Yahoo Lifestyle What's More Important for Heart Health: Lowering Dietary Cholesterol or Saturated Fat?
Heart health is a long-time pain point for Americans—physically and emotionally. Heart disease is the leading cause of death in the U.S., and that number crosses sex, racial and ethnic lines, according to the Centers for Disease Control and Prevention (CDC).
Numerous factors can raise the risk of heart disease, including uncontrollable ones (age and genetics) and controllable ones (diet). For years, lowering dietary cholesterol intake was seen as one of the best food-related tweaks you could make to slash your odds of developing cardiovascular disease. However, the current focus seems to have shifted to saturated fat.
What is more important to focus on to improve your heart health: Dietary cholesterol or fat? Doctors weighed in on whether saturated fat or dietary cholesterol had more of an effect on your cardiovascular system and why.
Related: How Long Does a Heart Attack Last? Cardiologists Explain
What Is Dietary Cholesterol?
Dietary cholesterol is one of two ways your body gets cholesterol. "There are two sources of cholesterol: That which you consume in your diet and endogenous cholesterol that your liver produces," explains Dr. Bradley Serwer, MD, an interventional cardiologist and chief medical officer at VitalSolution.
The word "cholesterol" has a negative connotation, which is a misnomer.
"Cholesterol is an essential nutrient for the body," says Dr. Yu-Ming Ni, MD, a board-certified cardiologist and lipidologist at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center. "It contributes to the structure of the cells of our body and can also be modified to make hormones such as estrogen and testosterone."
Dr. Ni says dietary cholesterol is mainly found in animal products like:
Meat
Dairy
Eggs
Shellfish
According to the American Heart Association, federal guidelines once stated that people should limit dietary cholesterol to 300 milligrams daily. However, there isn't a current federal maximum. That doesn't mean it's unimportant to heart health, so don't go HAM just yet. The current guidelines call for keeping dietary cholesterol consumption "as low as possible without compromising the nutritional adequacy of the diet."
"What is more important now is to follow a healthy eating pattern, most of which naturally have lower cholesterol intake levels," Dr. Ni says. "This includes the Mediterranean diet and vegetarian and vegan diets."
Also, you'll want to talk with your care team about your individual case.
"Some people do have higher blood cholesterol levels related to dietary cholesterol intake: we call these people hyper responders," Dr. Ni says. "In this case, lowering cholesterol intake might be beneficial for cardiovascular prevention."
Still, Dr. Serwer says the guidelines focus more on saturated fat—for good reason.
🩺 SIGN UP for tips to stay healthy & fit with the top moves, clean eats, health trends & more delivered right to your inbox twice a week 💊
What Is Saturated Fat?
The American Heart Association explains that saturated fats are usually solid at room temperature and suggests limiting it to 6% of your total calories. Someone consuming a 2,000-calorie diet would ideally consume no more than 13 grams of saturated fat per day.
These fats are "unhealthy," says Dr. Guy L. Mintz, MD, the director of cardiovascular health & lipidology with Sandra Atlas Bass Heart Hospital and North Shore University Hospital. Dr. Mintz says common sources of saturated fat are:
Meat, including pork, beef and lamb
Poultry with skin
Cheese
Butter
Coconut oil
Palm oil
"Saturated fat raises the levels of low-density lipoprotein (LDL) cholesterol in the blood," says Dr. Hani Jneid, MD, a professor & chief of cardiology at the University of Texas Medical Branch. "High LDL levels are linked to a greater risk of plaque buildup in the arteries, which can lead to heart diseases, heart attacks and strokes."
Dr. Jneid adds that diets high in saturated fat may contribute to inflammation, increasing the odds of chronic illnesses.
"Additionally, saturated fats are calorie-dense, and consuming too many can lead to weight gain and obesity, which further increases the risk of health issues like heart disease and diabetes," Dr. Jneid says.
Overall, the authors of one 2021 review said that the current evidence supports recommendations to limit saturated fat intake.
Related: The One Diet That Will Actually Lower Your Heart Attack Risk, According to Cardiologists
OK—Which Is More Important: Reducing Dietary Cholesterol or Saturated Fat for Heart Health?
It depends on who you ask, but Dr. Ni agrees with the current focus on lowering saturated fat to protect heart health.
"It is more important to lower saturated fat intake than it is to lower dietary cholesterol," Dr. Ni says. "While it is true that dietary cholesterol and saturated fat go together in many foods, eggs and shellfish are lower in saturated fat relative to their cholesterol amounts and are generally OK in moderation."
Dr. Jneid echoes these sentiments, though he says there's room for nuance.
"Some people, known as hyper-responders, may see a significant increase in their LDL levels when they eat cholesterol," Dr. Jneid says. "However, what matters more for heart health is the type of fats consumed. Reducing saturated and trans fats while eating more fiber-rich foods is generally better for your heart."
Dr. Mintz wants people to consider both when shopping and meal planning.
"Both saturated fatty acids and dietary cholesterol increase LDL cholesterol," he says. "A diet high in saturated fat will elevate cholesterol and lead to weight gain with associated inflammation. Dietary cholesterol will also lead to higher blood cholesterol."
Other Heart-Healthy Tips
Diet is an essential factor in heart health, but it's not the only one. Dr. Ni says other ways to lower your risk for heart disease include:
Eating a plant-based diet (more fruits, vegetables and whole grains, less meat)
Exercising at a moderate intensity (enough to feel yourself breathing harder) 30 minutes per day or 150 minutes weekly
Avoiding smoking
Sleeping at least seven to eight hours per night
Maintaining a healthy weight
Maintaining a healthy blood cholesterol, blood sugar and blood pressure level
Dr. Ni says your doctor can provide customized care and share ideal numbers for your health.
Up Next:
Sources:
Heart disease facts. CDC.
Dr. Bradley Serwer, MD, an interventional cardiologist and chief medical officer at VitalSolution
Dr. Yu-Ming Ni, MD, a board-certified cardiologist and lipidologist at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center
Here's the latest on dietary cholesterol and how it fits in with a healthy diet. American Heart Association.
Dietary Guidelines for Americans. USDA.
Saturated Fat. American Heart Association.
Dr. Guy L. Mintz, MD, the director of cardiovascular health & lipidology with Sandra Atlas Bass Heart Hospital and North Shore University Hospital
Dr. Hani Jneid, MD, a professor & chief of cardiology at University of Texas Medical Branch
Saturated fats and cardiovascular health: Current evidence and controversies. Journal of Clinical Lipidology.
