. “About High Cholesterol.” https://www.cdc.gov/cholesterol/about.htm (accessed March 23 2018).

Cleveland Clinic. “Phytosterols: Sterols & Stanols.” https://my.clevelandclinic.org/health/articles/17368-phytosterols-sterols–stanols (accessed March 23, 2018).

Harvard T.H. Chan School of Public Health. “What Should I Eat? Fats and Cholesterol.” Nutrition Source, Department of Nutrition, Harvard University. https://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/fats-and-cholesterol (accessed March 23, 2018).

Mayo Clinic staff. “Cholesterol: Top 5 Foods to Lower Your Numbers.” MayoClinic.com . http://www.mayoclinic.com/health/cholesterol/CL00002 (accessed March 23, 2018).

National Heart, Lung, and Blood Institute. Your Guide to Lowering Your Cholesterol with Therapeutic Lifestyle Changes (TLC). NIH Pub. No. 06-5235. Washington, DC: U.S. Department of Health and Human Services, National Institutes of Health, December 2005. http://www.nhlbi.nih.gov/files/docs/public/heart/chol_tlc.pdf (accessed March 23, 2018).

ORGANIZATIONS

American Heart Association, 7272 Greenville Ave., Dallas, TX, 75231, (800) 242-8721, http://www.heart.org/HEARTORG .

Centers for Disease Control and Prevention, Division for Heart Disease and Stroke Prevention, 4770 Buford Hwy NE, Mail Stop F-72, Atlanta, GA, 30341-3717, (800) CDC-INFO (232-4636), TTY: (800) 232-6348, Fax: (770) 488-8151, cdcinfo@cdc.gov, http://www.cdc.gov/dhdsp .

National Heart, Lung, and Blood Institute, PO Box 30105, Bethesda, MD, 20824-0105, (301) 592-8573, TTY: (240) 629-3255, Fax: (240) 629-3246, nhlbiinfo@nhlbi.nih.gov, http://www.nhlbi.nih.gov .

Full Text: 

Monique Laberge, PhD

Source Citation   (MLA 8th Edition) 
Laberge, Monique, PhD. "Dietary Cholesterol." The Gale Encyclopedia of Diets, edited by Deirdre S. Hiam, 3rd ed., vol. 1, Gale, 2019, pp. 347-350. Health & Wellness Resource Center, http%3A%2F%2Flink.galegroup.com%2Fapps%2Fdoc%2FCX2491000093%2FHWRC%3Fu%3Dstanhosp_main%26sid%3DHWRC%26xid%3Db50d5970. Accessed 23 May 2019.

Gale Document Number: GALE|CX2491000093

Disclaimer:   This information is not a tool for self-diagnosis or a substitute for professional care.

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