Health educator explains skinny on cholesterol
SLIPPERY ROCK, Pa. - Wendy Stuhldreher, Slippery Rock University professor emerita of public health and social work, unscrambles confusion about "good and bad" cholesterol like a chef separating egg yoke from white.
Stuhldreher said people need to understand the difference between dietary cholesterol versus blood cholesterol to make healthful eating decisions.
Cholesterol, especially in eggs, became a national talking point when new dietary guidelines from the U.S. Office of Disease Prevention and Health Promotion said cholesterol in the diet should no longer be considered a "nutrient of concern." The office said eating foods high in cholesterol such as egg yolks does not significantly affect the level of cholesterol in the blood or increase the risk of heart disease in humans.
Stuhldreher, who researches health and nutrition, said dietary cholesterol found in eggs and other animal products is not bad. Genetics contributes most to blood cholesterol. It is the type of fat people eat - saturated and trans - that worsens blood cholesterol.
"When you go to your health care provider to have a lipid or cholesterol profile done, that is not the same thing as cholesterol you eat," Stuhldreher said. "Most of your blood cholesterol is under the control of genetics. However, eating large amounts of certain saturated fats and trans fats, not dietary cholesterol, influences your blood cholesterol, also known as 'lipid profile.'"
The big misconception, she said, is that Americans eat too much cholesterol when the real problem is fat. While eggs are OK, greasy pork sausage and bacon are not because they contain high fat.
"We consume a lot of fat, especially trans fat," she said. "That is why blood cholesterol is high, not because we ate egg yolks. Many folks think shrimp is bad, because it is high in cholesterol. Like eggs, shrimp is a great low-fat choice depending on how it is prepared. Both shrimp and eggs contain high-quality protein and other nutrients that many Americans don't get from other sources."
While dietary cholesterol is found only in animal product food, Stuhldreher said food producers who market cholesterol-free potato chips or cholesterol free snacks have misled the public.
"By implying these foods, often high in fat, are somehow better because they don't contain cholesterol, is not the whole picture," she said. "High-fat foods and high cholesterol foods are not synonymous. There are a few foods in the American diet that are high in cholesterol. One of the greatest sources is the egg."
Why did experts once limit eggs and now they don't? Stuhldreher said there are many reasons. The science of determining the effects of dietary cholesterol is complicated. Doing research about what people ate was time consuming and cumbersome before computer technology.
"Think of hand calculating just the total intake of dietary cholesterol," she said. "You have to list all foods you ate, look them up in a table that lists each food and the milligrams of cholesterol and add those up. Then do that for diet records for all the subjects in the study and multiple days of them. The contribution of computer technology sped this mundane task up."
In the 1980s, computer databases for nutrient values were just coming on the scene. So entering foods and portion sizes was still challenging, she said.
In the 1990s, nutritional software packages were developed but were expensive. They are still expensive.
Another reason for the change, she said, is the medical community is constantly learning. Former eggbeaters now know more.
"Think of how open-heart surgery has evolved, initially cracking the chest bones and going into the heart. Now stenting is the norm," Stuhldreher said.
Stuhldreher said consumers should try to unscramble marketing hype from food companies and listen to health care providers.
"The bottom line is eggs are one of the least expensive, high-protein foods in our diet," she said. "Protein is particularly important to have at breakfast as you age. So I am thrilled to have eggs back in vogue again. The yolks contain some unique nutrients ¬- vitamin D, cholin and iron."
That doesn't mean people should live on eggs, bacon and coffee. "According to those epidemiologic studies, the people with the lowest mortality rates consumed a lot of vegetables, whole grains, lean protein, low-fat dairy and fruit," she said.
SRU advocates that wellness is multi-dimensional and should incorporate physical, emotional, dietary, spiritual, occupational and environmental components.
SRU's dining services offers nutrition information in many ways - a website called NutriSource, a nutrition kiosk in Boozel Hall, printed nutrition materials in Boozel and a dietician who is available for consultation. Menu screens provide nutrition information on items being served.
"Rather than labeling food as 'bad' or 'good,' we speak with students about understanding portion size, what nutrients they are received from different types of foods and the importance of eating a variety of foods - meaning you should always have a colorful plate," said Renee Bateman, SRU health promotion coordinator for health services at the McLachlan Student Health Center.
SRU's dining halls cook hundreds of eggs daily; fried, scrambled and omelets.
Brannt Pieniazek, an SRU public health major from Winterville, Ohio, said he eats and cooks eggs for students daily. He works as a chef at Weisenfluh Hall, where he fries eggs and bacon for breakfast sandwiches.
"I eat eggs for a good source of protein, especially egg whites since there's no fat," he said. "I'm very into fitness and nutrition and a lot of my friends also eat eggs for breakfast in the morning. I don't normally pay attention to the cholesterol levels in eggs because like I said, I eat them for the protein."
Normally in one whole egg, there are a little more than six grams of protein and five grams of fat. Of that fat, only one gram is saturated, which is the bad fat, so you're consuming around four grams of unsaturated fat that your body can use in a positive way, he said.
"Personally, I'll never stop eating eggs or egg whites," he said. "They are a great source of protein with hardly any carbohydrates and a little bit of fat. I also mix in spinach and/or deli turkey sometimes to make it healthier, even though in my eyes eggs are pretty healthy." Pieniazek said he reads nutrition labels to keep up with what's healthy.
"I take it all into consideration but mainly focus on the macros: protein, carbohydrates and fats," he said. "Since eggs do not contain many carbs at all, I usually eat some sort of oats or cream of wheat or turkey sandwich with my eggs to get a good amount of carbs. Carbs break down to give you energy so those are necessary usually 45 minutes to an hour before I workout and with breakfast. So once it's all said and done, I'm getting a good source of protein and fat from the eggs and good carbs from oats, cream of wheat, etc."
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