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How Too Much Cholesterol Can Contribute to Alzheimer’s Disease

Millions suffer from Alzheimer’s disease, and the available and foreseeable treatments are disappointing at best. Given the absence of disease-modifying treatments, there has been growing interest in effective strategies for the prevention of the disease in the first place. Even if we were able to just delay the onset by as little as 1 year, we could potentially prevent more than 9 million cases over the next 40 years. Once cognitive functions are lost in Alzheimer’s disease patients, they may be lost forever. Consequently, prevention, rather than a cure for Alzheimer’s disease appears to be a more realistic strategy to offset the catastrophic impact of this dementia.

As I discuss in my video Cholesterol & Alzheimer’s Disease “[c]onsiderable evidence now indicates that Alzheimer’s disease (AD) is primarily a vascular disorder,” based on a number of lines of evidence that point toward impaired circulation of blood to the brain. Vascular risk factors, such as high cholesterol, can be thought of as a ticking time bomb to Alzheimer’s disease. What’s bad for the heart may be bad for the mind.

Traditionally, there have been two competing theories for the cause of Alzheimer’s: the amyloid cascade model, which implicates the buildup of amyloid plaques within the brain, and the vascular model, which argues that it is the lack of adequate blood flow to the brain due to atherosclerosis. We now realize they are not mutually exclusive and that arterial disease can set up a vicious cycle in which atherosclerotic plaques in the arteries may contribute to Alzheimer’s plaques in the brain.

Although cholesterol has been portrayed as “tantamount to poison,” it is an essential structural component of all of our cells, and that’s why our body makes it. But, if there’s too much, it can become a major factor contributing to various diseases, including coronary heart disease, stroke, and neurodegenerative diseases like Alzheimer’s. Too much cholesterol in our blood is universally recognized to be a risk factor for the development Alzheimer’s disease, and cholesterol may play an active role in the progression of Alzheimer’s as well.

Autopsy studies have found that Alzheimer’s brains have significantly more cholesterol than normal brains, and it specifically appears to accumulate in the Alzheimer brain plaques. We used to think the pool of cholesterol in the brain was separate from the pool we had in our blood, but there is now growing evidence to the contrary. For example, low-density (LDL) cholesterol, the so-called bad cholesterol, may be able to cross the blood–brain barrier into the brain. So, a high-fat diet may not only increase cholesterol levels in the blood, but also the influx of cholesterol into the central nervous system.

In addition, having high cholesterol may even damage the blood-brain barrier itself, and allow for even more cholesterol to flow into the brain, providing the missing link between high cholesterol and Alzheimer’s. “Individuals with higher cholesterol levels at midlife have a higher risk of developing [Alzheimer’s disease].” Cholesterol over 250 could potentially triple the odds of Alzheimer’s.

We now have high-tech PET scanning of the brain that can directly correlate the amount of bad LDL cholesterol in our blood with the amount of amyloid buildup in our brains. You can even do it right in a petri dish. Adding cholesterol makes brain cells churn out more of the amyloid that makes up Alzheimer plaques, whereas removing cholesterol can decrease the levels of amyloid released from cells.

Amyloid degradation is also less efficient in a high cholesterol environment. Cholesterol can then help seed the clumping of the amyloid. Using an electron microscope, researchers can see the clustering of amyloid fibers on and around little microcrystals of cholesterol.

Once in the brain, cholesterol can also undergo auto-oxidation, causing the formation of highly toxic free radicals. So, having high cholesterol levels in the blood is thought to increase the risk of dementia, not only by inducing atherosclerosis and impairing blood flow, but also by potentially directly affecting neurodegeneration within the brain. In conclusion, excess dietary cholesterol could, in principle, contribute to the development of Alzheimer’s disease, and the evidence linking high cholesterol to Alzheimer’s appears to be steadily mounting.

Some of this work was paid for by drug companies hoping to capitalize on Alzheimer’s with cholesterol-lowering statin drugs. This is ironic, since statins themselves can cause cognitive impairment. Though rare, statin side effects may “include short- and long-term memory loss, behavioral changes, impaired concentration and attention, paranoia, and anxiety,” as early as five days after starting the drugs, but sometimes even months later, though folks should recover within a month of stopping the drugs.

A better strategy may be to change the lifestyle factors that lead to the high cholesterol in the first place—in particular, reducing saturated fat in the diet. It’s not enough for us to just tell our individual patients, though. “Systematic implementation of educational campaigns promoting radical changes in cultural and societal values” may be necessary to adopt Alzheimer’s-defeating strategies by patients in a broader sense, and “such actions may provide potentially huge dividends by preventing both cardiovascular disease and dementia”—two of our leading causes of death.


For more on how the same diet that can protect the heart may protect the brain:

 For information on concerns about the cognitive effects of cholesterol-lowering statin drugs, see my Statin Muscle Toxicity video. You can find out about the associated breast cancer risks of statins in Statin Cholesterol Drugs and Invasive Breast Cancer and statins’ surprisingly low level of effectiveness in The Actual Benefit of Diet vs. Drugs.

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:

Discuss

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.


222 responses to “How Too Much Cholesterol Can Contribute to Alzheimer’s Disease

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    1. Hi Linda! Here is a study I think you will find informative. This is another relevant and useful study. It has long been disputed whether aluminum is associated with Alzheimer’s, and while there is some evidence that proves relation, many fail to recognize it.

  1. LOL. The good doctor circles back to the 70 year old cholesterol again.

    http://www.faim.org/dr-bruce-fife

    http://www.faim.org/do-low-fat-diets-cause-alzheimers

    For example, researchers at Johns Hopkins University monitored a group of 392 subjects for 18 years. All of the subjects were 70 years of age at the beginning of the study. Every few years the investigators measured their cholesterol levels and conducted cognitive tests. The study revealed that those people with the highest blood cholesterol levels scored the highest on cognitive tests.6

    These results were supported by another study from Mount Sinai School of Medicine, in New York. In this study 185 subjects over the age of 84 and without dementia were assessed. Higher total cholesterol and higher LDL cholesterol was associated with higher memory scores on tests. The researchers’ conclusion: “high cholesterol is associated with better memory function.”7

    Researchers at Seoul National University in South Korea came to similar a conclusion. For three years they followed 106 elderly subjects with possible dementia. As with the other studies, those with the highest cholesterol readings performed the best on neuropsychologic tests. Those who eventually digressed into Alzheimer’s disease had lower cholesterol readings.8

      1. Let us not forget his books on creative clowning, ventriloquism, balloon sculpturing and how to earn a living as a children’s entertainer.

        He called himself Dr Dropo when he wrote books about clowning etc and now he calls himself Dr Fife when selling coconut oil and books hyping its supposed benefits. He seems to be a little coy about where his doctorate comes from. Not like “Dr” Johnny Bowden, the cholesterol apologist, who we know got his “doctorate” from an online diploma mill that has since been closed down. Bowden has written a lot of books too. However, neither of them is published in credible professional journals to my knowledge.
        http://articles.latimes.com/2010/dec/20/health/la-he-fitness-holistic-nutrition-20101220

        Believing somebody like this with very questionable credibility seems like a very brave decision. when a panel of expert scientists who reviewed the roles of fats in cardiovascular disease concluded “because coconut oil increases LDL cholesterol, a causeof CVD, and has no known offsetting favorable effects, we advise against the use of coconut oil.”
        http://circ.ahajournals.org/content/early/2017/06/15/CIR.0000000000000510

          1. It is called due diligence. If people buy a new car or washing machine, they usually do some research and checking first. We should all do this before “buying” the iclaims/infomercials put out by people selling stuff on the internet.

            You, on the other hand, are very good at ignoring the facts even when they stare you in the face.

            Are you a politician by any chance? Or perhaps a journalist?

            1. Jerry has introduced us to a new class of alternative facts – “Jerry-picked facts” – irrelevant, misleading, unreliable or actually contradicting his claims.

              1. Then there are Jerry-built facts …… the ones he constructs himself like how they all ate plenty of saturated fats and cholesterol in the traditional Okinawan and other Asian diets. Or his “fact” that all the evidence from all around the wiorld over the last 100 years showing that high saturated fat diets and high blood cholesterol levels are risk factors for chronic disease, is “bogus” and “faked”.

                “”built hastily of shoddy materials,” 1856, in a Liverpool context, from jerry “bad, defective,” probably a pejorative use of the male nickname Jerry (a popular form of Jeremy; compare Jerry-sneak “sneaking fellow, a hen-pecked husband” [OED], name of a character in Foote’s “The Mayor of Garret,” 1764). Or from or influenced by nautical slang jury (adj.) “temporary,” which came to be used of all sorts of makeshift and inferior objects.”
                https://www.etymonline.com/word/jerry-built

    1. Jerry, I watched my father, paleo before paleo had a name, go down with heart disease and Alzheimer’s rapidly. His cholesterol was very high for most of his life and he carried at least one APOe4 gene.

      Something I noted with both my father when he had Alzheimer’s and my grandmother when she had pancreatic cancer: both had lifelong high cholesterol that dropped very low during their final illnesses. Be careful about when the snapshot is taken and what it might mean.

      Personally, I opted for the Eat to Live diet long ago and keep my cholesterol low. I’m having no trouble learning a new language or doing complicated math at an age when my father was already slowing mentally.

      We can compare note in our 90’s.

      1. Pure paleo is wrong.

        If you look at paleo today, it is different. It is a diet that stresses to eat real meat and real fat, and a lot of plant foods also.

        Look at the Paleo Hack website if you are interested in what real Paleo is about.

    2. Every cell in animals’ bodies produce cholesterol; the brain and nervous system depend on it to build cell membranes (so do all other cells.) Healthy oils are necessary for healthy cell function (animal fat is not a healthy oil.)

        1. LG King, if you mean processed oils, you are right.
          But, if you mean no fats are essential to body function, that’s not true.
          The body can make the amount of saturated fat it needs. But it cannot make two essential fats, linoleic and alpha-linolenic. These need to come from food, vegetables.
          They are both very delicate fats and get easily damaged.
          When heated, as in cooking with vegetable oils, they are very inflammatory.
          First time I tested them in the lab, was the last time I ate a french fry.

    3. Jerry Lewis, are you a doctor or what? You seem to give a lot of conflicting advice. I wish you wouldn’t. You don’t seem to follow the information from Dr Gregors nutrition facts. If you don’t agree with him could you please hop over to a website in which you can agree. You are just causing me tons of trouble.
      Thanks

      1. Sue, though Jerry is a pain, he mirrors the kinds of comments I get when I’m out in public so it is useful for me to read and learn the rebuttals to his posts – it makes me a stronger debater when talking vegan nutrition with the public. Though he may not know it, Jerry actually makes stronger cases for Dr. Greger’s facts.

    4. John Hopkins University has been consistently shown in the past to be a regurgitative mouthpiece for industry. It accepts corporate money for funding. Ask them to do a study, fund it and then allow them to make proposals that reflect your company’s POV.

    5. LOL indeed. Jerry is once again posting the claims and arguments of the cholesterol sceptics (although “cranks” might be a more accurate description).

      This is the typical misrepresentation of the science used by these self-styled cholesterol secptics to justify their claims.

      Yes, there is an association between lower cholesterol and risk of Alzheimer’s in older people. The question then is is the relationship causal and, if so, does low cholesterol cause Alzheimer’s or does Alzheimer’s cause low cholesterol?

      The cranks claim that such associations ‘prove’ low cholesterol causes, or increases risk for , Alzheimer’s. When it suits them, though, the cranks always say that “correlation does not equal causation”. Yet here, they stridently argue that correlation proves causation (but conveveniently ignore the fact that it could equally well be argued, using their own ‘logic’, that Alzheimer’s causes lowered cholesterol).

      In fact, it is known that a disordered cholesterol mechanism is a feature of Alzheimer’s Disease. What is more, stable low cholesterol thoughout life is associated with lower Alzheimer’s risk whereas declining cholesterol for no apparent reason (weight loss, exercise etc) can be a subclinical marker for chronic disease including Alzheimer’s.

      “Results Cholesterol levels in men with dementia and, in particular, those with Alzheimer disease had declined at least 15 years before the diagnosis and remained lower than cholesterol levels in men without dementia throughout that period. The difference in slopes was robust to adjustment for potential confounding factors, including vascular risk factors, weight change, alcohol intake, and use of lipid-lowering agents.

      Conclusion A decline in serum total cholesterol levels may be associated with early stages in the development of dementia.” and

      “It is possible that the decline in cholesterol levels is a marker for early processes that reflect neurodegenerative changes and also lead to a decline in general health status.

      Further research is required to clarify the processes underlying the decline in cholesterol levels prior to dementia because they may represent occurrences early in the course of the disease. Decline in cholesterol level may also be a marker for factors underlying both physical and cognitive decline in old age.”

      https://jamanetwork.com/journals/jamaneurology/fullarticle/793179

      If I recall correctly from some of your earlier comentts, Jerry, you may be willing to post this sort of stuff which argues that high cholesterol is protective but you aren;t stupid enough to allow your own cholesterol to rise to high levels. I could be mistaken of course. Those earlier osts of yours were a little ambiguous. Care to clarify the situation for us?

  2. I had always thought that one of the precursors to Alzheimer’s was inflammation. Inflammation impacts the ways that the body then processes cholesterol. No inflammation, no buildup of cholesterol. Is this a connection that warrants further discussion? Thank you!

    1. Wonderful comment, Nan.

      When animal fat and processed carbohydrates (essentially sugar) are consumed together, they combine in the stomach to form propionic acid. This is a waxy substance which also forms the membranes of gram-negative bacteria. When absorbed into the bloodstream, the immune system releases inflammation-causing cytokines to stop the “infection.”

      Inflammation is the cause of all chronic non-infectious disease, including Alzheimer’s Disease.

      1. You are absolutely correct. The problem is that people eat a combination of transfat along with sugar, sometimes from good carb but they eat too much, and the combo causes oxidation and inflammation.

        The same thing happens to vegans who eat too much nut and seed and that is Omega 6 that causes inflammation.

        1. Gee Jerry, did you do a creative writing course at some point or do you just fnaturally antasise a lot? We know you don’t look at actual evidence even though you eagerly swallow the claims of people on the internet selling pills, potions and fad diet plans and copy-paste their claims here..

      2. I read Dr. Brederson’s book, ‘The End of Alzheimer’s’. He is a neurologist who has been researching Alzheimer’s for many years. He said it will never be prevented or cured with a drug, as there are at least 36 different elements causing it. But he has actually reversed the symptoms in several types of Alzheimer’s in real patients with his protocol.
        So it’s not true that there is no new, news, on this disease.
        He emphasizes that total cholesterol level should not be Less Than 150.
        He also believes in carefully regulating blood sugar levels.
        if you are concerned about this disease you owe it to yourself to get this book.

        1. I just finished the book “The End of Alzheimer’s” as well. I’d highly recommend it to NF readers as it emphasizes prevention and demonstrates reversal for early diagnosed cognitive impairment. The treatments are individualized based on the type of Alzheimer’s. Dr. Bredesen has a Facebook page with interviews posted.

        2. Re: He emphasizes that total cholesterol level should not be Less Than 150

          This is the first step toward not only prevent Alzheimer’s but also heart disease and cancer.

          Thanks for the reference to the book.

          You will hear in the audiobook about ATP, the energy molecule. The main fuels for ATP synthesis are glucose and fatty acids and you want the ATP to be fueled by fat and not glucose (sugar). The goal is to replace sugar with fat for fuel for ATP. This is the reason that why I mentioned healthy fat often, to people annoyance, but the message has to be sent.

          Nobody ever said to gorge on fat but we need some and albeit not a lot. MCT oil from coconut is the best because it is a medium chain fat. Forget about the stigma of saturated fat because this is a medium chain fat and not a normal fat.

          https://vimeo.com/206690575

          https://play.google.com/store/audiobooks/details?id=AQAAAAB-oFmgNM

          1. Jerry,

            The link you provided leads me to an Infomercial, not a scientific reference. After checking out the Bredesen Protocol, it sounds exactly the same as what Dr Greger has been telling us for years. Eat a Whole Plant Foods diet with no added sugar, oil, or salt. Nature’s plant foods give you all the nutrients you need in exactly the right proportions. Dr Greger explains the few things to add, such as vitamin B12, in many places on this website.

            The big difference is Dr Greger doesn’t charge a fee and doesn’t sell supplements. I know quite a few people who tell me that after they changed to a whole plant food diet,and eliminated meat, eggs, and dairy products, their cognitive ability improved tremendously.

            1. First of all, this is a snip of the audiobook. Of course they are not going to list the whole protocol for free. But if you are willing to look for a little bit on the Internet then you will find more info about his protocol.

              Secondly, there are more inside his protocol than just the simple mind approach of Dr G that most people here think it’s everything. Sure it is better than the SAD diet but it is not really much, in particular there is also damaging info such as keep your cholesterol at less than 100. Dr Bredesen is not the first one to point out but numerous studies have shown that a super low cholesterol causes Alzheimer’s and even heart disease and even cancer. Yes it is counter intuitive but when your ATP is fueled on sugar instead of fat then you have a problem. There are also damaging diet in Dr G daily dozen such as you can get loaded on Omega 6 freely, grain freely (lectin) and carb freely (sugar). If you read Dr Bredesen protocol carefully, you will see that he advises against it.

              And thirdly, the opinion that anyone making money is bad, and anyone not making money is good, and supplements are all bad, will lead to the wrong decision. Wait until you have Alzheimer’s and then see if you count on just WFPB and low cholesterol to cure it.

              And for cheapo people like you, here are more info about his protocol if you care to read without bias:

              https://mybiohack.com/blog/dale-bredesen-protocol-recode-alzheimers-mend

              https://www.hoffmancentre.com/2017/11/reversing-alzheimers/

              1. Jerry, these sites are done by people trying to make money off Dr. Bredesen’s research, ugh!
                This Jacob Gordon emphasizes ‘no lectins’. What? There is nothing about avoiding lectins in the book.
                The Hoffman site is a bit better, but still has things added and subtracted.
                Read the book!

                1. Thank you, Marilyn Kay. Jerry doesn’t care about facts. Many commenters have shown him really solid science based on double-blind, placebo-controlled studies and he just ignores them. He seems to be here to discredit Dr Greger day after day after day, not to learn anything. He knows everything already :-) And he seldom reads the links he sends. And he misquotes Dr Greger often. For example, I don’t recall ever hearing Dr Greger recommend that everyone should get their cholesterol down to 100.

                  1. Trashing and stereotyping and profiling. You are the one who does not want to learn anything and is just a me too fanatic follower with no opinion.

                  2. Re: I don’t recall ever hearing Dr Greger recommend that everyone should get their cholesterol down to 100.

                    He even said below 80. Geez you don’t even read what your doctor said.

                    1. Re: Lisa: You are confused–thinking of HDL and LDL instead of total cholesterol.

                      Talking about confusion, or should I say ignorance.

                      You don’t know this?

                      TC = HDL + LDL + (Triglycerides / 5)

                      The higher your HDL is, the higher your TC is.

                      Although you have this TC calculation, you don’t just look at TC but HDL should be above 60 and triglycerides close to 100 for optimal health.

                      LDL is not as important because it depends on the VLDL. If VLDL but LDL is slightly high then you are still OK.

                    2. Jerry, You said Dr. Greger “…even said below 80.”

                      Where did Dr. Greger say that?

                      On page 22 of “How Not to Die,” Dr. Greger wrote, “The population target should therefore be a total cholesterol level under 150 mg/dL.”

                2. I will read the book. I am looking for a coupon from Google to buy the audiobook because Google Play just adds audiobooks. I like to listen rather than reading,

        3. Dr Bredersen is a respected researcher and academic.

          However he makes some extraordinary claims based on fairly weak evidence. I think the study used to demonstrate the effectiveness of his approach looked at just 10 people, for example. They say that extraordinary claims require extraordinary evidence. We do not see extraordinary evidence here.

          His approach was trademarked and promoted commercially as the MEND protocol. Here is a cautious review of it
          https://sciencebasedmedicine.org/mend-protocol-for-alzheimers-disease/

          However, I understand that Dr Bredersen has since separated from that company and set up his own company. He now markets the approach as the Bredersen Protocol. His book no doubt helps sales.

          The statement that cholesterol should not be allowed to get under 150 is also a big red flag. Declining cholesterol is a symptom of Alzheimer’s – as it is of certain cancers for that matter. However advising that cholesterol should never be allowed to get under 150 to prevent Alzheimer’s is like saying that you should never lose weight if you want to prevent cancer. Both declining cholesterol and weight loss are recognised symptoms of Alzheimer’s and certain cancers. Yet we know that obesity is a risk factor for cancer and high cholesterol is a risk factor for Alzheimer’s. Both declining cholesterol and weight loss are symptoms of chronic disease not causes.

          That said, these sorts of statements appeal to people who don’t want to make the drastic lifestyle changes necessary to achieve healthy weight loss and to lower cholesterol. Consequently, they sell a lot of books.

          The alternative health crowd very sensibly say “follow the money” when talking about conventional medical and health care. Strangely (to my mind at least), they always refuse to discuss possible financial conflicts of interest when it come to the extraordinary claims of cures made by people selling particular therapies or therapeutic approaches.

          Caveat emptor.

          1. As a counterbalance to Breseden, I recommend people check out *The Alzheimer’s Solution* by the Drs. Sherzai from Loma Linda University. Not surprisingly given their location, they recommend a whole food plant-based diet including nuts/seeds, avocado and, yes, a small amount of EVOO for “brain nourishing fats”, as the put it. They are very much opposed to a ketogenic diet and even think it could lead to Alzheimer’s disease.

      3. Oral herpes is associated with alzheimers. A high percentage of people harbor it.

        Some cancers are associated with mild chronic infections. As people get older their immune systems start to fail to some extent.

        Inflammation levels are related to immune system function….poor function tied to higher inflammation?

    2. Hi I’m a moderator with NutritionFacts. Yes Alzheimer’s definitely warrants more research. When the inflammation component was initially looked at, there was hope that anti-inflammatory drugs could prevent or slow Alzheimer’s. Early clinical trials with anti-inflammatories failed to demonstrate this.
      Geographically, Alzheimer’s is much more prevalent where diets are higher in cholesterol. Alzheimer’s clusters int the same populations as diseases such as high heart disease, stroke, and type 2 diabetes. Regardless, reducing your cholesterol intake reduces your risk of a vast number of issues- heart attacks, stroke, cancer, and quite likely Alzheimer’s.
      Alzheimer’s has also been linked to free radicals. Animal based foods do not have antioxidants like fruits and vegetables and tend to activate free radical production. A plant based diet high in antioxidants can reduce this. This was looked at as part of the renowned China Study by T. Colin Campbell. Plant based, antioxidant rich foods are also very anti-inflammatory.

      NurseKelly
      Moderator

      1. I will be 84 soon and stopped reading these comments. I would love to see a bottom line on this subject agreed on by all the best. I do get annoyed reading what is here say.

  3. I am 52 and have been a wholefood-eating vegetarian all my life and switched to a low fat ( no added) whole food plant-based diet 8 months ago and yet my blood lipid profile is awful. There is no hereditary aspect to this as far as I know, both my parents enjoyed low cholesterol levels. My T3 is low, but my doctor says because my overall thyroid profile is just within normal that I have to accept that I’m okay as all others determinants are normal. The reason I mention this as my blood lipid issue contradicts what you are saying and I’m feeling very demoralized as a result.

    1. Rebecca, I feel you. I’ve been on a whole food plant based diet for over a year. No added salt, sugar or oil. Not a molecule of cholesterol has passed my lips. And yet my recent blood work came back with 249 total cholesterol. That sounds like someone who eats bacon and eggs for breakfast everyday. I hear you on the demoralized part. I’m reluctant to share my lifestyle with others cause I’m a rotten example. Guess diet is not always the reason or the answer.

      1. Thank you for your comment. I would love to know what causes high cholesterol in someone who has an impeccable diet and ultra-low inflammatory markers, who is fit and the perfect weight, yet has a cholesterol reading of 239 and a terrible ratio of LDL and HDL.

        1. For a part of the population, abnormal labs are genetic…somewhere along the line. Sorry, but you have to get treated pharmaceutically.

          1. Boie, most people just need to change their lifestyle. The change needed is not exactly the same for everyone, so you need to find what works for you.
            Are there people whose genetics are destiny, yes, but very, very few.

          1. This is almost certainly un true.

            The claim is based on a US study of the cholesterol level of heart disease patients in hospital

            However, they were in hospital presumably because they had had a heart attack or for surgery. Both heart attacks and surgery lower cholesterol. If you measure people’s cholesterol after they have had heart attacks or surgery, their cholesterol levels will be significantly lower than their levels befire the heart attack and surgery.

        2. Regarding your high cholesterol readings while on a low fat plant-based whole foods diet:

          It’s my understanding that the body carefully conserves cholesterol, removing it from the digestive tract, and returning it to the blood stream for reuse. Presumably because it is not a component of a natural human diet, and the body would rather reuse, than have to make more. So perhaps your body is just very good at conserving the cholesterol, and the cholesterol you ingested years ago is still being recycled. Just a thought.

    2. Hi Rebecca your doctor told you your overall thyroid is low. Low meaning within NHS guidelines. The fact is your T3 is low which is important. Your thyroid is low and also importantly it is likely your adrenals are stressed.

      1. Free T3 is a little lower than NHS normal range, although TSH and T4 were only borderline okay. Horrid lipid profiles too with 6.2 total cholesterol, but they always have been and have been virtually vegan for 48 years with no knowledge of any genetic issues in my family regarding thyroid or bad lipids. Really, really low inflammatory markers, essentially below the scale, low blood pressure and no real symptoms of low thyroid either. My life is pretty stress-free and I manage stress well when it happens. My NHS doctor says I shouldn’t be concerned, but I am.

        [https://my-email-signature.link/signature.gif?u=29000&e=16687726&v=6122ac1069e796c3b7759e6ae01d6f54530d5c1508000b952b4bfd8df40ad762]

        1. “Thyroid dysfunction has a great impact on lipids as well as a number of other cardiovascular risk factors. Hypothyroidism is relatively common and is associated with an unfavorable effect on lipids. Substitution therapy is beneficial for patients with overt hypothyroidism, improving lipid profile. However, whether subclinical hypothyroidism should be treated or not is a matter of debate. On the other hand, hyperthyroidism can be associated with acquired hypocholesterolemia or unexplained improvement of lipid profile. Overall, thyroid dysfunction should be taken into account when evaluating and treating dyslipidemic patients.”
          https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3109527/

    3. Do you eat any dairy products at all? Dairy is the largest source of saturated fat in the American diet…additionally, studies are finding the concentrated protein (found in low fat dairy) as much of a culprit in high cholesterol…

      1. No, I eat no dairy and no added refined oils other than what’s found in nuts and seeds which I eat in moderation. Also, my diet is 90% fruit and vegetable-based with no added sugar.

        [https://my-email-signature.link/signature.gif?u=29000&e=16689743&v=a1a222239d18530399261ead1e96226aed2ef4b65656207b2924000ea6c06913]

    4. Just within normal thyroid numbers may not be where Your body performs best.
      Also, is your doctor using the old formula? The normal guidelines have been changed. Did he do a complete panel, T3, T4, reverse also?
      What are your triglyceride numbers in relation to Hdl?
      That tells more what is going on than just total and Ldl.
      Doctors aren’t keeping up with the newest research.
      And, especially for women, drugs are not the answer unless they have documented heart disease.

    5. I would talk to another doctor about your thyroid. The current “normal” levels are not considered normal by most endocrinologist. I have been treated for hypothyroidism for several years by a very mainstream doctor. He does not keep my levels normal. He keeps them optimal. TSH well under 2. An internist, GP, or gynecologists might not know this.

    6. Sorry to hear that. It sounds really frustrating. Do you know what your lipid profile was before you changed your diet 8 months ago? Has is improved? Dr. Greger says heart disease starts in childhood. By 10, most of us eating the standard American diet have fatty streaks in our arteries. Even eating vegetarian most of your life, you may have been eating foods that raise cholesterol before you went whole food plant based. Vegetarian diets can be full of added oils, sugars, and processed foods. It may take some more time to improve.
      I would do a careful inventory of your diet and make sure no added oil or sugar or processed foods are sneaking in. It’s so easy to do in this society. Do you follow Dr. Greger’s Daily Dozen? I’d make sure you are including everything on it in your eating plan.
      https://nutritionfacts.org/video/dr-gregers-daily-dozen-checklist/
      If you have eliminated all the things that raise cholesterol, then you want to focus on adding things that lower cholesterol- whole grains, green leafy vegetables, legumes, amla powder, brazil nuts, kale. Here are a few videos you might find helpful:
      https://nutritionfacts.org/video/the-best-food-for-high-cholesterol/
      https://nutritionfacts.org/video/four-nuts-once-a-month/

      Another thing I’ve heard Dr. Greger recommend if cholesterol is not coming down is the portfolio diet-
      https://www.health.harvard.edu/diet-and-weight-loss/what-foods-are-included-in-the-portfolio-diet

      If you haven’t ever looked at Dr. Esselstyn’s work, you might find it helpful. His work was with high risk heart disease patients who had high cholesterols among other issues as well. His patients were very sick so his program was strict and tailored to them.
      http://www.dresselstyn.com/site/plant-based-nutrition/

      Sorry you are doing everything right and not getting the results you want. You are still doing a good thing for your health by eating a healthy plant based diet even if the numbers aren’t what your want.

      NurseKelly
      Moderator

      1. Thank you for taking the time to respond so fully. I have indeed enjoyed a diet for 48 years that is entirely wholefood plant-based with minimally processed foods and no added sugar. I stopped using olive oil in June ( all oils) and eating the occasional piece of cheese and milk in my tea, but my cholesterol has increased from 6.1 to 6.2 over the last 12 months. My free T3 is below what it should be, so am taking kelp with iodine and upping my physical exercise, which was already pretty good in a hope that it might normalise my thyroid. My blood pressure is low for my age 100/60 and my inflammatory markers are absurdly low so I hope despite years of bad lipids that I’m okay? I can’t do much more really?

        [https://my-email-signature.link/signature.gif?u=29000&e=16861643&v=5195232b0421053f57d1206a12fa54c214f67a4ea323a6a96c9631db7f182a24]

    7. Some doctors believe that what is considered a normal thyroid profile is not a true picture of healthy thyroid functioning. Check around on the subject?

  4. this is off topic, but I have no idea where to leave a general inquiry or comment, so I’m hoping someone on Dr G’s team will read and respond.
    It would be VERY helpful if the list of the Dr’s speaking engagements included the city/state where it will be taking place.

  5. Interesting article that gives me more cause to worry. I am one of those vegans on a WFPB diet that has LDL that has increased since I changed my diet. My other factors such as CRP are very low though. Just wondering if I’m at risk or not?

    1. Barbara, if your CRP is low then there is nothing to worry about. Cholesterol measurement is a lousy indicator anyway. Have low cholesterol and yet you can have heart disease. Have high cholesterol and there is no medical condition.

    2. Ref: Eat fat, Get thin Author: Mark Hyman, MD. It has all the scientific references of the folly of “Low Fat” diet promoted by the “government”.

      1. Hyman is a successful internet marketer. He knows what sell books. Solid science doesn’t. Sensational claims about eating fat do. if people want to know about the effects of fats on cardiovascular risk, they should consider the scientific evidence as summarised and assessed by real experts instead of the bold claims of people selling fad diets on the internet.

        http://circ.ahajournals.org/content/136/3/e1

  6. I wish Dr Greger would address rising cholesterol levels in postmenopausal women that coincide with declining estrogen levels. This is a real problem for those with, or at risk of, heart disease, and who may be intolerant to statins or other similar meds. In my own experience changing from a very “healthy” omnivorous diet to wfpb diet knocked off a whopping 40% from my cholesterol (still not below 140 TC though). After that first 30 days it has made a steady slow climb back up higher in spite of rigorous adherence. Is this normal ? Does the body seek to maintain cholesterol levels at some level it needs ? Already apply the portfolio concept . (if women average a longer lifespan, is this necessarily something to worry about ?)

    1. Susan, as I mentioned above, Dr. Bredersen, the only researcher who has reversed Alzheimer’s says that total cholesterol UNDER 150 is a risk factor for Alzheimer’s.
      Also, type of Ldl, and ratio of triglycerides and Hdl are more important than total numbers.

      1. Marilyn

        I don’t agree that Bredersen’s claims about cholesterol are correct however many books he may sell promoting his Bredersen Protocol. The evidence for his claims of a cure is pretty weak also.

        On the contrary, the evidence suggests that low cholesterol is a symptom of Alzheimer’s not a cause. If he has got that wrobg, what else has he got wrong?

        As for blood cholesterol, there is solid evidence that high cholesterol is causal when it comes to cardiovascular disease
        https://academic.oup.com/eurheartj/article/38/32/2459/3745109

        and Dr Greger in this video clearly sets out the substantial evidence that high blodd cholesterol is a risk factor for Alzheimer’s.

        1. Tom, I agree that cholesterol is important in heart disease. Studies show that. But I don’t think the exact numbers have been established.
          You read studies with large numbers of people, so do I.

          But I deal with real suffering people, one on one. And I have found that focusing only on cholesterol is a mistake.
          Dysfunction in other areas often plays a part. Why, for instance, do you think diabetics have such a high level of heart disease?
          Yet most doctors ignore A1c unless it’s above 6. The graph for heart attacks really goes up long before that,
          They also ignore inflammation, ferritin levels, homocysteine, uric acid levels, etc. they have become fixated on cholesterol levels, and oh, there’s a drug for that.
          Bottom line, I am impressed that Dr. Bredersen is a doctor who recognizes that disease has many different causes.
          And I think he has demonstrated the mechanism, and by now has dealt with 100’s of patients.
          Every researcher has to start with a few, and put up with all the naysayers.

          1. Hi Marilyn

            I agree that Alzheimer’s and most other diseases have multifactorial causes. But the fact that Dr Bredersen confuses a synptom of Alzheimer’s (lowered cholesterol) with a cause is concerning to me …. especially when he makes such big claims for his approach based on quite limited evidence.

            Possibly I am overcautious, but I would like to see these results replicated in larger studies,and in studies by other researchers, before accepting that the claims are true

            1. Tom, I too, would like to see more studies like Bredersen’s. He says he tried to do that, but because he has a complete protocol, not just a tweak, as in one drug, no one was interested.
              He may be wrong on some fine points, but right now his work is the only hope I can give people struggling with cognitive problems.
              The ‘only game in town’ as it were.

          2. Marilyn, there is no point to talk to a guy who believe so much in the fake cholesterol theory that he fry his own kidney and liver with statin.

            Regardless of zillions of fake “researches” in the last 70 years, just use your logic and understand what the role of cholesterol is. The following video explains well how cholesterol works. It does not say that it is a free ticket to have sky high cholesterol but you need some for your well being, but to be obsessed to keep cholesterol real low is what was causing havoc to our country and the world.

            TG will dig up dirt and trash at any expert who says that a too low cholesterol is bad for you. Like a politician turning into an used car salesman, he will use every tactics to discredit anyone he disagrees with and he can twist any theory.

            https://www.youtube.com/watch?v=PkKH8lTxvzA

            1. Jerry Lewis-
              The guy lecturing in your youtube url is a student, not an expert, let alone a world-class one. Who cares what he says?

              You are the one throwing dirt around and trashing whoever pushes back on your nonsense.

              1. Re: The guy lecturing in your youtube url is a student, not an expert

                This guy is dense and talks like TG. Are you guys siblings by any chance? So rather than critique the content of what this “student” said, it is stereotyping that a student must know nothing. Sure a PhD or MD know more. For one thing, I know that this “student” knows more than you and professor TG. An a lot of drop out students are founders and CEO of companies that build ‘puter and Internet browser so that you can post your craps.

                So here are some videos by real doctor and I also include videos of a chiropractor so that you can have the chance to trash.

                And I just discovered something from the Doctors. You guys don’t have a sex life because fat is needed for the sex hormone. And TG is impotent because he used statin.

                https://www.youtube.com/watch?v=tW8i7QRLu0s

                https://www.youtube.com/watch?v=OBXOB3J3b6w

                https://www.youtube.com/watch?v=GC9V1TWYLo4&t=198s

                1. You stated It does not say that it is a free ticket to have sky high cholesterol but you need some for your well being, but to be obsessed to keep cholesterol real low is what was causing havoc to our country and the world.”

                  This shows, it seems to me, that you were trying to use the lecture as support for some of your unsubstantiated health claims, in particular your claim that levels below 150 will cause dementia or Alzheimer’s disease. The video did nothing of the sort because it’s goal was simply to explain the physiology of cholesterol. Since anyone paying attention knows we need “some” cholesterol, the video had no bearing on your various fatuous claims about cholesterol and health.

                2. Note that the text under the first video states: * ” 4. The other big one is LDL, which is the unhealthy one, the lower the better”*, contradicting your claim that only vLDL and small, dense LDL are of concern.

            2. Jerry Lewis –
              As is typical, the youtube video you linked to says absolutely nothing about your claims concerning saturated fat, cholesterol generally or LDL being irrelevant to the development of coronary heart disease. All the **student** (who has some drawing talent) does is point out that there are various types of cholesterol: “cholymicron” (sic), vLDL, LDL , HDL, and that the amount of fat in a class increases as one goes from the first mentioned to the last. But LDL does contain a lot of fat, as he observes. After that he discusses how cholesterol gets into the body tissues.

              How does any of this support any of your mistaken claims?

                1. While I would have to disagree with Katie Ferraro on a number of points, I give her credit for trying to push people in a healthier direction than the SAD diet, but the AHA diet is pretty sad also.

                  But, she said one thing that is overlooked entirely by almost all MD’s. That is that insulin levels tend to decline in older people. Then the high carb diet they eat results in high blood glucose levels, which in turn, cause insulin resistance, further pancreas damage, and even higher glucose levels.
                  Exactly, my issue with the high carb diet. Works for many people, BUT not all, and certainly not for diabetics.

                  1. Marilyn, I gave you the wrong link. I mean to show you the following link.

                    https://www.youtube.com/watch?v=YGOpjPNtjes

                    In general, I agree with Dr Katie Ferraro but I disagree with her when she brings up the subject of eating less fat to lose weight. I never say to eat a lot of fat but we do need some and that’s not what makes you fat or cause disease. The above video talks better about this.

                    About carb, thanks to the ketogenic diet, it brings the awareness in me. But I am not going to the extreme like the ketogenic diet and get my carb below 50g or sometime 25g. Because there are so many beneficial foods that I have to eat and that’s what will raise my carb. In general, I try to keep my carb under 200g. Since I am aware of the carb now, if let say I eat some bread (homemade) then I have to cut on my pasta or rice. I don’t cut on vegetables, bean, nuts. fruits, etc. but all of those foods will raise my carb and so I have to cut some other foods that are not absolutely to eat like bread and pasta and rice.

                    1. Jerry, the problem I have with Bowden, and others like him is illustrated by his food pyramid. The biggest section, lots of animal food, i.e. lots of protein. I don’t believe that a high protein, and usually high heme iron, diet, is healthy.
                      You might be interested in Dr. Valter Longo’s work on that subject.

                  2. Re: Jerry, the problem I have with Bowden, and others like him is illustrated by his food pyramid. The biggest section, lots of animal food, i.e. lots of protein.

                    Marilyn, Bowden food pyramid may not be perfect but it is for meat eaters. But healthy eaters actually flip the bottom layer which is animal foods with the next layer which is plant foods and the triangle is even narrower, which means more plant foods and less animal foods.

                    But Bowden main point is to cut down on the carb.

                    Now if you want to avoid animal foods completely then you substitute animal foods with plant foods that have complete protein such as soybean and green peas but avoid the plant foods that have too much carb. You also notice that “healthy fats” are in the middle which means that you substitute carb and sugar with fats. Note that fruits are sugar and so you cut down on it (not stop completely).

                    Take a look at the “loser pyramid” at the bottom of the page:

                    https://www.gll-getalife.com/usda-food-pyramid

                    ———————–
                    I think the following is what you talk about Walter Longo food pyramid.

                    https://goo.gl/images/MgseQh

                    While he stresses more about plant foods, the problem is that he has bread and potato at the bottom of the pyramid which means that you eat a lot and that is carb.

                    I like Bowden food pyramid better and of you don’t want to eat animal foods then substitute with plant foods that have complete protein and flip the bottom two layers.

                    1. For healthy fats, it can be fats from avocado, nut and seed. But don’t eat too much nut and seed because of the Omega 6 unless you balance it with Omega 3.

                    2. I think the assumption that one diet suits all will soon become outdated and inefficient. There is already good research showing that we respond individually and sometimes with great disparity to different foods. Sure plants will always be good and trans fats bad but what lies in between may not be clear cut. I am currently conducting a simple personal experiment and it looks like the repercussions will be an overhaul to my breakfast regime which I had assumed was healthy ie- oats, almond milk, kiwi frut, berries and flaxseed

    2. It has been known for a very long time that oestrogen levels affect cholesterol levels eg this from 1988

      “Endogenous sex steroids seem to exert a major influence on plasma lipoprotein levels. During menopause, endogenous estradiol (E2) levels decrease, and the low-density lipoprotein cholesterol concentration, which gradually increases with age, rises more rapidly, with mean plasma levels exceeding those of age-matched men.”
      https://www.ncbi.nlm.nih.gov/pubmed/3173937

      This probably something you should discuss with your doctor or seek referral to a specialist.

  7. Chronic stress, which results in chronically elevations of cortisol, also increases formation of AB plaques. It has been found that cortisol affects supportive cells in the brain called astrocytes. Normally, astrocytes remove AB from the brain by engulfing it. But under chronically high cortisol (or dexamethasone, a drug that is a more potent derivative of cortisol), astrocytes lose this cleaning ability and instead PRODUCE AB themselves.

    Making a drastic cut back to my consumption of saturated fat and dietary cholesterol resulted in a drastic reduction to my cholesterol; it went from 314 down to 190. But I am still a rather neurotic person who is stress sensitive. I contemplate that chronic stress may be nearly as much a killer as the default American food: pizza.

    The hormone DHEA opposes cortisol, and the ratio of DHEA : cortisol diminishes in depressed people. DHEA has been found useful in treating stress-induced depression, and may be useful in the prevention of Alzheimer’s… but note that this is a speculation on my behalf, based on just 10 hours of reading about this subject.

    1. Dr. Bredesen would agree that chronic stress and adrenal dysfunction are a factor.
      Also high insulin levels because the body uses the same enzyme to degrade insulin that it uses to degrade amyloid-beta. So for many people eating a high carb diet is not good. He agrees with Dr. Gregor that saturated fats, particularly for those with ApoE4, are a factor.
      Many people seem to think that in order to be WFPB you have to be high carb also. But that is not true. You can eat lots of low carb vegetables, and fruits like berries.
      As for healthy fats, most veggies have some, olives, avocados, flaxseed, whole soybeans and nuts do also.
      The Epic study found that the biggest risk for all cause mortality was blood sugar levels. This surprised the researchers who thought they were going to find it was fats or cholesterol.

      1. Hi Marilyn

        Do you have a source for that statement about the strongest association with mortality being blood sugar levels? It sounds interesting.

        My recollection is that among elderly people in the EPIC study

        “CONCLUSIONS:
        Greater adherence to the plant-based diet that was defined a posteriori in this population of European elders is associated with lower all-cause mortality.”
        https://www.ncbi.nlm.nih.gov/pubmed/?term=17381929%5Buid%5D

        Similar results were found for people of all ages
        “Consumption of fruits and vegetables was inversely associated with all-cause mortality (for the highest quartile, hazard ratio = 0.90, 95% confidence interval (CI): 0.86, 0.94), with a rate advancement period of 1.12 years (95% CI: 0.70, 1.54), and with a preventable proportion of 2.95%. This association was driven mainly by cardiovascular disease mortality (for the highest quartile, hazard ratio = 0.85, 95% CI: 0.77, 0.93). Stronger inverse associations were observed for participants with high alcohol consumption or high body mass index and suggested in smokers. Inverse associations were stronger for raw than for cooked vegetable consumption. These results support the evidence that fruit and vegetable consumption is associated with a lower risk of death.”
        https://www.ncbi.nlm.nih.gov/pubmed/?term=23599238%5Buid%5D

        My understanding is that the EPIC findings broadly support the WFPB approach espoused by Dr Greger.

        It is also worth recalling that saturated fat raises blood sugar levels
        https://nutritionfacts.org/video/lipotoxicity-how-saturated-fat-raises-blood-sugar/

        1. Tom, everything you say here is true. Probably one of the reasons saturated fat raises blood sugar levels is that it can cause insulin resistance.
          The part of the Epic study I was referring to is no longer available without a fee. If you have access to it you can look it up.
          The part is “Association of Hemoglobin A1c with Cardiovascular Disease and Mortality in Adults: The European Prospective Investigation into Cancer in Norfolk”. Annals of Internal Medicine Vol. 141

          It says “In men and women, the relationship between hemoglobin A1c and cardiovascular disease, and between hemoglobin A1c and all cause mortality was continuous and significant throughout the entire distribution.
          The relationship was apparent in persons without known diabetes.
          Persons with hemoglobin A1c less than 5% had the lowest rates of cardiovascular disease and mortality.”

          Here in the US doctors still call A1c of 6%, and fasting glucose up to 126 pre-diabetes.

  8. I am a vegetarian (7 years) who adheres to a strict diet (almost no fats or sugar) and yet my cholesterol is 275! My GP says that my body simply makes it and that no amount of healthy living is going to bring it down to an acceptable level. He wants me to take Lipitor.

    1. While I’m not expert, this is where I would suspect that inflammation is playing a role in keeping your cholesterol elevated. There’s information on this site about anti-inflammation options as well as other sites. Don’t give up!

    2. As Nan suggests, cholesterol is not the cause of fat build-up in the arteries – inflammation is the trigger. Generally carnitine is involved as well.

      Carnitine is present especially in vertebrate muscle and other animal products. Red meat delivers L-carnitine to bacteria that live in the human gut. These bacteria digest L-carnitine and turn it into a compound called trimethylamine-N-oxide (TMAO). TMAO has been shown to cause atherosclerosis, the disease process that leads to cholesterol-clogged arteries.

      1. I don’t agree Corpsman.

        The idea that there is only one “cause” of arterial problems, and that if inflammation is a cause then cholesterol cannot be a cause, is not supported by the evidence. While you may find many cholesterol-sceptic cranks saying this on the internet, it is a very unscientific way of looking at things . And we know that high blood cholesterol levels promotes inflammation in any case

        This is not Highlander – there can only be one.

        All health authories around the world recognise that there are multiple risk factors for arterial disease. Cholesterol is one of those. You may find it useful to review
        https://nutritionfacts.org/video/how-do-we-know-that-cholesterol-causes-heart-disease/

        And the European Atherosclerosis Society set out the evidence showing that high cholesterol causes atherosclerosis.
        https://www.eas-society.org/news/341802/New-EAS-Consensus-Panel-Statement-out—LDL-causes-ASCVD-.htm

        I think that the premier Euopean professional association on this subject is a more reliable guide to what the evidence actually shows than the claims of snake oil merchants (even if they are doctors of some sort) selling stuff on the internet and vociferous cranks with websites.

  9. Hi, thanks for writing of the health benefits of Saffron intake. Personally, I have been using infant formula as a coffee creamer for a few years and since I added a good sized pinch of Saffron to my daily supplements, I have noticed a sustained improvement in my balance and ability to just stand up straighter.
    The infant formula is listed as neuro-complete on the label and my brain MRI has changed from
    “Why is it so dark” to a more normal review. Second MRI was done to find out more of the extent of the recoating of my eye nerve and improved vision. Neuro eye doc said tangles may have caused other issues? Anyway the reduction of tangling in the nervous system seemed worth the try. Don’t know if it is a worthwhile try for improvement through system analysis and I do feel an increase in physical well-being. Thanks again for the reference to Saffron.

  10. Something I would like to understand, Dr. Greger:

    You say to avoid saturated fat. Saturated fat is in vegetable products, as well–even in olive oil, but what does that have to do with cholesterol, which is a different thing–something that could be avoided in foods, as well?

    So we could avoid cholesterol–but we could also avoid saturated fats? I’m confused by your recommendation.

    1. Lisa, the wrong theory is that saturated fat causes cholesterol to rise, if cholesterol mearement means anything in the first place.

      In reality, eating good fats, bbe it saturated fat from coconut, or cholesterol from seafood (except fish that does not have), or cholesterol from butter, real meat, etc. cause the lipid profile or cholesterol measurement to improve. Meaning your HDL will go up, your LDL is average and your triglycerides will go down. It’s quite the opposite of what people think.

      In summary, eating fat does not mean that you will get fat. Fat accumulation in the body has nothing to do with the fats you eat but it has to do with inflmmation such as when you eat sugar or don’t eat foods with antioxidants.

      1. Jerry, I am WFPBNO. I do not eat “real meat,” (whatever that is,) nor butter or any other animal products. I have no problem with my LDL, HDL, or cholesterol. I simply want to understand what Dr. Greger is saying.

        1. Lisa, I gave the answer to your question, and I probably elaborate a little bit more.

          Your question is that some plant foods such as coconut contain saturated fat , but why does Dr G talk about cholesterol?

          Answer: the wrong theory is that if you eat saturated fat even from a plant food then your cholesterol will rise. This is wrong because it will lower your cholesterol measurement.

          1. Jerry, I am not asking for a theory. I’m asking for the reason he is saying not to eat saturated fat when there are two possibilities: eating saturated fat elevates cholesterol AND eating foods (like animal foods) that contain cholesterol.

            1. Geez that’s what I am trying to explain. According to Dr G (theory), eating saturated food (from plant foods) or eating cholesterol foods (from animal foods) will raise the cholesterol inside your body (which is not true but that’s Dr G theory).

                  1. Sorry, Jerry, but Chris Kessler is not a reliable source of scientific information. Proof? Here’s who he thinks is worth paying attention to:

                    Great books to read on REAL science:
                    Eat The Yolks by Liz Wolfe
                    Eat Meat and Stop Jogging by Mike Sheridan
                    Any books by Gary Taubes
                    Any books by Mary Enig
                    Any books by David Perlmutter

                    Any books by Chris Masterjohn

                    QED.

                  2. So, Jerry, an acupuncturist who sells stuff on the internet is a more reliable source of information on the health effects of high saturated fat consumption, and high blood choesterol levels, than expert scientific panels convened by the World Health Organization, national governments around the world and professional medical assocviations?

                    Thanks. I would never have known that if it weren’t for you.

              1. Jerry

                You couldn’t – or wouldn’t – get the facts straight if your life depended on it.

                This is not Dr G’s theory as you claim. It is what the evidence shows, And Dr G is simply reporting the evidence..

      2. >>>In reality, eating good fats, bbe it saturated fat from coconut, or cholesterol from seafood (except fish that does not have), or cholesterol from butter, real meat, etc. cause the lipid profile or cholesterol measurement to improve. Meaning your HDL will go up, your LDL is average and your triglycerides will go down. It’s quite the opposite of what people think.

        Can you cite studies supporting this contention? When you say sat fat improves lipid profiles, you need to state in relation to what. Whenever you are eating foods with sat fats, you are not eating other foods that would be better for your health, specifically, whole plant foods.

        Here’s a 2017 study indicating the opposite of your claim.

        strong>Health effects of saturated and trans-fatty acid intake in children and adolescents (2017)
        https://www.ncbi.nlm.nih.gov/pubmed/29149184
        “Reduced intakes of SFA have been shown to be associated
        with significant reduction in risk of CVD in meta-analyses of both prospective cohort studies
        and randomised controlled trials (RCTs), with the strongest associations seen when SFA
        are replaced by polyunsaturated fatty acids (PUFA)
        .[7±10] Similarly, cohort studies demonstrate that high intakes of TFA are strongly associated with increased likelihood of coronary heart disease and related mortality.[11] Controversially a recent meta-analysis of RCTs
        incorporating recovered and reanalysed data from two studies conducted fifty years ago [18,
        19] suggests increased risk of coronary heart disease death and cardiovascular disease when
        replacing SFA with n-6 PUFA.[18] The limitations of this new analysis have been widely
        reported.[20, 21]”


        “Results:
        Compared with control diets, there was a highly statistically significant effect of reduced
        SFA intake on total cholesterol
        (mean difference (MD) -0.16 mmol/l, [95% confidence interval (CI): -0.25 to -0.07]), LDL cholesterol (MD -0.13 mmol/l [95% CI:-0.22 to -0.03]) and diastolic blood pressure (MD -1.45 mmol/l [95% CI:-2.34 to -0.56]). There were no significant
        effects on any other risk factors and no evidence of adverse effects.

        Conclusions
        Advice to reduce saturated fatty acids intake of children results in a significant reduction in
        total and LDL-cholesterol levels as well as diastolic blood pressure without evidence of
        adverse effects on growth and development. Dietary guidelines for children and adolescents
        should continue to recommend diets low in saturated fat.”

        I think we can all agree what we are most interested in are outcomes, here reduction of heart disease, irrespective of the actual mechanisms of action. Assuming this, consider e.g. the following quote from Dr. Mirkin’s article (he is not a vegan doctor as he recommends eating fish):

        http://www.drmirkin.com/nutrition/the-saturated-fat-debate.html
        The Saturated Fat Debate
        Have recent headlines made you believe that you can eat unlimited amounts of saturated fat in red meat and dairy products? I hope not. A recent study from Harvard School of Public Health shows that when people replace five percent of calories from saturated fats with the same amount of calories from:
        • polyunsaturated fats, they gain a 25 percent reduction in heart disease,
        • monounsaturated fats, they gain a 15 percent reduction in heart disease, and
        • carbohydrates from whole grains, they gain a nine percent reduction in heart disease.

        However, if they replace the saturated fats in meats and dairy products with refined carbohydrates in bakery products and sugar added foods and drinks, they still are at the same high risk for heart attacks (Journal of the American College of Cardiology, September 28, 2015).”

        Duh. The dangers of eating lots sugar and refined carbs has been known for many decades. It’s beside the point. You need to make a specific argument that not eating sat fat is detrimental to one’s health when compared to a low sat fat (not necessarily low fat) whole plant food-based diet. Go for it!

        If I recall right, you also mistakenly seem to think that high HDL is necessarily protective. That’s wrong. There is more than one type of HDL, one of which is damaging. People with very high HDL often have the kind that is atherogenic.

        http://www.drmirkin.com/heart/hdl-cholesterol-a-new-understanding.html

        “An exciting new study from Texas Medical Center shows that regular HDL cholesterol may not be very effective in doing this, but another form called Nascent HDL carries these protein-fats much more quickly to your liver to be removed from your circulation (Arteriosclerosis, Thrombosis, and Vascular Biology, Nov 21, 2017). The Nascent HDL cholesterol goes directly to your liver and skips being converted to the mature form of HDL. It can clear plaque-forming particles from your arteries, and carry them to your liver, a thousand times faster than regular HDL does. It takes Nascent HDL less than two minutes to do this job, compared to several days that HDL is thought to take. “

        Also cf. http://www.drmirkin.com/heart/both-low-and-high-hdl-can-predict-harm.html
        “Another study that followed more than 600,000 people showed that having low levels (<30) of HDL cholesterol predicts increased risk for a premature death from heart attacks, cancers and other causes, while having high blood levels of HDL (>90) was associated with significantly increased rate of deaths from heart attacks (J Am Coll Cardiol, 2016;68(19):2073-2083). The death rate was lowest in those with HDL levels between 51 and 70. Also see my recent report on Nascent HDL Cholesterol”.

        The topic of saturated fat and health has been well discussed by Dr. Katz (Yale University):
        https://www.forksoverknives.com/high-saturated-fat-diets-cause-heart-disease/#gs.037CLZI

        To quote some of the article: The new commentary is, in a word, wrong. It is not necessarily wrong in every particular about saturated fat—there are some legitimate uncertainties there. It is wrong in the whole, because it commits the willful deception, or classic blunder, of conflating the part for the whole.

        Whatever the specific, mechanistic involvement of any given saturated fatty acid with atherogenesis and coronary disease, the reliably established fact is that diets high in the foods that are high in saturated fat lead to high rates of heart disease—while many variations on the theme of diets low in saturated fats, whether low high or middling in total fat, are associated with lower rates of heart disease, lower rates of all chronic disease, and lower rates of premature death.

        Their conclusion that saturated fat is exonerated is based on straw-man arguments. For one thing, it is very hard to isolate the effects of saturated fat. This is because saturated fat is a diverse class of nutrients with differing effects; because saturated fat is consumed in foods, not by itself; and because more of THESE foods in one’s diet ineluctably means less of THOSE foods. Consequently, the attribution of health effects to just one dietary factor is very difficult. The more enlightened researchers in this space have long shifted their focus to overall dietary patterns, and there—the evidence is nothing short of overwhelming: dietary patterns that produce the best health outcomes overall, including less cardiovascular disease, may be high or low in total fat, but are invariably plant-predominant and low in saturated fat.

        1. Note that the last part of the quote from Dr. Katz expressed the point about whole foods made by T. Colin Campbell in e.g. his book Whole. But then, Jerry, you’ve already attacked Campbell as some sort of a quack in some of your other posts. Let’s see, on my “team” of nutrition gurus, I have Dr. Greger, T. Colin Campbell, Dr. Fuhrman, Dr. Bernard, Dr. Katz (not a vegan), Dr. Mirkin (not a vegan), et al,, and on yours there are people like Chris Kessler, Denise Minger, Dr Perlmutter, et al. Think I’ll stick with my list.

        2. All the so-called researches that you quoted above are bad research after bad research that piled up on top of the 35 year old lie. You know how it goes, any “research” can be conducted in a way to produce the results that they want.

          Anyway, good saturated fat will raise total cholesterol in general but it is:

          – higher HDL or good cholesterol
          – Lower triglycerides or the very bad guy, and the best indicator of CHD
          – Slightly higher LDL but it is the large particle LDL that goes up but it is harmless. The small particle which is harmful, will go down. Look at the following article from Harvard that explains VLDL.

          https://www.health.harvard.edu/heart-health/non-hdl-cholesterol-explained

          And last, look at the 19 references at the end of this Huff article:

          https://www.huffingtonpost.com/entry/yes-coconut-oil-is-still-healthy-its-always-been_us_5950b5bee4b0326c0a8d09ad

          And this article:

          http://bmjopen.bmj.com/content/6/6/e010401

          In particular:

          http://europepmc.org/abstract/med/3519928

          The Demographic Yearbook of the United Nations (1978) reported that Sri Lanka has the lowest death rate from ischemic heart disease. Sri Lanka is the only of the countries giving reliable data where coconut oil (containing over 50% medium chain fatty acids) is the main dietary fat.

          1. Jerry –
            >>> Slightly higher LDL but it is the large particle LDL that goes up but it is harmless. The small particle which is harmful, will go down. Look at the following article from Harvard that explains VLDL.

            You must not have read the Harvard link you sent. Why does that not surprise me? It did not exonerate large LDL paarticles. To quote the article: Like LDL, it also causes cholesterol to build up on the inside of arteries, creating artery-clogging plaque. Both are considered undesirable so the higher your LDL and VLDL values, the higher your risk of heart disease.”.

            Sure, the worst culprit is small, dense LDL, but so what? You seem to be making the elementary logical mistake of assuming that since A is worse than B, B is either neutral or beneficial. Think about it.

            You make another mistake in assuming that all HDL is “good cholesterol”. HDL as a class might be better than LDL, but as one of the Dr. Mirkin articles, there are two types of HDL, one beneficial, one not.
            http://www.drmirkin.com/heart/hdl-cholesterol-a-new-understanding.html
            A review of 15 studies shows that the risk for heart attacks does not vary directly with the concentration of HDL in your bloodstream (Lipids in Health and Disease, November 14, 2017)
            “Further evidence for the lack of effect of HDL itself from preventing heart attacks comes from studies on diabetics. Diabetics are at high risk for forming plaques that cause heart attacks because diabetes impairs the ability of (Nascent) HDL cholesterol to clear the bad LDL cholesterol from your arteries (Cardiovasc Diabetol, 2017 Oct 12;16(1):132). Tests for levels of Nascent HDL are not yet available in commercial laboratories. Some of the Nascent HDL eventually forms HDL, so a test for regular HDL may sometimes predict the amount you have of this newly identified “good” Nascent HDL. However, some people with very high blood HDL levels are at increased risk for heart attacks because their protective Nascent HDL is converted so fast to regular HDL that they lose the benefit of the Nascent HDL protecting them from forming plaques in their arteries.”

            So relying on high HDL to compensate for high cholesterol is a gamble. Good luck with that, Jerry.

            You have repeatedly claimed that saturated fat, including SFAs from animals, is good for one’s health or perhaps in your view, necessary for optimal health. In your reply you mention “good saturated fat”.

            Which saturated fats do you consider good?

            Given your statements, I can only conclude you think all of the SFAs in animal food are health-promoting. But the science shows this is wrong, a point repeatedly made by Dr. Katz in various popular articles, e.g.

            https://www.huffingtonpost.com/david-katz-md/truth-about-saturated-fat_b_9427698.html
            “Believe it or not, there is a discernible truth about saturated fat, hard to perceive through the smoke of all the overcooked arguments though it may be. Let’s give it a go.

            We have know for a long time — many years — that all saturated fat is not created equal with regard to health effects. The details of a discussion encompassing, for instance, just stearic acid, lauric acid, palmitic acid, and myristic acid — to say nothing of caprylic, caproic, butyric, enanthic, and so on — could take many interesting pages. Suffice to say: some saturated fatty acids are quite convincingly established to be harmful, and others are not.”

            https://www.linkedin.com/pulse/healthiest-diet-known-science-dr-david-katz-interview-joy-weinberg

            “If you aggregate all the evidence from animal, cell culture, observational epidemiology, and human intervention studies on outcomes such as atherosclerosis (disease from plaque build-up inside the arteries), coronary disease, high LDL cholesterol, and so on, they line up. Saturated fat looks pretty damning.

            That said, not all saturated fat is the same. Saturated fat is a class of fat, with diverse members, and not all kinds have been associated with disease. For instance:

            1. Stearic acid, a long-chain saturated fat that predominates in dark chocolate, is well established to be innocuous. It doesn’t promote inflammation or oxidation. It doesn’t advance arthrosclerosis.

            Now, just because stearic acid is harmless does not mean it’s good for us. I’ve never considered harmlessness the benchmark for optimal nutrition.

            2. Lauric acid is another saturated fat, short-chain, that predominates in coconut. It also appears to be harmless, although the evidence is somewhat less well-developed than that for stearic acid.

            That is a largely-plant-based diet comprised mostly of vegetables, fruits, whole grains, beans, nuts, and seeds.”

            I have not checked out the references to your link to a Huff Post article, but I am quite confident that if I took the time, I would discover they do not overturn Dr. Katz’s expert opinion. But for fun, I did look at the link and discovered the author you cite is JJ Virgin, Contributor Celebrity nutrition, fitness, and mindset expert. OK, she’s a new one to your team of nutrition gurus. Now, should I trust her opinion over Dr. Katz’s? Here’s a small snippet of this bio from his website: “David L. Katz, MD, MPH, FACPM, FACP, FACLM is the founding director (1998) of Yale University’s Yale-Griffin Prevention Research Center, and current President of the American College of Lifestyle Medicine.” He is an epidemiologist and has written textbooks on “research methods and the interface of evidence and clinical decisions, and have run a clinical research lab for nearly 20 years”, to quote him from https://www.huffingtonpost.com/david-katz-md/sugar-and-saturated-fat-f_b_8227088.html

            Now, that’s a hard choice … not!

            Despite your numerous claims about the importance of consuming saturated fat, including animal fat, you have never presented any convincing evidence that saturated fats are healthful let alone required for optimal health. Not surprising, because there isn’t any. All one could reasonably argue is that some SFAs are possibly neutral (arguably,stearic acid, lauric acid). But even if true, this would not make them essential to a healthful let alone optimal diet. Nor would it exonerate all SFAs, and in particular those found in abundance in animal foods you recommend like tallow, lard, butter, meat, etc., again as Dr. Katz has been saying for years.

            I looked briefly at your other two links. The one in J Environ Pathol Toxicol Oncol. 1986 Mar-Apr;6(3-4):115-21 is 1986 study on rats. It also studied only MCTs. So you found one article from 1986 exonerating MCTs in rats. Big deal. Couldn’t read the article so I have no idea how sound the study was.

            The BMJ article Lack of an association or an inverse association between low-density-lipoprotein cholesterol and mortality in the elderly: a systematic review was a study on elderly people. The relevance of this article to the issue of cholesterol levels and general health is likely slim to none. The study had various admitted limitations e.g. Some of the participants with high LDL-C may have started statin treatment during the observation period and, in this way, may have added a longer life to the group with high LDL-C and some of them may have started with a diet able to influence the risk of mortality.. Others like Thea have pointed out in the past in other contexts that illness can cause cholesterol levels to drop. This was a meta-study and likely did not control for that possibility or other possible flaws. In any event, it would not overturn all the other science supporting the view that saturated fat is not a health food..

            1. This is a case of cherry picking reading to pick what you want to read and believe. And then you start to act like TG with page long of endless and brainless rambling.

              So the Harvard article talks specifically about VLDL to distinguish with LDL in general to talk about its danger.

              So LDL is composed of VLDL, the small particle, and the large particle one. VLDL is associated with triglycerides, the very bad guy and you want to keep it low, below 30.

              LDL in general, or large particle LDL, is needed by the body to carry cholesterol to the cells for its energy. But you need LDL up to a point. Too much will be bad for your heart. So this is a case of needing LDL but not too much (that’s why cholesterol below 150 will cause Alzheimer’s). So how do you know if your LDL is not too high? So if your VLDL is less than 30 then you can afford to have a LDL between 100 and 130.

              So if you consume healthy fat like coconut oil or fish / algae oil, it will push your HDL up to more than 50, you triglycerides will be less than 130, ideally less than 100, and a slightly higher LDL between 100-130, but your VLDL will be low at less than 30.

              The following video will explain a little bit better about what I said.

              https://www.youtube.com/watch?v=PkKH8lTxvzA

              1. Ok, Jerry, here’s your chance to shine.

                Provide me with some references to your claim
                “that’s why cholesterol below 150 will cause Alzheimer’s”.

                If you cannot, then I will have to conclude these are more of your “Jerry-picked facts”.

          2. “The recent estimates for mortality from CVD (cardiovascular diseases) for Sri Lanka was 524 deaths per 100,000 which is higher than that observed in many high-income countries.1
            Coronary artery disease (CAD) is the leading cause of death in Sri Lanka while stroke is the third cause of death.2, 3 CAD accounted for 34% of deaths in an autopsy study.4 For comparison, CAD accounts for only 17% of deaths in the US and UK.5
            …………………………
            A comparison of Sri Lankans who have immigrated from Kandy, Sri Lanka to Oslo, Norway showed striking differences in risk factors. Those living in Oslo had favorable lipid profiles and blood pressure levels despite being more obese; those living in Kandy had worse lipid profiles (higher total/HDL cholesterol ratios) despite having lower rates of obesity and abdominal obesity.8 Reduction in saturated fat intake from coconut in those who immigrated to Oslo may have contributed to this paradox.
            The average total fat intake of Sri Lankans is 25 percent of total energy, with 80% of that coming from saturated fat from coconut products (meat, milk, and oil). With regard to the type of dietary fatty acids, Sri Lankans consume 9 times more saturated fats than polyunsaturated fatty acids (PUFAs) compared with the current recommended ratio of less than one.1”
            http://www.cadiresearch.org/topic/asian-indian-heart-disease/cadi-sri-lanka

    2. Lisa

      Please ignore Jerry. He parrots every crackpot alternative health claim he finds on the internet and completely rejects the findings of expert assessments of the evidence. Rumour has it that he possesses a range of stylish tinfoil hats.

      Saturated fats raise blood cholesterol levels. That is the main reason why all credible health authorities advise us not to eat high saturated fat diets.
      http://circ.ahajournals.org/content/136/3/e1

      There is also evidence that saturated fat damages our arterial system also and promotes inflammation eg
      https://www.sciencedirect.com/science/article/pii/S0735109706013386
      http://advances.nutrition.org/content/6/3/293S.full

      Sure there is some saturated fat in most foods even broccoli but the amounts are small and unlikely to cause any problem. the problem arises when people eat significant quantities of saturated fat.

  11. Did read read (Pure) study by Saleem Yousof et al?
    I think this will change all bad ideas about fat and should change current dietary guidelines dear.

    1. Hamid: We are very familiar with the PURE study. PURE is great example of a study that sounds compelling, but in reality does not say what you think it says. See below for details if interested. The bottom line is that the science shows that a diet absent in animal products and low in saturated fat is still the best goal to aim for.

      ——————
      The reported conclusions of the PURE study have been thoroughly debunked. Here are two reviews which explain the errors made by the PURE researchers:
      From PCRM: http://www.pcrm.org/media/news/pure-study-killer-carbs-or-poor-living-conditions
      From Dr. Katz: https://www.linkedin.com/pulse/diet-health-puzzling-past-paradox-pure-understanding-david?trk=mp-reader-card&utm_content=bufferf15a6&utm_medium=social&utm_source=facebook.com&utm_campaign=buffer

      Well respected poster on NutritionFacts, TG, also wrote the following:
      “…it is worth bearing in mind that McMaster University has a history of producing studies which show dairy foods in a favourable light and/or which defend saturated fat consumption. What is more, they receive grant funding from the Canadian dairy Industry (and occasionally the US Dairy Council). Dairy Farmers of Canada calls McMaster University a “partner”.
      https://www.dairyfarmers.ca/who-we-are/our-partners

      Consequently, I tend to look closely at the study design of anything coming out of McMaster. In this case, comparing outcomes for people across different countries eating carbs with people eating fat etc, can often end up simply comparing the mortality rates of poor people in underdeveloped countries who eat primarily cheap low quality carbs with the mortality rates of people in wealthy developed countries whose diet is generally richer in fats etc. Not controlling for such factors would be expected to produce results exonerating saturated fats or implying that they are healthful. In fact, saturated fat and cholesterol apologists have been doing this same sort of thing for years. Plant Positive discusses this misleading approach here
      http://plantpositive.squarespace.com/blog/2012/3/25/tpns-40-41-playing-games-with-your-heart.html

      Like TG, the first two reviews above also point out the flaw of comparing two different economic groups with access to different amounts of calories and health care. What’s great about TG’s post is that he points out that this strategy has been used for *years* in order to twist the data and confuse people. Plant Positive is a great resource. If you haven’t checked out that work yet, it is worth doing.

      The Bigger Picture: Faulty study methods has been a big problem of meta studies in general. The following commentary published in JAMA explains the why and how of it: “The misuse of meta-analysis in nutrition research.” http://jamanetwork.com/journals/jama/fullarticle/2654401 “Controversial conclusions from meta-analyses in nutrition are of tremendous interest to the public and can influence policies on diet and health. When the results of meta-analyses are the product of faulty methods, they can be misleading and can also be exploited by economic interests seeking to counteract unflattering scientific findings about commercial products” IE: It’s good to keep that information in mind when you see headlines about research that seems to do nothing more than give you good news about foods you know are bad for you.

        1. Thanks Liisa and WFPB-Hal!

          (FYI: I’m not back. As the peek showed, none of the problems with the forum, including lack of productive moderating, have been fixed. Clearly. I just happened to be glancing around to check the status and saw this easy one. I could be wrong, but I thought that Hamid and anyone else looking might appreciate learning this information. PURE is such a great example of how a study can seem compelling when really it is bunk. This is why people who aren’t trained in reading studies need to be especially careful who they listen to.)

          Thanks for your notes to me. There’s something else I saw in looking at these comments: Despite the loss of productive moderation and helpful forum software and the resultant loss of so many of the honest and helpful participants, there are still some really great commenters around–like you two. :-) Good to see you still here!

          1. Thea,

            Thanks for the compliment. I don’t blame you for not posting here much anymore. This comments section has gone downhill since the paid trolls have taken over. I don’t post much either, but I do continue to watch the videos and make donations to NutritionFacts.org. It’s great to see that this site has become so successful despite the efforts of the trolls to destroy it.

      1. Welcome back Thea! If original volunteers/ commenters like yourself are back I may actually start reading this section vs quickly scanning to avoid ones who seem only to be here to dismiss, minimize and try to refute (without credible science based sources) the lifetime of work and respected reputation of Dr. Greger et. al. If you don’t agree that strongly there are plenty of other sites. Now if some like Darryl would return?

        1. Thanks Marie. No, I’m not back. This was just a one-time/occasional post because I happened to be checking in to see if anything had changed. (It has not.) I agree that NutritionFacts has lost a lot of great on-going participation due in part to it’s decision to allow trolls. (Which is not to say that some really great posters aren’t still heroically hanging in here and others occasionally jumping in.) Hopefully NutritionFacts will listen the community posters such as yourself in the future. It’s not too late to fix things–for now. :-)

          1. I once ran my own website and each morning I would open my dashboard to see how many visits and from where my website had received. It is entirely possible that NF.o’s traffic has increased lately and that could be the reason no extreme moderation is taking place.

            I haven’t been here all that long… maybe a year but who’s counting. But what I see is a dynamic exchange of ideas and a carving out of positions for one to defend or possibly, see something that they hadn’t thought of before but makes sense to them now.

            FYI, I personally have slipped a little more over to the dark side (WFPB diet) just from being here.

            Yes, I understand you wanting to be with only your own kind… WFPB-ers. It’s the same as Hispanics preferring their own, blacks the same and whites as well. It is our comfort zone.

            But sometimes it is a good thing to step outside our comfort zone. There is a lot of actually good and possibly life-changing information being shared here in the comments hoi polloi.

            The only way to know it is to see it.

            1. Lonie: We have had this conversation multiple times before. You are once again misrepresenting my comments–and this time in an obscene and unnecessarily offensive way. You have effectively called me a racist – something that used to be against the rules of this site. But don’t worry. No one will delete your comment. They no longer enforce the old rules against ad hominem attacks. It’s not even a rule any more as near as I can tell.

              To Repeat: The issue has nothing to do with wanting only comments which agree with this site. I’ve said (and demonstrated) multiple times an appreciation for people who come here with an honest attempt at understanding information and exchanging ideas–even if they disagree with me or this site. I appreciated Hamid’s comment for example and treated him with the respect he deserves. I completely agree with people who believe that seeing debate in the comments section is really helpful. Stepping out of my comfort zone is something I do routinely. Tolerating trolls is a different issue than not welcoming alternative views.

              I know for a fact that NutritionFacts’ decision to tolerate trolls has nothing to do with site traffic volume. That decision was made while I was still a full moderator and willing to do all the work of fully enforcing the site’s rules. NutritionFacts’ stance became, “Troll? What troll?” Dr. Greger said (publicly on this forum) in response to one of my comments that staff looked and just do not see any trolls. Either an entire staff is not able to recognize trolls (unlikely) or they are deliberately allowing it. Dr. Greger also said in public on this forum that he will only allow staff to delete comments if the comment contains clear racist etc language. This *was* in direct conflict of their own posting rules, which used to include restrictions against personal attacks and other rules about making this a welcoming place. (The rules have changed–sadly for the worse.) Personal attacks are now rampant on this site. So is snotty language that makes the forum unpleasant–dissuading the kind of participants that we should be courting.

              These are all bad decisions by NutritionFacts that have sadly lowered the value of this site. I’m not the only person to notice this. I am just one of the loyal opposition being vocal about it. NutritionFacts could easily fix these problems if they want to.

              That you see value in our resident troll puts you in the minority. That you feel a need to continually misrepresent my views says more about you than about me. That NutritionFacts is more likely to delete my comment (as they have done in the past with similar comments) than yours just makes me sad.

              1. Wow! Saying you are comfortable among your own kind is calling you a racist?! First of all I didn’t know WFPB-ers were a race. ‘-)

                But I will take a chance on being moderated… by calling you a

                FUDDY DUDDY!

                  1. To be fair Jerry, I think you invite some of the militant comments. That is, you use charged words and rebuttals that are a little demeaning sometimes. Case in point, Tom Goff actually gave you a compliment recently and in your reply you just had to throw in a barb.

                    Surely you must understand why people here (they probably outnumber you and on-the-fencers like me, 10-1) who consider themselves Evidence Based find you abrasive… you are telling them that the thing they believe will offer them the best hope for good health is wrong. And you keep telling them that over and over, yet many if not most have experienced a positive change from following Greger.

                    I personally don’t mind that you are like you are. I think you are just a few notions off from being a WFPB eater. But people who are put off by your gruff posts probably don’t know that about you. All they see is TROLL when they see one of your posts.

                    I get it… like me you’re not after likes (aside: I think everyone should get an automatic like as a participation trophy for posting ‘-)

                    I’m going to assume that as a person who “tells it like it is” you will tolerate my offering the same to you.

                    But however you take this, I offer you the satisfaction of having the last word. Say what you will in response…

                    1. Lonie,
                      You miss the point completely. The problem with Jerry’s posts are not that he does not “tow the party line”, rather it’s that he almost invariably never backs up his claims with a reasonable argument or supporting evidence, as has been documented in many posts by others seriously interested in facts.

                      I seriously doubt that e.g. Tom Goff would shy away from an earnest debate, and neither would Thea or others who are interested in supported facts. I have repeated looked at links Jerry has offered in support of claims and almost invariably they were irrelevant, misleading, or even inconsistent with his claims. For anyone following his remarks over the past several months, this is all too painfully obvious. Frankly, I am quite surprised that you do not seem to realize this.

                    2. I have repeated looked at links Jerry has offered in support of claims and almost invariably they were irrelevant, misleading, or even inconsistent with his claims. For anyone following his remarks over the past several months, this is all too painfully obvious. Frankly, I am quite surprised that you do not seem to realize this.

                      I think I see the disconnect here… that is, I don’t follow Jerry’s posts. ‘-)

                      I may read a line or two in some as I pass by and that’s where I drew my conclusions that it was his brusque manner that caused so many angry responses.

                    3. Lonie, first of all, I am not in a popular contest here to have to say what people here want to hear. I just want to speak the truth. So if someone posts something misleading and downright harmful to others, I will speak up. Now it is very hard to speak up and stay civil when people insult me in just about every post.

                      Secondly, I am not looking for your sympathy. The other day when I saw “Steve” trashing you and calling you racist, I just find it so funny that a mild and nice person like you does not escape insults from the righteous police on this board.

                      Thirdly, my posts are only meant to correct the misleading posts that can be harmful to people. But at no point, I am promoting animal food eating. You have to distinguish when people post incorrect info about animal eating and when they talk about wanting to be vegans to protect animals and the environment. You can be vegan to protect animal and the environment without having to post misleading info about animal foods.

                      I visit many so called Paleo websites and I never see people trashing about plant foods. In fact, they even encourage people to eat mostly plant foods and eat only a small amount of animal foods for optimal health. So why can’t the opposite happen in a vegan website?

                      Re: I think I see the disconnect here… that is, I don’t follow Jerry’s posts

                      Lonie, you don’t have to pretend that you read or not read my posts. But I understand that you care about public image and want people to like you and that’s OK by me.

                    4. I forgot to write to you about this guy TG. You are probably a nice and non tricky person to understand this guy. So you are questioning why don’t I play nice with him when he complimented me the other day?

                      First, I have seen so many times this guy who can talk nice with me in a few posts and exchange ideas about nutrition or supplements or health and in the very next post, he would stereotype and profile me. Or if he does not like someone because of what that guy writes, he will dig up dirt at that person. It’s like a politician turning into an used car salesman and he can twist facts and lies as he wishes.

                      I compare him to Kim Jong Un of North Korea. Just watch this guy. Right now he plays nice and participates in the Winter Olympics to win the heart of the world to get the embargo lifted and to buy time. But wait a few months or a year, he will be back to test nuke. We have seen him lied too many times. Same thing with this TG guy.

                    5. O.k, I promised you the last word so I will post your statements below mine. ‘-)

                      Actually I don’t read Tom’s posts either as a rule… or anyone else’s posts that are long. If they are more than a paragraph… forget it. I do read your short posts sometimes if they are in a conversation I am interested in. And you are partly right… it’s not that I particularly want people to like me, but what is said on the Internet stays on the Internet. So I try to conduct myself as if the person I am in a conversation with is standing face to face. Plus, if one is still active in business, one wants to appear to be a reasonable person.

                      Re: I think I see the disconnect here… that is, I don’t follow Jerry’s posts

                      Lonie, you don’t have to pretend that you read or not read my posts. But I understand that you care about public image and want people to like you and that’s OK by me.

                      I see the same thing in re: supplementation where people make statements that “I” think are wrong. I may put on my “Information Police” cap for a post or two but feel I have done my job if I just put what I believe is more relevant out there for others to accept or decline. I try not to use charged words (like stupid, moron, etc.) and keep it civil. I’ve found if you alienate folks you probably aren’t going to get many converts to your way of thinking.

                      Thirdly, my posts are only meant to correct the misleading posts that can be harmful to people. But at no point, I am promoting animal food eating. You have to distinguish when people post incorrect info about animal eating and when they talk about wanting to be vegans to protect animals and the environment. You can be vegan to protect animal and the environment without having to post misleading info about animal foods.

                      See? You are making it a us vs them by comparing Paleo vs Vegan, thus reducing the two choices as something political. It’s lifestyle, not politics.

                      And on that note I’m going to bow out and if you choose to respond, I promise I will not respond back. Got some good news today (camera sensor is in for upgrade ‘-) and am expecting to not be spending as much time here as I have been. I’ll still check in now and again to watch the videos as time permits.

                      But I hope you will keep on being Jerry. I’ve said it before and I’ll say it again… you are a catalyst that sometimes infuriates people into thinking and pulling up research to correct what they see as YOUR misleading posts. ‘-)

                      I visit many so called Paleo websites and I never see people trashing about plant foods. In fact, they even encourage people to eat mostly plant foods and eat only a small amount of animal foods for optimal health. So why can’t the opposite happen in a vegan website?

    2. Hamid, the Pure study was very badly designed. It compared apples to oranges as it were, and generally proved nothing. Did you actually read the study?

    3. The PURE study was purely observational and led by people at McMaster University which has a repuaation for producing studies that favour the dairy industry, staurated fat consumption and salt consumption.

      Harvard pointed out some of that study’s flaws
      https://www.hsph.harvard.edu/nutritionsource/2017/09/08/pure-study-makes-headlines-but-the-conclusions-are-misleading

      Dr Katz’s analysis is also instructive
      https://www.linkedin.com/pulse/diet-health-puzzling-past-paradox-pure-understanding-david/?trk=mp-reader-card

  12. My cholesterol levels were high 2 labs ago (6 mos apart) but my last tests showed it in range while my HDL had increased a bit and my LDL had decreased even more but still a smidge high.

    I’ve almost completely cut out chicken breast meat (two or 3 times a year) and have totally cut out red meat for years. I still eat herring filets (almost daily) for protein and DHA. I take White Willow Bark (natural aspirin sans side effects) and any other inflammation fighter I run across.

    Still, my main defense against the big A is Naringin, sleeping on my side, getting ~ 8 hrs sleep, and avoiding traffic (because the air is unhealthy.)

    I make many more food choices, like nut butters for instance, and supplements (too many to mention) so one or some may play a role in Alzheimer’s defense that I’m aware of.

    1. Forgot to mention I drink beet root juice at least twice a day to keep blood vessels open in order to ensure getting sufficient to the brain. My oxygen readings in all my labs have been at least 98.

    2. After posting, I read this new research on AD. In a nutshell it suggests mitochondria damage in the brain is the actual cause of AD and that A-beta and tau come along later.

      Their solution is to protect the mitochondria using an analogue of Co-Q10.

      I take Co-Q10 (which I hope has the same properties as the analogue) but some years ago I read that Alpha Lipoic Acid also had a protective effect on our mitochondria, although the ones in the brain weren’t mentioned. They said at the time they didn’t know how the Lipoic acid worked but suspected it “tweaked” the mitochondria causing it to react to the tweak in a way that made it stronger.

      Personally I take the more expensive R-Lipoic Acid as it has a natural chirality (molecular twist) whereas the Alpha Lipoic Acid (synthetic version) has the opposite twist.

      The link is here for the recent data:

      https://medicalxpress.com/news/2018-01-energy-storehouses-brain-source-alzheimer.html

    3. And I just read a companion piece to the one listed above that had similar data but a different approach to treatment… that is, instead of mentioning the Co-Q10, the referenced NR (nicotinamide riboside) as the treatment for mitochondria protection.

      This is good news because I’ve been taking NR for a few years now… but for its positive effect on SIRT-1. It’s expensive, but if it does what they say in the link below, it’s worth it.

      https://medicalxpress.com/news/2017-12-healthy-mitochondria-alzheimer.html#nRlv

  13. I suffer from an LDL level is 169, overall cholesterol 245. All of my other blood readings are normal, including triglycerides, which are 98. Since my last reading a year ago, nothing changed, even though I cut out eggs, am vegan about 4 days a week (on the other days, small amounts of meat or fish), and started taking plant sterols and stanols. I eat nuts every day.

    I was very disappointed that my readings didn’t budge. My mom is 89 and has dementia. My doctor says I am just under the reading that would cause her to recommend a statin, which I don’t want to take. I exercise every day. My parents and brother have low cholesterol.

    I’m at a loss as to what to do next. I could go full vegan, but somehow I doubt it will make much of a difference given I’m 90% there and nothing changed.

    Any ideas?

    1. Hi Magnus! I’m so sorry that you are disappointed by your current readings. If you haven’t yet, I would read over this article, and check out the videos along with it. I would give going fully vegan a go – you may be surprised by how much even a few servings of meat/animal products can affect your cholesterol. I would also recommend increasing your intake of soluble fiber, found in foods such as beans/legumes, oats, and vegetables. I hope that these suggestions help!

    2. A number of people have previously said that they had to go strictly WFPB before their cholesterol levels budged.

      Also, even things like coffee, alcohol and processed vegetarian foods can raise cholesterol.
      https://www.sciencedaily.com/releases/2007/06/070614162223.htm
      https://www.nhs.uk/conditions/high-cholesterol/causes/

      You could also consider consuming amla
      https://nutritionfacts.org/video/amla-vs-drugs-for-cholesterol-inflammation-and-blood-thinning/
      https://nutritionfacts.org/video/the-best-food-for-high-cholesterol/

  14. I am also in the high cholesterol “camp” with familial hypercholesterolemia. My total cholesterol is about 220 consistently and I follow Dr. Greger’s whole-food plant-based diet with no added oil. I’ve also avoided eating nuts as recommended by Dr. Caldwell Eselstyn. However I’ve recently wondered whether Dr. Greger’s advice to add a handful of nuts a day applies to me, or should I stick with my previous practice. I wish I could get a direct answer from Dr. G. Any thoughts about adding nuts?

    1. I switched to eating sprouted nuts (google that to read more about the distinction and why it matters) because it makes nuts more bioavailable by eliminating much of the phytic acid which binds with helpful minerals, etc.

    2. Hello Barry,
      Thank you for your question. I am a family doctor with a private practice in lifestyle medicine and also a volunteer moderator for this website.

      To properly answer your question, I need to know a little more about you. For example, if you have known coronary artery disease (CAD), or if your type of hypercholesterolemia includes having elevated triglycerides and/or a very low HDL level, that puts you at higher risk.

      Dr. Esselstyn treats many patients with known, severe CAD, and he is very strict about minimizing intake of ANY fats. If you are not at risk for CAD, then many people in the whole-foods-plant-based-diet movement would say that you can certainly eat nuts and seeds in moderation. That includes Dr. Greger.

      In How Not to Die, in the Chapter on Nuts and Seeds, pp 342-349, Dr. G’s recommendation for quantity of nuts & seeds is: 1/4 cup, or 2 tablespoons of nut or seed butter. He raises the issue than nuts and seeds are loaded with fat and calories — so there’s a concern they could cause weight gain. But he then goes on to show that those who eat nuts and seeds do NOT gain weight relative to those who don’t eat them. He explains that there are 3 reasons for this. The main reason is that eating nuts is very satiating — i.e. they suppress the appetite. Second reason is that nuts/seeds actually boost your metabolism. Third reason is that about 10% of the calories don’t get digested and pass through into the feces — because of the fiber content of nuts/seeds.

      I think the biggest problem of eating more than the recommended amount of nuts/seeds, even if they don’t cause weight gain, is that you would then most likely be eating less of other very healthy foods such as vegetables, fruit, and legumes. As I’m sure you’ve noticed, eating a big handful of nuts will quickly satisfy your appetite.

      Also, it depends a little on which specific nuts and seeds you’re talking about. Dr G points out that walnuts are particularly healthy because they are higher than other nuts in antioxidants and in omega-3 fatty acids. Most nuts have omega-6 fatty acids but little or no omega-3s. Among seeds, the clear winners for omega-3 are flax and chia seeds.

      I will also include here, a response from a nutritionist who used to work for NutritionFacts, about what to do if you are on a great plant-based diet and still can’t get your cholesterol down where you want it:

      “For those who have tried eating a whole food plant-based diet and still have high LDL, you should make sure you’re not eating plant sources of saturated fat, such as palm kernel oil, palm oil, coconut oil, and cocoa butter (found in chocolate). Of course if you were you wouldn’t be eating a whole food plant-based diet, but you’d be surprised how many people tell me they are and they’re like “Yeah, and I eat a spoonful of coconut oil a day.” I’d also cut out unfiltered coffee. Then once you have gotten rid of the things that increase your cholesterol you need to pack your diet with foods that actively lower your cholesterol. So, for example, the components of the portfolio diet for lowering cholesterol. I’ll highlight some of the diet tips found in Dr. Jenkins protocol using Dr. Greger’s videos as reference.
      1) Load up on foods high in soluble fiber. This means tons of beans (see what kind are best: canned or cooked), vegetables like okra, plenty of whole fruit, oatmeal, and flax/chia seed. Find ways to use beans. Lentil stew, dal, curries, bean burritos, bean soup. If you don’t like beans whole, like in a salad, maybe try them as a spread or as hummus?
      2) Take about 2 Tablespoons of ground flaxseed daily and 4 Brazil nuts monthly. Sprinkling ground flax on oatmeal in the morning is an easy way to get enough. Or add it to a smoothie. If you buy the flax whole just add it in the blender first, grind it, and then add the rest of your ingredients.
      3) Focus on several cups of greens daily to help keep nitric oxide flowing. Vegetables loaded with nitrates have been shown to improve heart health. Beets and arugula have tons! (See video on where other vegetables rank on nitrate levels). Yes, green smoothies count if you’re adding the right foods like berries and dark green leafy vegetables (kale, spinach, even parsley). What’s better? Raw or cooked vegetables? Well, it may depend on what veggies are cooked. Lastly, a word of caution for those going wild on greens is that overdosing on raw greens can happen.
      Dr. Greger says to get thyroid function tested, too. A low-functioning thyroid can contribute to high cholesterol so it’s good to rule that out. Weight loss is also important if there is too much abdominal fat. Is your height more than twice your waist circumference? So there are a lot of factors to consider, but if folks are practicing heathy eating and managing body weight and still find their LDL is not coming down they should definitely consider a statin. As I always say make sure to check with your doctor about all of this. It’s important to be transparent and communicate with everyone.
      Joseph Gonzales, R.D.

      I hope this helps.
      Dr. Jon
      PhysicianAssistedWellness.com
      Volunteer moderator for NutritionFacts.org.

      1. Thanks for your informative post, Dr. Jon.

        To get a little more granular (pun intended) I would like to hear more of your thoughts regarding putting seeds/nuts in a smoothie. I usually add flax seeds, pumpkin seeds, sesame, sunflower and sometimes Brazil nuts (with broccoli and fruit). I have a high speed blender that leaves no noticeable seed particles intact. I imagine that this fine grinding is not the same a making a butter as it does not really separate the oils from the seed particles.

        But, am I so decreasing the fiber content that I am actually absorbing more of the fats, etc. that are not now passing through my gut and is this something to worry about? Should I focus more on putting fruits and veggies in the blender and drink that smoothie down while eating whole seeds/nuts by hand? (I know flax is an exception, because it needs to be ground. Thanks.

    3. @plantbasedbarry
      My husband was in similar boat for years and slowly went WFPB and looks feels so much better. He just turned 66 but looks much younger. His hormones and other numbers are great. Interesting due to a temp dental implant he had to avoid his daily nuts/ seeds (hard foods) for a few months. His cholesterol numbers got slightly worse. Even his family Dr advised him to start eating nuts again when he could. Guess what happened? Yes, his blood sugar re balanced and his cholesterol is now back to healthy. Google videos on the now 100 year old retired heart surgeon Dr Ellesworth Wareham for inspiration. Also Dr. Kim A. Williams (former president-elect, American College of Cardiology). And if you haven’t watched the documentary ‘The Widowmaker’ please do…hint forget the stress test and have an ultrasound and or CT to check the level of plaque in your arteries and or calcium score. My husband now has no trace. I’m not an MD so can only suggest from experience. Have some faith in yourself and LAUGH. Watch a funny cat video after the above!

  15. In their book “The Alzheimer’ Solution, Dr. Dean and Dr. Ayesha Sherzai, directors of the Alzheimer’s Prevention program at Loma Linda university, consider there to be 4 interconnected pathways to Alzheimer’s: chronic inflammation, oxidation, glucose dysregulation and lipid dysregulation. High cholesterol is, in their view, one of the risk factors playing a role in lipid dysregulation.

    No one quite knows exactly how Alzheimer’s evolves but they do present a fair amount of scientific evidence for their multi-factorial view. Their approach to helping their patients, which apparently has been reasonably successful, includes a number of not surprising lifestyle factors, a key one of which is a whole food plant-based diet that is high in anti-inflammatory foods. They also stress the importance of exercise, restorative sleep, and destressing. I think their book is a good place to start for anyone trying to prevent or reverse cognitive decline.

    http://teamsherzai.com/

    Aside: they also wrote a popular article on the ketogenic diet and how it might lead to Alzheimer’s disease.
    http://nutritionstudies.org/can-ketogenic-diet-lead-alzheimers-disease/

  16. As a lot of new visitors to this website are becoming aware, NutritionFacts is a really great website. There are numerous videos in which Dr Greger presents the results of unbiased research papers on a wide variety of nutrition topics. He condenses the complex information into easily understood language. And there is a good search tool at the top of the page that will lead you to past videos on numerous topics. It is one of the few nutrition websites that I know of that is entirely non-profit, accepting no ads, selling no products, and funded entirely through public donations.

    In fact, the website has become so popular lately that it appears there are now many trolls who are paid to flood the comments section with false information that contradicts what Dr Greger reports. They are easily spotted because they post comments so often and most of them are very negative towards Dr Greger and the research that he presents. They sometimes throw in a few positive comments to throw new readers off, but one has to only look back at the comments on previous videos to see how they operate. I would only trust the legitimate NutritionFacts Moderators for nutritional information here. There are a few excellent posters who often post comments here, but one has to look over the comments of past videos to be able to separate the good ones from the trolls.

    I have been visiting this website for many years now and learned so much from Dr Greger’s concise summary of unbiased research. It has has truly transformed my health for the better. So my advice is to enjoy and learn from the videos and blog posts here, but be on the lookout for trolls when reading the comments.

  17. Those who can’t bring cholesterol even after a healthy plant based diet please get your thyroid checked. If you are hypo your cholesterol should drop fast after you start taking synthroid. This is what happened to me.

  18. I have been watching this topic from those directions and enjoy every new thing science learns.

    I will only object to these sentences: “Once cognitive functions are lost in Alzheimer’s disease patients, they may be lost forever. Consequently, prevention, rather than a cure for Alzheimer’s disease appears to be a more realistic strategy to offset the catastrophic impact of this dementia.”

    I object, because brain plasticity is one of the most exciting science categories there is. Up there with the fact that they can print functioning new organs like kidneys out of the patients own cells in 7 hours on a 3D printer. You can see a Wake Forest doctor holding a kidney on Ted Talks on YouTube and you can also watch “The Brain That Changes Itself” and videos on brain plasticity and doctors getting new neurons for functions, which people have lost using technologies like TMS and Ultrasound and Direct Current. One of the researchers with TMS showed the pretty new baby neurons and showed the new neuronal pathways. Indeed, you can half half your brain removed and it might take a few years, but you can get the functions you lost back. (My step-mother had a stroke, so I have been researching neurogenesis and Ted Talks showing me the scans of the new neurons and patients with new functions made me happy.)

    All this being said, there is a med, which they developed for Parkinson’s, which increases neurogenesis. I am not big into meds, but people with Alzheimer’s, Parkinson’s and Stroke survivors might be able to change their brains faster and that would be a med they only needed to take until the new neurons grow.

    Yes, I am not sure brain plasticity will work as well for Alzheimer’s, as it does for stroke, but, they have the same theory for all of them now, so I am believing in big things.

    And, yes, preventing it is the best thing of all, which is why vegan excites me.

  19. Dr. Dale Bredesen has a new book out and says that he and doctors he has trained to use his Recode process, have been successful in curing hundreds of patients with Alzheimers. Can you shed any light on this? Thanks Randy

      1. TOm, I am absolutely amazed that you would take anything on this website seriously!
        Ok, so other articles defend artificial sweeteners, dairy, eggs and margarine!
        Really?

        1. I think that website has its good points and bad points. Harriet Hall just uses it as a soapbox to vent her own biases and prejudices but I’ve always thought that Novella himself was fairly reasonable.

          For example, I don’t think there is any doubt that margarine is a healthier option than butter. I don’t use either of them personally but it is quite clear that modern margarines made without trans fats are the better option. In the Lyon Diet Heart Study, for example, heart disease events and risks dropped when butter and cream were replaced by margarine. Other changes occurred also but the evidence that modern margarines, especially the stanol-based ones, are less unhealthy than butter is pretty solid (forgive the pun).

          Perhaps it’s different in the US and they still sell a lot of the old hydrogenated margarines there? Yes, they are probably worse than butter but they are less than 1% of sales in Australia, I understand. In Europe they have probably been even more active in removing trans fats from margarines and other foodstuffs.
          http://www.euro.who.int/en/media-centre/sections/press-releases/2014/europe-leads-the-world-in-eliminating-trans-fats

          Modern margarines are better. See this fact sheet below. It is particularly interesting because Dairy Australia is a major sponsor of that website and yet the website still clearly indicates that margarines are the healthier option compared to butter
          http://www.nutritionaustralia.org/national/resource/margarine-vs-butter

          In the US, the Mayo Clinic and Harvard come to pretty much the same conclusion
          https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/butter-vs-margarine/faq-20058152
          https://www.health.harvard.edu/staying-healthy/butter-vs-margarine
          https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5480968/

          I don’t think that sciencebased medicine is out on a limb here with this advice. All credible authorities seem to say the same thing on this matter..

          1. Tom, as someone who worked in the edible oil industry, I have tested margarines. I would not recommend either butter or margarine to anyone.
            Butter, because of the saturated fat, margerine because it is highly processed and the fats it contains are omega 6, and already damaged by the time you eat them.
            Plenty of studies show increased rates of cancer caused by the high peroxide values in processed vegetable fats.
            Dr. Gregor in some of his early videos points out another problem, the bad omega 3-6 ratio. One of the reasons he said, why vegans don’t have the low rate of cardio events one would expect.
            If someone has to have some fat on their veggies, I recommend a very good quality olive oil. Least bad choice.

    1. I have a thought about “too much” cholesterol. What if the cholesterol were waiting for some other healthy metabolic process to occur, but the process never happened? What if the body made enough cholesterol for that metabolic process? What if the cholesterol were waiting to be turned into something useful for the body? When the process didn’t occur, the cholesterol just flowed in the blood waiting for the process–but it waited and waited and waited and . . . If the process occurred, then the cholesterol would be used up; the condition for Alzheimer’s would not happen; in fact, the condition would mitigate against any disease of the brain or heart or kidneys or . . . well, it is just a thought. I hope it gets “put to the test.”

  20. Dr. Bredesen’s book(mentioned above) is NOT in agreement with Greger, Esselstyn or the Campbells. He includes fats and meats and fasting to promote a ketogenic state. My husband I are on Dr Esselstyn’s Reverse Your Heart Disease diet which allows no fat or animal protein. Our lab numbers are beautiful! My husband’s angina pain is eliminated. But after reading Bredesen as well as watching Dr. Hyman’s docu-series this week on brain health, we are concerned about our brains. Incidentally, Dr. Bredesen’s 30 plus years of research indicates there are 30 different issues that effect the balanced healthy function of our brain and it begins decades before symptoms. Interestingly as well while Dr. Esselstyn is on one end of the Clevelsnd Clinic campus advising his diet, Dr. HYman has taken a leadership role in the Cleveland Clinic’s Functional Medicine program advocating a fat and meat no grain diet on the other end of the campus. This can keep you up at night!!!

    1. I am wondering if your concern was about staying on an ultra-low fat diet long term.

      You might also want to check out The Alzheimer’s Solution: A Breakthrough Program to Prevent and Reverse the Symptoms of Cognitive Decline at Every Age by Drs. Sherzai of the Loma Linda University. They do research on brain health and run a clinical practice. Their view on diet is more in line with Greger, Campbell, et al. especially when it comes to low sat fat, sugar, high whole plant food intake, but they do recommend for brain nourishment, avocados, flax seeds, nuts, algal omega 3 (DHA/EPA),and even small amounts of extra virgin olive oil, so pretty clearly not an ultra-low fat diet.

      Dr. Fuhrman argues in his book The End of Heart Disease and elsewhere that over the long term, vegan diets with less than 15% calories from good fats (nuts/seeds, no oils) could well be detrimental to one’s neurological/brain health.

      I am wondering what Dr. Greger’s position is on the topic of ultra-low fat but otherwise healthful vegan diets and neurological health over the long term.

      1. I have Dr. Thomas Campbell’s book, ‘The Campbell Plan’. Frankly, I find many of the recipes in it terrible, how is using pastry flour, brown sugar, pasta etc. whole food plant based? The body doesn’t process flour much different from pure sugar.

        1. Marilyn,
          I’m surprised about those recipes. No flour or refined carbs for me except rarely some whole wheat pasta.

          But my question was whether you were concerned about the possible negative effects of ultra-low fat diets on neurological health over a long period of time, as is e.g. Dr. Fuhrman, who recommends a minimum of 15% of calories but does’t object to 30% (or maybe higher) if one maintains the desired body weight as long as the source are mostly nuts/seeds (no oils).

          I happen to be a WFP vegan who gets about 25-27% of calories from fat in the form of nuts/seeds and avocado. I also exercise a lot and so have no extra calories left over turning into fat so “the fat I eat does not become the fat I wear”.

          This is one area of disagreement between e.g McDougall and Fuhrman that I think deserves more discussion.

          1. David, I agree that the effect of long term low fat diets needs to be studied. There is a reason that statins often cause memory problems. Is it the drug itself? Is it the extremely low fat diet recommended with them?

            There was a study done years ago, 2005-7, in Spain, purportedly showing greater numbers of patients starting ALS, Parkinson’s and Alzheimer’s in those taking statins compared to a matched group not taking the drugs.
            I was dealing with a patient with ALS at the time who, although he did not have high cholesterol or heart disease, had been put on a statin. Three neurologists who specialize in ALS that I spoke to, noted they had seen that pattern.
            Of course that study disappeared, not popular with the pharmaceutical industry.
            Glad you are doing well.

    2. A fat and meat diet is extremely popular and Dr Hyman’s book sales have been astronomical. So were Dr Atkins. That sort of thing brings in the patients (and the $). No wonder the Cleveland Clinic gace him a prominent role.

      However, the the research and medical communities are in agreement that the scientific evidence shows that (red) meat is unhealthy and so are trans fats and saturated fats. The World Health Organization has assessed red meat as “probably carcinogenic” and various high level reviews have shown how unhealthy trans and saturated fats are. That sort of thing doesn’t sell books though. It doesn’t give people an excuse to eat butter, bacon and cheese for one thing

      i really wouldn’t give any thought to Hyman’s claims. Some of Bredersen’s seem suspect also.

  21. Another goofy study paid for by a statin selling drug company. Mothers breast milk is 50% saturated fat. Should one stop breast feeding. Nothing wrong with high Cholesteral. Every cell in your body and fat brain need Cholesteral . Sugar and trans fats are the enemy.

    1. Another goofy comment by someone who has been taken in by the claims of cranks and marketers

      That is simply untrue. Breast milk is not 50% saturated fat. Even the fat content alone of breast milk does not contain 50% saturated fat. Even if it were, so what? The nutritional needs of a baby/toddler might just be different from those of an adult.

      As for the claim that high cholesterol is not a problem, this is a dangerous fantasy promoted by cynical snake oil merchants and highly vocal loons. The evidence that it is a problem for cardiovascular disease is overwhelming eg
      https://www.eas-society.org/news/341802/New-EAS-Consensus-Panel-Statement-out—LDL-causes-ASCVD-.htm

      And this study discusses the evidence that it increases risk for Alzheimer’s. Furthermore, there is also evidence that high blood cholesterol promotes cancer. This has been around for a while but a recent study throws some light on the mechanism

      “New UCLA research could help explain the link between a high-cholesterol diet and an elevated risk for colon cancer.
      In a study of mice, scientists from the David Geffen School of Medicine at UCLA discovered that boosting the animals’ cholesterol levels spurred intestinal stem cells to divide more quickly, enabling tumors to form 100 times faster. ”
      https://www.sciencedaily.com/releases/2018/01/180125135551.htm

      1. Now that’s a very convincing document everyone should read. Looks like that supposedly faked, last century theory has some scientific legs after all. Who would’ve guessed Jerry was wrong.

        1. Of course you can always cherry pick and select whatever biased “researches” that you want to justify your fake theory. I can “prove” for instance that car is dangerous and should be banned based on the number of accidents it caused. Or computer is behind the increase in cancer because the cancer rate was lower when we did not have it. Or I can do “research” by feeding the poor lab rat with nothing but saturated fat and the rat dies and then I conclude that saturated fat is bad, so that I can get grant money for more fake “research” money.

    1. Yes Henry thanks for the Dr. Seneff website , she mentions that 25% of babies are feed soy formula (used to be much higher) and that soy formulas increase the isoflavones (estrogenic effect ) in babies blood by 13000 to 22000 times greater . This causes an early onset of menarche by 42% before 12.5 years old . This also according to Dr Seneff causes a increase risk of infertility and breast cancer in later years . Maybe should double check a healthy diet instead of a wild goose chase of studying disease and useless tests .
      Received my order of “How not to Die ” this week , will be checking that out , thanks

      1. Soy during teenage years greatly PROTECTS women from getting cancer later.
        Eating animal products LOWERS the age of the onset of menarche.
        The support for this assertion can be found on nutritionfacts.org.

    2. Seneff is a notorious crackpot on nutritional matters, Her assocaition with rhe Weston Price Foundation is a big giveaway.

      I am surprised that anyone here would take her seriously …. but then JL and Buster come here too. Mind you I am surprised that anyone anywhere takes her seriously.

    3. Seneff doesn’t look healthy herself–looking at her pictures. Why would someone trust health opinions from a doctor who doesn’t look healthy herself?

      1. Seneff is not a doctor. She works in in the computer science/AI lab at MIT. Her PhD is in CS and EE. She has no special training or expertise in medicine or nutritional science, as far as I have been able to determine.

  22. Look into the work of Dale Bredesen, MD. Recent book “The End of Alzheimer’s”. He suggests Alzheimer’s develops as a cumulation of many different abnormalities that all contribute to the disease. He reports 10 cases of reversal in the published literature and has a bigger experience now, in the 100s of patients. He states it’s like having 36 holes in the roof…if you patch one you’ll still get wet, you need to patch enough to get the healing mechanisms to take over. He wants the total cholesterol to be at least 160 as cholesterol is a structural component of the gray matter. He is a proponent of a plant based diet high in fat, but not a vegan diet (fair warning).

    1. His claim that cholesterol needs to be high flies in the face of the evidence.

      Also, I am wary of medicos making sensational claims based on weak evidence like this, especially when they are monetising their claims. He is now selling training and certification in the Bredersen Protocol to healthcare practitioners for example. this reresents a financial conflict of interest to my mind.

  23. Sorry but the cholesterol theory of Alzheimer’s Disease is false. Cholesterol does not cause atherosclerosis and therefore it cannot cause Alzheimer’s nor dementia. There is no such thing a “bad LDL cholesterol.” This is backed up by the fact that statin drugs that dramatically lower LDL cholesterol have never been proven to prevent Alzheimer’s Disease and in fact CAUSE dementia to the extent that ALL statin drugs come with a black box warning that they cause “cognitive dysfunction and memory loss!” Their effect on heart disease is negligible-to-none depending on which study you read.

    Many gullible and naive people who take them year-after-year end up with dementia or Alzheimer’s Disease, Parkinson’s, ALS etc. Apparently lowering LDL cholesterol and blocking the melvonate pathway in the liver has significant and significant brain and body damaging effects. This does not occur in “1 – 2%” of the people who take them…………it is more like 20 – 30%! Statins cause arterial calcification, peripheral neuropathy, congestive heart failure, Type II diabetes, cataracts, muscle weakness and pain due to CoQ10 depletion, I could go on and on……….. probably all due to their mitochondrial poisoning effects. Reducing mitochondrial function is THE hallmark of accelerated aging, hence reducing brain mitochondrial function would not surprisingly lead to cognitive losses and ultimately dementia.

    I am in the trenches directing a Cardiac Rehabilitation program and I see the damaging effects of lowering cholesterol in my patients. Back in the 70’s and 80’s before statins came along virtually every single dietary intervention study that attempted to lower cholesterol failed to show any cardiovascular prevention effects. I do not recommend lowering LDL cholesterol by any means as there are a hundred variables that affect it, including hypothyroidism which is endemic in our population. Those people who survive to 100 years old have an average serum Total Cholesterol of 250. Levels below 150 are correlated with a higher death rate in many studies. The Lipid Hypothesis of Atherosclerosis has been debunked IMHO.

    The more likely cause of Alzheimer’s Disease is a “Type III diabetes” and insulin resistance due to too many simple dietary carbs as well as excess oxidative stress and lack of exercise along with other hormone, antioxidant and nutrient deficiencies…………especially Vitamin C. I have become a firm believer in Dr. Linus Pauling and Dr. Matthias Rath’s Unified Theory of Atherosclerosis which focuses on the health of the arterial wall rather than the myriad of blood components that are statistically linked to arterial plaque. As we all know, correlation does not prove causation.

    1. Wow! I hope that you will post here more often to debunk this low fat and cholesterol bad theory that has ravaged our country and the world.

      “Sorry but the cholesterol theory of Alzheimer’s Disease is false. Cholesterol does not cause atherosclerosis and therefore it cannot cause Alzheimer’s nor dementia. There is no such thing a “bad LDL cholesterol.” This is backed up by the fact that statin drugs that dramatically lower LDL cholesterol have never been proven to prevent Alzheimer’s Disease and in fact CAUSE dementia to the extent that ALL statin drugs come with a black box warning that they cause “cognitive dysfunction and memory loss!” Their effect on heart disease is negligible-to-none depending on which study you read.

      I am in the trenches directing a Cardiac Rehabilitation program and I see the damaging effects of lowering cholesterol in my patients. Back in the 70’s and 80’s before statins came along virtually every single dietary intervention study that attempted to lower cholesterol failed to show any cardiovascular prevention effects. I do not recommend lowering LDL cholesterol by any means as there are a hundred variables that affect it, including hypothyroidism which is endemic in our population. Those people who survive to 100 years old have an average serum Total Cholesterol of 250. Levels below 150 are correlated with a higher death rate in many studies. The Lipid Hypothesis of Atherosclerosis has been debunked IMHO.”

      1. Many gullible and naive people who take them year-after-year end up with dementia or Alzheimer’s Disease, Parkinson’s, ALS etc. Apparently lowering LDL cholesterol and blocking the melvonate pathway in the liver has significant and significant brain and body damaging effects. This does not occur in “1 – 2%” of the people who take them…………it is more like 20 – 30%! Statins cause arterial calcification, peripheral neuropathy, congestive heart failure, Type II diabetes, cataracts, muscle weakness and pain due to CoQ10 depletion, I could go on and on……….. probably all due to their mitochondrial poisoning effects. Reducing mitochondrial function is THE hallmark of accelerated aging, hence reducing brain mitochondrial function would not surprisingly lead to cognitive losses and ultimately dementia.

        I am in the trenches directing a Cardiac Rehabilitation program and I see the damaging effects of lowering cholesterol in my patients. Back in the 70’s and 80’s before statins came along virtually every single dietary intervention study that attempted to lower cholesterol failed to show any cardiovascular prevention effects. I do not recommend lowering LDL cholesterol by any means as there are a hundred variables that affect it, including hypothyroidism which is endemic in our population. Those people who survive to 100 years old have an average serum Total Cholesterol of 250. Levels below 150 are correlated with a higher death rate in many studies. The Lipid Hypothesis of Atherosclerosis has been debunked IMHO.

      2. Ok here you go. This is from an anti-aging physician in Florida.

        Similar to what is reported below, the degree of cholesterol lowering in statin studies does not correlate with clinical results. In other words, if “high cholesterol” was a causative agent in vascular disease then we would expect those with the highest levels who have the greatest degree of lowering to have the greatest degree of benefit. In fact, none of the statin studies show that. The minuscule 0.8%/year reduction in C-V death rate over a 5 year period in the Scandinavian Simvastatin Survival Study was distributed over the entire serum cholesterol spectrum ,confirming this effect is “pleiotrophic” and possibly due to the inflammation reducing effects of statins. They block nuclear factor kappaB which is pro-inflammatory. Duane Graveline MD discussed the “five faces of statins” in detail and describes the good and bad aspects of interrupting this and other metabolic pathways (CoQ10, Dolichols, and cholesterol to name a few). Testosterone and sperm production with libido reductions are also “side effects” of statin drugs. Testosterone has C-V protecting effects, so why would we want to further lower already falling-with-age free testosterone levels with a statin drug? Answer: We wouldn’t!

        https://spacedoc.com/articles/the-five-faces-of-statins

        Statins also block the Vitamin K pathway leading to arterial calcification. President Trump has been persuaded by his primary care physician to take a statin which he has done for the last 9 years (at least) and during this time his Coronary Calcium Score has progressed from 34 to 98 to 139. That’s not too bad on a scale of 0 – 400, but it indicates progression of some degree of atherosclerosis and the statin is not only not stopping it, it may be worsening it and slowly calcifying one or more of his coronary arteries. I see patient after patient who have been on a statin for several years and experience what I consider to be rapid progression of disease and another cardiac event (new onset angina, new MI, new stent, new CABG surgery or re-do CABG). My own impression is that statins accelerate the progression of atherosclerosis………..they certainly do not stop it nor slow it down in my experience.

        Lowering serum LDL levels is not only an exercise in futility via a statin drug, it leads to a Pandora’s box of negative unwanted direct effects that reduce quality of life and lead to other drug induced diseases and no real effect on heart disease, Most all statin studies show no reduction in heart attacks nor strokes from taking one, only a very slight reduction in death rate in some but not others. The 4S study found exactly that and that was in men who already had existing coronary artery disease. In the “at risk” healthy population, the results are even more abysmal.

        RANDY ICE PT, CCS

        Cholesterol Levels and Atherosclerosis: Autopsy Studies Show No Correlation Posted on December 12, 2017

        Cholesterol Levels and Atherosclerosis: Autopsy Studies Show No Correlation By Jeffrey Dach MD Drs William Ware (25) and Uffe Ravnskov(1) have both pointed out an inconvenient truth. Many autopsy studies dating back to 1936 all show the same finding: cholesterol levels do not correlate with the amount of atherosclerosis found on autopsy studies.(1)(25) If accepted as true, this would indeed disprove the cholesterol theory of atherosclerotic heart disease. Left Image: CAT scan of atherosclerotic disease in coronary artery (white arrow). Courtesy of Pathology Outlines.com Drs Landé and Sperry conducted an autopsy study published in the 1936 Archives of Pathology. They say: “In fresh autopsy material in 123 cases of violent death they compared the serum cholesterol content with the lipid content of the aorta. No relationship was present in any age group. It is concluded that the incidence and severity of atherosclerosis in man is not directly correlated with the blood serum cholesterol content.”(2) Dr KS Mathur did another autopsy study published in 1962 in Circulation.
        Two hundred cases were selected from medicolegal autopsies for a study of the relationship of serum cholesterol to the amount and severity of atherosclerosis in the aorta and the coronary and cerebral arteries… No correlation could be observed between the serum cholesterol level and the amount and severity of atherosclerosis in the arteries.(3) A more recent study of 51 autopsies, by Dr Braz in the 2007 J Med Biol Res showed: “that in patients with severe atherosclerosis blood cholesterol and triglyceride levels seem to have little influence on coronary lipid content, indicating that other factors may contribute to arterial lipid deposition and plaque formation.”(4) Dr Paterson published two studies in 1960 and 1963 (Circulation) evaluating “Serum lipid levels and the severity of coronary and cerebral atherosclerosis in adequately nourished men, 60 to 69 years of age.” He says: “No significant relationships,nor any trend toward such relationships,were found in 18 individual analyses concerning the coronary arteries. Furthermore, the mean serum lipid levels were consistently (but not significantly) higher in persons who did not have demonstrable sequelae of coronary sclerosis at autopsy than in persons who had sequelae. We conclude from these results that the validity of the “lipid theory” of atherosclerosis remains unproved, as far as the coronarv arteries are concerned.“(5-6) Many other have reported similar findings (7,8) Mainstream Cardiology Has Rejected This Information Of course, as Dr William Ware has pointed out, mainstream cardiology has ignored and rejected the information that autopsy studies showing no correlation between serum cholesterol and extent and severity of coronary artery disease.(25) Another inconvenient fact ignored by conventional cardiology is that modern imaging studies with Calcium Scoring have falsified the cholesterol theory of heart disease.(25) This was discussed in my previous article.
        My Neighbor Bill Last week I was having a beer in the back yard with my neighbor, Bill who is recovering from a triple bypass operation. Bill said: “It was my darn cholesterol that caused it….I’m taking Lipitor (statin drug) and my cholesterol is a lot lower now.“ I said “that’s great, Bill”. People believe that cholesterol causes heart disease thanks to drug company television advertising. I didn’t have the heart to tell Bill the theory cholesterol causes heart disease has been disproved by numerous autopsy studies. I knew that Bill believed in the cholesterol theory of heart disease, and any information to the contrary would induce a state of shock and disbelief. The benefit from statin drugs is not solely from reduction of LDL cholesterol. Rather, the benefit of statin drugs, if any, arises from the pleotrophic effects as anti-inflammatory drugs.(17-18) Pleiotropic Effects Explain Clinical Benefit of Statins (if any)

        This is a quote from Dr Kavalipati(17): “Over the years, analyses of several clinical studies, including the landmark HPS and ASCOT-LLA trial, reported findings with statins that were inexplicable with the lipid-lowering mechanism alone.”(17) At the same time the statin drug reduces serum cholesterol, there is a simultaneous pleiotrophic effect (anti-inflammatory) which is completely independent from the cholesterol lowering effect. How much clinical benefit is due to cholesterol lowering, and how much benefit is due to pleiotrophic effects is a matter of debate. According to Dr Oesterle in Circulation Research 2017: “Statins may exert cardiovascular protective effects that are independent of LDL-cholesterol lowering called pleiotropic effects…..The relative contributions of statin pleiotropy to clinical outcomes, however, remain a matter of debate and are hard to quantify because the degree of isoprenoid inhibition by statins correlates to some extent with the amount of LDL-cholesterol reduction.”(18) All the Benefits of Statin Drugs Are Due to Pleiotrophic Effects My best guess is that all the benefits of statins are due to pleiotrophic effects. This is supported by the fact that other lipid lowering drugs using a different mechanism from statins failed to prevent heart attacks or strokes. (23,24) A perfect example is the new drug, evacetrapib, which lowers LDL and increases HDL cholesterol using a different mechanism from statins. After the evacetrapib failed to prevent heart attacks or strokes in a huge randomized placebo controlled trial published in 2017 NEJM, the drug was abandoned. (23,24) The drugs lowered cholesterol, but had no clinical benefit in preventing cardiac events.
        Statin Drug Studies Before and After 2005 Dr Michel de Lorgeril in his two articles from 2015 and 2016 reveals an unpleasant fact.(22,23) Because of the Vioxx Scandal, Congress tightened rules for clinical drug trials in 2005. Statin drug studies before 2005 are of questionable validity, and after 2005 are more “transparent”, “honest” and of greater validity.(22,23) This is Dr Michel de Lorgeril’s conclusion: “In conclusion, this review strongly suggests that statins are not effective for cardiovascular prevention. The studies published before 2005/2006 were probably flawed, and this concerned in particular the safety issue. A complete reassessment is mandatory. Until then, physicians should be aware that the present claims about the efficacy and safety of statins are not evidence based.”(22) Statins Not Beneficial In Primary Prevention Regarding primary prevention of heart disease by statin drugs in healthy patients with only elevated cholesterol and no known underlying heart disease, Dr Michel de Lorgeril says that Statin drugs have no benefit, and their discontinuation might even save lives: “We conclude that (1) despite the recent hype raised by HOPE-3, the cholesterol-lowering rosuvastatin is likely not beneficial in intermediate-risk individuals without cardiovascular disease (primary prevention). This trial may even represent a typical example of how evidence-based medicine has been flawed in commercial studies. (2) Statin discontinuation does not lead to increased (Ischemic Heart Disease) IHD and overall mortality, at least in the months following interruption of treatment. On the contrary, one might even conclude that statin discontinuation could save lives.“(23) Conclusion: Many autopsy studies dating back to 1936 show no correlation between cholesterol level and severity of atherosclerotic disease. The clinical benefit of statin drugs, if any, is entirely due to the pleiotrophic effects. Reduction of cholesterol with non-statin drugs do not prevent heart attacks or strokes.(19-25) For more information on what really causes heart disease and how to prevent it see my previous article on this topic.

    2. Spot on and the best way to test of future problems is the Krafft insulin assay. A wonderful piece of research dating back to the 1970’s but promptly buried by the research community

      1. I have read that study, and agree that both high and low insulin levels are a problem. But no primary physician is going to do these tests.
        The research is all over the place, and testing for one facet of diet cannot be conclusive. I do think saturated fat is a problem, but so are damaged vegetable oils.
        I would like to see older people put on truly healthy diets, low saturated fat, no added vegetable oils, no high glycemic foods. Get fats from food. At least 9 serving of veggies and low carb fruit a day. Who is trying that approach?

        Most people I see have both diabetes and heart disease. Drives me crazy, since the diabetes needs a very low carb diet to get A1c in normal range.
        But, if they are normal, or even low weight, (20% of them), they need calories from somewhere. Diets like Esseltyne and Campbell recommend drive their post-prandial numbers thru the roof. Multiple studies show that’s a formula for heart disease.

        1. As mentioned in my other comments to you, it seems to me that Dr. Fuhrman’s approach fits the bill – low glycemic, whole food plant-based diet allowing plenty of fats from nuts/seeds and avocado, and prefers limiting even complex carbs to some extent, depending on the individual needs. Cf. The End of Heart Disease or his website for details.

          1. I agree, I think Fuhrman’s recommendations are balanced.
            I like his Gbombs, (greens, beans, onions, mushrooms, berries and seeds,nuts) approach.
            But that is essentially what Dr. Gregor recommends. His daily dozen.
            The problem is with people who, for genetic reasons, cannot convert beta-carotene to vitamin A, or alpha-linolenic to EPA, DHA.

  24. There is so much to like about this web site but the obsession with cholesterol is really dangerous when it spills over into dementia. A bigger threat for dementia is low cholesterol levels, the type brought about by statins. We now have cholesterol guidelines dictated by drug companies that mean perfectly healthy LDL levels eg 3.0 mmol are suddenly dangerous. The biggest danger to the promotion of dementia is a high simple carb diet which in turn promotes cardio vascular disease.

    1. If low cholesterol is really the cause of Alzheimer’s, then how do you explain away the fact that individuals with the APOE4 allele have the greatest risk of developing Alzheimer’s? These individuals tend to have the highest cholesterol levels in the population if they are consuming a Western diet. On the other hand, APOE4 positive individuals who consume a very low fat, plant based diet have low cholesterol levels and do not get Alzheimer’s.

      Dr. Jamie Koonce

      1. You are making a gigantic leap from correlation to causation. I would suspect that type 4’s due to interference with sat fat processing resulting in disruption of reverse cholesterol transportation have higher levels of circulating and therefore oxidising cholesterol. If this is the case then it is a hugely damaging proposition to suggest that everyone should have a cholesterol levels below X. Why do people with cholesterol levels above X on whole food diets not get Alzheimers. This argument is kind of like suggesting that white blood cells tend to be high when people have some disease or another and therefore we should lower white blood cells into the basement for all members of the population

    2. Btw, do you think testing C Peptide levels after a standard meal of any value. I have read that a number of studies show older people do not make enough insulin, or their body no longer has a healthy response.
      Also, could you expand on the vitamin K pathway. Do you mean K1 or K2?
      I have seen studies done in Holland showing arterial plaque reduction using K2.

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