Why Dietary Cholesterol Does Not Matter (For Most People)

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The amount of cholesterol in your diet and the amount of cholesterol in your blood are very different things.

Although it may seem logical that eating cholesterol would raise blood cholesterol levels, it usually doesn’t work that way.

The body tightly regulates the amount of cholesterol in the blood by controlling its production of cholesterol.

When your dietary intake of cholesterol goes down, your body makes more. When you eat greater amounts of cholesterol, your body makes less. Because of this, foods high in dietary cholesterol have very little impact on blood cholesterol levels in most people (9Trusted Source, 10Trusted Source, 11Trusted Source, 12Trusted Source).

However, in some people, high-cholesterol foods raise blood cholesterol levels. These people make up about 40% of the population and are often referred to as “hyperresponders.” This tendency is considered to be genetic (13Trusted Source, 14Trusted Source).

Even though dietary cholesterol modestly increases LDL in these individuals, it does not seem to increase their risk of heart disease (15Trusted Source, 16Trusted Source).

This is because the general increase in LDL particles typically reflects an increase in large LDL particles — not small, dense LDL. In fact, people who have mainly large LDL particles have a lower risk of heart disease (3Trusted Source).

Hyperresponders also experience an increase in HDL particles, which offsets the increase in LDL by transporting excess cholesterol back to the liver for elimination from the body (17Trusted Source).

As such, while hyperresponders experience raised cholesterol levels when they increase their dietary cholesterol, the ratio of LDL to HDL cholesterol in these individuals stays the same and their risk of heart disease doesn’t seem to go up.

Of course, there are always exceptions in nutrition, and some individuals may see adverse effects from eating more cholesterol-rich foods.

Dietary cholesterol and heart disease

Contrary to popular belief, heart disease is not only caused by cholesterol.

Many factors are involved in the disease, including inflammation, oxidative stress, high blood pressure, and smoking.

While heart disease is often driven by the lipoproteins that carry cholesterol around, dietary cholesterol, in itself, has little to no effect on this.

However, high-heat cooking of cholesterol-rich foods can cause the formation of oxysterols (18Trusted Source).

Scientists have hypothesized that high blood levels of oxysterols may contribute to the development of heart disease, but further evidence is needed before any strong conclusions can be reached (19Trusted Source).
High-quality research finds no link to heart disease

High-quality studies have shown that dietary cholesterol is not associated with an increased risk of heart disease (20Trusted Source, 21Trusted Source).

A lot of research has been conducted on eggs specifically. Eggs are a significant source of dietary cholesterol, but several studies have shown that eating them is not associated with an elevated risk of heart disease (22Trusted Source, 23Trusted Source, 24Trusted Source, 25Trusted Source, 26Trusted Source).

What’s more, eggs may even help improve your lipoprotein profiles, which could lower your risk.

One study compared the effects of whole eggs and a yolk-free egg substitute on cholesterol levels.

People who ate three whole eggs per day experienced a greater increase in HDL particles and a greater decrease in LDL particles than those who consumed an equivalent amount of egg substitute (27Trusted Source).

However, it’s important to note that eating eggs may pose a risk for those with diabetes, at least in the context of a regular Western diet. Some studies show an increased risk of heart disease in people with diabetes who eat eggs (28Trusted Source).