Does (eating) cholesterol cause cardiovascular disease?

There has been much speculation about whether or not high levels of cholesterol increase the risk of cardiovascular disease. Some studies show a direct correlation of increased cholesterol with increased risk of cardiovascular disease. While some say this relationship is much more complex, these studies suggest that the opposing studies are over-exaggerating [1]. Therefore, it can be difficult to know exactly what to believe on this controversial topic.


Cholesterol is one of the body's lipids. It's an essential building block for the structure of cells, steroid hormones and vitamin D.  An individual's cholesterol level depends on how their body makes cholesterol in the liver as well as their diet. There are two types of cholesterol produced in the liver; the 'good' kind or high-density lipoprotein (HDL) and the 'bad' kind or low-density lipoprotein (LDL) [2].


LDL can stick to artery walls, causing the arteries to narrow, which eventually blocks oxygen transport and consequently causes a heart attack. Some studies have found that LDL levels are more predictive of CVD than total cholesterol levels alone, which makes sense since HDL actually protects against the hardening and narrowing of the arteries [3]. These studies also suggest that it's not so much the dietary cholesterol as it is the individual's cholesterol synthesis (or blood cholesterol) that has an impact on the risk of CVD. One study showed that consumption of up to seven eggs per week (a food high in cholesterol) does not have significant effects on blood cholesterol levels, and would therefore not have a significant impact on the risk of CVD [4].


However, other studies have shown that some individuals, such as people older than 65 and middle-aged women, with elevated cholesterol levels are clearly at increased risk of coronary disease [5]. A correlation in a specific age group concludes that their bodies must be functioning in a similar way, with regards to how they synthesize cholesterol. Researchers measured LDL cholesterol levels and saw that higher levels predicted coronary heart disease in the two people groups (older people and middle-aged women). It was recommended to increase physical activity, lose excess weight, and follow a diet low in saturated fat and cholesterol in order to reduce the risk of CVD.


I suppose the controversy is exactly how one acquires high cholesterol rather than if it causes CVD, since both sides are in agreement that high levels of cholesterol (specifically LDL levels) are a risk factor for CVD. One side states it has more to do with how the body manufactures cholesterol and the other says it depends on how much cholesterol and saturated fat you consume. I think that it depends on how your body processes cholesterol, since the studies that have proved this (like the egg study) are more recent and seem to be much more thorough. Hopefully this post has encouraged you to do some research of your own on cholesterol and come to your own conclusion! Remember: cholesterol is an essential nutrient for our bodies, so don't cut it out of your diet completely. However, it is a good idea to minimize the amount of LDL cholesterol you eat. Continue to keep your heart healthy and happy!