Dietary Cholesterol

If you want to decrease your cholesterol levels, you should ingest less cholesterol! The NCEP guidelines recommend less than 200 mg of dietary cholesterol per day. For reference, one large egg yolk has 200 mg. For some people—let’s call them responders—blood cholesterol levels rise and fall pretty directly in relation to the amount of cholesterol and fat in their diets.

In others, there’s little connection. The same goes for dietary fat. A 1997 study done at the Human Nutrition Research Center on Aging at Tufts University looked at how 120 men and women responded to the same low-fat, lowcholesterol diet recommended by the NCEP.

On average, LDL levels dropped. Yet though everyone ate the same thing—the researchers provided the volunteers with all their food and drink—the average result masked a wide range of LDL responses, ranging from a 55 percent decrease to a 3 percent increase among men and a 39 percent decrease to a 13 percent increase among women.

Because there isn’t a simple way to test whether you’re a responder before you try an improved diet, the only way to gauge this is to limit dietary fat and cholesterol and see what happens. If your cholesterol doesn’t drop, you can still stick with the healthier food choices, but at a minimum you will know whether your diet is playing an important role in your elevated cholesterol level.

The Tufts University study brings up an important fact about dieting in general and cholesterol lowering in particular: everyone is different! A diet that helped your friend lose weight and lower her cholesterol might not work for you, because of either biological or lifestyle differences.

What you need to do is find a plan that works for you and stick with it. Don’t get discouraged if you have to try a few different kinds before one feels right. One trick that works for some people is keeping a food diary. For some reason, knowing that they have to write down that trans-fat-loaded brownie or high-fat hamburger makes them think twice before biting down.

It’s also a good way to see what your eating habits are in black and white—they may turn out to be different from what you think! If you’re a very social person, it might help you to call in some “diet reinforcements” in the form of friends. If they’re looking to eat healthier, too, you can talk about or e-mail each other your daily diet diary.

Hearing “Good job!” or “You’ll do better tomorrow” can go a long way toward helping you stick with your plan. Other systems, like rewarding yourself with a small (nonedible!) treat each day or week that you do well may also provide motivation.

Again, what works for you depends on who you are as a person, so try some different methods and see what feels right. Remember, too, that if you slip one day or week and fall back into your old eating patterns, you shouldn’t give up. Old habits can be stubborn.

Don’t be too hard on yourself; just start over again as many times as you need to. Eventually, your new habits will become your norm. Figuring out whether your diet is working can be hard. First of all, most people want to see results immediately, and when the pounds don’t start flying away within the first week, they convince themselves the diet isn’t working.

On a healthy diet, you can expect to lose only about one to two pounds a week. Another good way to monitor your progress is to get your lipid profile checked after about two or three months of your new diet, and then again at six months. If you’re a “responder,” you should see a drop in your LDL cholesterol.

Once you have reached your target levels, have a follow-up every six months to make sure your cholesterol is staying at a healthy level. Depending on your cholesterol levels, if you don’t see a drop in LDL cholesterol, you may need to either see a dietitian for a more thorough review of food choices and diet plans, or start on drug therapy.