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Ask Dr. Gourmet

How much cholesterol in my daily diet is too much?

I have recent found out my cholesterol number is 264. I am forty-three, 160 pounds, female. I fully realize my main problem is lifestyle. I have completely changed that. I’ve cut out fast food, started exercising and am trying to quit smoking. Here’s the problem….I spend so much time reading and studying labels but am having a terrible time understanding the cholesterol information. I have read your articles about avoiding the saturated fats but still, everything I think should be good for me is loaded with cholesterol. Fish for instance, 60 or more mgs of cholesterol. And your breakfast recipe for fritattas, a whopping 243 mgs of cholesterol.

PLEASE HELP ME MAKE SENSE OF THIS! Is there a dietary limit to be followed when it comes to cholesterol?

Dr. Gourmet Says...

A breakfast frittata

First off, congratulations for making the decision to get healthy. It won't take long for you to see results and forty years from now you'll feel great about your decisions.

We have learned that improving your cholesterol profile is about so much more than dietary cholesterol. If fact, for most people the amount of cholesterol that is consumed is not an issue. There have been a number of reviews of the research in the last year looking at the impact of consuming cholesterol on one's cholesterol profile. To quote the conclusion of a major review article, "the earlier purported adverse relationship between dietary cholesterol and heart disease risk was likely largely over-exaggerated."

There are so many more factors in helping to improve cholesterol profiles than dietary cholesterol. Reducing saturated fat is one, but just as important is the choice of saturated fat. Making ingredient choices of fresher, less processed foods is key. For instance, a 4 ounce serving of flank steak has about 175 calories and 3.3 grams of saturated fat. A single one ounce slice of bologna has half the calories but the same amount of saturated fat (and has all that other stuff in it that you don't want to even think about). Keep in mind that this is four ounces of steak vs. a single one ounce slice of bologna! Wow!

Increasing your fiber intake by ramping up good quality whole grains, legumes and fruits is clearly connected with improved cholesterol profiles and reduction in illness and death from all causes. Fish is a great choice, especially the fattier fish that are full of Omega-3 fats like tuna, mackerel, salmon, sardines and halibut. Likewise, nuts and great quality oils that are rich in monounsaturated fats have been shown to lower cholesterol.

The most common foods that contain cholesterol that you might choose are eggs, shrimp, liver and lobster. In most every research study we have there's no link with these ingredients and elevation of cholesterol. In fact, those eating up to 5 eggs a week have been shown to have a better cholesterol profile. (This is why some of the breakfast recipes on the Dr. Gourmet web site have higher cholesterol: they use great quality proteins - eggs.) One key may be preparation and what you serve with these ingredients - eggs and bacon, fried shrimp, deep fried chicken livers - are best saved for the most very special occasions.

When talking with patients I tell them to not look too closely at the amount of cholesterol in the food they are eating but focus on fresh and not processed ingredients, whole grains, good quality fats, legumes, fruits, nuts, fish and lots of veggies. If they have done this and their cholesterol profile is still a problem, it is then worth looking at dietary cholesterol, but I have found this to be the minority of folks.

Lastly, one of the best things you can do is to quit smoking and kudos to you for working on this. We know that tobacco increases cholesterol, but more importantly, it increases the bad (LDL) cholesterol while reducing the good (HDL) cholesterol.

Thanks for writing,

Timothy S. Harlan, MD, FACP
Dr. Gourmet