For more than half a century, scientists have debated the role of dietary cholesterol in a healthy diet. Because it was often associated with saturated fat, limiting dietary cholesterol – especially by restricting egg consumption – seemed to benefit heart health efforts.
More recently, accumulating data has caused researchers to broaden their thinking about how dietary cholesterol – and eggs – fit into a healthy eating pattern. “We’ve advanced considerably,” says professor Linda Van Horn, chief of the nutrition division in the department of preventive medicine at Northwestern University’s Feinberg School of Medicine in Chicago. “And we proceed on these issues as we learn more.”
Change can be confusing. So here are answers to a few common questions.
Are dietary cholesterol and blood cholesterol the same thing?
No. Dietary cholesterol is found in food. Blood cholesterol – which includes HDL (“good”) and LDL (“bad”) – is one of eight essential measures of heart health identified by the American Heart Association. A diet high in saturated fat can lead to high LDL cholesterol levels and further lead to plaque buildup in the walls of your arteries. This restricts blood flow and can lead to a heart attack or stroke.
Your doctor can check your blood cholesterol levels with a blood test.
What is dietary cholesterol, then?
Dietary cholesterol comes from animal-based foods. According to a 2019 AHA science advisory on dietary cholesterol and cardiovascular risk – which Van Horn helped write – high-fat meat, eggs, butter and full-fat dairy products are major sources. It’s especially abundant in processed meats – “sausages, burgers, hot dogs or similar foods,” Van Horn says.
Dietary cholesterol also can be found in baked goods made with eggs, butter or cream.
Although dietary cholesterol was once singled out as a contributor to heart disease, the 2019 science advisory said studies have not generally supported an association between dietary cholesterol and cardiovascular risk.
How much dietary cholesterol can I eat?
Federal dietary guidelines recommend keeping dietary cholesterol consumption “as low as possible without compromising the nutritional adequacy of the diet.”
The good news is that leaves room for flexibility. But it is not a free pass to eat all the dietary cholesterol you want.
“The general recommendation is to eat less than 300 milligrams of dietary cholesterol per day,” Van Horn advises.
But focusing on that number, or the lack of evidence linking dietary cholesterol to health risks, could be a misstep, she notes. That’s because foods high in dietary cholesterol also tend to be high in saturated fat. The exception is shellfish, such as