Does Cholesterol Size Matter

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Egg Consumption & LDL Cholesterol Size

Maria Fernandez has received nearly a half million dollars from the egg industry and writes papers like “Rethinking dietary cholesterol.” She admits that eggs can raise LDL cholesterol, bad cholesterol, but argues that HDL, so-called “good cholesterol,” also rises, thereby maintaining the ratio of bad to good. To support this assertion, she cites one study that she performed with Egg Board money that involved 42 people.

If we look at a meta-analysis, a measure of the balance of evidence, the rise in bad is much more than the rise in good with increasing cholesterol intake. The analysis of 17 different studies showed that dietary cholesterol increases the ratio of total to HDL cholesterol, suggesting that the favorable rise in HDL fails to compensate for the adverse rise in total and LDL cholesterol. Therefore, increased intake of dietary cholesterol from eggs may indeed raise the risk of coronary heart disease.

The Egg Board responded (as seen in my video, Does Cholesterol Size Matter?) by saying that the increased heart disease risk associated with eating eggs needs to be put in perspective relative to other risk factors, arguing that it’s worse to be overweight than it is to eat eggs, to which the authors of the meta-analysis replied, “Be that as it may, many people do not find it a major hardship to cut back on egg intake, whereas most people find it impossible to lose weight permanently.”

Fine, Fernandez admitted, eggs increase LDL, but she claims that the increase is in large LDL, arguing that large, fluffy LDL particles are not as bad as small, dense particles. Indeed, large LDL only raises heart disease risk of women by 44%, instead of 63% for small LDL. Light large buoyant LDL still significantly increases our risk of dying from our #1 killer. The difference is similar for men: large LDL only increases risk of heart attack or death by 31%, instead of 44%. As the latest review on the subject concluded, LDL cholesterol has “clearly been established as a causal agent in atherosclerosis … Regardless of size, LDL particles are atherogenic.” Yet Egg Board researcher, Fernandez, wrote that the formation of larger LDL from eggs is considered protective against heart disease, relative to small LDL. That’s like saying getting stabbed with a knife is protective–relative to getting shot!

Health practitioners should bear in mind, she writes, that “restricting dietary cholesterol puts a burden on egg intake” and leads to the avoidance of a food that contains dietary components like carotenoids and choline. She wrote this in 2012, before the landmark 2013 study showing that choline from eggs appears to increase the risk of stroke, heart attack, and death, so she can be excused for that. But what about the carotenoids in eggs, like lutein and zeaxanthin, which are so important for protecting vision and reducing cholesterol oxidation? As I explored previously, the amounts of these phytonutrients in eggs are miniscule. One spoonful of spinach contains as much as nine eggs. Comparing the predictable effects on eye health of organic free-range eggs versus corn and spinach, the effect of eggs is tiny.

What about the effects of eggs on cholesterol oxidation? We’ve known for decades that LDL cholesterol is bad, but oxidized LDL is even worse. Therefore, according to Fernandez, since eggs have trace amounts of antioxidants, eggs may prevent cholesterol oxidation. But the science shows the exact opposite. Consumption of eggs increases the susceptibility of LDL cholesterol to oxidation. The researchers found that not only does eating eggs raise LDL levels, but also increases LDL oxidizability, in addition to the oxidizability of our entire bloodstream. This was published 18 years ago, yet Fernandez still tries to insinuate that eggs would reduce oxidation.

She acknowledges receiving funding from the American Egg Board, and then claims she has no conflicts of interest.

This is why a site like can be so useful, because even when a paper is published in the peer-reviewed medical literature, it can misrepresent the science. But who has time to check the primary sources? I do! If you’d like to support this work, please consider making a tax-deductible donation.

Here are some other videos in which I contrast the available science with what the egg industry asserts:

Visit our Eggs topic page, and Cholesterol topic page for all our videos on the latest research,

Only the meat industry may be as bold: BOLD Indeed: Beef Lowers Cholesterol?

For more on the role of cholesterol, see:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death, More Than an Apple a Day, From Table to Able, and Food as Medicine.


Michael Greger M.D., FACLM

Michael Greger, M.D. FACLM, is a physician, New York Times bestselling author, and internationally recognized professional speaker on a number of important public health issues. Dr. Greger has lectured at the Conference on World Affairs, the National Institutes of Health, and the International Bird Flu Summit, testified before Congress, appeared on The Dr. Oz Show and The Colbert Report, and was invited as an expert witness in defense of Oprah Winfrey at the infamous "meat defamation" trial.

185 responses to “Egg Consumption & LDL Cholesterol Size

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      1. Julie: Personally for me, this is good, because has three new videos a week. I also visit other sites that give sensible and research-based nutrition advice. In addition, whenever I have time, I read papers. So there’s a lot of information I have to assimilate and remember, so I find it useful to be reminded of the facts I’ve been exposed to before. Those who want us to adopt or continue bad habits for their own financial gain use repletion as reinforcement in the form of advertisement, so articles like this help me keep me on tract.

        1. I agree George! I am glad to see info presented in previous years come up again. There is so much information concerning diet and health that this great website has given me, so to be reminded of the details is very helpful.

          1. TheHulk: Here’re the sites I visit in addition to
            Linus Pauling Institute (to find information on micronutrients)
            Plant Positive
            Dr. Clyde
            Dr. Klaper
            Dr. Lisa Watson

        2. George, I could not have said it better. In my case, however, I also rely upon the occasional repetition to overcome my increasingly unreliable memory.

      2. Some people enjoy articles more than watching videos, and vice-versa. At least the info is present in both formats, and can be shared with friends and family in the form that will be better received. Can’t please everyone…

  1. Dr G’s approach has set the standard by which I can evaluate analysis from a wide range of doctors and researchers. In my offline topical library, this post went into the “eggs” file, as well as the “conflict of interest” file. This way when (not if) I read 10 articles next year insisting eggs and cholesterol don’t matter, I have a reference basis of an opinion not corrupted by money. And I have found it’s not just medical research that has been bought and paid for, but also the dinosaur media and even the alternative media must be objectively scrutinized. Then we have the Paleo folks and other screamers who get emotionally unstable at the thought that eating dead flesh, especially processed dead flesh, is somehow not only not harmful but also helpful.

    Bottom line, following Dr G and a few others (e.g., Esselstyn, Ornish, Campbell) have reversed multiple chronic diseases simultaneously, including the stuff I wasn’t even working on. By accident I learned the broad based application to heal and protect using WFPB diet. Dr G has taught me the gold standard of research which I apply to everyone else (whether they like it or not).

  2. The article did not mention if eating egg whites only and discarding the egg yolks is fine. I have high cholesterol but would like to eat egg whites. Dr. Greger, is this ok?

    1. Alden: Here is my standard reply when people ask about egg whites. See if this helps answer your question.
      There are two problems with eggs, the yolk and the white. (To paraphrase Dr. Barnard.) Egg whites are likely a big problem health-wise, just like the yolks. It is true that egg whites do not have cholesterol. But egg whites are essentially all animal protein. Here’s what we know about animal protein in general and egg whites in particular:

      Dr. Barnard links potential kidney problems to animal protein (though I don’t have the details on that). And Dr. Greger talks about the problems of animal protein in general in his annual summary video, “Food as Medicine: Preventing and Treating the Most Dreaded Diseases with Diet”

      Here on NutritionFacts, you can get a great education on how animal protein is linked to the body’s over-production of a growth hormone called IGF-1. IGF-1 helps cancer to grow. To watch the series about IGF-1, click on the link below and then keep clicking the “next video” link on the button to the right until you get through the bodybuilding video. Then you will have seen the entire series.

      Here’s another great tidbit from NutritionFacts on another mechanism linking egg whites to cancer as well as increased virus infections: “why would animal protein and fat increase cancer risk? Well, as I noted in Bowel Wars, if you eat egg whites, for example, between 5 and 35% of the protein isn’t digested, isn’t absorbed, and ends up in the colon, where it undergoes a process called putrefaction. When animal protein putrefies in the gut, it can lead to the production of the rotten egg gas, hydrogen sulfide, which, over and above its objectionable odor, can produce changes that increase cancer risk. Putrefying protein also produces ammonia.”
      To learn more details about the process, check out:

      Darryl at one point reminded me of the methionine issue, which I think I first learned from Rami and later from Dr. Greger. Egg whites have *the* highest concentration of methionine of any food:,18,9,0,13,14,5,4,42,16,17,15,6,3,2,11,7,19,21,12,10,8,22
      Dr. Greger did a nice video showing the link between methionine and cancer.

      Darryl also pointed out that, “…high methionine diets increase coronary risk in humans. In its associations with cardiovascular disease and other disorders, homocysteine may be functioning partly as a marker for the major culprit, excess methionine.”

      Dr. Greger posted some videos on how animal protein can raise insulin levels. The first of the following videos even specifically addresses egg whites.

      In summary: there are at least three pathways potentially linking animal proteins, especially egg whites, to cancer: the IGF-1, methionine, and putrefaction. And there is some good evidence that egg white consumption contributes to heart disease and potential problems with T2 diabetes by raising insulin levels in a bad way. All of these reductionist-type studies lend support the bigger general population studies showing that the healthiest populations on earth are those which eat the least amount of animal protein.

      With all of the information we have about the harmful effects of animal protein in general and egg white in particular, I think it’s best to stay away from egg white. Why not get your protein from safe sources? IE: Sources which are known to have lots of positive health effects and will naturally give you a balanced amount of protein? (ie: whole plant foods) Make sense?

      1. Oh give me a break! You sound like we all need to be vegans, sorry – for some of us this isn’t desirable, necessary, or practical. In addition, my eggs have less cholesterol since I have my own 25 backyard Pasture raised chickens

    2. Alden, I’d recommend you to double-check your cholesterol levels – I mean ALL markers, not just total cholesterol. And get rid off ALL processed foods. This includes highly refined carbs, highly refined “proteins” (this is mainly about all processed meat, but soy pseudo-food as well) and refined fats (all commercial oils – canola, soy, sunflower). I agree in 99% of cases with Dr. G’s point of view, but in this case – I disagree. Oxidised LHL cholesterol (aka main evil) creation has little to do with eggs consumption… And as always – I am talking about highest quality eggs – I eat 2 raw yolks EVERY morning for past 4 years (not a single day missed) and my cholesterol is ABSOLUTELY fine.

      1. What is your ApoE carrier status? It makes a HUGE difference in lipid metabolism.
        I would guess not 3/4 and certainly not 4/4.

        1. Hi, it is ¾, but I really did not pay too much attention to that. At least not until I got a bit broader test (= paid…) done. From what I’ve learned – it is mainly extremely high Omega-6:Omega-3 ratio and combination of high-sugar (in combination with fats) meals that stands behind inflammation in our vessels that ends up with hyperlipidemia. Ancel Keys would be proud of him – what he started in 50’s still continues even though there is dozens of studies that discredit his work and even evidence that soon after his “7 countries study” some other studies that showed the opposite were simply “buried”. This low-cholesterol craze (without differentiation and with vague claims) is something that I do not understand – we have 60+ years of data that CLEARLY show Ancel was WRONG. And that prescribing statins based on total cholesterol readings IS a CRIME… And just for the record – my diet is 95+% whole-plants + 2 eggs daily + some home-made fermented milk products (from raw-milk) and 1 portion of grass-fed beef a week…

          1. That’s a surprise. I am also 3/4 and when eating a “clean” omnivorous diet I was at TC of 215 (with the attendant crappy LDL reading).
            Would you share your actual Cholesterol numbers. For different people “absolutely fine” mean different values.
            I guess the 95% plant nutrition mitigates/negates the deleterious effects of egg and beef consumption.

            1. Total cholesterol 4,3mmol/l, HDL 1,95mmol/l, trigs 0,31mmol/l. My point is that there is NOTHING deleterious if we talk about eggs from free-range chicken (my mom’s chicken on “worm/grass” diet) and truly grass-fed beef (I am a vet doc by background so I know what to check when doing unannounced visits on the farm where I buy the meat) prepared on a lot of herbs in slow-cooker – no grilling, no frying… I would rather eat 100% plant-based diet (and take some supplements) than buying meat of eggs from conventional sources…

              1. Stellar figures indeed – especially the trigs.
                I agree that home-raised free-range hens and cows do not have much in common with the commercially raised ones – the predominantly grain diet, hormones and all sorts of chemicals are missing.
                However, I am still not convinced that the TMAO created by the carnitine content of the eggs/beef (regardless of source) is nothing to be concerned about. Methionine is also another concern when dealing with animal protein. OTOH, I think fermented milk products have NOTHING to worry about( compared to other dairy items) as the hosts of beneficial probiotics they supply more than negate any potential harmful effects of dairy residues in them.

                1. I would not be – even though there is not that much studies on this topic, I believe cooking grass-fed beef the most careful way (in slow-cooker, at about 68 degrees Celsius for 14-15 hours, with a lot of fresh herbs with no added fat) is the best way to limit TMAO on minimum. Moreover – if you stick to the equation “more TMAO consumed = higher CVD risk”, EPIC study ( shows no difference. Methionine is OK – my homocysteine never risen above 2 µmol/l. Moreover, to keep homocysteine “at bay” you need to have enough folate and B12 which you can easily get with small amounts of TOP quality eggs/beef. I believe it is that 95+% plants + 5% of chosen animal sources that keeps my body performing at the highest level. I am 46, but feel like 30, haven’t been in docs office for past 17 years and still competing in triathlon, 5/10K trail runs and obstacle races. And winning over easily-to-be-my-son’s ;-)

                  1. In the end, we are all free to believe and experiment on ourselves however we choose. Our genetics and age can be a huge factor, but after having it all catch up to me in a big way, I would rather see people err on the side of caution than play Russian roulette with their health and mortality. This website exists to share the best current information that applies to the majority of us, based on science and studies. I think I have some pretty persuasive personal anecdotes and opinions too, but they apply to me and I don’ think passing them off as some kind of general fact instead of personal opinion is appropriate here. For example, just one meal with even minimal animal products as “flavoring” and the following days my joints ache, my brain fogs, I feel lethargic, and my IBS returns with a vengeance…things I always just thought I was stuck with until I learned differently. I’m sure there are others like me, but should I assume everyone is the same? You are one person and you are still young. I’m very glad you’ve had success, but it’s inappropriate to generalize what you believe or what works for you, to others, and could even be detrimental.

                    1. Hi there, I did not claim here that what preach must apply to everyone. My way is prevention and as already noted, I have never been severely ill and it works like that for those that preach prevention = no sudden or step-by-step switch from 100% junk to the current diet. And I believe that our body has healing capacity on its own – if you give your body chance… This means PROPER diet. If someone rigidly following paleo lifestyle tells me that she is allergic to eggs, my reply is the same – if you cannot heal your allergies with food, you should think of changing your diet. Proper food CAN really be your medicine.

                2. If food really did make a significant contribution to TMAO levels, and high TMAO levels cause heart disease, then we’d expect to see much higher rates of CHD among people who eat more fish—since fish has a much greater effect on TMAO than eggs. Yet this is the opposite of what studies indicate: Eating more fish (especially cold-water, fatty fish) has consistently been shown in both observational and randomized controlled trials to reduce the risk of death from heart disease. (by Chris Kesser)

                  1. You seem forget that fatty fish comes with a large amount of heart-healthy omega-3s – something that eggs cannot boast with.
                    Dietary cholesterol in fatty fish is also minimal unlike eggs.

                    They are simply different nutritional *packages* and it is not fair to treat them as comparable protein sources.

              2. Sorry you have to deal with undeserved criticism on this site. I eat and COOK very much like you. Grass fed & grass finished beef daily, 15 free range, organic eggs per week and a strenuous lifting workout every day, but no running. 66 years old; 200 lbs; total cholesterol 185, HDL 66; Triglycerides 65; C-Reactive protein 0.20. Sounds like you are doing great. Congrats.

                1. WanttobeGalt: Your diet is showing in your numbers. Safe levels (ie, the levels where people do not get heart attacks) of cholesterol are below 150 total and LDL below 70, the levels we are born with (and levels which stay the same in cultures which eat healthy). Sadly, there are a sizable number of people who get heart attacks with total cholesterol between 150 and 200. If you want to know how to fix your potential heart disease problem without drugs, you can learn a lot more on this site. From your posts, I don’t think you are interested. So, I’ll leave it at that. I’m glad you think you are doing well and hope that you do well into the future.

          2. This sounds like the looney tunes nonsense about Ancel Keys that is found on the internet. Have you even read the studies by Ancel Keys or are you just repeating claims that you have found in books or on the internet?

            Most of these claims are obvious lies which can be easily disproved by simply reading Keys’ work and the evidence about the role of cholesterol and staurated fat in disease.

            For an honest assessment of the work of Ancel Keys you can view these videos and blogs:

      2. Only problem with raw egg whites is they have a compound that inhibits your ability to absorb biotin (Google avidin)

        I agree with eggs not being a problem however, as I eat 2-3 every day with coconut oil and have very low cholesterol (<100)

    3. Eggs are included in this write up.

      trimethylamineoxide (TMAO).

      When we eat red meat, its carnitine interacts with our gut bacteria, forming
      trimethylamine, which is then metabolized by the liver into TMAO. And it
      appears that TMAO is not our friend.

      TMAO promotes the formation of cholesterol plaques in our blood vessels, which make
      them less healthy and may lead to heart attack, stroke, and death. TMAO reduces
      our body’s ability to excrete cholesterol. And, if that is not
      bad enough, TMAO may be linked to death from prostate cancer.

      The good news is that people who eat an exclusively plant-based diet appear to form
      little TMAO. In fact, when researchers fed steak to a vegan, virtually no TMAO
      was made. Why is that? Vegans, it seems, do not select for the specific gut bacteria that lead to the
      formation of TMAO, whereas meat eaters do. Hence, it’s as if plants create a
      coat of armor in our stomachs, protecting us when they are not even there.

      So if we’re protected by plants, is it okay for us to eat steak for just a few days? Are we
      protected from TMAO? It appears that we may not be. The trillions of bacteria
      in our gut change very quickly. In fact, they may meaningfully shift even
      within one to two days! So aside from the many other deleterious effects of
      meat, even one day of steak could cut a chink in the natural armor afforded us
      by eating plants.

      Notably, red meat is not the only source of TMAO. Choline, which is found in chicken,
      fish, dairy ― and even plants ― is another. Choline is structurally similar to
      the carnitine in red meat, and with the help of the same gut bacteria, also
      forms TMAO. Accordingly, when investigators fed omnivores an egg, they made

      Although we have no dietary need for carnitine, we do require dietary choline. So how
      can we get the choline we require without the unwanted company of toxic TMAO?
      The answer appears to be in the armor. Eating a plant-based diet selects for
      gut bacteria that do not lead to the formation of TMAO. So even though we are
      eating choline in plants, our stomach’s plant-derived protection is in place,
      practically freeing us from concern about TMAO.

      Science’s understanding of the interaction of our diet and gut bacteria and their
      influence on our health is at an early stage. However, evidence is mounting
      that a plant-based diet may be beneficial for this interaction in many ways.
      Yet another reason to go (or stay) plant based!

      1 N Engl J Med 2013; 368:1575-1584
      April 25, 2013 DOI: 10.1056/NEJMoa1109400

      2 Nat Med.
      2013 May;19(5):576-85. doi: 10.1038/nm.3145. Epub 2013 Apr 7

      3 Am J Clin
      Nutr. 2012 Oct;96(4):855-63. Epub 2012 Sep 5

      4 Nature 505,
      559–563 (23 January 2014) doi:10.1038/nature12820


      1. This connection between carnitine and choline intake, our gut bacteria, and the creation of TMAO by the liver may go a long way in explaining the paradox as to why some cultures who are mostly plant-based but eat meat or fish occasionally, still remain healthy and live to a ripe old age. It does take a little time for the gut microbiome to change from plant-based to meat based, so no TMAO is produced when eating meat on very rare occasions. And as JoAnn says above, TMAO is associated with both atherosclerosis and cancer, and the meat can’t be eaten frequently because the gut bacteria can begin to change in a matter of days. Note: I’m certainly not advocating eating meat occasionally, but just repeating what the science says and pointing out an explanation for what seems to be puzzling to many people :-) Dr G addresses this topic in the video at:

  3. I don’t think it adds to the quality of the discussion to imply that an opposing spokesperson is immoral or not telling the truth because they were funded by industry. a great deal of the scientific research in that country is funded by industry and it is NOT ALL BIASED OR SLANTED. If you can legitimately state that the preponderance of the scientific evidence shows that LDL level rises disproportionately higher than the level of HDL with increased egg consumption, then you don’t need to slide in that comment about “taking egg industry money”, implying that her results are deliberately falsified or untrue.

    1. Her results came close to being falsified in order to sell eggs. The tobacco companies did the same thing and they were subject to the RICOH Act. It is a crime to hide or falsify information in order sell a product. Exxon is now subject to the same Act because they hid the fact that they knew global warming was happening because of the use of fossil fuels.

      Why would there be an opposing spokesperson to eating healthier? The egg institute is biased because they want to sell eggs and they know they aren’t good for people. Big Pharma wants sell drugs, and sometimes they hide the fact that their drugs have terrible side effects. Big Ag wants to sell meat. They create studies to make it look like there products are not harmful, or not as harmful as they really are.

      If you are a person who believes in these products and you are expressing an opinion, that is legal. If you are hired by one of these companies to come to a site like this to cause confusion about something being said, then you too are subject to the RICOH Act, and you too are committing a crime.

        1. Every animal on this planet except humans, knows not to defecate in it’s own nest. Whether you believe in the science of global climate change or not, it is time for us to take responsibility for our own actions. We need learn to clean up after ourselves and we need use renewable energy because it’s better and we can do it.

          By the way, I believe in the time tested steps set forward in the scientific method. Is there some type of methodology that can be used to learn about the planet and the cosmos that you can suggest?

          1. Actually, some animals suffer biological difficulties precisely because they do defecate in their own nests. Several bird species are examples. To subscribe to the presumption that humans are inherently unprepared to inhabit the planet and then to suggest the scientific methodology seems somewhat conflicting to me. It is by our scientific methodology that we earn and justify our place on the planet.

            I also believe that scientific methodology can be used to learn about the planet and cosmos; however, we should not selectively ignore sources that oppose current political agendas. This is exactly what we have been doing, with the “help” of media.

            Climate change is a known fact of science that few deny. The alleged role of man in the age old natural climate change cycle is the issue. The fact is, world governments have, for generations, proposed that global leadership (or domination if one is not afraid to use the term) can best be accomplished via the facet of climate and/or a pollution aspect. As source elements of wealth are selectively targeted, fossil fuel production is the obvious choice because of it’s international posture and because it has the economic base to capture more of what is needed in order to involve masses of population and economy. How? Through global taxation.

            Once global taxation becomes a common catalyst, the Pandora’s has been opened.

            Humankind has made enormous strides and has elevated itself tremendously due to prudent use of fossil fuels. This proves to be an immeasurable source of power and wealth to those who would exploit it for either good or for evil. I am one who believes that wealth or success, in and of itself, is not evil and is not automatically an abuse of those who do not possess wealth. This power and wealth is desired by those who would dominate great populations. Individual national government taxation is not enough to accomplish this. Therefore global means of taxation are being attempted. We must remain diligent and understand that as many scientists deny the role of man in climate change as there are those who imply the role of man. The contribution of fossil fuels to climate change is, so far, not established but is only a theory. I, for one, am extremely cautious and pessimistic about the push for international carbon taxation based upon theory and I believe we should all be.

            1. Oh boy, I did hit your balywick didn’t I. I should have read through you prior comments before saying anything to you. I’ll have to take a bit of time to read through your argument to offer either a well reasoned refutation or agreement with what you’ve said.

              So, please give me a day or two to respond.

              Apprin, I will say this right now. You seem to spend a lot of time reading through comments finding people to refute about this particular subject. It’s obvious that you have strong political beliefs that you want to express and I truly respect that. But, here we really want to help people find a healthy way of eating. Let’s focus on that, okay? Good health is something everyone deserves, even bleeding heart liberals and libertarians.

      1. The government’s own analysis has NOT conclusively demonstrated that human activities are responsible for global warming. Expressing an opposing viewpoint to a THEORY is part of the scientific method, and is NOT a criminal act.

        This whole “state of fear” approach to the discussion of global warming is VERY reminiscent of the fear-based growth of the Eugenics Movement of the late 19th and early 20th Centuries. Do a little reading of history and science before you mock an opposing opinion or threaten someone with false charges of criminal behavior. Disagreeing with the THEORY that human behavior is responsible for global warming is NOT a crime. There is NOT only one “true” perspective on any aspect of weather and climatology, which are among the most complex and least understood phenomena in our knowledge base.

        What has become of freedom of expression and thought? If someone disagrees with you, you accuse them of engaging in criminal conspiracy? This is more appropriate behavior for Kim Jong Un’s North Korea or Vladimir Putin’s Russia, not the United States of America, at least not the country in which I was born and raised.

        1. It is a crime to knowingly deceive people in order to make money. You can have an opinion, that is true. Any one can express any silly idea they want, but if you know you are lying and you are paid to lie it is a crime.
          Look up RICOH Act.

    2. That is true. This website did what is basically an ad hominem attack on the original study. I would hope this website would be above stooping to that level.
      People in glass houses should not throw stones. Most of the pro vegan studies are funded by the pro vegan organizations and studies favoring organic foods are funded by the organic food industry.

      1. Could you please back up your claim about “most pro vegan studies are funded by pro vega organizations” with some examples/references?

      1. I’m an Experimental Analyst who works for the U.S. Army. My career, my employment and my livelihood have NOTHING to do with the food industry nor with any food-related activist group. No one is paying me to express my opinion about scientific method.

        So, if you really think that all studies are biased in favor of those who fund them, then you must believe that there is no objective work being done in science anywhere? Because someone has to pay for every study or experiment, and even the government has its own interests and perspectives.

        Who can you trust under your cynical belief system that all studies are biased?

        1. very true. That is why we have multiple levels of peer review — independents with no connection with the original study looking over the methodology and results, looking for bias or faulty analysis. Then the study is submitted to a journal for publication, who, if a respected journal, then have own peer reviewers look the research over again. This second time is blind. The reviewers do not know who the author(s) are (identifying information redacted) and the author(s) do not know who are the peer reviewers. Then the journal editorial board decides whether to publish it or not.

          When I see a self-published research paper appear on the internet with no peer review, I scrutinize very critically and skeptically.

  4. Dear Dr. Michael Gregor and all the volunteers who help out,
    I Love you! Thank you so much for this site, and presenting the facts about nutrition using our best data. You are doing more for Americans health than anyone else is and I tell everyone i meet about
    Thank you for doing this good work, and you are also helping innocent animals inadvertantly who suffer inexplicable horrors in those factory farms, as well as helping the people who suffer these grave illnesse due to the SAD diet.

    Everyone should have the choice to live a long healthy life, and by publishing this data and explaining it, people have a chance to fix their health issues.

    I know one man, 75 years old who lowered his BP naturally by implimenting the knowledge he learned on Nutrition facts into his daily diet. Now he is off two medications and has one to go. He also tells everyone about your site.

    A million thanks to you guys!

  5. The following information just came from a PCRM (Physician’s Committee For Responsible Medicine) “Breaking Medical News” e-mail. It is so fun and also relevant to today’s post. I just have to share.

    “Danish Tax on Fatty Foods Improves Health

    A Danish tax on foods high in saturated fat, including meat and dairy products, improved the nation’s health, according to research published in the European Journal of Clinical Nutrition. Researchers assessed the effects of the tax and the resulting dietary changes and compared the consumption of fats, salt, fiber, and fruits and vegetables with disease risk. Overall, the Danish people decreased their saturated fat consumption by 4 percent but increased their intake of vegetables and fiber by 7.9 percent and 3.7 percent, respectively. Researchers predict these changes could save up to 123 lives a year by reducing preventable deaths from chronic disease caused by lifestyle, including cardiovascular disease.”

    FROM: Smed S, Scarborough P, Rayner M, Jensen JD. The effects of the Danish saturated fat tax on food and nutrient intake and modelled health outcomes: an econometric and comparative risk assessment evaluation. Eur J Clin Nutr. Published online April 13, 2016.

      1. If imposing taxation in the name of good health actually works … Perhaps we will be so fortunate that our own government will tax us to smithereens so that we find ourselves healthy and wise (but not wealthy). Considering that government has never actually solved a problem economically, I would not bank upon it. The figures that are posed by the Danish government can be squeezed to indicate any result. Like morality, logic, wisdom and fortitude cannot result from taxation. It is by these qualities that we will gain good health. Not by forced taxation.

      2. Our elected “representatives” care about protecting the moneyed interests who finance their next political campaign. We are just movie extras in their fictional film entitled “Representative govt in action”, to whom they will say anything to get our votes. . . and then sell us out to protect their campaign contributors. . . like the meat and dairy industries.

        1. Or who will sell us out to over-reaching big-government socialists who want to tell all of us how to live. Leave me alone! Don’t try to tell me how to live, and I’ll do you the same favor. Whatever happened to individual liberty and self-reliance?

      3. It is my own business what I choose to put into my own body. Any government is way out of line imposing a particular dietary practice on anyone. Next we can expect to see an attempt by the UN or some other bunch of over-reaching globalists to outlaw the consumption of meat.

  6. If people would stop eating eggs, dairy, meats it would help to prevent potential pandemics like the bird flu. Also, it would protect the environment from such destruction as the razing of the amazon basin in order to provide land for cattle, and crops to feed the cattle. If everyone would just grow their own garden around their house, they could grow enough food that would supply most of their daily needs. There is a family in California that has only 1/5 of an acre and they grow more than they need. The “sheeple” are so easily manipulated by the powers that be to work their asses off as wage slaves and then use their money to buy eggs and meat which are addictive. The world was built on slavery and it continues to be built on slavery. And, Donald Trump or Hillary Clinton will continue to keep us all in chains.

    1. While agree with most of your statements, I don’t think urbanites can sustain themselves. How do you see concrete canyons like NYC or London or HK to grow enough food within their boundaries to feed all the population in those areas?

      1. Cuba is an excellent example of how an entire country became self sustainable in food and in many other areas of life despite all of the sanctions and economic blockades that the US imposed upon Cuba for years and years. Cuban citizens were allowed to have plots of land to grow food. Parks were turned into huge gardens. All empty lands were turned into gardens. People living in close quarters in apartments planted all sorts of edible plants in plant containers. Cuba did not have to import any food items. All of the people of Cuba had plenty of food to eat, and most of it was vegetables and fruits. There was very little meat to eat because raising cattle was not cost effective and not the best way to utilize the land for food. So, Cubans became near vegetarians over the years. Many Cubans also ate fish from the ocean since the ocean is very close to all of the major cities.

        Based upon the Cuban successful experiment of being food independent with a whole plant diet for the most art, people living in large cities such as London or New York could also use these same techniques. If you live in an apartment in Manhattan you can grow enough lettuce in a 5 gallon plant container to last you for a long time, before you have to replant it. You can use grow lights to stimulate plant growth inside an apartment. You can move your 5 gallon containers to a balcony to collect sunlight. But, what I am trying to say is that plants like lettuce, celery, peppers, strawberries, kale, spinach, and many others just keep on reproducing leaves, berries, and fruits when you pick them. They are like a perpetual motion machine. A 5 gallon container with just one Kale plant will keep on reproducing leaves as you pick them for your salad. This 5 gallon container of just one Kale plant will keep a family of 4 stocked with enough kale leaves for an entire season. What I am suggesting is that an apartment dweller have 20 five gallon containers in their apartment. Each container would have a different plant. These plants grow really big in a season. TWENTY different plants growing at the same time in an apartment is enough food to supply a family of four at least 2 good size salads every day. Also, apartment dwellers can sprout seeds and make healthy meals with sprouts. Everything you need to start this endeavor you can buy on E-bay — growing lights, seeds, sprout jars, 5 gallon containers, and dirt is dirt cheap wherever you are. This is just the beginning of what you can do.

          1. It is very difficult to get people to even listen to you talk about being a vegetarian much less being a vegan. I was trying to tell an individual today who just turned 60 years old how he could improve his life by simply cutting out meat. He looked at me like I was from Mars. He quickly changed the subject in our conversation. People are so addicted to meat and they have been eating meat since they were born and this makes it extremely difficult to convince people even when you have scientific documents in your hands to give them to read.

            I have found that the only time people will really listen to you about vegetarianism or the vegan life style is when they are in a really super big health crisis and they have nobody else to turn to…..then they will give you the time of the day and listen. And, in these cases only a handful of them will actually turn to the light and attempt to eliminate meat from their diets. It’s a sad state of affairs. But, none the less we who know the truth must help to heal the planet and protect the plants by spreading the good news about veganism.

            As the planet starts to die from the dead zones in the ocean, from the deforestation of the Amazon basin, by the desertification of good crop land, and the extinction of various animals….then some of the leaders around the world will start to connect the dots and start talking about real solutions. Until then, we must carry on to save the planet….and save the animals.

            1. It’s true that most omnivores shy away from anything but the mildest references to vegetarianism (especially veganism!). But I find that when first fed a delicious vegan meal, people are a lot more open. Also when people have a child or loved one with a health problem, and I show them, they are more receptive (Yes, maybe THEY could benefit by a vegan diet!). It is mostly just a matter of gently whittling away at their misconceptions. She: You can’t eat fish either?! Me, laughing: I can eat anything I want, I just don’t want to eat fish. She: But it’s so good for you! Me: But it’s not! I don’t want the poisonous mercury, pollutants, and cholesterol and saturated fat destroying my arteries! She: But you have to die of something eventually. Me: Not for a long time, and I intend to still be beautiful! This elicites a laugh. Then I dropped it. This conversation happened yesterday. Do you see how she maintained fish was so healthy, and then conceded it may be killing people? But the idea of Going Veg is threatening to many. So I try to keep it light. But I don’t have to let it slide when people say I “can’t” eat this or that, I make sure they know that I can eat whatever I want. But I can also not eat it, meal after meal if I please. In my mind veganism is freedom. You’d be surprised how many people don’t feel free to be vegan, mostly because of husbands children, parents, friends, co-workers. In my opinion, I am free and they are trapped in a self-defeating pattern. So I gently plant the seeds and let them grow.

        1. if people in a free society are to work the daily hours required to survive economically, they will in no way have enough time to cultivate, plant, maintain, harvest, store, replant and provide the diversity necessary to sustain themselves. Perhaps in a society that has been cast aside by the free world because of their Marxist leaning, unemployed people can find the time for this; however, I do not see this happening in a progressive society. First, in addition to the required time, people simply do not have the knowledge. It would take generations to change the mindset and with our technical abilities today (remember, we are not Cuba) our society would soon turn back to large, more efficient agriculture. We now have a society in which approximately two percent of the people feed 100 percent of the people while the other 98 percent specialize in other necessary industries. If we returned to am agri-based society of small family farms, much that we enjoy and need would have to eliminated and we would soon resemble the shambles of a Cuban-type of society. Personally, I’ll take the USA as it evolves … imperfect but ever-seeking perfection.

          1. If you own a house on just 1/4 of an acre you can have a self sustaining garden that could supply you a LOT of fruits and vegetables. Rome wasn’t built in a day. I am fortunate to have one acre of land. It took some effort to build the raised garden using cinder blocks, but once the garden was established, it just about takes care of itself. And, there is not that much maintenance, especially with fruit trees. Same thing with a container garden in an apartment, all you have to do is fill the 5 gallon bucket with some dirt, put in some seeds, put on the grow lights and give it a little water every day. The tomato plant will do all the work. A garden does not take that much work once you get it set up. The knowledge to do this is not rocket scientist “stuff”. Anybody really wanting to get into this, can watch a zillion tutorials on YouTube on how to do a low maintenance garden or container garden.

            Here’s the problem, people are going to be forced into doing this eventually just like the Cubans were, because what we have happening right now is NOT sustainable. All of the cattle, chickens, pigs that are being raised on huge swaths of land are one of the biggest causes of land erosion and methane pollution in the atmosphere. More and more land of the Amazon basin is being turned into land for cattle production and for growing grains for the cattle to consume. More and more people around the world are wanting to eat meat, and there are people who are willing to provide it to them for a profit. As our ecosystem is being deforested and land eroded the harm also effects all the other living creatures in the ecosystem all the way from insects to large wild mammals. The run off of fertilizers and pesticides to grow these huge crops of corn and soy run off into the streams, rivers, and wind up in the Gulf Of Mexico where there is a huge dead zone that keeps on spreading day after day. What America has right now is not sustainable. The whole system will eventually collapse, just by the sheer deforestation and desertification of the land mass. Getting back to the dead zone in the Gulf of Mexico, this is creating a huge problem for the ecosystem in that area….and it is only getting worse. We are already polluting our drinking water with all kinds of chemicals. If we keep it up…we will just poison ourselves on a large scale resulting in a shorten life span…and maybe that will solve the problem. But, it is a huge problem. And, those at the top of the food chain are not going to fix it. Look how long it has taken the government to even lift a little finger to help the people in Flint, Michigan with their water problem and that problem is still on going. All we can do is fend for our own selves. The only reason the Cuban people resorted back to growing their own gardens is because it was either do that or starve to death. Again, people only “move” when their is a crisis. It will take a huge crisis to get the American people to start growing “victory” gardens again.

            1. I own a house on 40 acres of totally organic-capable agricultural land and am descended from generations of farmers who, only a couple of generations ago, were self-supporting and organic farmers. Also, I am retired from the USDA and have experienced the “other” side of agriculture, extensively. It takes ten to twelve hours per day of skilled and trained effort to sustain a family’s nutritional needs. How many families can do this while earning a living?

              The idea of people resorting to small plots of land and producing their own food is indeed a lofty and a just dream; however, in our current state of society, it simply can’t happen and remains a dream, except for a minority of people.

              To be brutally honest, the vast majority of our population is, unfortunately, soft, weak, untrained and spoiled. It has taken us generations to arrive at this condition but it is, I believe, a true and accurate assessment. We are surrounded by, with a few undeniable exceptions, a populace comprised of video game experts and inner city dwellers who know little more than pounding concrete.

              The reality of our culture is that most people have no clue what to do with land, outside of driving across it on their way to the grocery store. Indeed, a learned, skilled and energetic family can make a go of producing their own food on small plots; however, to have this make a difference in our populace simply isn’t a feasible expectation. I truly wish it were possible but I am a realist.

              If Mom and/or Dad do not have to be working eight hours per day and they own (or more accurately, rent from our gub-a-mint) acreage, have been trained in the realities of agricultural production, it is possible. How many fit this description? It takes ten to twelve hours per day of grueling labor to produce enough food for a family. The preservation, storage and preparation aspects are yet another set of specialty skills that are inescapably crucial after waiting three to four months for your planted acreage to produce crops.

              We will have to rely upon changes to big agriculture that make it economically feasible to use organic methods that somehow can compete with non-organic methods that now dominate. Current agriculture is not some evil or demonic system that purposely robs us of good health. Petro-based fertilizers, pesticides and herbicides were developed with all prudent intentions. These developments have been a boon to the planet. We have seen enormous elevation in food and fiber production because of these developments. In time, we are learning that there are unforeseen costs to this elevation and now, because we are gifted with the ability to navigate our futures through science, we must work on realistic solutions that will maintain the good and eliminate the down side of our progress.

              1. Jules Devares lives in the city very close to downtown Los Angeles. He grows 6000 pounds of food, eggs, and honey on 1/10th of an acre. He uses intensive gardening in raised garden beds. He makes $20,000 per year selling his produce PLUS totally feeding his family of 4. The family is an example of what Americans can do to become healthy, and self sustaining. I have done the same thing that Jules has done on my ONE acre of land. check out his video…..this will prove it to you.


        2. Yeah, Cuba is just great. Hundreds of thousands of political prisoners in government prisons all over the island, a murderous dictatorial communist government under the Castro brothers that kills or beats up anyone who speaks against them….what a great example.. Are you crazy? Cuba is a piece of hell created by communism, it is not a good example of anything. The Cuban people would be MUCH happier under freedom than under the thugs and assassins of the Castro regime. And by the way, the Castro regime has been a big partner in terrorism in America and Africa, and in smuggling poisonous drugs into America.

          1. Hugo, I agree with you. I am just pointing to the fact that a country can be independent and self sustaining if they grow all of their fruits and vegetables on all available land. Let me put it another way, the evil land of Cuba was able to become self sufficient because the evil leaders allowed the persecuted people to own plots of land and to grow food on all available land. They were allowed to do this, because if they did not do it, then the entire little evil kingdom would collapse. So, the poor persecuted people fended for themselves and grew food on all available land and were able to survive not from the help of the evil leaders, but from their own ingenuity.

    2. Using that logic … Perhaps Bernie Sanders will simply give free vegetarian food to everyone. It’ll go well with all the other free “stuff” that he promises in his Utopian dream.

  7. All this is based on the assumption that dietary cholesterol causes the rise of serum cholesterol, and hence dietary cholesterol causes coronary heart disease. Where are the gold standard proof of these hypotheses?

    1. Jason Huang: For starters, you could review the meta-analysis (meaning lots of studies were included) discussed in the post above: “If we look at a meta-analysis, a measure of the balance of evidence, the rise in bad is much more than the rise in good with increasing cholesterol intake. The analysis of 17 different studies showed that dietary cholesterol increases the ratio of total to HDL cholesterol, suggesting that the favorable rise in HDL fails to compensate for the adverse rise in total and LDL cholesterol.”

      Note how the word “meta-analysis” is a link in the article above. So, you can look into the details of the 17 studies that show the relationship between increased dietary cholesterol and serum cholesterol if you want. (Only 17 studies happened to be included in that one meta-analysis. I believe that there are a whole lot more studies than that. This is just to get you started.)

      1. All meta studies can only show there were some associations. About a half who died of coronary heart diseases had normal cholesterol level. Cholesterol is essential to life. Cholesterol is needed for body repairs including arteries. Many hormones are made up of cholesterol. Your body will generate cholesterol if there is zero cholesterol from diet. Cholesterol is vital to the functions of the brain and nerves. Cholesterol is needed for digestion. Serum vitamin D (not the one you buy from the store) is made up of cholesterol.

        1. Jason: I have given you specific studies as well as meta analysis. And the meta analysis is made up of specific studies, which you can investigate. I gave you the answer to your question. Do you really want to dismiss the science?
          re: “About a half who died of coronary heart diseases had normal cholesterol level.” This is a misleading statement. It is only true if “normal” means the average levels in a sick society like America.


          The important/valid statistic is this: Almost no one with “human-normal” cholesterol gets heart disease. Babies are born with total cholesterol levels at about 150 or below and LDL at about 70 or below. These numbers are the normal values for humans. And if those normal values are maintained through a lifetime, the person does not get heart disease. (Societies which eat a primarily plant based diet — watch those eggs! — are able to maintain these levels.) The problem is that you are listening to people who claim that high levels of cholesterol are normal. There is a NutritionFacts video which covers this information that you can find and watch to get the sources/references.
          re: “Many hormones are made up of cholesterol. Your body will generate cholesterol if there is zero cholesterol from diet. Cholesterol is vital to the functions of the brain and nerves. Cholesterol is needed…” This is what is known as a strawman’s argument, because none of these statements is really in dispute. Yes, your body needs cholesterol. But you really hit the crux of the mater when you pointed out that our bodies make cholesterol. In fact, our bodies make all the cholesterol we need. We don’t need to consume any at all. And we know that when we do consume cholesterol, especially along with consuming saturated fat, our bodies start hitting high levels of cholesterol (ie, levels above 150/70). And then those high levels of cholesterol raise our chances of dying from heart disease.
          Consider it this way: Your body needs water. Everybody agrees with this. But even too much water will kill you. Similarly, everybody agrees that we need some cholesterol in our bodies (not our diet). HOWEVER, too much cholesterol in our bodies (like too much water) can kill you. How do we know what too much cholesterol is? By looking at the amount below which, NO ONE gets heart disease. And how do we maintain human-normal levels of cholesterol? By eating a whole-food plant based diet. By staying away from meat, dairy and eggs as much as our individual biology requires.

          1. Now we are arguing over words. I am saying high or low serum cholesterol level is not the marker of coronary heart disease. Many heart doctors can relate that fact. In a UCLA study, 65% of more than a thousand patients with severe heart failure had cholesterol below 129 ml/l.
            ref: Horwich TB and others. Low serum total cholesterol is associated with marked increase
            in mortality in advanced heart failure. Journal of Cardiac Failure 8, 216-224, 2002

            1. Jason Huang: re: “I am saying high or low serum cholesterol level is not the marker of coronary heart disease.” Thank you for that clarification. Most people who make your point are quoting from statistics which twist the meaning of ‘normal.’ Either way, I’m arguing that you are wrong (or only right if the numbers are twisted). I make the case for why you are wrong in my post above.
              I don’t *think* the study you quoted backs up your position. I think you are mixing up statistics. I couldn’t find the study, but I believe I found the abstract. The abstract talks about advanced heart failure, mortality and cholesterol levels. As near as I can tell, the study does *not* talk about people dying specifically of heart attacks and *that* mortality rate relationship to cholesterol levels. Coronary artery disease is just one potential cause of heart failure and looking at mortality as a statistic by itself does not tell us whether the patient died of a heart attack or some other cause (like say complications from their diabetes which had caused the advanced heart failure). The people would have had to have died of a heart attack due to clogged arteries for this study to back up your position. And since the people already had advanced heart disease from some whatever source/cause when this study started, I don’t see how the study supports your position. Their hearts were weakened by some disease which may or may not be coronary artery disease …
              I think you might want to make another point at this stage of the conversation: “But the study shows that lower cholesterol levels were associated with higher mortality. So, low cholesterol is dangerous even if low cholesterol were preventative for heart attacks.” Here’s where your “association does not equal causation” point could really come in handy. One thing we have learned from various studies on this topic is that they measure/show reverse causation regarding mortality and cholesterol levels. I suspect (I don’t know) that is what we are seeing in the study you referenced. It looks like people with low cholesterol have higher all-cause mortality, but what is really going on is that the diseases making people sick tend to lower people’s cholesterol levels. And when people are that sick, they tend to die more…
              Someone else who is more able to review studies would have to take it from here if you want to argue about that study. I think I have provided you with a lot of evidence to address your initial question which was: Is there good evidence showing that dietary cholesterol increases blood cholesterol? The answer is a resounding, “Yes!”
              And just for fun, I have to point out the first part of the abstract of the study you are referencing (assuming I found the right study) “Although hypercholesterolemia is a well-defined risk factor for morbidity and mortality in coronary artery disease,…” Doesn’t that support what I am saying?


              And here is the conclusion at the end of the abstract: “Serum TC represents a novel prognostic factor for patients with advanced HF.” I think all that’s saying is that people who *already have* advanced heart failure might be able to look at their total cholesterol levels to see how much at risk they are for dying. Ie, cholesterol levels might be a good indicator of how far the disease has progressed. Does anyone else want to look at the study to see if I got that right?

              1. The point I am making is that do not be misled that the lower of the serum cholesterol the better. To debunk the hypothesis, all you need is one contradiction.
                There are many counter examples to the cholesterol hypothesis.
                Some people with familial hypercholesterolemia die of coronary heart disease, like many others. But some live into their 80s without CHD.

                1. Jason Huang: re: “To debunk the hypothesis, all you need is one contradiction. There are many counter examples to the cholesterol hypothesis.”

                  Your statement makes no sense. Your statement is like saying that if you can find one person who smokes a lot and doesn’t get lung cancer, then smoking has nothing to do with lung cancer. Of course, no one says that. Everyone I know understands that smoking increases disease risk. But we can all find examples of people (even whole populations) who seem to have no effect from smoking. That doesn’t mean that the science linking smoking and lung disease isn’t very, very clear.

                  Similarly, no one is saying that high cholesterol *will* cause coronary heart disease. What the data shows is that high cholesterol increases the *risk* of heart disease (just like smoking increases the risk of lung cancer). Below 150/70 (a normal cholesterol level for humans) and you are very unlikely to have a heart attack from CHD. Above those numbers and you face disease risk. Since heart disease is the number one killer in America, lowering cholesterol levels to a healthy level is definitely to the better if one wants to maximize chances of avoiding health problems.

                  1. You should know that it is body’s natural response to a toxic condition/environment to raise the cholesterol. As people get older, the higher the serum cholesterol, the better he/she is protected. The body needs to increase the cholesterol, similar to raising body’s temperature to find virus/bacteria.

                    1. Jason Huang: If I understand you correctly, you think that cholesterol levels naturally go up as we age. This is not true:
                      “Medical myths and dogmas die hard. Researchers creating a new body of knowledge for prevention and control of heart disease had to disprove and displace a bunch of doozies, like we used to think that heart disease was just an inevitable consequence of aging, or that cholesterol and blood pressure just naturally go up as we age. All these are now bygone notions, refuted by massive data…” from Cholesterol levels only go up as we age if we have been eating unhealthy diets full of cholesterol and saturated fat.
                      And as I have shown, higher cholesterol levels impose higher risks, not “protection” as you say.
                      I wanted to find for you the NutritionFacts video that has a study/graph showing that there are entire populations where cholesterol does *not* rise as people age. With a plant based diet, cholesterol levels stay at just about the level people are born with for their entire lives. Sadly, I couldn’t find that video. Hopefully someone can help out. In the meantime, here’s related information:
                      “In the 20th century, networks of missionary hospitals in rural Africa found coronary artery disease virtually absent… In a sense, these populations in rural China and Africa were eating the type of diet we’ve been eating for 90% of our last 20 or so million years–a diet almost exclusively of plant foods. How do we know it was their diet that protected them, and not something else? … Dietary recommendations must be put to the test. That’s why the pioneering research of Pritikin, Ornish, and Esselstyn is so important, showing that plant-based diets can not only stop heart disease, but have been proven to reverse it in the majority of patients. Indeed, it’s the only diet that ever has…” from:
                      The *only* diet shown to reverse heart disease is the whole plant food based diet which lowers cholesterol levels.

                    2. To counter your diet fix, the old Japanese people in US follow closely to the diet they had back home country, Japan. But their Japanese diet does not save them from CHD. Their rate of CHD is at least as high as the general population in US.
                      In Greece, there are two islands next to each other, Crete and Karpathos. They both have the same diet and similar climate. Karpathos has 5 times the risk of heart disease compared to Crete. Now, you wouldn’t call the difference is due to the diet.
                      Similarly, the Icelanders who migrated to Canada have much higher rate of CHD than their countrymen back in Iceland.

                    3. Jason Huang: re: “… the old Japanese people in US follow closely to the diet they had back home country, Japan. But their Japanese diet does not save them from CHD.” This is not true based on the information I have read. I have read that to the extent that first generation Japanese follow their old diet, they are protected from CHD. But as each generation eats closer and closer to the American diet, the more heart disease they get. NutritionFacts has at least one video about this topic also. And I know that Dr. McDougall talks about this situation also.
                      As for your Crete and Karpathos example, I’m not familiar with that one. I don’t know if your statement that they have the same diet is true or not (you’ve gotten a lot factually wrong so far…). Some of the questions about this situation would be: Is “5x” a meaningful number in the context? (Ie, what are the absolute numbers?). And what is causing the heart disease difference between the two if it is not diet? We know that in the US, the cause of the vast majority of heart disease is the diet. As explained in my post above, three different researchers have proven that a low fat whole plant food based diet can reverse heart disease. This is the *only* diet proven to reverse heart disease. I’m not saying that *all* heart disease is caused by diet. I think one of the NutritionFacts videos puts the figure at 90% related to diet. Perhaps your two islands example points to another cause that culture is dealing with. Either way, your example has *nothing* to do with whether cholesterol levels relate to heart disease or not. Your example would be like saying that because there are other causes to lung cancer, it’s not possible for smoking to also be a cause of lung cancer.
                      I don’t know what your point is about Icelanders. But at this point, the conversation feels pretty over. You can look at the actual science, of which I’ve tried to find several links for you, or you can dismiss it.

                    4. I have learned that there are many factors involved in CHD.
                      Cholesterol sulfate is required to convert into vitamin D sulfate. Cholesterol sulfate keeps the blood flow. We all know that vitamin D is very important. When diet low in sulfur, there is a shortage of cholesterol sulfate. If the liver is busy with other things, then it cannot generate cholesterol sulfate. Glutathione and homocystine are all sulfur based.
                      And there is methanol issues. Dietary methanol can be converted into formaldehyte via ADH I. Formaldehyte can and will create athero-plaques under the endothelial layer, and this is where ADH I site are. Methanol can come from cigarette smoking, canned fuirts/vegetables, fruit juices from concentrates, and from environment, paper mills for example. Burning wood generates methanol too.
                      What I am trying to say here is that don’t think cholesterol hypothesis is the truth. There are many factors.

                    5. Jason – I think debates are generally good as it forces everyone to doublecheck their assumptions, but I wish you would cite references for your claims. I’d be particularly interested in your sources for the claim about the diet of older Japanese in the US, as a start.

                    6. One has to be careful that studies after 1976 were tainted more factors, mainly dietary methanol. I am all for good diet. If we are blindly focusing on the cholesterol hypothesis, then we will not find the causes of CHD any time soon.

                      The study on Japanese, “Acculturation and coronary heart disease in Japanese-Americans”, was published in 1976. The study did not account for differences in dietary sulfur. This is why they concluded: “This difference in CHD rate between most and least acculturated groups could not be accounted for by differences in the major coronary risk

                      From 1976, fruit juices from concentrates (including V8) became widely accepted as healthy. Unknowingly, dietary methanol was increased. In 1981, aspartame was allowed into food supply. By 2000, death rate of Alzheimer’s, multiple sclerosis, lupus, heart disease and diabetes started increasing.

                    7. Thanks for the reference. The abstract is interesting but unfortunately I have no access to the entire article.

                    8. Have you read what Ravnskov writes about foam cells in that book? He clearly fails to grasp the biological mechanisms. I think we best not use books like that in discussions like these. I agree that cholesterol is not the only risk factor when it comes to CVD. I think everyone agrees with you on that. However, it’s most likely the most important risk factor.

                      There are dozens of trials showing saturated fat increases serum cholesterol levels and that leads to an increased CVD risk. However, we mustn’t forget the studies in which people were able to reverse their actual heart disease in ways we can measure. Only a low-fat plant-based diet has been proven capable of this.

                    9. Even if you are a vegetarian and have zero cholesterol intake, one can still get very high level cholesterol in your blood. This is because when one is under stress (physical, emotional, and chemical), our body is intelligent and raises the cholesterol in response to the stress(es).
                      Have you read Dr. Malcolm Kendrick’s book? A person, he knew quite well, had a heart attack, at age 36. The person was fit, doing international cycling. He was also extremely thin. His resting pulse was 50 per minute, he blood pressure was 120/70. His total cholesterol level was 3.0 mmol/l (117 mg/dl). He was a vegetarian and a non-smoker.
                      So, don’t keep thinking by manipulating (lower) the cholesterol will save people from CVD.

                    10. You’re arguing against a statement that no one ever made. That LDL cholesterol is the sole culprit in heart disease. We argue that it’s the main culprit. Despite your robust anecdote, I think we better stick to the science.

                    11. I have replied in this discussion that how methanol came into our body.
                      Normally, when people eat fruits and vegetables, the pectin in these plants produces and is fermented in our gut methanol, together with some ethanol too. The methanol in blood is very low, about less than 10 mg, not any problem. However, civilization created many foods containing methanol, more and more. The first was the canned foods. Then, smoking. In 1970s, we had juices (from concentrates) and V8. In 1980s, aspartame in diet drinks (12-oz) contains about 200 mg. About 11% (22 mg) gets in blood circulation.

                    12. Do you have any proof to back up this little hypothesis of yours? That this is the major cause of heart disease. I highly doubt you do. It sounds to me like you’ve already made up your mind and no amount of evidence will change that.

                    13. You don’t have read the book but I did, you read through over 700 references used in the book,
                      There is another factor: cholesterol sulfate in blood. Modern diet is low in sulfur due to mega-agriculture. Many modern diseases including some cancers are associated with low cholesterol sulfate.
                      I suspect high cholesterol sulfate helps reducing or preventing the damages by formaldehyde via methanol. If you observe the people live near active volcano(es) and those live where there is plenty of sunshine, they enjoy much healthy life than general population, less CVD, obesity, or diabetes.

                    14. I have to address your assertion: “That LDL cholesterol is the sole culprit in heart disease.” Studies only show there is an association between LDL cholesterol and CVD. One only sees there is LDL cholesterol (actually oxidized LDL) at the atherosclerosis sites in the arteries. If the cause is the LDL, why atherosclerosis plaques not found in the vein since LDL is free everywhere?

                      There is an analogy of elementary school accident to the LDL is culprit: During a recess of an elementary school, a stone smashed the glass of the principal’s office window. She immediately rushed to the window and found a boy, the only boy, stood next to the broken window, outside. The principal was convinced that that boy threw the rock.

                    15. For the foam cells, you read Dr. Woodrow Monte’s book, While Science Sleeps. He explains, in his book, that when methanol is transformed into formaldehyde within the intima of the artery by the alcohol dehyogenase I (ADH I), present in the intima. Formaldehyde attacks the protein lining the outside of the native LDLs, converting them into a formaldehyde modified, or more specifically, an oxidized LDL which activates the scavenger sites on the macrophage and induce its conversion into a foam cell.

                    16. If you look through the data of people in Iceland, Japan, Oregon in US, you will find that the their obesity and CHD rates are lower than the general population. Their common factor is they live near active volcano. Their diets are rich in sulfur.

                    17. A lot of studies showed that the rate of death among older people with lower cholesterol was higher.

                    18. The death rate is lower for those whose cholesterol is higher.
                      Why are we then bashing the cholesterol, like poison?

                    19. Jason: Your statement is incorrect for the general population. re: “The death rate is lower for those whose cholesterol is higher.” I can try to explain reverse causation again. See if this makes more sense to you:

                      What we know is that people who get very sick have a drop in cholesterol levels just before they die or as part of being sick. Older people (those closer to death) may also see a drop in cholesterol levels. Thus, *in those cases*, a low cholesterol level is a symptom of being sick. This is what reverse causation means. Normal causation would be: “low cholesterol level causes disease and early death”. Reverse causation, what you are referring to in your posts, is “disease causes low cholesterol”.

                      Now consider this: What we also know is that people who have consistently low/healthy cholesterol levels through their lives have almost no chance of getting or dying from CHD. In other words, when a responsible researcher looks at the relevant data, he/she will tell you that the death rate is lower for those who maintain a lower rate of cholesterol through their lives. If I remember correctly, Tom Goff gave us a wonderful post on this very page/discussion that provides some links/studies about this very topic. You can look for that post to learn more/get backup data if you are interested.

                      So, the bottom line (as backed up in my earlier posts and which you can find out even more on other pages on this site) is that:

                      >>> 1) we know that diet affects cholesterol levels. Specifically, we know that consuming cholesterol and saturated fat are particularly bad in terms of raising cholesterol levels above healthy levels.

                      >>> 2) we know that cholesterol levels above 150 total/70 LDL create risk for CHD. Cholesterol numbers below 150/70 (ie, the levels we are born with) are safe levels for the vast majority of people.

                      >>> 3) a low fat whole plant food diet has been clinically proven multiple times to reverse CHD. And what’s more, a low fat whole plant food diet is the only diet (the only treatment as far as I know since I don’t count surgery as a reversal–just a temporary treatment of a symptom) known to do so.

                      All of this, plus much much more data, is why we bash *unhealthy levels* of cholesterol. I hope it makes sense this time.

                    20. No, it is not all truth “consuming cholesterol and saturated fat are particularly bad in terms of raising cholesterol levels above healthy levels”. The statement is based on the assumption that high fat and high cholesterol cause heart disease.

                      In 1953 Ancel Keys, director of the Laboratory of Physiological Hygiene at the University of Minnesota published a paper, which, looking back seems to have been an early kick-off for the cholesterol campaign.
                      According to Dr. Keys, fat food was the culprit. His proof was a diagram, which showed that the intake of fat food and the death rates from coronary heart disease followed each other closely in six countries.

                      But why did Dr. Keys use the figures from six countries only? At that time information was available from 22 countries and if all of them were included the association was in fact rather weak. For instance, the death rate from coronary heart disease in some countries was 3-4 times higher than in countries where the consumption of fat was the same.

                      The many exceptions to Ancel Keys’s hypothesis indicate that something in the Western life style other than fat food is the cause of coronary heart disease.

                      In the early 1960s, Professor George Mann and his team from the Vanderbilt University in Nashville, went to Kenya in Africa with a mobile laboratory to study the Masai people. The diet-heart idea had just started its triumphal progress. Professor Mann had heard that the Masai people did not eat anything but milk, blood and meat. Wouldn’t it be a good idea to test the dietheart idea on the Kenyan plateau? Shortly before and with the same purpose Dr. Gerald Shaper from the Makerere University of Uganda had traveled a little further north to another tribe, the Samburus.

                      The Samburus and the Masai people are slender people who have survived as shepherds for thousands of years. Their life is free from the mental stress and competition of Western civilization, but you cannot call it comfortable. Every day they walk or run many miles with their cattle, searching for food and water.

                      Their own diet is extreme. According to their view, vegetables and fibers are food for cows; they themselves eat milk, meat and blood only, or at least the younger men do. A male Samburu may drink almost a gallon of milk each day. He has never heart about the cholesterol campaign, and therefore he drinks the creamy milk as it is, which means that his intake of animal fat is far above that of most Western people. Also, his intake of cholesterol is high, especially during periods when he adds 2-4 pounds of meat to his daily diet.

                      Masai people drink “only” half a gallon of milk each day. However, they eat more meat than the Samburus. Their parties are sheer orgies of meat; on such occasions 4-10 pounds of meat per person is not unusual, according to Professor Mann.

                      If the diet-heart idea was correct, coronary heart disease should be epidemic in Kenya. But Mann found that no Masai dies from a coronary. Rather, the Masai people would die of laughter if they heard about the cholesterol campaign.

                      But this was not the only surprise. The cholesterol of the Masai tribesmen was not sky-high as Mann had expected; it was very low. In fact, their cholesterol was among the lowest ever measured in healthy people, about fifty percent of the value of most Americans.

                      However, this aberration from the diet-heart idea seems petty compared with the next one. Curiously, Dr. S. L. Malhotra from Bombay, India is never cited in the many reviews advocating for the prudent diet. He studied coronary heart disease among more than one million male employees of the Indian railways. During a five-year period he recorded 679 deaths from that disease. Most cases, 135 per 100.000 employees, were noted in Madras in southern India; fewest cases, 20 per 100.000 employees, were noted in Punjab in northern India.

                      Thus, death from coronary heart disease was seen about seven times more frequently in Madras, and those who died were on average twelve years younger than in Punjab. But in Punjab, people ate 10-20 times more fat, and they smoked eight times more cigarettes. And while the small amount of fat that people ate in the weak-hearted province of Madras was mainly of vegetable origin, the fat they gorged on in the strong-hearted Punjab was mainly of animal origin.

                      How can you tell the dietary fat and cholesterol causing CHD?

                    21. Jason: There is nowhere to go with this conversation. You dismiss real evidence provided to you and you keep repeating talking points that have been disproven/shown to be wrong again and again and again. I could go through each of your points in this latest post and explain the ways in which your content is wrong, but I’ve spent a great deal of time doing just that in previous posts and not gotten through. I understand why you think the way you do. That false information is repeated many places. It sounds convincing. I really do sympathize. But unless you are open to learning the truth, there is no further point to this conversation.
                      I started this conversation because I thought you were asking an honest question about evidence linking dietary cholesterol to serum cholesterol. (And I actually answered the question.) I’ve carefully read your posts, followed up on research you quoted (which did not end up supporting your claims), and done my own research, where I found your information to be incorrect. You do not acknowledge any of that.
                      So, now I put it on you. If you want to understand why high serum cholesterol levels are the root cause of CHD (other risk factors rely on the existence of high cholesterol already present) and if you want to understand why your points, such as your points on Ancel Keys, are just plain wrong (a fabrication of history), I will refer you to other pages on this site (you might start with the topic page on cholesterol I also refer you to Plant Positive who specifically addresses your talking points, including Ancel Key’s work, in great detail. If you fancy yourself a seeker of truth, I challenge you to find that information: to watch the videos on Plant Positive’s site and to repeat any parts you don’t understand until it makes sense (he talks fast). You can even follow up with the original research if you want to verify what Plant Positive says. Good luck.

                    22. Let’s close this conversion. If you want to believe in saturated fat causes high cholesterol which causes heart disease, that is your choice. I don’t, at least no evidence to show such.

                    23. If you’re looking at cholesterol levels between 160 and 200, look again. 200 is NOT a safe number. Look at the Framingham Heart Study please.

                2. ” To debunk the hypothesis, all you need is one contradiction.” – this is an oversimplification since medical research is not abstract logic. Studies have disparate strengths and weakness, etc. It is not easy to sift through all the studies to come to valid conclusions. One should rely on the preponderance of sound evidence, coupled with plausible biological models of causation, to decide on what to believe.

        2. Our bodies make all the cholesterol we need, there is no need to ingest any, so go ahead and experiment on yourself and let us know how it goes.

          1. Our body is intelligent. It will raise and lower the serum cholesterol levels as needed at the time. Not everyone is the same. Therefore, the cholesterol level should not be the same. This 150 number is assumed set by big pharmas.
            For example, those young law students during their finals are all have high cholesterol.
            Another example, there was a person, just finished a physical, in the parking lot, had a car accident. She was rushed back in the hospital where she just had a physical. The doctors there compared her cholesterol levels before and after the accident and found, yes you guessed it, her cholesterol level went through the roof.

            1. @disqus_aiBNphpDlU:disqus Where did you hear about these “young law students”? Please also cite your example of a person who had a physical and … Your interpretation of stress/harm induced increases on cholesterol levels do not seem sound. High cholesterol levels in response to stress/harm may indeed occur, but who is to say that such high levels of cholesterol are optimal for our bodies? For example, when we develop scar tissue, is the scar tissue optimal tissue? Do we want scar tissue? It may very well be that high cholesterol in response to injury is the lesser of two evils (the greater evil being the injury or stress). Ingesting cholesterol when you don’t need to is unnecessary. You previously mentioned the body’s fever mechanism. Sure we sometimes need fevers but inducing a fever without a need for it is useless and harmful.

              1. As you know, your hormones are made of cholesterol. Your brain is made of cholesterol. When you had a bad diet, your liver is unable to produce needed cholesterol.

    2. Jason: Just for fun, I came up with some more studies for you to research. In one of Plant Positive’s videos, he shows one study that’s pretty fun: “Here’s an old study with one man going on and off cholesterol supplementation from egg yolks.” For more details:

      And here is another article from Dr. Greger which specifically addresses the topic you are interested in (dietary cholesterol = increase in blood cholesterol). You can click through to the study if you are interested:

      All of these many, many studies paint a clear picture, especially when you take into consideration the faults Dr. Greger has pointed out for studies which show little or no relationship between dietary cholesterol and blood cholesterol. Those studies use well-known biology tricks/have fatal flaws. We know about those tricks and see them in the studies. Thus, we know that there really is no confusion or controversy on this topic.

    3. I just read some abstracts of recently published research that have me rethinking dietary intake of cholesterol containing foods. I grew up on a farm and always enjoyed eating eggs. I stopped six months ago based on various readings and my elevated blood cholesterol. I don’t know what to believe now but I may have to pay a visit to my “egg lady” soon. Am J Clin Nutr. 2016 Mar;103(3):895-901. doi: 10.3945/ajcn.115.122317. Epub 2016 Feb 10 Am J Clin Nutr. 2015 Apr;101(4):705-13. doi: 10.3945/ajcn.114.096925. Epub 2015 Feb 11.

      1. Our body is intelligent. It will raise your cholesterol in your blood when it needs. When one is under stress (the stress can be physical, emotional, and chemical), the body will generate a lot of cholesterol.

        1. So basically you are saying that the body takes care of all of its cholesterol needs, and thus there is no need to ingest dietary cholesterol.

          1. The liver makes all the cholesterol it needs as required. Just as it makes all the non-essential fatty acids like s
            aturated fat, monounsaturated
            fat, omega 9s, docosahexaenoic acid
            (DHA), eicosapentaenoic acid (EPA), DGLA
            and arachidonic acid (AA).

  8. Michael Gregor, you are the BEST. The problem with the money system of things is that people will do anything for it… such as twisting facts to mislead people – to their detriment… for the purpose of increased sales. I applaud you for setting records straight. Thank you!

  9. reconciling the vegans, e.g. dr. greger, with the growing paleo proponents is difficult. i don’t want to be comfortable with information that pleases me. i do wonder about the data from two populations in Tennessee, 5,000 years ago. One population had a maize-based diet, the other was hunter-gatherer. The hunter gatherers were vastly healthier re: height, bone density, muscle mass, infant mortality, infections, dentition, etc. The maize population was in relatively horrible health. This data was not revealed by paleo proponents.

    1. Maize that isn’t nixtamalized is nutrient deficient, you don’t specify. The science is pretty clear what harms and what benefits, and if you are still in doubt, spend a week or two in the woods with no gear and you will quickly learn what is food. Plant parts, bugs, whatever you can easily gather. As for your comment about the “growing” paleo proponents…come on, they have been so debunked by so many sources it isn’t even debatable. It’s simply a matter of believing what they LIKE, and we are all free to do just that, the choice is yours.

    2. The fact that in other locations the first farmers were just as healthy as the hunter gatherers is not mentioned by paleo advocates either. Finding one example to support a claim is easy enough but what about the totality of the evidence? Plant positive has some useful videos on this eg

      And paleo is really just another low carb diet. Low carb diets deliver higher mortality. They are not a good idea.

    1. You are right! Framingham showed us that what people say is ‘normal’ TC isn’t normal at all. Back when, 80% of young Korean soldiers had gross evidence of CAD when the Asians had next to none. In 1999, a study of young persons between the
      ages of 16-34 years who died of accidents, homicides and suicides, found that
      the disease is now ubiquitous. The Standard American Diet is killing us. At the turn of the century we at 70% plants. Now we eat 30% plants, if that!

  10. What about the large meta analysis Japanese study which concluded that people with total cholesterol had lower mortality rates than those with low total cholesterol? Could someone explain this to me? …….According to an eight-year study of about 26,000 men and women in Isehara, Kanagawa Prefecture, the death rate of men whose LDL cholesterol levels were between 100 mg/dl and 160 mg/dl was low, while the rate rose for those with LDL cholesterol levels of less than 100 mg/dl.

    1. Were those low cholesterol levels achieved by statins? if so, then the study shows only that using meds to lower cholesterol does not fix the underlying problem.

    2. This is what is known as reverse causation. Certain diseases like cancer, Alzheimers, alcoholism. malnutrition (common in the elderly because of loss of appetite) etc cause cholesterol to decline. If people have these diseases, they will naturally suffer higher mortality than people who do not have these diseases. However, people with stable low cholesterol do not experience excess mortality – quite the opposite. These facts has been known for decades but the cholesterol advocates still keep trotting out these misleading studies to confuse people. And if low cholesterol caused excess mortality, then people whose cholesterol is lowered by statins would have excess mortality. They do not. Quite the opposite.You will also see similar claims being made about overweight being “protective” in old age – because cancer etc etc cause people to lose weight, and most people in Western countries are overweight, there is a link between declining weight in old age and mortality. Reverse causation again.

      There are a number of reports in the literature on this phenomenon but this discussion from 1995 is a good place to star:

  11. I don’t know if this is going to post or not, because of the new ‘disqus’ sign up, but here goes. I first want to say that this information has been very helpful. I started using 1/4 teaspoon of ginger 3 times a day, and my estrogen has gone down from 2-3 times its normal levels to perfectly normal. I immediately started feeling calmer once I started taking ginger powder, although my ovary area hurt the first day or two and I start bleeding unexpectedly. The OBGYNs actually suggested surgery because my estrogen was up to 8 times as high as it was supposed to be last summer (but I was losing weight and liquid fasting) and then 2-3 times as high this past January. Now, it’s completely fine! I’m a woman in my mid-40s.
    When I started fasting last summer, which I define as a liquid, no eating fast, I was led to start reading all about diet. I happened upon the, which was great. I read the book and decided to become a pescetarian. Then, I happened upon, and cut back on my meat eating drastically. [Also, reports a study where in only 2 weeks of a clinical trial, the vegetarian group had a significant mood improvement whereas the omnivores and pescetarians did not.]
    So, I’ve eaten meat maybe 10 times in the last 4 months, mostly very small servings of fish in a sushi roll. I’ve maintained my 25 pound weight loss of almost a year ago and feel pretty good. I eat eggs and some low-fat cottage cheese. The only times I eat cheese is on rare occasion that I eat veggie pizza.
    However, I wanted to comment on the vegan diet. I tried it for a week, and I felt awful. At the end, I had my blood taken and my BUN levels were 5. That might have been from the 10 hour water fast, but still. I felt doing a 40 day liquid fast, where I just consumed soups, fresh fruits and vegetable juices and a raw egg (with almond milk) a day was MUCH easier than going vegan.
    Also, I think it’s genetic. I don’t know if I have that chromosomal issue that Dr Greger mentioned in one of his videos, but I might. Or it may just be my DNA, metabolism, etc. I’ve always been an athlete, to include a college athlete and a military officer. Even on a cheeseburger-every-day diet, my cholesterol was 188. In 1999, it was 144. In 2010, it was 188. In 2014, it was 176. In 2015, it was 163-179. This year, after 9 months of mostly vegetarian/pescetarian diet from mid 2015 to now, it is 153.
    My HDL has been: 2010 – 67, 2014 – 72, 2015 – 57 to 60, and 2015 – 63. No big changes, even on a vegetarian diet.
    My LDL has changed however: 1999 – 64, 2010 – 109, 2014 – 91, 2015 – 105 to 93, and 2016 – 73.
    My triglycerides are actually higher on the vegetarian diet by a bit: 1999 – 43, 2010 – 58, 2014 – 64, 2015 – 68, and 2016 – 73.
    So, after being a vegetarian, my cholesterol is noticeably (but not drastically) lower, but my LDL is significantly lower than it has been at any time in the last 6 years. I have exercised fairly consistently my whole life, and until the last 9 months ate a significant meat and cheese diet.
    Anyway, sorry Dr. Greger, but I am NOT giving up eggs. I pray for the chickens every day and pray that their owners treat them well. I buy pastured when I can. I buy Trader Joe’s cottage cheese, because supposedly they treat their cows better, although I have waivered back and forth about totally cutting out milk and being mainly an ovo-vegetarian. I used to eat fish and no milk. Now, I eat a little bit of cottage cheese and fish very infrequently.
    I like my diet change because I am maintaining my weight. My LDL and cholestoerol is down. I feel better. My breath doesn’t stink unless I start eating meat again. I ate chicken once in the last 6 months, and I could tell my breath stunk for about 24 hours afterward!
    My blood pressure is down, although it was never officially hypertensive. Although biking 7 miles a day at a moderate pace also lowered my blood pressure a lot even on an omnivore diet. [I think you downplay the benefits of exercise, too much. I love exercising and the way I feel during and after. It helps my mood too.]
    Also, I started putting 1-2 cloves of garlic in my celery/cucumber/carrots/arugula drink I juice everymorning. I had gas badly for 2 weeks, but then it stopped. I never have gas when eating bean. My blood pressure is down even more. I feel calmer, and my skin is not dry anymore! just from juicing garlic. Love it. I also read that garlic binds to mercury to help remove mercury from our bodies.
    Anyway, I also use golden algae now, b/c of, and I use turmeric, which I think helps. So, THANK YOU, for your work and information.
    Oh, and I take 2 grams of B12 3 times a week, and I think that is helping. My B12 levels are up from 300 to 432. I read that Japan and Europe consider their citizens in need of B12 supplementation if their levels are under 450-500.
    I apologize to everyone for the long post, but I don’t think I’ve commented in over 8 months. Hope it helps, because I get my blood checked fairly regularly.

    1. DLS787: You wrote, “I wanted to comment on the vegan diet. I tried it for a week, and I felt awful.” Some people are able to go cold turkey when it comes to a vegan diet. But other people’s bodies are so addicted to animal foods, that they need to be slowly weaned off in order for their bodies to reset to a healthy condition. It sounds like you are one of the latter types of people.

      This idea of failed vegans being addicts comes from Dr. Klaper who has a lot of experience in this area and has helped many patients to transition to a healthy diet. You can see a clip from a talk from Dr. Klaper on the topic in this video: “Are Failed Vegans Addicts?”

      I’ve seen the full talk, so I’ve seen the solution to the problem (which I think is cut off in this clip). The solution for a person in your situation would be to treat animal products, like say an egg or your cottage cheese, as medicinal. Pick one animal product and figure out how little you can eat each day and still feel OK. Don’t eat any other animal products. After you stabilize on that small daily amount for a bit, see if you can skip a day. If every other day works for a couple of weeks, see if you can go every two days. Etc. Until at some point, and it may be months down the road before your body is really healed, you don’t need it any more! :-)

      1. Hello Thea, yes I thought of that. However, I can go about 2 days and feel OK. I frequently go for a day without any animal products, without even purposefully doing so, and I feel fine. If I eat animal products, it’s rare I eat cottage cheese and eggs the same day. I usually eat one or the other. When I do, I usually eat either one raw egg or two cooked eggs in a mexicali burrito (no cheese) with bell pepper, jalapeno peppers, onions and hot sauce. That’s my favorite animal product meal. I will watch the video. Thank you.

        I do think there needs to be a realization, however, that some people do not fit in the 2 standard deviations from the mean (assuming a normal probability distribution curve) in the studies that are done. I find that most medical doctors and medical professionals (even PhDs unless they’ve had a lot of statistics courses) take a finding – without fact checking the data (although peer reviewed is definitely a start) – and then make it factual statement for everyone. As even Dr. Greger’s videos show, that break down the trial participants into the individual level, not all participants react positively to the treatment.

        Dr. Greger actually has a video that talks about how some people (1 in 100,000 and 1 in 40,000 in Japan) do need to eat meat. I don’t think I’m one of those. But even when eating cheesburgers ever day, I had NO cholesterol problems as long as I was taking Vitamin D and fish oil. In fact, a few months ago, I had a cardio scan of my heart, because I was interested, and it showed ZERO calcification. Not even a little calcification. It showed ZERO calcification, and I’m a 46 year old woman. However, my blood pressure was prehypertensive, which in addition to my extremely high estrogen levels, was the reason for my diet change, mostly.

        I think the vegan community needs to watch out for is expecting people to go cold turkey, which is what you mention. I tried the Hallelujah Diet in year 2000 when I was deathly ill and rail-thin. Before I met them, my blood work was all out of kilter and medical community just yawned. The Health Minister I happened upon is the very first person who ever, ever, ever told me that what I eat could have a profound effect on my health. It was amazing. But it was unsustainable, and after a few months of it, I was extremely anemic (I now know after looking at the medical records 15 years on), although my other blood work was fine. The diet was unsustainable because it was so so strict – 85% raw, no cooked food, everything homemade, 1 tablespoon of oil on a salad at night, only use a masticating juicer, etc. it was great for some people, but I didn’t have the money or energy to buy only organic, make all my meals from scratch, and the masticating juicer took up my entire kitchen cabinet and broke after not too long. While cold turkey may work for some, it’s been a 1.5 year transition for me to change my eating (and drinking of soda) habits.

        I’ve read stories about vegans who stop being vegans and become meat eaters. I don’t understand that. I’d rather be like Jonathan Safran and struggle and debate with myself for years and then be fully committed, than to just be ultra strict and then just abandon it for whatever reason. I’ve been at this for 10 months now, and after being a meat and cheese eater every single day, I think I’m doing a pretty good job.

        I follow my diet for many reasons: my health, the animals, and the environment, in that order. Actually, I don’t know that chickens and cows are properly drained of their blood, in accordance with old testament laws, so that gives me another reason to abstain. Eating blood was a big deal (no no) back the ancient of days. As well, I’m in between jobs, so vegetarianism is cheaper, honestly. I never did like buying and cooking meat, because I wasn’t very good at it, so I’d eat out too much. Now that I don’t eat meat, except for maybe sushi 1-2 times a month (sometimes veggie sushi), I don’t eat out. So, I have about 5 reasons I follow my diet, and I think that keeps me going.

        While I’m at it, I just want to throw this out there: in the Old Testament, animals were sacrifices to atone for the Israelites’ sin. I think God did this, in part, to make the Israelites feel the pain of sin. Cows were used mainly as tractors, not for their meat, in the olden days. Sheep were used for their milk and wool (Solomon mentions goat’s milk; Apostle Paul mentions sheep’s milk….cow’s milk is never mentioned in the bible, although I don’t think it’s forbidden). Goats? Don’t know what they were used for except to eat. There was no refrigeration, either. So, when an animal was slaughtered, the priests and the others had to stop and eat. I think it’s entirely possible that the Old Testament Israelites only ate meat once a week at most….just like the Blue Zones communities. If they ate their flocks and herds too often, they’d decimate their flock and herds. So, when Christians – and maybe Jews – use the Bible to justify a lot of meat eating, I think they have it wrong. Further, the animals lived good lives back then and were killed quickly and humanely with a sharp knife to the jugular so they would lose consciousness quickly. Also, pigs were forbidden, and we’ve seen the disgusting worms that pigs have. That’s on PBS and everywhere. Crustaceans were forbidden and they are the most prominent creatures on the BMAA list.

        I am grateful for I am also grateful to the I frequently visit these site and others to keep me going and on the right path for my health, the animal, and the environment.

        [Also, I think Dr. Greger should not mention the environment or animal welfare to the greatest extent possible in his videos, because then I start thinking, “Well, is he saying this because he cares about the animals or because it’s good for my health?” I don’t think the research needs an animal welfare argument. I think it can stand on its own. As well, some people don’t care about animal welfare unfortunately, and my conflict with eating fish is that most have good lives and that Jesus ate fish. Although I completely understand the sustainability issue, which is why I now use golden algae. I am also concerned about mercury. I think it’s fine to say, “We have a lot of mercury in the water because of coal plants, but not “Charlie the Tuna seems happier on the can.” ]

        I understand the vegan community, but I think there is a reason that the Blue Zones are comprised of vegetarians, not vegans. Having said, I’m getting closer to veganism, or at least ovo-vegetarianism, and think about one day having backyard chickens/hens as pets and for their eggs. Chickens or cows wouldn’t survive in the wild, but we have a responsibility to treat them well in life and in death.

        Anyway, thank you so much for the link. I was actually thinking about the weening concept, before I read your reply. It seems 2 days is the most I can go without feeling badly – so far – without animal products. I exercise a lot, and that might something to do with it. It’s cheaper and quicker for me to buy and cook an egg than to eat pounds of lentils and beans, although I do eat beans.

        Thanks again.

          1. Thank you. I know you are trying to help. I would like for Dr. Gregor to start telling us more about the demographic profile of the clinical trial participants. Are they mostly ill? Are they mostly male? Makes a big difference. I had anemia overlooked for 20 years by the military and the VAMC, even though they had the lab work. I just pulled all the lab work last year. They mostly deal with males, and males have problems with hemochromatosis, not anemia, by and large. They saw my hemoglobin at 9.8 and said nothing to me. I was breaking teeth due to obsessive ice chewing. It was 5 years later before someone caught it at 10.8. At that point, I thought I would never be able to work in a 9 to 5 job again. That’s how lousy I felt from an extremely treatable condition. I had other serious symptoms, too, but I didn’t think to go to anyone else because for 20 years the military said nothing to me.

            It was only my superior athletic ability that enabled me to endure, I suppose.

            I, and many other women athletes and military officers, lost our menses in the summer due to arduous training. My blood pressure actually bordered on too low, and my pulse was consistently 60.

            Now, my BP is 100-110/60-70, after being hypertensive on a meat diet.

            I have friends who are history buffs tell me that hundreds if not thousands of years ago, tribes that had women as hunters eventually became extinct because the women were too thin to bear children. They lost their menses, too. Hence, my comment about the Blue Zones’ vegetarianism versus veganism, and my cynicism of trying to make any person a zero fat intake person. Sure, for many sedentary Americans – especially men – with clogged arteries, a vegan diet would be fine with B12 supplementation.

            So, there is a reason that statisticians say “On average…” before making almost any statement about their findings. It’s because their findings never describe every single person.

            Last, I’ll note – on quite an ‘aside’ – that research is actually making my faith stronger not weaker. There is a reason the Bible says that people are not to eat the (subcutaneous) fat and blood of an animal. Toxins are carried and stored in the blood and fat. HIV, SARS, and Ebola have all come from Africa and China where the people eat animals never intended for human consumption (cats and monkeys). The people handling the animals and their blood are infected with viruses. This is well known.

            I think Africans should start keeping chickens and eating the eggs for the B12 versus killing cats and monkeys and all manner of creatures so they can eat meat.

            Thanks again for your suggestion. If I ever do go vegan, I will use your suggestion.

  12. It was my understanding looking at meta-data was that cholesterol is naturally produced by the body in the absences of consuming it and that you will die from internal hemorrhage if you have no cholesterol or low cholesterol. and that there was no such thing as good and bad cholesterol. and that the real problem is internal damage to the artery. due to additive put in food and table salt that damage the artery and the cholesterol build up to patch these injury’s in the bend in our veins and artery’s and this is the real problem not the cholesterol.

    1. That is a bizarre mix of basic facts and false claims used by cranks to justify eating high cholesterol foods. Unfortunately, there are some very weird claims made about cholesterol on the internet and in fad diet books.

      The body makes all the cholesterol it needs. There is no need to eat foods that contain cholesterol.
      Additionally, consuming foods high in saturated fat, smoking, drinking,lack of exercise and being overweight can also cause high blood cholesterol. High blood cholesterol is a significant risk factor heart disease.

    2. movieproducers: Your body produces all the cholesterol it needs. The problem comes when you consume cholesterol and saturated fat to the point that the cholesterol in your blood exceeds safe levels. The good news is that we know exactly which levels are safe and how to prevent the problem.

      No one is suggesting that you need zero cholesterol in your body. As I said, your body makes all the cholesterol you need. You do not need to worry about having too little of it. Even people who are born with very little cholesterol (compared to “normal” people) lead perfectly normal lives.

      When we go above the human-normal/safe levels of cholesterol in our blood, then we incur heart disease risk. That’s very clear from a bazillion and one studies. Here’s what else we know: People are generally born with cholesterol levels at or below these levels: 150 total and 70 LDL. People who maintain these normal levels through their lives do not get heart attacks from plaque buildup.

      The way to maintain healthy levels of cholesterol is to not eat meat, diary, eggs, and plant foods high in saturated fat (like coconut and palm oils). The only diet *proven* (through multiple clinical trials) to reverse heart disease is a low fat whole plant food based diet.

      All of these statements are fully backed up by massive amounts of data/valid studies. You can start to learn about the sources of this data and pick up more details by exploring more videos and articles on this site. I invite you to do so. You can use the search box at the top of the screen or go to the cholesterol “Health Topic” page.

  13. Diagnostic labs have also pushed subclassification of HDL particles, where it appears small, dense HDL particles are predictive of lower CVD risk while the medium and large HDL particles aren’t (1). Egg feeding studies have only demonstrated increase of large HDL particles, not the small ones (2, 3), so even here eggs don’t appear to hit the target.

    I STOPPED TAKING CRESTOR and/or PHENOFIBRATE several months ago and instead
    I have been taking 1200 mg of LECITHIN, 3 gel caps with each meal for the past month
    and my TOTAL Cholesterol has dropped from 240 to 187, and my HDL and LDL both
    now sit in mid range of desirable levels! I am happy with using this NATURAL
    TREATMENT and I am not the only one who has had similar good results !
    Studies be damned

  15. I read in “World’s Healthiest Foods” by George Mateljan (2nd edition) that Choline is an essential nutrient because it is a key partner in the process of Methylation. Do you agree? LMH

    1. Choline is necessary. how can we
      get the choline we require without the unwanted company of toxic TMAO? The answer appears to be in the armor. Eating a plant-based diet selects for gutbacteria that do not lead to the formation of TMAO. So even though we areeating choline in plants, our stomach’s plant-derived protection is in place,practically freeing us from concern about TMAO.

  16. Esselstyn advises that HDL is not as useful a marker as it was once thought. “It is not uncommon for HDL to fall when consuming plant based nutrition. Do not be alarmed. The capacity of HDL to do its job has been shown recently by scientific research that there is no relationship between the capacity of the HDL molecule to function optimally and its blood level. Recent research has confirmed that the HDL molecule can be injured and weakened when one is ingesting a pro inflammatory western diet and conversely it appears despite a lower than normal level to be optimized by anti inflammatory plant based-nutrition.” So eating the meat or eggs or other animal food may result in an HDL particle that is actually inflammatory.

  17. One thing about cholesterol I don’t understand is that study after study I read about where groups were divided by total cholesterol being under 200 and total cholesterol being over 200, the groups with total cholesterol over 200 all lived longer than those under 200.

    1. Phil Desautel: The studies you are talking about involve something known as reverse causation. This means that disease caused low cholesterol, not that low cholesterol caused disease and higher mortality. Pointing to studies which measure reverse caution is a well known trick used by cholesterol deniers. Tom Goff recently did an excellent post on this topic. (And I finally found his post!): The article that Tom linked to includes this quote:
      “Among nearly 6000 healthy Japanese-American men enrolled in the Honolulu Heart Study, they measured total serum cholesterol at two time points, with mortality follow-up extending for up to 16 years. Results showed the expected association of elevated cholesterol with coronary disease. In addition, falling levels of cholesterol were linked to an excess risk of hepatic disease and cancer in particular, whereas low (<4.7 mmol/L, <180 mg/dL) but stable levels over time were not associated with excess risk. Their findings provide evidence that the association previously reported between low cholesterol and noncoronary mortality probably reflected the cholesterol-lowering metabolic consequences of long-term subclinical disease rather than a hazard associated with low cholesterol per se."
      This is a very important concept to understand if you are going to be analyzing cholesterol studies.
      Hope that helps to clear up your confusion. The bottom line to understand is that: When people maintain the cholesterol levels they are born with (total 150 or below and LDL 70 or below), they do not get heart disease. (There is at least one NutritionFacts video on this topic, but I can't find it right now. Hopefully you can find it if you are interested.) But if people eat significant amounts of meat, dairy and eggs and thus allow their cholesterol levels to go above the safe levels, they incur the risk of dying from the number one cause of death in America.

        1. You rock 2tsaybow! I wonder if I’m thinking of two different videos or I’m making something up. Because I remember parts of this video about covering the levels we are born with, but I would have sworn (perhaps this is why ma said never to swear?) that there was a video that really dived into the point about measuring 1 or 2 cholesterol levels of native population(s) which showed that their cholesterol levels stayed the same throughout their whole lives and perhaps even went down some. This video mentions something about that briefly, but does not give the details that I remember. BUT your video is right on anyway and even if I can find the video that I’m thinking of, I would still want to include the video you just found for me as part of the references for my point. So, thanks!!!

          1. You’re right Thea, there was an article or a video that had spoke about our cholesterol rate at birth. I just couldn’t find it and thought this would work. Dang, you are good!!!!

      1. Thank you for the additional information. I don’t understand what’s being said in the following taken from above: “In addition, falling levels of cholesterol were linked to an excess risk of hepatic disease and cancer in particular, whereas low (<4.7 mmol/L, <180 mg/dL) but stable levels over time were not associated with excess risk." Does this mean that the people in the study who got cancer which caused lowering of their cholesterol when they were dying during the study period? I would have thought that the people selected for the low cholesterol group would have had a maintained low level cholesterol going into the study?

        1. Phil: Thank you for asking for clarification. Most people who don’t understand don’t want to and fail to ask. So, you get lots of brownie points just for asking.
          The answer to one of your questions is that : Yes, some diseases, such as cancer, cause cholesterol levels to lower. There can be more than one reason for this to happen. For example, we know that just by losing weight, cholesterol levels tend to go lower. And people with serious diseases such as cancer tend to loose a lot of weight. (There is a NutritionFacts video which covers this.) But with cancer, I believe I have read (and this is a vague memory and may not be true) that sometimes some cancers themselves directly affect cholesterol levels beyond the weight loss mechanism. But I could be wrong about that.
          You also asked about why someone who starts out with a high cholesterol level and who ends up with a low cholesterol level would be counted in the study with low cholesterol when they died. I can’t say for sure, but I think that’s just the way that studies work,, especially this study which is trying to get at the answer of what a healthy cholesterol level is and what happens over time. They are reporting on the cholesterol when the person died. But as you saw in the quote, the study also reports on the progression. Thus, we know that people who consistently maintained low cholesterol through the study period do *not* have excess risk of increased mortality as the cholesterol deniers would have you believe.
          Many other studies do not accurately follow people over time. Some studies even just start with very sick people. Just a couple of days ago, someone else on this forum shared a study with me that started with extremely sick people and then showed that the people with the lowest cholesterol had the highest mortality. Now you understand why such a study is meaningless when it comes to figuring out healthy cholesterol levels for people who are not at the ends their lives. Even the study abstract backed up what I am trying to explain to you now. Only a cholesterol denier, someone who denies the evidence/science concerning cholesterol, would say otherwise.
          Does that make more sense?

          1. As a follow up: There are several ways/methods the cholesterol deniers work. If you are interested in a detailed analysis, the videos at are a great resource. And lots of fun too. But also a fairly big investment in your time. If you want a shorter and also fun look, here are some videos on NutritionFacts which share some of the tricks used by the cholesterol deniers. (Note that the video on this page shares one such “trick” or actually, lie not even included in the list below.)
            And for a quick primer on how cholesterol levels *do* work:

          2. Thus, we know that people who consistently maintained low cholesterol through the study period do *not* have excess risk of increased mortality as the cholesterol deniers would have you believe.

    2. The above statement was in the Thea response to my browne points question, and I think this is the key information gleaned from the answer I received. I’m an egg, meat and dairy eater but not excessive daily amounts and I have cholesterol levels in line with governmental guidelines which Dr. Greger is questioning as adequate. I’m not a cholesterol denier but only wan to get to the bottom of the truth. I monitor health information from Dr. Greger, Dr. Mercola, Dr. Hyman, and the Health Science Institute and make my healthy lifestyle decisions based on a blended strategy of the health information provided by these valuable sources.

    1. Hi Jessica — Great question! And a large topic.

      Please look at these videos on egg consumption for more information that is on this site.

      Dr. Greger recently wrote an article called Egg Consumption and LDL Cholesterol Size.

      The authors mention in the full text of the article that their study sample is small and only includes middle aged men making it difficult to generalize their findings to a population level.

      My question is this — are there any plant based research subjects in this study? If a person replaces one high cholesterol food with another, you will not notice an increase in disease. Both foods cause the disease. In my view, a better study design would compare egg consumption to whole foods plant based.

      On a slight tangent, Dr. Greger likes to say something like (I’m paraphrasing) — ‘If you have normal cholesterol levels in a country where it is normal to drop of a heart attack, are you sure normal is where you want to be?’

      1. Yes, this does clear things up for me, and I am grateful for the response. Since reading Dr. Greger’s book and changing my diet I receive a great deal of info from well meaning friends that appear to be huge animal food fanatics. Thank you again for the response.

  18. My colleagues were searching for TX LLCL-73 some time ago and found a company that has an online forms library . If others require TX LLCL-73 too , here’s

  19. For the past about 6 months I have been eating a diet of at least 50% if not 65% some days of fat. This includes coconut oil (lots of saturated fat) with 2-3 eggs (oooh scary cholesterol) EVERY MORNING, avocado, lots of mixed nuts, etc., and I cut down severely on refined carbs. I got my cholesterol checked the other day and it was UNDER 100. Explain that.

    It has also been observed that too much excess sugar in the liver cannot be metabolized and therefore turns into fat cells- possibly playing a larger role in cholesterol levels than we may realize

  20. Can someone voice an opinion on this link?:
    Reevaluating Eggs’ Cholesterol Risks

    Particularly on the last two paragraphs:

    The new study’s findings do dovetail with large studies by other groups having no industrial financing. For instance, in 1999, Frank B. Hu of the Harvard School of Public Health and his colleagues reported no increased risk of coronary heart disease or stroke in men or women who ate more than one egg per day. The analysis compared diet and cardiovascular risk among nearly 38,000 participants of two long-running epidemiologic studies.

    A Michigan State University analysis, reported a year later, analyzed the diets and blood-cholesterol data for more than 27,000 people—a representative cross-section of the U.S. population. It found that cholesterol was lower in people who ate more than four eggs per week than among people who eschewed eggs. However, the researchers cautioned, “this study should not be used as a basis for recommending higher egg consumption for regulation of serum cholesterol.”

  21. Are the primary sources linked somewhere? Some of us do like to check them out and look at how the actual studies and experiments were designed.

  22. Dr. Gregor can you post the HDL series. My friend taking amla, has a HDL of 55, Total cholesterol of 93 and normal LDL levels. What is a normal HDL level and how do we know it is “good”? Could you email me? Thanks

    1. Good HDL for men is 40+ and women is 50+. Anything above 60 adds as a positive risk factor (as opposed to negative health risk factors) so it will increase your health even if your other numbers (total cholesterol, LDL, triglycerides) aren’t where they should be.

        1. A class in college while getting my dietetics degree. If you look on any major website (American Heart Assn, Mayo Clinic, etc) or ask your doctor they will have the same information.

  23. Thank you. I am in trouble now. I stayed away from eggs for a while, then news start showing up that the cholesterol does not shows in the blood, whatever that means. Now I am addicted to pouched eggs.

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