Comment by themk
3 days ago
Dietary cholestrol hasn't really been overturned, but sure there is some nuance. Some people do respond badly to dietary cholestrol (like you said, individual advice is sometimes required), but dietary cholestrol is also not a linear response afaiu. That is, if you eat one egg a day, you may as well eat 4, but if you can completely eliminate dietary cholestrol it could make a difference. So, many guidelines don't bother with suggesting it, because it's too hard to eleminate it to the point of mattering for the average person.
All that to say, the science isn't wrong, but the practicalities influence the advice.
The guidelines haven't changed, but they should be. The association between cholesterol and CVD is specifically related to blood cholesterol levels. However, in healthy individuals, blood cholesterol levels are not strongly impacted by dietary cholesterol choices - since cholesterol is synthesized in the body, there is homeostasis, and higher cholesterol intake leads to lower rate of synthesis, maintaining the same blood levels.
However, some individuals suffer from a bad regulation of this homeostasis, and for them dietary cholesterol does lead to persistent high levels of blood cholesterol as well. So the guidelines should apply for them, but not for everyone else.