CardioExchange Archive

CardioExchange, an NEJM practice community for medical professionals dedicated to improving cardiac patient care, was active from 2009 to 2015. CardioExchange fostered discussion between clinicians from across the globe.

February 11th, 2015

New US Guidelines Will Lift Limits on Dietary Cholesterol

The influential Dietary Guidelines Advisory Committee has recommended that limitations on dietary cholesterol be removed from the upcoming 2015 edition of Dietary Guidelines for Americans. Recommendations to reduce dietary cholesterol have been a mainstay of the USDA and other guidelines for many years, starting with guidance from the American Heart Association in the 1960s.

The proposed change reflects a major shift in the scientific view of cholesterol in recent years. Although serum cholesterol is still considered an important risk factor, cholesterol consumed in food is now thought to play a relatively insignificant role in determining blood levels of cholesterol. In previous guidelines, excess dietary cholesterol was considered to be a public health concern. The draft of the new report [PDF] states:

 “Cholesterol is not considered a nutrient of concern for overconsumption.”

The proposed change was first reported on Tuesday by Peter Whoriskey in the Washington Post. He reports that “a person with direct knowledge of the proceedings said the cholesterol finding would make it to the group’s final report, which is due within weeks.” The final guideline will be published later this year by HHS and the USDA. Whoriskey writes that the guidance”has broad effects on the American diet, helping to determine the content of school lunches, affecting how food manufacturers advertise their wares, and serving as the foundation for reams of diet advice.”

“It’s the right decision,” Steve Nissen told USA Today. “We got the dietary guidelines wrong. They’ve been wrong for decades.” Nissen also said that advice about reducing saturated fat and salt may be wrong, but no major change in these areas is expected in the new guidelines.

Categories: General, Prevention
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2 Responses to “New US Guidelines Will Lift Limits on Dietary Cholesterol”

  1. carol vassar, MD says:
    February 13, 2015 at 2:14 am

    As presented here, the new guidelines are as irresponsible as the old ones. The disruption to businesses and and to people’s lives should not be taken so lightly by medical experts. If serum cholesterol is important, then whether or not a person needs to limit the cholesterol in their diet is determined not by some expert’s hunch or regret about previous inadequately supported recommendation, but by the individual’s serum cholesterol changes in response to dietary changes.

  2. LORENZO FITZIG, MD says:
    February 14, 2015 at 3:41 pm

    Been in practice for > 30yrs and it seems that this is the typical arc of how guidelines change over the years. Wait long enough and even the most basic, dogmatic, Ia type guidelines may change. Look at such issues as sodium intake, tight DM control, BP control in the elderly and the approach to lipid treatment, to mention just a few.