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Optimal Phytosterol Dose

Those eating plant-based diets get the most phytosterols, but there is still room for improvement to maximize cholesterol reduction.

August 15, 2012 |
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Supplementary Info

Optimal Phytosterol Dose, 4.6 out of 5 based on 5 ratings

Sources Cited

Racette SB, Spearie CA, Phillips KM, Lin X, Ma L, Ostlund RE Jr. Phytosterol-deficient and high-phytosterol diets developed for controlled feeding studies. J Am Diet Assoc. 2009 Dec;109(12):2043-51.

Agren JJ, Tvrzicka E, Nenonen MT, Helve T, Hänninen O. Divergent changes in serum sterols during a strict uncooked vegan diet in patients with rheumatoid arthritis. Br J Nutr. 2001 Feb;85(2):137-9.

Mensink RP, de Jong A, Lütjohann D, Haenen GR, Plat J. Plant stanols dose-dependently decrease LDL-cholesterol concentrations, but not cholesterol-standardized fat-soluble antioxidant concentrations, at intakes up to 9 g/d. Am J Clin Nutr. 2010 Jul;92(1):24-33.

Phillips KM, Ruggio DM, Ashraf-Khorassani M. Phytosterol composition of nuts and seeds commonly consumed in the United States. J Agric Food Chem. 2005 Nov 30;53(24):9436-45.

Demonty I, Ras RT, van der Knaap HC, Duchateau GS, Meijer L, Zock PL, Geleijnse JM, Trautwein EA. Continuous dose-response relationship of the LDL-cholesterol-lowering effect of phytosterol intake. J Nutr. 2009 Feb;139(2):271-84.

Acknowledgements

Images thanks to: Dbenbenn, Zscout370, Jacobolus, Indolences, and Technion via Wikimedia Commons.

Transcript

If our enterocyte trash recovery bins are half filled with phytosterols might vitamins get crowded out too? We didn’t know until last year, but the answer is no, even with a whopping 9 gram dose. Vitamin absorption was unaffected. “Plant stanols dose-dependently decrease bad cholesterol concentrations, but not antioxidant concentrations in our blood

Now 9 grams is like 10 times what we would expect from even a healthy diet There's a plateau effect. At that 9 grams a day you’re way out here at then end, but as you can see, the cholesterol-lowering curve starts to flatten out… at about 2.

So we can pretty much maximize cholesterol-blocking at around 2 grams, 2000 mg. The standard American diet has been measured as low as 78mg a day here’s like a model American Heart Association diet, and this is how high folks eating plant based diets can get—higher than any other diet pattern reported. That could get you a good 5% reduction, but there’s definitely room to bump that up further--if necessary. Those who have improved their diet so much they're no longer eating any cholesterol should be acing their cholesterol tests, but in rare cases your body might not be able to get rid of enough endogenous production. And so doubling phytosterol intake could easily double LDL reduction down to 10%, which could double heart disease risk reduction.

In terms of whole foods sources to maximize cholesterol reduction, seeds provide the most—especially sesame, then nuts—especially pistacio, then legumes like peanuts.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring watch the above video. This is just an approximation of the audio contributed by Kerry Skinner.

To help out on the site please email volunteer@nutritionfacts.org

Dr. Michael Greger

Doctor's Note

Are there diminishing returns associated with other phytonutrients? SeeMaxing Out on Antioxidants and Kiwifruit and DNA Repair. The "enterocyte trash recovery bins" of which I speak are an analogy I introduced in How Fiber Lowers Cholesterol, the second of a loose five-part series on the cholesterol-lowering effects of nuts and seeds. Yesterday's video-of-the-day How Phytosterols Lower Cholesterol offered a bit of phytosterol background and tomorrow's video-of-the-day Optimal Phytosterol Source explains why whole food sources (nuts and seeds) are superior to phytosterol-fortified foods and supplements. Which other foods lower cholesterol levels? See New Cholesterol Fighters. And why should one worry about cholesterol in the first place? See Blocking the First Step of Heart Disease, Cholesterol and Lower Back Pain, Cholesterol and Female Sexual Dysfunction, and Heart Attacks and Cholesterol: Purely a Question of Diet for a few of the five dozen videos I have on the topic. Then, of course, there's athousand other topics—enjoy!

For some context, please check out my associated blog post: Optimal Phytosterol Dose and Source.

  • Michael Greger M.D.

     Are there diminishing returns associated with other phytonutrients? See Maxing Out on Antioxidants and Kiwifruit and DNA Repair. The “enterocyte trash recovery bins” of which I speak are an analogy I introduced in How Fiber Lowers Cholesterol, the second of a loose five-part series on the cholesterol-lowering effects of nuts and seeds. Yesterday’s video-of-the-day How Phytosterols Lower Cholesterol offered a bit of phytosterol background and tomorrow’s video-of-the-day Optimal Phytosterol Source explains why whole food sources (nuts and seeds) are superior to phytosterol-fortified foods and supplements. Which other foods lower cholesterol levels? See New Cholesterol Fighters. And why should one worry about cholesterol in the first place? See Blocking the First Step of Heart Disease, Cholesterol and Lower Back Pain, Cholesterol and Female Sexual Dysfunction, and Heart Attacks and Cholesterol: Purely a Question of Diet, a few of the five dozen videos I have on the topic. Then, of course, there’s a thousand other topics—enjoy!

    • HemoDynamic, M.D.

      It looks like Chocolate has the best Beta-Sitosterol (Black part of bar graph) to total sterol content ratio.
      ;-}
       
      This is what we want because it is the Beta-sitosterols that have been well know to reduce cholesterol levels.  Here is a link to one of them but there literally are over a hundred of these articles.
      http://www.ncbi.nlm.nih.gov/pubmed?term=Woodgate%20D%2C%20Chan%20CH%2C%20Conquer%20JA.%20Cholesterol-lowering%20ability%20of%20a%20phytostanol%20softgel%20supplement%20in%20adults%20with%20mild%20to%20moderate%20hypercholesterolemia.%20Lipids.%202006%3B41%3A127-132 

      In fact I have used Beta-Sitosterols to not only reduce cholesterol but Benign prostatic hypertrophy (BPH) between 2-5 grams per day. I have had mixed results with the BPH and Beta Sitosterol usage though.

      But why take a pill when you can eat Vegan?!

      Especially, Chocolate!!

      ;-}

      One caveat, however, is the fat you eat is the fat you wear–so if you go overboard of the nuts and seeds you might start to look like one–that unsvelte pear shape.

      • SJ M.D.

        Literally – If you are fat because of eating pork, lard, butter, cheesefat, trans fatty acids, bacon etc – that is what you will find on your belly in the fat cells – yikes….

    • coacervate

      When I eat walnuts and seeds like pumpkin and sunflower, i get serious pain, diarhea and fever.  What is the next best way to go for phytosterols and omega 3?

    • HemoDynamic, M.D.

      While searching for my favorite plant phytosterol package, Soybeans, which were not included in this nut and seed survey ;-( I found out, sadly, that 100g of Soybeans only contain 50 grams of Phytosterols, lower than the lowest of the low in this study Brazil Nuts.  http://nutritiondata.self.com/facts/vegetables-and-vegetable-products/2621/2,
      but I also came across this fantastic study:

      “A single daily dose of soybean phytosterols in GROUND BEEF decreases serum total cholesterol and LDL cholesterol in young, mildly hypercholesterolemic men”
      http://www.ajcn.org/content/76/1/57.short

      You’ve heard of Tofurkey but how about Tofeef.
      ;-}

  • veganrunner

    I came across this article and thought you all would enjoy. I wish we had it available when Sophie became so upset under the video “What Woman Should Eat” regarding the egg (cholesterol) and cigarette comparison. 

    http://soc.li/QQOFcEV 

    • veganrunner
      • SJ M.D.

        Egg-yolk years – I like that!

        As a doctor I always ask my patients about alcohol consumption and tobacco – maybe I will start asking about egg-yolk abuse…..

        • veganrunner

          I think you should. Let me know how it goes and I will follow suit. :-) 

    • WholeFoodChomper

      Hopefully Sophie did not “unregister” from the site and can benefit from this info. Thanks for sharing!

      • R Ian Flett

        There is lots of evidence showing that egg yolk cholesterol need not be harmful. However given the average appalling Western diet where atherosclerosis has commenced at a young age and lots of animal fats are consumed, then egg yolks add insult to injury. The comparison with cigarettes is invalid except in a trivial total correlation. The causative factors and contexts are quite different.
        In some cases egg yolks may improve health by adding to low cholesterol or adding much needed choline. Cigarettes never improve health. Sofie was quite right in decrying the incorrect use of total correlations being used to equate cigarettes with cholesterol.
        There is a total correlation of gasoline consumption with road deaths by country, but gasoline does not cause road accidents.
        The equation of cholesterol with cigarettes is pure vegan propaganda although I would still avoid them in most cases.

        • veganrunner

          R lan Flett did you read the article or abstract? I doubt the journal Artheclerosis has a vegan agenda.   

        • WholeFoodChomper

          I understand your point, R Ian Flett.  Maybe the message about the harmful effects of eggs was not made very eloquently in the original video or article. Still, for the most part it seems that staying away from egg yolks makes a lot of empirical and nutritional sense.

        • Toxins

          R Lan Flett, there is not “lots” of evidence showing egg yolk being unharmful. In fact, there is only one study showing this, funded by the egg industry. The egg industry has claimed that cholesterol from eggs is not important and is not harmful. The fundamental flaw
          in the study the egg industry has used to make this claim is that they measured fasting   lipid levels at night and not levels through out the day after egg consumption. “Diet is not all about fasting lipids; it is
          mainly about the three-quarters of the day that we are in the nonfasting state. Fasting lipids can be thought of as a baseline; they show what the endothelium was exposed to for the last few hours of the night.”

          http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2989358/?tool=pubmed

          • R Ian Flett

            The issue of dietary cholesterol versus endogenous cholesterol (from the liver) has been debated for decades in hundreds of papers. Shellfish were on the nose for years until their cholesterol was found to be relatively harmless – if not beneficial. The jury is still out on dietary cholesterol because it’s all very complicated. Some people cope with lots of dietary cholesterol and others don’t, depending on many other variables. Cholesterol is critically important to the body and some people don’t produce enough – including some on statins. The various cardiology institutions issue regular bulletins on this and their recommendations wax and wane, but currently at least two eggs per week are considered safe by most institutions. I eat none, despite having my arteries checked and being totally clean. Basically, I agree with Dr Greger that most animal products are nutritionally damaged during processing – purely for profit.
            There is a big difference between being a committed Vegan for ethical reasons and practising VeganISM, versus adopting an animal product free diet for purely scientific, health reasons as I tend to. The committed Vegan often believes it’s their ethical duty to proselytise and so ‘cherry picks’ their science. This happens a lot in this forum. I respect your ethical choice, but can we please keep the science separate. It’s sounding uncomfortably like the tactics used by fundamentalist, anti-evolutionists. Eggs are not ‘evil’, however they may well be unhealthy in their current supermarket form. It’s not your duty to find fault with them at every opportunity. The gross abuse of statistics in this valuable forum, by some, reveals an excessive emotional commitment that distorts the complex science involved.

          • Toxins

            I have already posted this elsewhere, but here it is again. Current levels of omega 3 in eggs are highly
            inadequate and one must consume around 30 eggs to reach an acceptable
            level of omega 3 for the day. A male needs around 1.6 grams of omega 3
            per day, a female needs around 1.1 grams a day. Omega 3 processes to
            EPA which is also processed to DHA, which is highly anti inflammatory.
            Omega 6 processes down to arachadonic acid which is highly
            inflammatory. The fact that eggs are the top source of arachadonic acid
            nulls and voids benefits received from the omega 3 in the egg itself.
            High intake of arachadonic acid is linked to autoimmune diseases such
            as  rheumatoid arthritis, ulcerative colitis, as well as a clear link
            with  cancer development.http://www.ncbi.nlm.nih.gov/pubmed?term=20950616uidhttp://www.ncbi.nlm.nih.gov/pubmed/18774339http://www.ncbi.nlm.nih.gov/pubmed/21139128 The
            Harvard physicians study followed 20,000 doctors for 20 years and
            those that ate just one egg a day had significant increase in all cause
            mortality.http://www.ncbi.nlm.nih.gov/pubmed/18400720 In
            fact, David Spence, director of stroke prevention/atherosclerosis
            research center and one of the worlds leading stroke experts, said that
            based on the latest research, you can eat all the eggs you want IF your
            dying of a terminal illness. Eggs are not considered health promoting
            nutritionally speaking.http://www.ncbi.nlm.nih.gov/pubmed/18400699 Eggs have been linked with heart failurehttp://www.ncbi.nlm.nih.gov/pubmed/18954578 As well as type 2 diabetes.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2628696/?tool=pubmed  Furthermore,
            in the Canadian Journal of Cardiology, David Spence, David Jenkins
            (the inventor of the glycemic index) and Jean Davignon (director of
            atherosclerosis research group) posted a review on eggs claiming that
            the egg industry has been downplaying the health risks of eggs through
            misleading advertisements. As soon as you eat one egg, you expose
            your body to several hours worth of oxidative stress, inflammation of
            ones arteries, endothelieum impairment (what keeps you blood running
            smoothly) and increases the susceptibility of LDL cholesterol to
            oxidize (beginning stages of heart disease).http://www.ncbi.nlm.nih.gov/pubmed/21076725http://www.ncbi.nlm.nih.gov/pubmed/9001684If you can provide counter evidence claiming that eggs are beneficial to ones health please do so, but otherwise I see no logic in claiming that eggs are safe to eat twice a week, and to make the statement that we have a dietary need for cholesterol, this is simply untrue.

          • Toxins

            Allowing the consumption of eggs even twice a week does not make sense to me one it is understand what health detriments come with egg consumption.

            current levels of omega 3 in eggs are highly inadequate and one must
            consume around 30 eggs to reach an acceptable level of omega 3 for the
            day. A male needs around 1.6 grams of omega 3 per day, a female needs
            around 1.1 grams a day. Omega 3 processes to EPA which is also processed
            to DHA, which is highly anti inflammatory. Omega 6 processes down to
            arachadonic acid which is highly inflammatory. The fact that eggs are
            the top source of arachadonic acid nulls and voids benefits received
            from the omega 3 in the egg itself. High intake of arachadonic acid is
            linked to autoimmune diseases such as  rheumatoid arthritis, ulcerative
            colitis, as well as a clear link with  cancer development.http://www.ncbi.nlm.nih.gov/pubmed?term=20950616uid
            http://www.ncbi.nlm.nih.gov/pubmed/18774339
            http://www.ncbi.nlm.nih.gov/pubmed/21139128

            The
            Harvard physicians study followed 20,000 doctors for 20 years and
            those that ate just one egg a day had significant increase in all cause
            mortality.
            http://www.ncbi.nlm.nih.gov/pubmed/18400720

            In
            fact, David Spence, director of stroke prevention/atherosclerosis
            research center and one of the worlds leading stroke experts, said that
            based on the latest research, you can eat all the eggs you want IF your
            dying of a terminal illness. Eggs are not considered health promoting
            nutritionally speaking.
            http://www.ncbi.nlm.nih.gov/pubmed/18400699

            Eggs have been linked with heart failure
            http://www.ncbi.nlm.nih.gov/pubmed/18954578

            As well as type 2 diabetes.
            http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2628696/?tool=pubmed

            Furthermore,
            in the Canadian Journal of Cardiology, David Spence, David Jenkins
            (the inventor of the glycemic index) and Jean Davignon (director of
            atherosclerosis research group) posted a review on eggs claiming that
            the egg industry has been downplaying the health risks of eggs through
            misleading advertisements. As soon as you eat one egg, you expose
            your body to several hours worth of oxidative stress, inflammation of
            ones arteries, endothelieum impairment (what keeps you blood running
            smoothly) and increases the susceptibility of LDL cholesterol to
            oxidize (beginning stages of heart disease).
            http://www.ncbi.nlm.nih.gov/pubmed/21076725
            http://www.ncbi.nlm.nih.gov/pubmed/9001684

            The
            egg industry has claimed that cholesterol from eggs is not important
            and does not raise cholesterol levels. The fundamental flaw in the study
            the egg industry has used to make this claim is that they measured
            FASTING lipid levels at night and not levels through out the day after
            egg consumption. “Diet is not all about fasting lipids; it is mainly
            about the three-quarters of the day that we are in the nonfasting state.
            Fasting lipids can be thought of as a baseline; they show what the
            endothelium was exposed to for the last few hours of the night.”
            http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2989358/?tool=pubmed

            In addition, there is no dietary need to consume cholesterol, this is simply nonsense to make such an assertion.
            http://www.nap.edu/openbook.php?record_id=10490&page=542
             

    • Paddycakes

      I don’t think ONE egg per week is going to affect my arteries. What do you think?

      • Paulc

        I am astounded that someone who would be intelligent enough to be
        reading Dr. Greger would be myopic enough to through the baby out with
        the bath water, and throw scientific research out with it. In
        Psychology, we call that cognitive dissonance.

  • Elderberry

    Very interesting. After the previous video, “How Plant Sterols Lower Cholesterol, I had been wondering whether, as a conscientious vegan (plants, beans/legumes, grains, seeds/nuts, fruits, no processed oils or sugar) I was running a risk of flushing out too much cholesterol. Thanks, SJ M.D., for your response. And now from today’s video, I gather that there is no such thing as having too much cholesterol flushed out of your body? 

    • SJ M.D.

      No – flush it out!

      Probably this is why Tears for Fears made “The seeds of life” :-)

      Ahead of their time………:-)

  • Ellen

    The table of best food sources is confusing to me.Could you explain the grey/black portions of the individual lines – what do they signify individually. I see where pumpkin seed looks so unlike the other sources. I’ve been eating walnuts like there is no tomorrow but now feel I should switch to sesame seed.

    • Valnaples

      @Ellen, perhaps consider rotating these good nuts and seeds instead of only eating walnuts? I usually alternate organic raw pumpkin seeds with walnuts from day to day for a snack or in a salad and perhaps I need to also rotate in sesame seeds (which I adore, I just don’t eat them that regularly but heck, they are easy to throw into a green salad!)

    • Paulc

       The black part of the bars represents the amount of beta-sitosterol plus campesterol plus stigmasterol, the three most common type of plant sterols, and so, often the only ones that are measured and reported. The grey bars represent other rarer forms of sterols which are not commonly reported.

      This chart is limited to the amount of sterols in mostly nuts and seeds and by the weight of the food, about 3 1/2 ounces- more nuts and seeds than is healthy to eat in one day.

      I’d be more interested in the amount of phytosterols we can get on a per calorie basis. In that case, lettuce, capers and sour pickles would be the top choices, followed by sesame seeds with asperagus, beet greens and unpeeled cucumbers not far behind, nosing out sunflower seeds.Okra, cauliflower, bamboo shoots, lemons, beets, Brussels sprouts, grapefruit, sprouted mung beans, tomatoes, oranges, pumpkin, cabbage, sweet peppers and radishes are also decent sources for the calorie-conscious.

      I’m also concerned that most nuts and seeds may throw of your omega 6/3 ratio and that they’re highly concentrated in calories. Seems to me that veggies are a better option.

      • Thea

         Paulc: Nice reply.  I’m wondering where you got your data for the amount of phytosterols in various plants.  For example, how did you figure out that “…lettuce, capers and sour pickles would be the top choices…”  I’m interested in trying to understand how all of this translates into practical eating and seeing a table with the data you are talking about coold be really helpful.  Thanks.

      • veganrunner

        I find your calorie interest so fascinating. Since tweaking my diet I find I can’t get enough calories. If I don’t include nuts and seeds in my diet I end up losing weight. 

        • Paulc

           I imagine you’re very physically active so that you can get away with eating a few nuts and seeds. I tend to gain weight with them and have to be careful and have to diet a couple or three days a week to avoid gaining weight.

          • veganrunner

            now Paulc aren’t we all supposed to be getting an hour of cardio a day? Nutrition is only part of the equation. 

          • Paulc

             What I’ve read indicates that high intensity interval training is preferable. I also do bodyweight exercises and stretching.

          • veganrunner

            Well actually no. 60 minutes of cardio is the best. (on most days)  The heart loves to beat at a moderate training rate for a prolonged time. 

            http://nutritionfacts.org/topics/exercise/

            But what I tell my patients is that if it gets you moving its good. What is your high intensity work out? You get your HR up high (180 ) and hold it there for how long? 

          • veganrunner

            And strengthening exercises of course. (bodyweight exercises?). I think stretching is kinda overrated unless you have a joint with a decreased range of motion. There is actually quite a bit of research that demonstrates stretching might encourage injury. Plus who has that kind of time! 

      • R Ian Flett

        The longest bar in the chart is wheat germ, but it’s also very high in gluten.

        • WholeFoodChomper

          According to Dr. Greger’s gluten videos, unless one has a gluten allergy or intolerance gluten should not be an issue. If gluten is an issue, luckily there are other items that one can pick from the chart.

          Gluten IS good for 99% of people (but not for the 1% who have celiac disease):
          http://nutritionfacts.org/video/is-gluten-bad-for-you/

          In fact, if there is no good medical reason to go gluten free; it may even be bad for an individual’s good gut bacteria to go gluten free:
          http://nutritionfacts.org/video/update-on-gluten/

          • R Ian Flett

            Sorry, but there is lots of evidence that the extra gluten bred into the endosperm of modern grains is a low level problem for many people irrespective of whether they are technically ‘gluten intolerant’.
            The amount of gluten now consumed is much higher than any traditional grain diet over the past thousands of years. Obviously I made the post to warn those who had a known gluten problem, but were unaware that wheat germ is one of the highest sources. Gluten intolerance is much higher than 1% and you don’t have to have celiac desease to have a problem with it. I also never used the words “gluten free”.

          • WholeFoodChomper

            Maybe I missed it in some other part of this discussion/thread, but given the brevity of your initial comment in this thread (the one after Paulc’s comment), I don’t think your intention was obvious at all. In any case, I was simply pointing out Dr. Greger’s videos on gluten since you raised the topic of gluten. (To be clear, I never attributed the term “gluten free” to you. “Gluten free” is term that I used to summarize the second video that I referenced.) 

            I look forward to learning more about the wheat/gluten issue as more empirical information about it rolls out.  At the moment, it seems to me to be a bit over-hyped.  I think that in due time, science will reveal more, but for now I think the science on the matter is still too young to be broadly applicable (or, at least, applicable to me).

          • veganrunner

            Hi Wholefoodchomper

            So I have spent the last 1/2 hour looking for this research article but I can’t find it. So you have to take my word for it. One of my patients is a gastroenterologist. He knows gluten gives me a stomach ache and fatigue. So he gives me this article from JAMA published 2011 (I think) regarding gluten intolerance. 

            The message was that there are people who are not actually testing positive for celiacs but have symptoms. The bottom line was to do an elimination diet and challenge gluten after 6 weeks. And then to be careful because it is in a lot of processed foods as thickeners. It even went so far as to suggest a diet. 

            I can’t tell you how refreshing it was to read the research article. Was the medical profession finally coming on board? Was my patient finally going to address it and stop recommending the “little purple pill?” 

          • WholeFoodChomper

            Thanks for sharing the info, veganrunner. If you happen to find that JAMA citation, could you please share it with me. (Do you remember any key words in the title? Maybe I could do some research on my end as well.)

            I have had the Celiac blood test done, and I’m in the clear. Thankfully, I don’t experience any symptoms after eating wheat either. (Although, I know that there are people who do, and I do not mean to discount their experiences.) Still, I would like to read about it to learn some more. Heck, I may even try the elimination diet to see if I feel better in some way.

          • Veganrunner

            Ok. Here is a good review. I think it might be one of the articles mentioned.

            http://www.gastrojournal.org/article/S0016-5085(12)00088-1/fulltext

          • WholeFoodChomper

            Thanks for sharing.  I’ll add it to my reading list.

          • WholeFoodChomper

            Thanks for sharing.  I’ll add it to my reading list.

    • Thea

       Ellen: It is also confusing to me.  Thanks for asking this question!

  • Lincat13

    So are pistachios, almonds, pine nuts, macadamia nuts, and cashews all better to eat instead of walnuts to lower cholesterol?  I’m a bit confused.  I thought walnuts were the magic nuts to pop.

    • SJ M.D.

      We have to see the bigger picture – as well as there are no magic pill to cure the diseases from the SAD (and european) there are no single nut, seed, vegetable, fruit, legume, nutrient etc who will do the trick. The message is to eat a variety of plant foods, not just one kind of nut, one kind of vegetable etc.

      So eat a variety of plant foods and avoid meat, eggs and dairy – my advice would be to enjoy the great taste of plant food, and stop thinking that this nut lowers cholesterol, this vegetable lowers the risk of cancer, this berry fights infection – this way of thinking spoils the pleasure of eating great tasting plant foods.

      • veganrunner

        Exactly! Variety is the spice of life! 

    • Paulc

       Walnuts are promoted for their omega-3 content, so the phytosterols are just a bonus. Flax seeds also a good source as Dr. Greger has noted in several videos.

  • http://www.facebook.com/profile.php?id=640861216 Gary Yuen

    Maybe you help me check some studies on guggul. It’s the main Ayurvedic herb for “cholersterol” (and arthritis). There are other herbs that have cataloged phytosterols but who knows if they matter ; they are more used for other conditions. Ashwanganda is also sometimes used for cholesterol. As far as grains, I’d guess barley is best for this, and it’s also recommended by Hippocrates for the summer.

  • BPCveg

    Reading some of these posts, I have formed the impression that many vegans are unclear on how many nuts we can consume before exceeding guidelines. To remedy this problem, I am performing a calculation below on how many walnuts a day someone on a 2000 calorie diet can consume before they would exceed the Institute of Medicine recommendations.

    The Institute of Medicine recommends that adults get 20 to 35% of calories from fat. Source: http://www.iom.edu/Reports/2002/Dietary-Reference-Intakes-for-Energy-Carbohydrate-Fiber-Fat-Fatty-Acids-Cholesterol-Protein-and-Amino-Acids.aspx
     
    For this calculation I am assuming that the fat contribution of grains, fruits, legumes  and most vegetables are generally so low that they make a negligible contribution to our daily fat intake; correction for these sources of fat should not alter my calculation substantially. 

    Let’s adopt the upper limit of 35% set by the Institute of medicine and see how many walnuts that equals. 
     
    For a 2000 calorie diet this amounts to 2000 x 0.35 = 700 calories from fat. 

    Since fat has 9 calories per gram, therefore, 700 calories of fat equals 78 grams of fat.

    Since each ounce of walnut has 18 grams of fat, the number of ounces of walnuts we can eat is 78g / 18 g = 4.3 ounces.

    Please note that 4.3 oz of walnuts equals 120 grams of walnuts, which is just over one cup.

    Please also note that saturated fat for this serving would be around 7 grams, which is 36% of daily value, well within guidelines.

    Of course, some of us have higher calorie needs due to our energy output. Therefore, the number of nuts that we can eat would go way up!

    I am not suggesting that we get all our fat from eating walnuts. I simple want to give people an idea of how many nuts one can eat before exceeding standard recommendations.

    • SJ M.D.

      The problem is that the “recommendation” of 35% of calories from fat is hopelessly wrong; the same guidelines accept 10% of the calories from refined sugar! If you want to stay healthy – wich nature intended – it is 10% calories from fat and 0% calories from refined sugar.

      • BPCveg

        Actually nature doesn’t have any intentions, nor does evolution. Neither nature nor evolution take sides on dietary issues. 
        If we humans want to optimize our diets, then we have to understand the underlying physiological mechanisms that are relevant to nutrition and adjust our diet accordingly.
        By all means, go ahead and challenge the standard recommendations on fat, but I think you would be more convincing to readers of this website if you backed up your claims with peer reviewed scientific studies.

        • WholeFoodChomper

          BPCveg, I like your physiological perspective. I’m also quiet wary of evolutionary explanations or justifications based on nature (whether they are for plant-based eating or not).  

          Historically (and possibly nutritionally) speaking, much harm  has been justified using this sort of logic and reasoning. As far as I am concerned, appeals to evolutionary and natural explanations are a slippery slope.  Sticking to the empirical evidence and physiological reasoning, is the way to go.

          • BPCveg

            Good point….lots of misinformation is spread using evolutionary explanations.

    • Veganrunner

      Wow that’s a lot! Nuts and seeds are probably pretty close in calories so 1 cup of seeds and nuts per day. That would be really hard to do and I eat them both everyday. I have sesame, hemp, flax, sunflower, chia in the fridge and I use probably 2 Tbs in either my oatmeal or smoothy depending on which I feel like. Then throughout the day I may have walnuts, almonds, or pistachio nuts. Maybe 2 oz.

      John when I watched Forks Over Knives I know the overwhelming message was no fat, no nuts. But didn’t you (if you watched the video) think that message was directed at the population of obese people and/or suffering for heart disease? And that makes since. People who need to lose weight or have heart disease need to really limit their fat intake from nuts, seeds, avocados etc. but Dr. Greger has demonstrated through various research articles that nuts and seeds are rediculously nutritious for us. But 1 cup per day? That doesn’t even sound appetizing!

      • BPCveg

        Veganrunner: I completely agree with you that diversifying sources of all nutrients is important. I think my back-of-the-envelope calculation suggests that those who center their diets around fruits and vegetables shouldn’t need to worry about having an extra handful of nuts, if they feel like it.

    • WholeFoodChomper

      BPCveg, you rock!

      • BPCveg

        Thank you. I too diversify my fat intake using multiple whole food plant sources.

  • John

     Looking at the chart at the end of the video , it appears one would have to seriously increase one’s intake of nuts and seeds to make a difference in the amount of phytosterols consumed. 
     Flaxseed, for example, has just 200 mg of phytosterols per 100 grams of flaxseed.  100 grams is 10 tablespoons of flaxseed!!  I usually eat about 1 tablespoon a day.

    Seeds like sesame, sunflower, pistachio, pumpkin are very high in the ratio of omega 6 to omega 3.  It would appear that increasing one’s consumption of those nuts greatly would very negatively affect the omega 3 ratio, especially if one was eating a low fat diet.

    By the way, Dr Esselstyn “prescribes” NO nuts for his advanced heart disease patients.

    • veganrunner

      Good-morning John,

      OK everyone correct me if I am wrong–I can take it! :-)

      The SAD is filled with processed foods. Crackers, cookies, chips etc. And they are very high in omega 6 because they are generally cooked with soy oil or the like. Again high in omega 6 (and trans fat) 

      But for most of the people on this website I will would guess do not eat those products. Therefore our omega 6 to omega 3 ratio is not upside down. 

      We know that whole foods are key. Whole nuts and whole seeds. And maybe the ratio of some are scued towards Omega 6 but don’t you think the health benefits outweigh the paranoia I keep reading about in these comment sections? For the general population who eat all that crap yeah they better stay clear. 

      Maybe I am wrong. Maybe people watching these videos are still eating all the processed stuff, as long as it animal free. So please help me understand this. 

      Dr. SJ what do you think? Are you in bed yet? Denmark right? 

      • SJ M.D.

        Yes – Denmark (late afternoon right now).

        I must emphasize that this is just my opinion: Don`t focus on one single nutrient, one single fruit, nut, legume and don`t focus too much on one single ratio (omega 6/3). If you go for whole foods, plant based and eat a variety of different foods, I don`t see a problem. Personally I also take 200-400 mg  vegan omega 3 pr day though.

      • WholeFoodChomper

        I agree with you, vegan runner.  And, it seems that Dr. G. does as well.  Here is what he says about omega-6:

        “I try to think in terms of whole food sources rather than nutrients (have you read The China Study? It has a whole chapter trying to make that point). I’d be happy to talk with you about ratios and percentages, but in terms of practical advice I’d encourage people to minimize their intake of the omega-6 rich oils (such as safflower, sunflower, and cottonseed, and all of the processed garbage manufacturers make with them), and try to eat healthy omega-3 rich whole foods such as walnuts and flax seeds every day. And especially for men as well as women who are expecting, breastfeeding, or even thinking about getting pregnant I would encourage consideration of taking an algae- or yeast-derived long-chain omega-3 supplement.”

        http://nutritionfacts.org/2011/09/18/ask-the-doctor-qa-with-michael-greger-m-d-week-2/

  • BPCveg

    :)

  • BPCveg

    Well said! Thanks.

  • Paddycakes

    It’s difficult to understand how much 2000mg is, of nuts/seeds; I wish he would have given us a measurement in which we could relate. Nevertheless, I’ve learned more from Dr. Greger, MD, than anyone, than, perhaps, Dr. McDougal. Thanks, Dr. G.

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