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Cholesterol Gets a Bum Rap

Written by: Tom Nikkola – Director of Nutrition & Weight Management 

For years, cholesterol has had a reputation for being a culprit in cardiovascular disease risk and general health problems. We’ve been told to strive to lower our cholesterol levels and eat a low-cholesterol, low-fat diet — but does research support this idea? A new article published in the prestigious British Journal of Nutrition (BJN)[i] presents some of the facts surrounding cholesterol and helps bring clarity to much of the confusion.

What is cholesterol?

WebMd describes cholesterol as “a waxy, fat-like substance made in the liver and other cells and found in certain foods, such as food from animals, like dairy products, eggs and meat.” Cholesterol is not found in plants. The description of cholesterol as a “waxy, fat-like substance” paints a picture of some kind of dangerous material that’s likely to clog up our arteries and lead to cardiovascular disease. (Not surprisingly, on the same page is a banner ad for the most popular cholesterol-lowering statin drug in the world.)

Cholesterol is far more than just a fatty substance, destined to block blood vessels. In fact, cholesterol is a hormone precursor, important for vitamin D synthesis, mineral balance, blood sugar regulation and the body’s sex hormone production. It is important material found throughout body cells. Our bodies demand a certain amount of cholesterol, which varies by individual. It is so critical to metabolic health, that the body will produce its own when supplies are low and reduce production when sufficient amounts are provided through the diet.

Does dietary cholesterol affect blood cholesterol levels?

Due to the body’s ability to increase and decrease production based on dietary intake, many people see little change in blood cholesterol changes from eating a low-cholesterol diet. The Standard American Diet (S.A.D.) contains about 300-450 milligrams of cholesterol per day and the body produces about 800-1400 milligrams on its own, totaling about 1000-2000 milligrams per day in the body. Individuals vary, but for each of us, the body maintains a fairly tight control of what is available.

The BJN cites an article from 16 years ago showing how reducing dietary cholesterol consumption by 50% only reduced blood cholesterol levels by 0.3%! A study published in the journal, Lipids, showed when individuals consumed a difference of 800 milligrams per day of cholesterol, their blood cholesterol levels changed by only 6%.[ii]  While this research has been available for quite some time, people continue to be told to cut down on cholesterol and saturated fat — even though it appears to have little, if any effect on the body’s cholesterol level.

A certain percentage of the population is prone to raised cholesterol levels from dietary cholesterol, but even for them, consuming excessive amounts on a regular basis hasn’t been shown to raise cholesterol levels significantly. Being overweight seems to have an effect on cholesterol synthesis, with overweight individuals synthesizing almost twice as much cholesterol as those at an ideal weight.

Does elevated cholesterol increase heart disease risk?

According to research, elevated cholesterol levels generally do not appear to raise the risk of heart disease. Much of the thought around the benefits of reducing cholesterol levels come from research done on statin drugs. Statins do reduce blood cholesterol levels and, in men at risk of future heart problems, may reduce the risk of a cardiac event. The benefits shown for this subset of the population have perpetuated the belief that reducing cholesterol reduces the risk of heart disease. However, more recent thought suggests statins’ benefits come from their ability to reduce inflammation, which is more likely the cause of cardiovascular problems. With that, it would appear many people have been misguided in the idea of the need to reduce cholesterol levels, at least by way of dietary modification. As the authors of the BJN explain:

“Recent epidemiological studies have not shown any relationship between cardiovascular risk and dietary cholesterol intake and/or egg consumption, or else have shown a very low effect, except in diabetic subjects.”


Because cholesterol plays such a critical role in optimal metabolic health, it’s important for people to understand the difference between what research shows about blood cholesterol, dietary cholesterol, the foods we eat and cardiovascular health. Rather than looking at cholesterol as a problem by itself, it's important to see it as a result of something else in the body going awry, a topic we'll address next week.

To gain additional insight into this important topic, check out the recent presentation by Dr. David Diamond, neuroscientist and professor at the University of South Florida, at a recent lecture for the USF College of Arts and Sciences at the University Club in downtown Tampa, entitled How Bad Science and Big Business Created the Obesity Epidemic. 

This article is not intended for the treatment or prevention of disease, nor as a substitute for medical treatment, nor as an alternative to medical advice. Use of recommendations in this and other articles is at the choice and risk of the reader.

Share thoughts and post questions below.



[i] Lcerf JM, de Lorgeril M. Dietary cholesterol: from physiology to cardiovascular risk. Brit J Nut. 2011;106:6-14

[ii] Boucher P, de Lorgeril M, Salen P, et al. Effect of dietary cholesterol on LDL-receptor, HMGCoA reductase and LRP mRNA expression in healthy humans. Lipids. 1998;33:1177-1186

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