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Dietary Cholesterol: What You Need to Know

Medically Reviewed by Brunilda Nazario, MD on June 16, 2021

High “bad” cholesterol, or LDL cholesterol, raises your odds of heart disease, heart attack, and stroke. But current nutrition guidelines from national organizations, such as the American Heart Association, no longer include a recommended daily limit on cholesterol from food. Yet, when it comes to heart health, your doctor doesn’t want you to ignore dietary cholesterol either.

If you find this message confusing, you’re not alone. Here’s what you need to know.

What Is Cholesterol?

It’s a waxy substance your body makes. A certain amount of cholesterol in your bloodstream is good for you. It helps you build cells and make certain hormones. It also helps your skin make vitamin D from sunlight. But you don’t need to get cholesterol from food. Your liver makes enough to keep you healthy.

Dietary Cholesterol and Heart Disease

There isn’t good evidence to show that dietary cholesterol alone can raise your odds of heart disease. But many foods that contain cholesterol are also high in saturated fats. That includes red meat, poultry, and full-fat dairy products, such as butter and cheese. Too much saturated fat raises your LDL cholesterol levels.

The problem with LDL cholesterol is that it can build up in your arteries. These are the tubes that carry blood from your heart to the rest of your body. Cholesterol buildup can lead to fatty clumps called plaques. They can narrow your arteries and make it harder for blood to pass through. Plaques can also break off or cause blood clots. This process can lead to heart disease, heart attack, and stroke.

Eggs and Heart Disease

Just as the message about dietary cholesterol may be confusing, the message about eggs has been confusing, too. Yes, eggs are high in cholesterol. But they are low in saturated fat. In general, there isn’t a big link between eating eggs and getting heart disease. But that doesn’t mean there’s no connection at all. While some studies find no relationship between heart disease and eggs in your diet, others find the opposite, especially for people who already have type 2 diabetes or heart failure.

We need more research on eggs and heart disease. But experts are quick to point out that most people don’t eat this popular breakfast food alone. They often serve them up alongside less heart-healthy items like bacon and sausage. And there’s no doubt about the link between these processed meats and heart disease and other health problems.

It’s generally safe for healthy people to eat one egg a day. You might be able to have more if you don’t have health problems, you avoid other animal-based products, or you’re older. Ask your doctor what’s right for you.

Who Should Worry About Dietary Cholesterol?

Everyone should follow a heart-healthy diet. That’s an eating plan that’s naturally low in dietary cholesterol (less than 300 milligrams a day) and saturated fats. Some examples include the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets.

With that said, experts think your genes play the biggest role in your cholesterol levels. That means that, for most people, cholesterol from food generally doesn’t have much of an effect on the levels in your blood. But some people are more sensitive to dietary cholesterol. For these people, cholesterol levels may indeed skyrocket in response to cholesterol-rich foods. But it’s hard to know if you’re one of those people. There isn’t a test to find out.

Your doctor will likely suggest you limit foods with dietary cholesterol if you have certain health problems or risk factors, such as:

Get a Cholesterol Test

High cholesterol doesn’t have symptoms. You might not feel anything different until you have a heart attack or stroke. But your doctor can run a simple blood test to check your levels. Most adults should get a test every 4 to 6 years. Tell your doctor if you have a family history of high cholesterol. They might want to check your levels more often.

WebMD Medical Reference

Sources

SOURCES:

Kunal N. Karmali, MD, cardiologist, Northwestern Medicine Central DuPage Hospital.

Circulation: “Dietary Cholesterol and Cardiovascular Risk: A Science Advisory From the American Heart Association.

Dermato Endocrinology: “Sunlight and Vitamin D.”

American Heart Association: “What is Cholesterol?”

CDC: “Cholesterol: Cholesterol Myths and Facts,” “Cholesterol: Getting Your Cholesterol Checked.”

JAMA: “Associations of Dietary Cholesterol or Egg Consumption With Incident Cardiovascular Disease and Mortality.”

JAMA Internal Medicine: “Associations of Processed Meat, Unprocessed Red meat, Poultry, or Fish Intake With Incident Cardiovascular Disease and All-Cause Mortality.”

Cleveland Clinic: “Why You Should No Longer Worry About Cholesterol in Food.”

Harvard T.H. Chan School of Public Health: “The Nutrition Source: Cholesterol.”

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