American College of Cardiology President: Why Cholesterol Still Matters

The New Dietary Guidelines

The media has focused a lot of recent attention on the new Scientific Report of the 2015 Federal Dietary Guidelines Advisory Committee, which no longer lists cholesterol as a nutrient of concern for overconsumption. Dr. Kim Williams, president of the American College of Cardiology, had mixed reactions to the new guidelines.

“There was so much good in the new guidelines that the committee should be commended. They encourage people to cut down on red meat, saturated fat, and sugar intake. Their recommendations are consistent with the current literature on red meat and overall mortality, as well as improving risk factors, as shown in the Adventists Health Studies. The Adventists studies demonstrated less hypertension, obesity, and diabetes with less animal products in the diet.”

He wasn’t happy, however, about the new take on cholesterol.

“The evidence does not support the notion that cholesterol is no longer a nutrient of concern. Previously, the advisory committee supported a 300 mg per day cholesterol limit. But given that eggs contain about 200 mg of cholesterol, people can reach that limit before lunchtime, merely by eating eggs for breakfast.

“For their new cholesterol guidelines, the advisory committee used two references, one being our ACC/AHA [American College of Cardiology/American Heart Association] joint guidelines. They misrepresented the conclusions of our report as showing no evidence of a relationship between dietary cholesterol and serum cholesterol. But what we actually said in that report was that the data reviewed with strict limitations (such as requiring no more than 3% change in weight) was inadequate to make inferences about the effects of ingested cholesterol on serum cholesterol.”

Shin Meta-Analysis Offers Perspective

Williams went on to talk about the Shin meta-analyis, which looked at how egg consumption was related to the risk of cardiovascular disease and diabetes. This analysis compared people who ate less than one egg per week to people who ate more than one egg per day.

“The study authors concluded that in six to twenty years, there was no increased cardiovascular risk between the low- egg and high-egg-eating groups. However, the study also clearly demonstrated that the group with high egg consumption developed diabetes 42% more often. And people in the egg-eating group who were already diabetic showed a 69% increased risk of having a cardiac event. This is of concern, as diabetes continues to increase in the United States—21 million Americans and growing.  As doctors and scientists, we need to implement public health measures to improve long-term health.”