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Fat chance
Time:16 Apr 2015
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Source: Globaltimes

According a new health advisory report, reducing cholesterol intake does not substantially affect the amount of cholesterol in a person's blood, which is mostly determined by genetics. Photo: Li Hao/GT

A recently published US health advisory guideline states that "cholesterol is not a nutrient of concern for overconsumption," reversing a position held by many health advisory bodies around the world for the past three decades.

Previously, it was believed that consuming high cholesterol foods was directly related to increased cholesterol content in a person's blood, heightening the risk of cardiovascular disease, obesity and stroke. But the Scientific Report of the 2015 Dietary Guidelines Advisory Committee, prepared every five years for the Secretary of Health and Human Services and the Secretary of Agriculture of the US, now states that "available evidence shows no appreciable relationship between consumption of dietary cholesterol and serum cholesterol."

The report goes on to say that removing foods containing cholesterol from one's diet does not lower blood cholesterol, and that more important than the total amount of blood cholesterol is the amount of "good cholesterol" - which is more dependent on genetics than on diet.

Although the guideline is specific to the US, its recommendations are carefully considered by governments and health authorities around the world.

The most recent version of the Chinese Dietary Guidelines, published in 2007 by the Chinese Society of Nutrition, suggests a daily intake of cholesterol not exceeding 300 milligrams, which is the same as what the Dietary Guidelines for Americans has suggested since 1977.

Case study

Wang Bin, a 30-year-old IT worker in Beijing, began a rigorous diet three months ago after a sudden increase in weight.

But after significantly reducing his consumption of red meat, and replacing most of his former diet with vegetables and salad, he found that his blood cholesterol level still increased.

"It has been the strictest diet I had ever been on," said Wang, who lost 2.5 kilograms over the period. "What else could I have done to lower my blood cholesterol level?"

The answer, according to Ma Guansheng, a professor of nutrition and food at the School of Public Health at Peking University, is that Wang might not need to.

Ma explained that 70 percent of cholesterol found in a person's blood is produced by the human body itself, in the liver, totaling about 1,000 milligrams per day. Only 30 percent of a person's blood cholesterol can be attributed to diet, with meat, Egg yolks and Dairy Products being common items that are high in cholesterol.

"Diet only has a very slight influence on a person's blood cholesterol level," said Ma. "A normal level of blood cholesterol is 2.8 to 5.9 millimoles per liter. For every 100 milligrams of cholesterol consumed through food, the maximum increase in a person's blood cholesterol level is 0.038 millimole per liter."

Yang Wenjiao, a Beijing-based nutritionist, said that an individual's blood cholesterol level was largely dependent on genetic and metabolic factors. For an ordinary healthy adult, the effect of consuming more or less cholesterol in food was relatively small.

"Adolescents and healthy adults, who have an active metabolism and strong constitution don't need to limit their cholesterol intake," said Yang. "If they consume more high cholesterol foods, their bodies can detect the amount of cholesterol they are consuming, and automatically produce less cholesterol to maintain a healthy balance."

It was only for older people and people who had health problems such as hyperlipidemia (elevated lipid levels in the blood) that needed to monitor and restrict cholesterol intake, said Yang.

'Good' and 'bad' cholesterol

L¨1 Shuzheng, director of the cardiology department at Beijing Anzhen Hospital, noted in a 2013 Xinhua News Agency report that it was important to distinguish between "good" cholesterol (high density lipoprotein cholesterol, or HDL-C) and "bad" cholesterol (low density lipoprotein cholesterol, or LDL-C).

"Good" cholesterol helps balance the total amount of cholesterol in a person's blood and prevents the accumulation of fatty acids in blood vessels, while "bad" cholesterol tends to accumulate in the arterial vascular wall, inhibiting blood circulation and increasing the risk of cardiovascular diseases such as blood clots, heart problems and stroke, said L¨1.

However, a small amount of "bad" cholesterol was also necessary, said L¨1, to generate muscle mass after physical exercise.

Common tests for blood lipids measure four indexes, distinguishing between a person's triglyceride level, total blood cholesterol level, and his/her "good" and "bad" cholesterol levels.

A report on the Prevention of Cardiovascular Disease published by the World Health Organization in 2007 noted that people with a total cholesterol above 8 millimoles per liter, a HDL-C above 8 millimole per liter, or a LDL-C above 6 millimole per liter were considered to be at a greater risk of cardiovascular diseases.

However, Yang said that it was unnecessary for healthy adults to fret too much about their cholesterol intake, as cholesterol is a naturally regulated substance produced by the body that serves a number of vital functions.

"Cholesterol is an important constitutive substance of cell membranes and nerve fibres, as well as helping produce vitamin D, bile acid, sex hormones and adrenocortical hormones," said Yang. "['Good' cholesterol] helps digest excess fat, and keep the blood vessel wall healthy."

To reduce the "bad" cholesterol in blood, people should eat a healthy dietary and do more exercise. Photo: Li Hao/GT

Other factors

Ma said that there was no direct evidence connecting cholesterol intake to cardiovascular diseases.

"A 16-year-long study conducted in Japan [published in the Journal of the American Heart Association in 2012] showed that people with a low daily cholesterol intake, between 150-200 milligrams, were twice as likely to die from a heart disease than those who had a high daily intake, above 300 milligrams," said Ma. "The research also showed that there is no link between daily cholesterol intake and the likelihood of stroke."

Cai Honglin, a nutritionist at Wuhan Union Hospital in Hubei Province, said in a People's Daily report in 2012 that in terms of cardiovascular health, the key was to lower the amount of "bad" cholesterol, which was more dependent on living a healthy life style than reducing cholesterol intake from one's diet.

"Factors that increase the risk of cardiovascular diseases include obesity, smoking, consumption of alcohol, high blood pressure, advanced age and lack of physical exercise," said Cai.

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