If you’re concerned about heart disease, here’s one less thing you may not have to worry about: the cholesterol in the foods you eat. Eggs and shrimp, once considered the villains of high blood cholesterol, are now pretty much off the hook. “Eggs just aren’t a problem for most people. Same with shrimp,” says Dr. Arthur Agatston, a preventive cardiologist and author of the bestseller, The South Beach Diet and its more recent follow-up, The South Beach Wake-Up Call. “Recommendations to reduce dietary cholesterol never were grounded in fact,” adds Dr. Beatrice Golomb, associate professor of medicine at the University of California at San Diego.
Not only that—there are indications that even the levels of cholesterol in your blood are less important in predicting your risk for heart disease than other factors. Here are six reasons why cholesterol may not be the heart-health indicator it once was.
1. The only large study to look at the impact of egg consumption on heart disease, Harvard’s Nurses’ Health Study, found no connection between the two. Up to seven eggs a week was fine.
2. Recent research has found that while the cholesterol in eggs does raise LDL cholesterol slightly, it affects only the large-particle, “fluffy” type of LDL that is not associated with heart disease risk.
3. Studies show that the strongest dietary links to high cholesterol and heart disease are trans fats (partially hydrogenated or hydrogenated), saturated fats and total calories–especially empty calories from refined carbohydrates.
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4. Even high blood cholesterol is not a sure predictor of heart disease. “There are lots of people with high cholesterol who do not develop heart disease, and some with low cholesterol who do,” says Dr. Stephen Devries, a preventive cardiologist in the Chicago area and executive director of the nonprofit Gaples Institute for Integrative Cardiology. The high blood cholesterol-heart disease link is strongest for middle-aged men who already have heart disease. They benefit the most from lowering cholesterol.
5. Other risk factors for heart disease may matter more than cholesterol, DeVries says. “Family history is very important, so is high blood pressure, high blood sugar, lack of physical activity and stress.”
6. Lowering cholesterol doesn’t reduce heart disease risk as much as other interventions. For instance, a Mediterranean-type diet can reduce your risk for heart disease by 70 percent–that’s twice as much as cholesterol-lowering statin drugs. It’s not low fat, but it is low in trans-fats and saturated fats, processed foods and refined carbohydrates—and rich in nutrients from vegetables, fruit, fish and nuts. Oils used in the Mediterranean diet are loaded with healthy monounsaturated fats found in olive and canola oils.
For screening purposes, doctors still recommended you get your cholesterol level checked every five years. If you have been diagnosed with high cholesterol, the recommendation is to have it checked every year. More important than total cholesterol is the total cholesterol to HDL cholesterol ratio, which should be 3.5 to 1 or lower.