Inconsistencies in National Dietary Guidelines for Cholesterol

17/01/07 A new study from the Life Sciences Research Office, Inc., (LSRO) explores why various nations’ dietary guidelines differ in their treatment of cholesterol. Food fat, cholesterol and fiber can influence blood levels of LDL-cholesterol, a known risk factor for heart disease and cardiac fatalities.

The U.S. recommends a maximum daily intake of 300 mg for cholesterol. In contrast, Australia/New Zealand, Canada, and the United Kingdom do not make specific recommendations for cholesterol intake, relying instead on limits for total and saturated fat intake and other dietary modifications to achieve healthy blood cholesterol levels.

LSRO was asked by the American Egg Board (Park Ridge, IL) to examine the history and development of U.S. government dietary guidelines for current cholesterol intake and compare those methods with approaches taken by Health Canada, the U.K. Science Advisory Committee on Nutrition, the National Health and Medical Research Council of Australia and New Zealand, the World Health Organization/Food and Agriculture Organization and others.

LSRO found that all the reviewed guidelines reflect the need to reduce saturated fat and that the general trend over time has been to recommend significant reductions in saturated fats and moderate reductions in total fat intake, and more recently to limit trans fat intake. In contrast, the maximum intake value for cholesterol of 300 mg, which was initially developed in 1968 by the American Heart Association for patients with high blood cholesterol, has not changed since it was recommended for the general U.S. public in 1970 and incorporated into food labels since 1995. Recent reviews of the scientific literature by U.S. authoritative bodies led such groups to conclude that “the relationship between cholesterol intake and LDL-cholesterol concentrations is direct and progressive, increasing the risk of coronary heart disease” and that cholesterol intake should be kept as low as possible within a nutritionally adequate diet.

To date, other countries viewing the same evidence as the U.S. come to the conclusion that the cholesterol in food is not the main influence on blood cholesterol and focus dietary guidance on reducing total fat and saturated fat intake by encouraging intake of lean meats, reduced-fat dairy foods, and a variety of whole grains, fruits and vegetables.

No other extensive catalog of the history of cholesterol dietary guidelines has been published.  This report provides a framework to understand the evidence on which the guidelines are based. Considerable more detail is provided in the project report, The Scientific Evidence and Approach Taken to Establish Guidelines for Cholesterol Intake in Australia, Canada, the United Kingdom, and the United States, making it a unique and valuable reference for physicians, nutritionists, clinical researchers and public health policymakers.