Conclusion:

We confirm from the review of the literature on epidemiological data, meta-analysis, and clinical interventions where dietary cholesterol challenges were utilized that there is not a direct correlation between cholesterol intake and blood cholesterol. This lack of correlation is mainly due to the compensatory mechanisms exerted by the organism to manage excess dietary cholesterol, including decreases in cholesterol absorption and down-regulation of cholesterol synthesis. A great number of epidemiological studies and meta-analysis indicate that dietary cholesterol is not associated with CVD risk nor with elevated plasma cholesterol concentrations. Clinical interventions in the last 20 years demonstrate that challenges with dietary cholesterol do not increase the biomarkers associated with heart disease risk. Further, in the specific circumstances where eggs are the source of dietary cholesterol, an improvement in dyslipidemias is observed due to the formation of less atherogenic lipoproteins and changes in HDL associated with a more efficient reverse cholesterol transport. However, if the cholesterol sources are consumed with saturated and trans fats, as happens in the Western diet pattern, increases in plasma cholesterol may be observed. The most recent epidemiological data and clinical interventions for the most part continue to support the USDA 2015 dietary guidelines that removed the upper limit of dietary cholesterol.

The document reviews the relationship between dietary and blood cholesterol, highlighting that recent epidemiological studies and clinical interventions have found no direct correlation between the two. It notes that outdated dietary guidelines limited cholesterol intake to 300 mg/day, but newer research suggests that dietary cholesterol does not significantly impact blood cholesterol levels.

The review discusses how dietary cholesterol from eggs does not increase the risk of cardiovascular disease (CVD) and may even have beneficial effects on plasma lipoprotein subfractions and HDL cholesterol. It also mentions that the body has mechanisms to manage excess dietary cholesterol, such as decreased absorption and down-regulation of cholesterol synthesis.

The document concludes that current evidence supports the removal of upper limits on dietary cholesterol, as recommended by the 2015 USDA dietary guidelines.