Cholesterol in food not a dietary concern

Dear Dr. Roach: My husband and I have been watching our fat intake, and we have eliminated almost all red meat and processed foods from our diet.

We do eat a lot of fish (salmon primarily) and boneless/skinless chicken. I am, at times, confused about the information on nutrition facts labels. As an example, the label on a package of boneless and skinless chicken pieces indicates that the saturated fat content is 3% and the cholesterol content is 22%. I’ve seen similar numbers on other “healthy” options, with saturated fat below 10% and cholesterol around 20%.

Is that a good ratio for healthy eating? I am trying to lower my cholesterol level, which is currently around 230 mg/dL, but when I see a cholesterol content of 20% or more with a very low saturated fat level, I’m wondering if I’m really picking healthy foods.

S.K.A. The effect of dietary cholesterol on blood cholesterol is more complicated than you might think. Our body makes most of the cholesterol in the blood, and if you take more cholesterol in, your body just makes a little less so that the effect is slight. Most experts do not emphasize dietary cholesterol in a healthy diet.

You’ve made a wise choice in eliminating most processed foods. Red meat remains controversial, but in my opinion, the preponderance of the data supports limiting intake of red meat and saturated fat. Most saturated fat comes from meat and fullfat dairy products. Independent of your cholesterol level, these changes are likely to lead to better overall health.

Dear Dr. Roach: How much caffeine is too much?

R.C. A dose of up to 400 mg of caffeine daily is safe for most people. Eight ounces of coffee averages around 100 mg of caffeine, but that number can vary a lot by the type of coffee and how strongly it is brewed. Black tea has about half the caffeine content as coffee does per cup, roughly 50 mg, with green and white teas containing 25 to 30 mg per cup.

Energy drinks can contain various amounts of caffeine, with common brands averaging around 110 mg in a 12-ounce can. True overdoses are uncommon — most cases are from caffeine pills.

Dear Dr. Roach: I am a carrier for the sickle cell gene. My A1C has been slightly elevated for years. I would like to know if having the sickle cell trait affects the results of an A1C.

P.S. Having the sickle cell trait has almost no effect on a person’s overall health; however, it does cause a few slight changes. One is that the blood cells might not last quite as long; evidence for this is conflicting. The machine that measures A1C levels might also have a systematic error in measuring A1C levels with a different type of hemoglobin. In a recent study, the A1C level was about 0.3% lower in people with the sickle cell trait.

If your levels have been slightly elevated, putting you in the “prediabetes” category, it’s possible that your level was actually in the diabetes category, if you were already close to the cutoff point. An oral glucose tolerance test is the most sensitive test for diagnosing diabetes, but you might not need that. The advice for a prudent diet and regular exercise would be the same.