Q & A

How much does the cholesterol I get through food really affect my blood cholesterol level?

A: It depends. Most people absorb about half the cholesterol they consume through foods, but absorption rates vary (from 20 to 60 percent) from person to person. This variation may help explain why dietary cholesterol seems to increase levels of “unhealthy” LDL blood cholesterol in some people more than others, says EatingWell advisor Alice Lichtenstein.

Controlling blood cholesterol: does diet make a difference?

In any case, saturated and trans fats have a bigger detrimental effect on blood cholesterol levels, and heart health in general, than dietary cholesterol does. “Trans and saturated fats not only affect how much plaque is deposited in blood vessels, but also may damage the tissue of blood vessels,” says Susan Moores, M.S., R.D., a spokesperson for the American Dietetic Association. With a few exceptions—notably eggs and shellfish—foods high in cholesterol, such as fatty meats and whole-milk dairy, also tend to be high in saturated fat. Cutting back on sources of saturated fat automatically limits intake of dietary cholesterol.

Really, the best approach to controlling blood cholesterol is a big-picture one. “Most important to heart health is achieving a healthy body weight through diet and exercise,” explains Lichtenstein. Independent of specific dietary choices, research shows that shedding excess pounds lowers “unhealthy” LDL cholesterol and boosts the “healthy” HDL kind.

Bottom line: Unless your doctor has advised you to, don’t sweat counting dietary cholesterol; it’s just one factor (and not the most important one) affecting blood lipids. Limit intake of saturated fats by loading up on vegetables, fruits and whole grains, choosing low-fat dairy and lean proteins, and substituting healthy oils for butter. When shopping for crackers, snacks and margarine-type spreads, buy only those that are labeled trans-fat-free (and don’t include “partially hydrogenated fat” in the ingredients list). Maintain a healthy weight. And, if you’d like, enjoy an egg each morning and shellfish several times a week.

—D. Milton Stokes, M.P.H., R.D.

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Heart Healthy Diet Center

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USER COMMENTS — Add Your Comment

Keep in mind that current research shows that your heart disease risk factor is influenced by your total chol divided by your HDL (good) chol. So, knowing all of your chol #'s is very important! (TC, LDL, HDL) Up with the good, down with the bad!

Gina DeMuro, MS RD LD CDE, Albertville, AL

I really wish more people would use wise judgment based upon their own situations and not just on a lab test and suggestions of a doctor. Thank goodness I made my own decisions on my cholesterol situation or I would have been on potentially liver-damaging statins for nothing. Watch your diet for a month or so and take the tests. Be aware of the new guidelines for LDL #'s. It's not the low #'s they have found are not so healthy afterall. Read - read - read!! Get informed!!

Heidi Schlatter, Granby, CT

Without Rx, my cholesterol would continue at 620. LDL the bad one was over 200, and HDL, the good one was just 30. Mine is genetic; at age 30, my daughter had similar readings. My father died of a first heart attack at 70. Same with most of his family. They did not have Rx back then; just no salt or fat.

Marcia, Atlanta, GA