Carbohydrates & Cholesterol: Recommendations from the National Cholesterol Education Program

NCEP Evidence Statement: When carbohydrate is substituted for saturated fatty acids, LDL cholesterol levels fall (Strength of Evidence: A2, B2). However, very high intakes of carbohydrates (greater than 60 percent of total calories) are accompanied by a reduction in HDL cholesterol and a rise in triglyceride (B1, C1). The latter responses are sometimes reduced when carbohydrate is consumed with viscous fiber (C2); however, it has not been demonstrated convincingly that viscous fiber can fully negate the triglyceride-raising or HDL-lowering actions of very high intakes of carbohydrates.

NCEP Recommendations: Carbohydrate intakes should be limited to 60 percent of total calories. Lower intakes (e.g. 50% of calories) should be considered for persons with the metabolic syndrome who have elevated triglyceride or low HDL cholesterol. Regardless of intakes, most of the carbohydrate intake should come from grain products, especially whole grains, vegetables, fruits, and fat-free or low-fat dairy products.

Macronutrient NCEP Dietary Recommendations

Carbohydrate: 50-60% of Total Calories* **

Protein: 15% of Total Calories

Total Fat: 25-35% of Total Calories*

Monunsaturated Fat: Up to 20% of Total Calories

Polyunsaturated Fat: Up to 10% of Total Calories

Saturated Fat: Less than 7% of Total Calories

Dietary Cholesterol: Less than 200mg/day.

*Allows an increase of total fat to 35% of total calories and reduction in carbohydrate to 50% for persons with the metabolic syndrome. Any increase in fat intake should be in the form of either polyunsaturated or monounsaturated fat.
**Carbohydrate should derive perdominantly from foods rich in complex carbohydrates including grains--especially whole grains---fruits, and vegetables.