Diet - cholesterol

Alternative names
Cholesterol

Definition
Cholesterol is a soft, waxy substance present in all parts of the body including the nervous system, skin, muscle, liver, intestines, and heart. It is both made by the body and obtained from animal products in the diet.

Function
Cholesterol is manufactured in the liver for normal body functions including the production of hormones, bile acid, and Vitamin D. It is transported in the blood to be used by all parts of the body.

Food Sources

Dietary cholesterol is present only in foods of animal origin (not in foods of plant origin).

Cholesterol is found in eggs, dairy products, meat, poultry, fish, and shellfish. Egg yolks and organ meats (liver, kidney, sweetbread, and brain) are high in dietary cholesterol. Fish generally contains less cholesterol than other meats, but some shellfish is high in cholesterol.

Foods of plant origin (vegetables, fruits, grains, cereals, nuts, and seeds) contain no cholesterol. Fat content is not a good measurement of cholesterol content. For example, liver and other organ meats are low in fat but very high in cholesterol.

Side Effects
Excessive cholesterol contributes to atherosclerosis and subsequent heart disease. The risk of developing heart disease or atherosclerosis increases as the level of blood cholesterol increases.

Recommendations

Approximately 25% of the adult population in the U.S. has elevated blood cholesterol levels. More than half of the adult population has blood cholesterol levels that are higher than the “desirable” range, as specified by the medical community. Elevated cholesterol levels often begin in childhood. Some children may be at higher risk than others due to a family history of High cholesterol.

The recommeded level for total cholesterol has been lowered in the past few years. Depending on the laboratory, either less than 200 or less than 190 milligrams per deciliter (mg/dl) is considered “desirable” because that level carries the least risk of heart disease.

When the level is above 200 mg/dl, the risk for coronary heart disease increases. It is also important to know the levels of High Density Lipoprotein (HDL, also known as the “good cholesterol”) and Low Density Lipoprotein (LDL, or “bad cholesterol”). You must consult your health care provider to measure and discuss your cholesterol profile.

To lower High cholesterol levels, eat less than 30% of the total daily calories from fat. Of that 30%, less than one-third should be from saturated fat and not more than one-third should be from polyunsaturated fat. At least one-third of the total fat calories should be from monounsaturated fat. Less than 300 milligrams (mg) of dietary cholesterol per day should be consumed.

Recommendations for children’s diets are similar to those of adults. It is imperative that children’s caloric intake be adequate to support growth and activity level and that the child achieve and maintain a desirable body weight

The following two sample menus provide examples of an average American diet and a low-fat diet. The nutrient analysis shows that, for the same number of calories, a low-fat diet provides 190 mg of dietary cholesterol vs. the 510 mg of dietary cholesterol of an average American diet.

AVERAGE AMERICAN DIET

     
  • breakfast       o 1 egg scrambled in 1 teaspoon of butter       o 2 slices of white toast       o 1 teaspoon of butter       o 1/2 cup of apple juice  
  • snack       o 1 cake donut  
  • lunch       o 1 ham and cheese sandwich (2 ounces of meat, 1 ounce of cheese)       o white bread       o 1 teaspoon of mayonnaise       o 1-ounce bag potato chips       o 12-ounce soft drink       o 2 chocolate chip cookies  
  • snack       o 8 wheat thins  
  • dinner       o 3 ounces of broiled sirloin       o 1 medium baked potato       o 1 tablespoon of sour cream       o 1 teaspoon of butter       o 1/2 cup of peas, 1/2 teaspoon of butter

LOW FAT DIET

     
  • breakfast       o 1 cup of toasted oat ring cereal       o 1 cup of skim milk       o 1 slice of whole-wheat bread       o 1 teaspoon of margarine       o 1 banana  
  • snack       o 1 cinnamon raisin bagel, 1/2 ounce light cream cheese  
  • lunch       o turkey sandwich (3 ounces of turkey)       o rye bread       o lettuce       o 1 orange       o 3 fig newtons       o 1 cup skim milk  
  • snack       o non fat yogurt with fruit  
  • dinner       o 3 ounces of broiled chicken breast       o 1 medium baked potato       o 1 tablespoon of nonfat yogurt       o 1 teaspoon of margarine       o 1/2 cup of broccoli       o 1 dinner roll       o 1 cup skim milk

TOTALS
Average American diet:

     
  • 2,000 Calories, 84 grams fat, 34 grams saturated fat, 425 milligrams cholesterol       o 38% total fat       o 15% saturated fat

Low fat diet:

     
  • 2,000 Calories, 38 grams fat, 9.5 grams saturated fat, 91 milligrams cholesterol       o 17% fat       o 4% saturated fat

The sample menus demonstrate that because the fat is high in calories, the low-fat diet has a greater quantity of food than the typical American diet for the same 2,000 Calories.

The low-fat diet example is too low in fat for small children to promote good growth. In addition, it may be difficult for them to consume such a large volume of food. Children should have a diet that is closer to 30% of calories from fat. Lower-fat diets may be appropriate in some cases but require careful follow-up from a physician and dietitian.

Johns Hopkins patient information

Last revised: December 2, 2012
by Arthur A. Poghosian, M.D.

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All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.