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CNN Explains: Cholesterol
01:46 - Source: CNN

Story highlights

Dietary Guidelines Advisory Committee issues 2015 scientific report

Cholesterol in food no longer considered a "nutrient of concern" and has little effect on blood cholesterol, report says

Intake limits recommended on sodium, saturated fat and added sugars

CNN  — 

For more than a week, speculation has been running rampant. Here’s how it all started.

On February 10, The Washington Post published a headline that got a good amount of attention: “The U.S. government is poised to withdraw longstanding warnings about cholesterol.”

Every five years, the Department of Health and Human Services, along with the Department of Agriculture, issues “Dietary Guidelines for Americans,” a federal publication that has far-reaching implications on what we eat. The guidelines affect everything from the way companies can advertise their products, to what’s in your child’s school lunch, to the diet advice offered up by nearly every doctor and nutritionist in the country.

Remember the food pyramid from when you were growing up? Today’s iteration, MyPlate, relies on these guidelines as well. They’re also the basis for the information on nutrition facts labels on just about all food packaging.

So you can see why so many people are anxiously awaiting the 2015 update.

The 112-page report from 2010 included 23 recommendations for the general population and six additional recommendations for specific population groups, such as pregnant women. The three major goals emphasized were:

• Balance calories with physical activity to manage weight.

• Consume more of certain foods and nutrients such as fruits, vegetables, whole grains, fat-free and low-fat dairy products and seafood.

• Consume fewer foods with sodium (salt), saturated fats, trans fats, cholesterol, added sugars, and refined grains.

What’s stirring the pot now is one bullet, on one slide (page 7) of thousands of slides, shown at one of seven public hearings held over the last two years to discuss the latest revisions to the guidelines:

“Cholesterol is not considered a nutrient of concern for overconsumption.”

Inside the advisory report

Sure enough, there it is, buried on page 91 of the 572-page Scientific Report of the 2015 Dietary Guidelines Advisory Committee: “Previously, the Dietary Guidelines for Americans recommended that cholesterol intake be limited to no more than 300 mg/day. The 2015 DGAC will not bring forward this recommendation because available evidence shows no appreciable relationship between consumption of dietary cholesterol and serum (blood) cholesterol, consistent with the AHA/ACC (American Heart Association / American College of Cardiology) report. Cholesterol is not a nutrient of concern for overconsumption.”

What has foodies buzzing is that this is somewhat of a tectonic shift regarding one of the main nutritional designations of the foods we eat. Cholesterol has been a prominent part of dietary warnings and guidelines since the American Heart Association put the compound in its crosshairs more than half a century ago.

Dr. Steven Nissen, chairman of cardiovascular medicine at the Cleveland Clinic, told CNN: “The idea we need to limit saturated fat and cholesterol shifted Americans from a well-balanced diet to high-sugar diets, which made people eat more and get fatter.”

The reality, according to Nissen, is that only 15% of circulating cholesterol in the blood comes from what you eat. The other 85% comes from the liver. “So if you go on a diet,” he says, “you’re not changing your cholesterol very much.” Still, nutritionists are not recommending you go out and binge on cheeseburgers and fries.

A lot is riding on this decision. Foods that are high in cholesterol, like eggs, shrimp and lobster, could see a major uptick in sales. These foods, perhaps limited inside – or banished from – your home, could make a big comeback.

Who’s telling you what to eat

The 14 outside experts who made up the 2015 Dietary Guidelines Advisory Committee are nationally recognized in the fields of nutrition, medicine and public health.

In a letter to the HHS and USDA secretaries, 2015 DGAC chairwoman Barbara Millen highlights the major diet-related health problems she says we’re facing and must reverse.

“About half of all American adults – 117 million individuals – have one or more preventable (emphasis hers) chronic diseases that relate to poor quality dietary patterns and physical inactivity, including cardiovascular diseases, hypertension, type 2 diabetes, and diet-related cancers,” Millen writes.

“More than two-thirds of adults and nearly one-third of children and youth are overweight or obese. These devastating health problems have persisted for decades, strained U.S. health care costs, and focused the attention of our health care system on disease treatment rather than prevention. They call for bold action and sound, innovative solutions.”

Millen hopes the report will “establish a ‘culture of health’ at individual and population levels and, in so doing, make healthy lifestyle choices easy, accessible, affordable and normative – both at home and away from home.”

“Dramatic paradigm shifts are needed to help individuals and families take more active roles in their personal health and to incentivize health care and public health services, programs, and research to focus more on prevention and personal diet and lifestyle management.”

What’s wrong with the American diet

The report identifies underconsumed “shortfall nutrients,” including vitamins A, D, E and C, as well as folate, calcium, magnesium, potassium and fiber.

For adolescent and premenopausal females, iron is also considered a shortfall nutrient.

The DGAC singles out two nutrients which are overconsumed: sodium and saturated fat.

No surprise, that’s the result of eating too many refined grains, solid fats and added sugars.

The committee was cautiously optimistic about one age group: Young children (ages 2-5) are the only ones consuming the recommended amount of fruit and dairy, so perhaps there’s hope for the future. The report urges a better understanding of how to maintain and encourage good eating habits that are started early in life.

What you should be eating

It’s not just what we eat, it’s how we eat it. When looking into the common characteristics of healthy diets, the committee focused on research examining dietary patterns, because “the totality of the diet – the combinations and quantities in which foods and nutrients are consumed – may have synergistic and cumulative effects on health and disease.”

A healthy dietary pattern is higher in vegetables, fruits, whole grains, low- or nonfat dairy, seafood, legumes and nuts; moderate in alcohol; lower in red and processed meat; and low in sugar-sweetened foods and drinks and refined grains.

The DGAC encourages dietary patterns that are low in saturated fat, added sugars and sodium. The goals for the general population are:

• Less than 2,300 milligrams of dietary sodium per day.

• Less than 10% of total calories from saturated fat per day.

• A maximum of 10% of total calories from added sugars per day.

“Sodium, saturated fat, and added sugars are not intended to be reduced in isolation, but as part of a healthy dietary pattern that is balanced, as appropriate, in calories,” the report states. “Rather than focusing purely on reduction, emphasis should also be placed on replacement and shifts in food intake and eating patterns.”

“Sources of saturated fat should be replaced with unsaturated fat, particularly polyunsaturated fatty acids. Similarly, added sugars should be reduced in the diet and not replaced with low-calorie sweeteners, but rather with healthy options such as water in place of sugar-sweetened beverages. For sodium, emphasis should be placed on expanding industry efforts to reduce the sodium content of foods and helping consumers understand how to flavor unsalted foods with spices and herbs.”

What’s next?

“For decades, the Dietary Guidelines for Americans have been at the core of our efforts to promote the health and well-being of American families,” said HHS Secretary Sylvia Burwell and Agriculture Secretary Tom Vilsack in a joint statement. “Now that the advisory committee has completed its recommendations, HHS and USDA will review this advisory report, along with comments from the public – including other experts – and input from other federal agencies as we begin the process of updating the guidelines.”

The public is now encouraged to view the independent advisory group’s report and provide written comments for a period of 45 days. Look for the government’s final, updated guidelines by the end of the year.

Meantime, remember what Mom always told you: Eat your fruits and veggies – that is, if you want to have dessert.

CNN’s Debra Goldschmidt and Jen Christensen contributed to this report.