ANAHEIM, CALIF. -- Splurging on a high-fat, high-cholesterol meal as often as every other day need not raise cholesterol levels if people compensate by reducing fat and cholesterol in other meals, according to a study released last week.
The study found that 14 people who followed a diet containing no more than 25 percent fat, most of it unsaturated, and moderate amounts of cholesterol could eat a ham-and-cheese sandwich and a Haagen-Dazs milkshake every other day without substantially altering their heart disease risk -- if the total amount of cholesterol and fat they consumed in their diets did not jump too high.
"The idea is that if somebody needs to go out with the kids to McDonald's or go to a wedding and have a meal high in fat, they should reduce the fat content in other meals," said Dr. Margo Denke, an endocrinologist at the University of Texas Health Science Center in Dallas.
She reported her findings at the annual meeting of the American Heart Association.
Nancy Ernst, coordinator of nutrition programs for the National Heart, Lung and Blood Institute in Bethesda, said of Denke's study, "It's not surprising."
"It's your overall diet that's important, and that's a concept that isn't emphasized as often as it should be," she said.
The NHLBI said this fall that most Americans should strive for a total cholesterol count of 200 milligrams per deciliter. People above 240 are considered to be in the high range and at increased risk of heart attack.
Saturated fat -- mostly from meat and dairy products -- contributes to elevated cholesterol levels and raises the risk of heart disease; unsaturated fats, from vegetables and fish, are not harmful.
Ernst, a nutritionist, said she advises people to think of eating as a kind of banking. "If you're going to overspend on your account one day, you have to underspend the next."
Denke, who did the study last year while working with Dr. Jan Breslow at Rockefeller University in New York City, said she was trying to find out how to advise patients who could not always watch their diets.
"I took care of a lot of stockbrokers, and they didn't want to make their health an issue at lunch," she said. "They go out to talk business, not cholesterol."
Her study suggests that even if they have a high-fat, high cholesterol lunch they can keep their heart disease risks low by cutting back at breakfast or dinner or the next day's lunch.
"You have to look at the sum percentage increase in fat," and keep it low, she said.
Her findings are not a license to eat high-fat foods all the time, however. Splurging a little in the morning, a little at lunch and a little at dinner will likely raise the saturated fat and cholesterol content of the diet beyond desirable levels, she said.