Nation & World

U.S. poised to withdraw warnings about cholesterol

The nation’s top nutrition advisory panel has decided to drop its caution about eating cholesterol-laden food, a move that could undo almost 40 years of government warnings about its consumption.

The group’s finding that cholesterol in the diet need no longer be considered a “nutrient of concern” stands in contrast to the committee’s findings five years ago, the last time it convened. During those proceedings, as in previous years, the panel deemed the issue of “excess dietary cholesterol” a public health concern. The most current finding was discussed at the group’s last meeting.

The new view on cholesterol in the diet does not reverse warnings about high levels of “bad” cholesterol in the blood, which have been linked to heart disease. Moreover, some experts warned that people with particular health problems, such as diabetes, should continue to avoid cholesterol-rich diets.

But the finding, which may offer a measure of relief to breakfast diners who prefer eggs, follows an evolution of thinking among many nutritionists who now believe that for a healthy adult cholesterol intake may not significantly affect the level of cholesterol in the blood or increase the risk of heart disease. The greater danger, according to this line of thought, lies in foods heavy with trans fats and saturated fats.

The panel laid out the cholesterol decision in December, at its last meeting before it writes a report that will serve as the basis for the next version of the Dietary Guidelines, a federal publication that has broad effects on the American diet. A video of the meeting was later posted online, and a person with direct knowledge of the proceedings said the cholesterol finding will make it to the group’s final report, which is due within weeks.

After Marian Neuhouser, chair of the relevant subcommittee, announced the decision to the panel at the December meeting, one panelist appeared to bridle.

“So we’re not making a 1/8 cholesterol 3/8 recommendation?” panel member Miriam Nelson, a Tufts University professor, said at the meeting as if trying to absorb the thought. “OK. … Bummer.”

Members of the panel, called the Dietary Guidelines Advisory Committee, said they will not comment until the report is published.

‘A shift in thinking’

The Dietary Guidelines, which are due later this year from the Department of Health and Human Services and the Department of Agriculture, help determine the content of school lunches, affect how food manufacturers advertise their wares, and often serve as the foundation for reams of diet advice. Some foods that are high in cholesterol – such as liver, lobster and shrimp – may find more takers.

Walter Willett, chair of the nutrition department at the Harvard School of Public Health, called the turnaround on cholesterol a “reasonable move.”

“There’s been a shift of thinking,” he said.

But the change on dietary cholesterol also shows how the complexity of nutrition science and the lack of definitive research can contribute to confusion for Americans who, while seeking guidance on what to eat, often find themselves afloat in conflicting advice.

Warnings since 1961

Cholesterol has been a fixture in dietary warnings in the U.S. at least since 1961, when it appeared in guidelines developed by the American Heart Association. Later adopted by the federal government, such warnings helped shift eating habits – per capita egg consumption dropped about 30 percent – and harmed egg farmers.

Yet even today, after more than a century of scientific inquiry, scientists are divided.

Some nutritionists said lifting the cholesterol warning is long overdue, noting that the United States is out-of-step with other countries, where diet guidelines do not single out cholesterol. Others support maintaining a warning.

The forthcoming version of the nation’s Dietary Guidelines – the document is revised every five years – is expected to navigate myriad similar controversies. Among them: salt, red meat, sugar, saturated fats and the latest darling of foodmakers, omega-3s. As with cholesterol, the dietary panel’s advice on these issues will be used by federal bureaucrats to draft the new guidelines.

The publication offers Americans clear instructions – and sometimes very specific, down-to-the-milligram prescriptions. But such precision can mask sometimes tumultuous debates that surround these issues.

“Almost every single nutrient imaginable has peer reviewed publications associating it with almost any outcome,” John P.A. Ioannidis, a professor of medicine and statistics at Stanford and one of the harshest critics of nutritional science, has written. “In this literature of epidemic proportions, how many results are correct?”

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