18 July 2018 | Online since 2003

10 April 2015

Influential US committee recommends abandoning cholesterol restrictions

“On average, the US diet is low in vegetables, fruit and whole grains and too high in calories, saturated fat, sodium, refined grains and added sugars”

An influential committee of American doctors and nutritionists has recommended that advice to limit consumption of cholesterol should be dropped.

The Dietary Guidelines Advisory Committee (DGAC) - comprising 14 experts in the fields of nutrition, medicine and public health - is the top panel on nutrition in the United States. The committee has just handed its latest recommendations to the US Health and Human Services Secretary and the country’s Agriculture Secretary. And it has decided to abandon any suggested restrictions on the intake of dietary cholesterol.

The experts say in their report, “Previously, the Dietary Guidelines for Americans recommended that cholesterol intake be limited to no more than 300 mg/day. The 2015 DGAC will not bring forward this recommendation because available evidence shows no appreciable relationship between consumption of dietary cholesterol and serum cholesterol, consistent with the conclusions of the AHA/ACC (American Heart Association/American College of Cardiology) report. Cholesterol is not a nutrient of concern for overconsumption.”

The report will be welcome news for the egg industry, which has run a long campaign to break the perceived link between egg consumption and heart diseases. For many years organisations like the British Heart Foundation and other international bodies involved in promoting a healthy heart recommended that consumers should restrict the number of eggs they ate. It was believed that cholesterol in eggs could lead to high blood pressure and heart disease. But recommended restrictions have now been largely abandoned by health organisations following numerous scientific studies that showed that eggs could be safely eaten without restriction. This new thinking has now been accepted by the expert committee, which advises US Government departments. In one section of its report the committee actually lists eggs amongst the foods that should be classified as nutrient dense.

The report describes nutrient-dense foods as” foods that are naturally rich in vitamins, minerals, and other substances that may have positive health effects, and are lean or low in solid fats and without added solid fats, sugars, starches, or sodium and that retain naturally-occurring components such as fibre.” It says, “All vegetables, fruits, whole grains, fish, eggs and nuts prepared without added solid fats or sugars are considered nutrient-dense, as are lean or low-fat forms of fluid milk, meat and poultry prepared without added solid fats or sugars.”

The experts say that “nutrient-dense foods provide substantial amounts of vitamins and minerals (micronutrients) and relatively few calories compared to forms of the food that have solid fat and/or added sugars.”

Recent scientific research has not only broken the link between the consumption of eggs and risk of heart disease; it has also led to a belief that eggs should be viewed as a superfood. One large egg provides varying amounts of 13 essential vitamins and minerals, including nutrients that are not found abundantly in other foods, including vitamin D and choline. Lutein and zeaxanthin, which are present in egg yolk, are antioxidants that may prevent macular degeneration and consequent age-related blindness. Whilst eggs contain only small amounts of these nutrients, research shows that lutein and zeaxanthin from eggs may be more bioavailable, or better used by the body, than from more concentrated sources like supplements. A recent study published in Food and Function found that daily consumption of egg yolks was associated with increases in plasma lutein, zeaxanthin and beta-carotene in people with metabolic syndrome.

Research conducted over recent years has provided evidence that eggs can lower the risk of heart disease, lower breast cancer risk, lower the risk of age related eye disease and lower muscle loss. Scientists say that an egg is an important source of choline. Studies have shown that choline is needed for optimal foetal brain development, it reduces neural tube risk and lowers inflammation markers. Eating eggs can replace what appears to be a shortage of choline in the diet.

Whilst concerns about consumption of dietary cholesterol have been abandoned, the expert committee has raised some other serious concerns about the American diet. Barbara Millen, chair of the DGAC and a nutrition epidemiologist, said in a letter, which accompanied the report, that there had been few improvements in consumers’ food choices during recent decades.

“On average, the US diet is low in vegetables, fruit and whole grains and too high in calories, saturated fat, sodium, refined grains and added sugars,” she said. “Under-consumption of vitamin D, calcium, potassium and fiber are of public health concern for the majority of the U.S. population,” she said. “Furthermore, more than 49 million people in the United States, including nearly nine million children, live in food insecure households. Creative, evidence-based strategies are needed to reverse these alarming trends.”

The report says that about half of all Americans have one or more preventable chronic diseases that relate to poor dietary patterns and physical inactivity, including cardiovascular disease, hypertension, type 2 diabetes and diet related cancers. And it says that more than two thirds of adults and nearly one third of children and youths are overweight or obese.

Public comment is now being invited on the committee’s report before Government issues its Dietary Guidelines for Americans later in the year. After receiving the report, the Health and Human Services Secretary and the Agriculture Secretary issued a joint statement saying, "For decades, the Dietary Guidelines for Americans have been at the core of our efforts to promote the health and well-being of American families. Now that the advisory committee has completed its recommendations, HHS and USDA will review this advisory report, along with comments from the public - including other experts and input from other federal agencies - as we begin the process of updating the guidelines."

The Dietary Guidelines for Americans was first published in 1980. Beginning in 1990, Congress ordered that a new edition should be released at least every five years. The guidelines contain the latest, science-based nutrition recommendations for the general public with the goal of preventing disease and promoting healthy, active lifestyles. It is written for and used primarily by nutrition and health professionals, policy makers and educators, and is the foundation for federal nutrition efforts, including education initiatives and food assistance programs.


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