Dietary cholesterol has almost no impact on blood cholesterol (lipoprotein) levels, because ingested esterified cholesterol is not absorbed by the intestine.

noli's read

Peter Attia highlights a scientific consensus here that has evolved significantly since the nutritional recommendations of the 20th century. Current research, including a major meta-analysis published in the 'Journal of the American College of Nutrition' (2021) and various randomized controlled trials (RCTs), confirms that for the majority of individuals, the consumption of dietary cholesterol has little influence on circulating lipoproteins, as the liver regulates its own production based on intake. Attia's explanation regarding intestinal absorption is scientifically grounded: dietary cholesterol is primarily in esterified form and requires prior hydrolysis by pancreatic enzymes, a process with limited efficiency. While this point is solid, it is important to remain nuanced: in 'hyper-responders' (approximately 20-25% of the population), the impact on blood cholesterol can be more pronounced, although the correlation with cardiovascular risk remains debated. The statement is therefore robust for the general population, but it simplifies a biological reality that can vary depending on genetic profiles.

the sources

1. 1Drouin-Chartier JP et al. 2020
2. 2Zhong VW et al. 2019