DIETARY-CHOLESTEROL AND THE OPTIMAL DIET FOR REDUCING RISK OF ATHEROSCLEROSIS

The importance of dietary cholesterol in the incidence of hypercholest erolemia in the population remains a topic of scientific debate. Analy sis of the results from over 30 years of cholesterol feeding studies ( n=128) in more than 2750 patients indicate that for the majority of in dividuals modest changes in dietary cholesterol. have little if any ef fect on plasma lipoprotein cholesterol levels. Data demonstrate that o n average a change in cholesterol intake of 100 mg/day results in a ch ange in plasma total cholesterol of 0.07 mmol/L (2.5 mg/dL). The studi es also show, that the extent of response to dietary cholesterol is in dependent of the amount of dietary fat and of the baseline plasma chol esterol level. In contrast, the dose adjusted plasma cholesterol respo nse to a dietary cholesterol challenge is affected by the type of diet ary fat and the baseline dietary cholesterol intake. Based on these da ta a reduction in dietary cholesterol intake from 450 to 300 mg/day wi ll, on average, lower plasma cholesterol levels by 0.10 mmol/L (3.7 mg /dL). This decrease is modest and highly variable due to significant i nterindividual heterogeneity of responses. It is estimated that one-th ird of the population Is sensitive to dietary cholesterol whereas two- thirds are resistant to plasma cholesterol changes. In comparison, a 1 % decrease in energy intake from saturated fat decreases plasma choles terol 0.08 mmol/L (3 mg/dL). Consumption of products marketed as 'No c holesterol' with high total and saturated fat clearly does not contrib ute to the optimal diet for reducing plasma cholesterol levels or risk of atherosclerosis.