Jo Ann S. Carson
To promote CV health in their patients, clinicians should recommend a healthy dietary pattern low in cholesterol, according to a science advisory from the American Heart Association published in Circulation.
These healthy dietary patterns, such as the Mediterranean diet and the Dietary Approaches to Stop Hypertension (DASH) diet, emphasize the intake of fruits, vegetables, whole grains, low-fat or fat-free dairy products, lean protein sources, nuts, seeds and liquid vegetable oils, according to the advisory.
“Consideration of the relationship between dietary cholesterol and CVD risk cannot ignore two aspects of diet. First, most foods contributing cholesterol to the U.S. diet are usually high in saturated fat, which is strongly linked to an increased risk of too much LDL cholesterol,” Jo Ann S. Carson, PhD, RDN, LD, professor of clinical nutrition at University of Texas Southwestern Medical Center and chair of the advisory’s writing committee, said in a press release. “Second, we know from an enormous body of scientific studies that heart-healthy dietary patterns, such as Mediterranean-style and DASH style diets, are inherently low in cholesterol.”
Patterns consistent with current guidelines have an elevated ratio of polyunsaturated fatty acid to saturated fatty acid. Minimizing the intake of major sources of saturated fat intake and including liquid nontropical vegetable oils can result in improved CV health through low cholesterol intake, according to the advisory.
It is easier to focus on dietary patterns because trying to achieve a specific dietary cholesterol target can be difficult, the researchers wrote.
“A recommendation that gives a specific dietary cholesterol target within the context of food-based advice is challenging for clinicians and consumers to implement,” they wrote. “Hence, guidance focused on dietary patterns is more likely to improve diet quality and to promote cardiovascular health.”
Moreover, the statement included recommendations for patients with dietary restrictions:
- Vegetarians who do not ingest cholesterol-containing meat may include more dairy and eggs in their diets within moderation.
- Patients with dyslipidemia, particularly those with diabetes or elevated risk for HF, should be cautious in eating food high in cholesterol.
- Older patients with normal cholesterol levels may consume up to two eggs per day within a heart-healthy dietary pattern, given their convenience and nutritional value. According to the advisory, in the current literature, eggs are not associated with elevated CVD risk.
Another recommendation of the scientific advisory was that healthy individuals may include up to one egg or equivalent per day. An example of an egg equivalent would be a 3 oz serving of shrimp.
“Saturated fats, mostly found in animal products such as meat and full fat dairy, as well as tropical oils, should be replaced with polyunsaturated fats such as corn, canola or soybean oils,” Carson said in the release. “Foods high in added sugars and sodium (salt) should be limited.” – by Scott Buzby
Disclosures: The authors report no relevant financial disclosures.