Myth: Eating cholesterol and saturated fat raises cholesterol levels in the blood.

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Most cholesterol is made by our bodies and not ingested in our diet.  

Bacon wrapped steak

Bacon wrapped steak

Like most of you, I grew up being told that foods like red meat, eggs, and bacon raise our cholesterol levels and that I should avoid them. This belief is based on the fat diet hypothesis.   It is deeply ingrained in our society that it will not be easily replaced by a more truthful and helpful concept.  Is there any truth to the hypothesis?  

So what is the basis of the hypothesis?  The diet-heart hypothesis was developed based on the results of many studies in both animals and humans more than half a century ago.  The problem is that the majority of the studies have been debunked.  In fact, saturated fat levels appear to be inversely associated with heart disease[1].  The hypothesis was pushed heavily by politicians in the 50s through late 70s even though there was limited evidence to back it up in humans.  The majority of the major studies were found to no longer support the concept that saturated fat was a significant cause of cholesterol elevations and heart disease[2].  The fact is that the majority of cholesterol floating in our veins is made in our livers and not from our diet.    

One of the most vilified foods that reportedly raises our cholesterol is the wonderful egg yolk.  There have been multiple recent studies that debunk this age-old belief.  Even in groups that respond to saturated fat with increased cholesterol productions, cholesterol only modestly increases, and it is both an increased LDL and HDL[3].  It has limited effect because the ration is nearly unchanged.  In other words, eating cholesterol unlikely to cause a heart attack.  You can ditch the disgusting egg-white omelets and start eating yolks again.  That’s a good thing; eggs yolks are full of rare nutrients that will actually help your health.  
The bottom line: Cholesterol and saturated fat are not our enemies.   Close to one million Americans have a heart attack each year, but cholesterol and saturated fat are not the cause. It is time to look for another macronutrient to vilify.  In fact, one critique and review of the evidence suggests that our high carbohydrate and low-fat diet may have increased the risk of heart disease[4].  Enjoy your cholesterol and saturated fat, but that does mean that I am recommending that you eat piles of bacon at every meal.  I am just saying you do not need to avoid it.   

References

[1]
K. Yamagishi et al., “Dietary intake of saturated fatty acids and mortality from cardiovascular disease in Japanese: the Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC) Study.,” Am J Clin Nutr, vol. 92, no. 4, pp. 759–65, Oct. 2010. [PubMed]
[2]
P. Siri-Tarino, Q. Sun, F. Hu, and R. Krauss, “Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease,” Am J Clin Nutr, vol. 91, no. 3, pp. 535–546, Jan. 2010. [PMC]
[3]
L. Djoussé and J. Gaziano, “Dietary cholesterol and coronary artery disease: a systematic review.,” Curr Atheroscler Rep, vol. 11, no. 6, pp. 418–22, Nov. 2009. [PubMed]
[4]
S. L. Weinberg, “The diet–heart hypothesis: a critique,” J, vol. 43, no. 5, pp. 731–733, Mar. 2004 [Online]. Available: 10.1016/j.jacc.2003.10.034″ target=”_blank” rel=”noopener noreferrer”>http://dx.doi.org/10.1016/j.jacc.2003.10.034
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About the Author

ChuckH
I am a family physician who has served in the US Army. In 2016, I found myself overweight, out of shape, and unhealthy, so I made a change to improve my health. This blog is the chronology of my path to better health and what I have learned along the way.

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