Cholesterol - Blood versus Dietary - Whats the Difference?

~ Coach Maxine, Registered Dietitian

Blood cholesterol and dietary cholesterol, what’s the difference?

Simply put, blood cholesterol is the cholesterol in your bloodstream. It’s made by your body and
recycled by your liver. High blood cholesterol levels increase the risk of heart disease but cholesterol
itself is not necessarily bad.

The body uses cholesterol to make hormones (including oestrogen and testosterone) vitamin D, bile
acids and other vital compounds. Your liver and intestines make around 80% of the cholesterol
needed by your body which leaves only 20% from the foods you eat.
Dietary cholesterol on the other hand is cholesterol that comes from eating animal products such as
meat, eggs, shellfish, cheese and other full fat dairy products. If someone consumes foods high in
cholesterol, their liver will respond by slowing down cholesterol production to balance out their
levels.

A small group of people are hyper-responders to cholesterol. These people are more sensitive to
dietary cholesterol and consuming cholesterol-rich foods can significantly impact their blood
cholesterol levels.

Health professionals and dietary guidelines previously recommended that people should limit their
dietary cholesterol intake to 300mg/day. It was later found that most of the old research supporting
this recommendation was conducted on animals.

Multiple studies have now shown that there is no direct correlation between cholesterol intake and
blood cholesterol in humans. Dietary cholesterol has been found to positively influence the LDL-to-
HDL ratio which is one of the best indicators of heart disease risk.

More about eggs

In the past, people were advised to limit the number of eggs they ate to 3 or less per week. The
reasoning behind this guideline was that eggs (which are high in dietary cholesterol) would
dangerously increase blood cholesterol.

The guidance around eggs has now thankfully changed over the years and yet many people still feel
a bit ‘scrambled’ on what to believe.

Current research sheds a very positive light on eggs not only due to the effect they have on blood
cholesterol but also due to their unique nutrient profile and impressive nutrient density. It was
found that people who eat eggs are more likely to meet their daily requirements for several
micronutrients without negatively impacting blood cholesterol.

The science now continues to support the idea that saturated fat in food, not cholesterol, causes
health concerns. The American Heart Association removed their recommendations to limit dietary
cholesterol intake and the USDA’s Dietary Guidelines don’t specify a limit.

For the general public it has been shown that regularly eating eggs is safe as long as they are
consumed as part of a balanced diet, as with all foods. Hyper-responders are the ‘egg-ception’ to
this as they need to be more careful of their cholesterol intake.

In summary

Dietary sources of cholesterol are no longer a concern but beware of cholesterol-rich foods that are
also high in saturated fat which will negatively affect blood cholesterol levels.

High-cholesterol foods to watch out for:

• Full-fat dairy products (full cream milk, butter and full-cream yogurt and cheese) are high in

saturated fat.

• Fatty meat (such as ribs, pork chops and marbled meat). Opt for lean ground meat as well as

lean cuts of beef (such as sirloin, filet, flank steak, brisket flat and tenderloin) and skinless
chicken fillets. Choose minimally processed sausage or deli meat that is lean.

• Deep-fried foods such as potato fries, fried chicken and fried pastries have a high amount of

saturated fat from the oil they’re cooked in. Use an air-fryer for a similar taste without the
oil.

• Cakes, cookies and other baked products containing high amounts of butter and sugar

High-cholesterol foods that form part of a heart-healthy diet:

• Eggs- One large egg yolk contains around 185mg of cholesterol and only 1.6g of saturated

fat. Eggs are protein packed and contain a variety of nutrients including vitamin D, B12,
selenium, lutein and others. Be sure to cook eggs with an oil spray and a non-stick frying
pan.

• Shellfish- A 3-ounce serving of shrimp contains 160g of cholesterol and minimal saturated

fat. Shellfish is rich in protein, selenium, zinc, B vitamins and low in mercury.

References
1) Dietary Cholesterol and the Lack of Evidence in Cardiovascular Disease - PMC (nih.gov)
2) Nutrients | Free Full-Text | Is There a Correlation between Dietary and Blood Cholesterol?
Evidence from Epidemiological Data and Clinical Interventions (mdpi.com)
3) Association of eggs with dietary nutrient adequacy and cardiovascular risk factors in US adults |
Public Health Nutrition | Cambridge Core