Editing Cholesterol (section)

==Dietary sources==
[[Animal fat]]s are complex mixtures of [[triglyceride]]s, with lesser amounts of both the [[phospholipid]]s and cholesterol molecules from which all animal (and human) cell membranes are constructed. Since all animal cells manufacture cholesterol, all animal-based foods contain cholesterol in varying amounts.<ref name="isbn0-9531949-5-7">{{cite book|title=Lipid analysis: isolation, separation, identification, and structural analysis of lipids| vauthors = Christie WW |publisher=Oily Press|year=2003|isbn=978-0-9531949-5-7|location=Ayr, Scotland }} {{page needed|date=July 2023}}</ref> Major dietary sources of cholesterol include [[red meat]], [[Yolk|egg yolks]] and whole [[Egg as food|egg]]s, [[liver]], [[kidney]], [[giblets]], [[fish oil]], shellfish, and [[butter]].<ref name="USDA">{{cite web|url=https://ndb.nal.usda.gov/ndb/nutrients/report?nutrient1=601&nutrient2=&nutrient3=&&max=25&subset=0&offset=0&sort=c&totCount=7211&measureby=g|title=Cholesterol content in foods, rank order per 100 g; In: USDA Food Composition Databases|publisher=United States Department of Agriculture|date=2019|access-date=4 March 2019}}{{dead link|date=October 2022|bot=medic}}{{cbignore|bot=medic}}</ref> Human [[breast milk]] also contains significant quantities of cholesterol.<ref name="ajcn-breastmilk">{{cite journal | vauthors = Jensen RG, Hagerty MM, McMahon KE | title = Lipids of human milk and infant formulas: a review | journal = The American Journal of Clinical Nutrition | volume = 31 | issue = 6 | pages = 990–1016 | date = June 1978 | pmid = 352132 | doi = 10.1093/ajcn/31.6.990 | doi-access = free }}</ref>

Plant cells synthesize cholesterol as a precursor for other compounds, such as [[phytosterols]] and [[steroid]]al [[glycoalkaloid]]s, with cholesterol remaining in plant foods only in minor amounts or absent.<ref name="USDA" /><ref name="sonawane">{{cite journal | vauthors = Sonawane PD, Pollier J, Panda S, Szymanski J, Massalha H, Yona M, Unger T, Malitsky S, Arendt P, Pauwels L, Almekias-Siegl E, Rogachev I, Meir S, Cárdenas PD, Masri A, Petrikov M, Schaller H, Schaffer AA, Kamble A, Giri AP, Goossens A, Aharoni A | title = Plant cholesterol biosynthetic pathway overlaps with phytosterol metabolism | journal = Nature Plants | volume = 3 | issue = 1 | pages = 16205 | date = December 2016 | pmid = 28005066 | doi = 10.1038/nplants.2016.205 | s2cid = 5518449 }}</ref> Some plant foods, such as [[avocado]], [[flax seed]]s and [[peanut]]s, contain phytosterols, which compete with cholesterol for absorption in the intestines and reduce the absorption of both dietary and bile cholesterol.<ref>{{cite journal | vauthors = De Smet E, Mensink RP, Plat J | title = Effects of plant sterols and stanols on intestinal cholesterol metabolism: suggested mechanisms from past to present | journal = Molecular Nutrition & Food Research | volume = 56 | issue = 7 | pages = 1058–1072 | date = July 2012 | pmid = 22623436 | doi = 10.1002/mnfr.201100722 | doi-access =}}</ref> A typical diet contributes on the order of 0.2 gram of phytosterols, which is not enough to have a significant impact on blocking cholesterol absorption. Phytosterols intake can be supplemented through the use of phytosterol-containing [[functional foods]] or [[dietary supplement]]s that are recognized as having potential to reduce levels of [[low-density lipoprotein|LDL]]-cholesterol.<ref>{{cite web|url=http://www.efsa.europa.eu/en/efsajournal/pub/1813|title=Scientific opinion on the substantiation of health claims related to plant sterols and plant stanols and maintenance of normal blood cholesterol concentrations|year=2010|author=European Food Safety Authority, Journal}}</ref>

===Medical guidelines and recommendations===
In 2015, the scientific advisory panel of [[United States Department of Health and Human Services|U.S. Department of Health and Human Services]] and [[United States Department of Agriculture|U.S. Department of Agriculture]] for the 2015 iteration of the Dietary Guidelines for Americans dropped the previously recommended limit of consumption of dietary cholesterol to 300&nbsp;mg per day with a new recommendation to "eat as little dietary cholesterol as possible", thereby acknowledging an association between a diet low in cholesterol and reduced risk of cardiovascular disease.<ref>{{Cite web |title=2015-2020 Dietary Guidelines {{!}} health.gov |url=https://health.gov/our-work/nutrition-physical-activity/dietary-guidelines/previous-dietary-guidelines/2015 |access-date=2023-08-23 |website=health.gov}}</ref>

A 2013 report by the American Heart Association and the American College of Cardiology recommended focusing on healthy dietary patterns rather than specific cholesterol limits, as they are hard for clinicians and consumers to implement. They recommend the [[DASH diet|DASH]] and [[Mediterranean diet]], which are low in cholesterol.<ref>{{cite journal | vauthors = Carson JA, Lichtenstein AH, Anderson CA, Appel LJ, Kris-Etherton PM, Meyer KA, Petersen K, Polonsky T, Van Horn L | title = Dietary Cholesterol and Cardiovascular Risk: A Science Advisory From the American Heart Association | journal = Circulation | volume = 141 | issue = 3 | pages = e39–e53 | date = January 2020 | pmid = 31838890 | doi = 10.1161/CIR.0000000000000743 | doi-access = free }}</ref> A 2017 review by the [[American Heart Association]] recommends switching [[saturated fats]] for [[polyunsaturated fats]] to reduce [[cardiovascular disease]] risk.<ref>{{cite journal | vauthors = Sacks FM, Lichtenstein AH, Wu JH, Appel LJ, Creager MA, Kris-Etherton PM, Miller M, Rimm EB, Rudel LL, Robinson JG, Stone NJ, Van Horn LV | title = Dietary Fats and Cardiovascular Disease: A Presidential Advisory From the American Heart Association | journal = Circulation | volume = 136 | issue = 3 | pages = e1–e23 | date = July 2017 | pmid = 28620111 | doi = 10.1161/CIR.0000000000000510 | s2cid = 367602 | doi-access = free }}</ref>

Some supplemental guidelines have recommended doses of phytosterols in the 1.6–3.0&nbsp;grams per day range (Health Canada, EFSA, ATP III, FDA). A meta-analysis demonstrated a 12% reduction in LDL-cholesterol at a mean dose of 2.1&nbsp;grams per day.<ref>{{cite journal | vauthors = Ras RT, Geleijnse JM, Trautwein EA | title = LDL-cholesterol-lowering effect of plant sterols and stanols across different dose ranges: a meta-analysis of randomised controlled studies | journal = The British Journal of Nutrition | volume = 112 | issue = 2 | pages = 214–219 | date = July 2014 | pmid = 24780090 | pmc = 4071994 | doi = 10.1017/S0007114514000750 }}</ref> The benefits of a diet supplemented with phytosterols have also been questioned.<ref name="Weingärtner_2009">{{cite journal | vauthors = Weingärtner O, Böhm M, Laufs U | title = Controversial role of plant sterol esters in the management of hypercholesterolaemia | journal = European Heart Journal | volume = 30 | issue = 4 | pages = 404–409 | date = February 2009 | pmid = 19158117 | pmc = 2642922 | doi = 10.1093/eurheartj/ehn580 }}</ref>