Dietary cholesterol, heart disease risk and cognitive dissonance

McNamara, Donald J.

doi:10.1017/s0029665113003844

Cited by 30Nutritional Studies and DietLipoproteins and Cardiovascular HealthCholesterol and Lipid Metabolism

Dietary cholesterol, heart disease risk and cognitive dissonance

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McNamara, Donald J.·2014·Proceedings of the Nutrition Society

DOI 10.1017/s0029665113003844

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Abstract

In the 1960s, the thesis that dietary cholesterol contributes to blood cholesterol and heart disease risk was a rational conclusion based on the available science at that time. Fifty years later the research evidence no longer supports this hypothesis yet changing the dietary recommendation to limit dietary cholesterol has been a slow and at times contentious process. The preponderance of the clinical and epidemiological data accumulated since the original dietary cholesterol restrictions were formulated indicate that: (1) dietary cholesterol has a small effect on the plasma cholesterol levels with an increase in the cholesterol content of the LDL particle and an increase in HDL cholesterol, with little effect on the LDL:HDL ratio, a significant indicator of heart disease risk, and (2) the lack of a significant relationship between cholesterol intake and heart disease incidence reported from numerous epidemiological surveys. Over the last decade, many countries and health promotion groups have modified their dietary recommendations to reflect the current evidence and to address a now recognised negative consequence of ineffective dietary cholesterol restrictions (such as inadequate choline intake). In contrast, health promotion groups in some countries appear to suffer from cognitive dissonance and continue to promote an outdated and potentially hazardous dietary recommendation based on an invalidated hypothesis. This review evaluates the evidence for and against dietary cholesterol restrictions and the potential consequences of such restrictions.

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Cholesterol intake has correlated with serum cholesterol levels but has not correlated well with CVD events.
“Whereas cholesterol intake has correlated with serum cholesterol levels, it has not correlated well with CVD events (65,66).”
From Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report (2019) · cites this paper as [66]

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Authors: McNamara, D. J.
Corresponding author: McNamara, Donald J.
Venue: Proceedings of the Nutrition Society
Publisher: Cambridge University Press (CUP)
Published: 2014-01-09
Volume: 73
Issue: 2
Pages: 161-166
ISSN: 0029-6651 (ISSN-L)
1475-2719
DOI: 10.1017/s0029665113003844
OpenAlex: W2094168840
Cited by: 30
References: 63
Citations by year: 2025: 1 · 2024: 1 · 2023: 4 · 2022: 2 · 2021: 1 · 2020: 2 · 2019: 6 · 2018: 5 · 2017: 1 · 2016: 2 · 2015: 3 · 2014: 2
FWCI: 0.42
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.cambridge.org/core/terms (unspecified)
Locations: Proceedings of The Nutrition Society (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
Health Sciences › Medicine › Surgery › Cholesterol and Lipid Metabolism
Keywords: dietary cholesterol, heart disease risk, serum cholesterol, HDL cholesterol, LDL/HDL ratio, dietary recommendations, choline intake, cognitive dissonance, health promotion, dietary fat restriction
MeSH terms: Animals, Cholesterol, Dietary, Cognitive Dissonance, Diet, Heart Diseases, Humans, Cholesterol, HDL, Cholesterol, LDL, Nutrition Policy

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Dietary cholesterol, heart disease risk and cognitive dissonance

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