We've been watching it and avoiding it like the plague.

Why? Does that do any good? The answer may surprise and depress you

This is Healthcare Triage.

Okay, let's start with heart disease, which is still pretty much the biggest killer in the industrial world.

Most of the problems come from atherosclerosis, where the walls of blood vessels

thicken and fatty plaques form. Later, clots can develop

or fragments of plaques can break off and clog up other vessels. If those blockages

occurring vessels that feed the heart

you have a heart attack.If those vessels feed the brain, you have a stroke

neither is good. And look, you need cholesterol. It's not poison.

Your liver makes about a thousand milligrams of it a day, cuz you need it to make

certain vitamins and hormones.

It's necessary to make cell walls, and it helps digest and move fat around your body.

It gets around in two forms. Low-density lipoprotein, or LDL cholesterol is the bad kind.

It's the one that's been implicated in causing atherosclerosis.

But there's also high-density lipoprotein, and that's the good cholesterol

Now there are many things that have been linked to heart disease and atherosclerosis is just one of them.

Plus, the right medical treatment about cholesterol to focus on is debatable

Is it the total amount? The LDL level only?

The ratio about the RHEL? Something else?

All hotly contested. But what wasn't contested, at least not terribly publicly,

was that we should avoid cholesterol in our food and that

is where the dietary recommendations come in. For a long long time,

we've been told that we should limit our intake of cholesterol to no more than

three hundred milligrams a day.

That's not a lot, just one egg has about 220 milligrams of cholesterol in it.

So you know with two-egg-omelet will be a bad idea

Forget the three-egg-omelet. Mattered you ate nothing else with cholesterol all day

Cholesterol warnings have been in effect since the 1960s, since 1994,

laws required food in the United States to report cholesterol values on nutrition labels

So people could make more informed choices, and we cut out eggs

we cut out meat, we cut out shrimp.

Some of us even cut out milk, which was a good idea for other reasons. And that sucked.

Today the average adult male in the United States consumes about three

hundred forty milligrams of cholesterol a day.

And experts complain that's not good enough.

Plus, I ate egg white omelette. Have you tried them? Tasteless

Was it necessary? To the research, turns out there have been good studies

on whether dietary cholesterol affect the level of cholesterol in your blood.

For instance, a 2004 study took people and randomized them to one of two groups.

One was given the equivalent of more than three eggs a day per 30 days,

and the other got a placebo. Then they switched group. They measured their serum cholesterol after each intervention period.

What they found and what's been found in many other studies

is that about 70 percent of people are what we call hypo responders to dietary cholesterol.

This means that after consuming three eggs a day for 30 days,

they've seen no real increase in their plasma cholesterol ratios.

Their cholesterol levels have almost no relationship to what they eat.

There have been many randomized controlled trials in this area.

In 2013, researchers published a systematic review of all recent studies

just from 2003 year after.

Twelve of the met criteria and seven of them control for background diet.

Most of the studies the controlled for background diet found that altering

cholesterol consumption had no effect

on the concentration of blood LDL cholesterol. A few studies could only

detect differences in small subgroups of people

with certain genes or a predisposition to problems. In other words,

in most studies, all people didn't respond to changes in their intake of cholesterol.

in just a few, a minority of patients responded to changes in their dietary cholesterol.

Have recommendations change for the publication and any studies?

No~ I still get lectures from people telling me that this or that has too

much cholesterol in it. But all that may be about to change.

In December, a dietary guidelines summit committee,

met to discuss possible changes to the next set of dietary guidelines for the United States to be released this year.

After their meeting, the published report

You can go look at it. It said and I quote "Cholesterol is not considered a nutrient of concern for over consumption.

I'm sure that will come as a surprise to the vast

majority of Americans and people worldwide,

who for decades have been watching the cholesterol intake religiously.

It's very possible that the US government might finally change their

dietary guidelines this year to reflect this back.

But we don't yet know for sure. Now that doesn't mean the bad levels of

cholesterol in your blood are dangerous,

it also doesn't mean that all the people on drugs to help produce their

cholesterol level don't need them.

it's now thought that it's the consumption of saturated and trans fats perhaps,

which make more of difference and that's what we should focus on.

But we haven't been totally evidenced based on our fat recommendations either

and that's the subjective of next week's Healthcare Triage.