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Alzheimer’s Disease and Dietary Copper

Though the underlying cause of Alzheimer’s disease has yet to be found, there is increasing concern about the role of metals in the development of the disease, as I discuss in my video Alzheimer’s Disease, Copper, and Saturated Fat. “Iron and copper,” for example, “are strongly concentrated within the neuritic plaques and neurofibrillary tangles that represent the hallmarks of the [Alzheimer’s] brain.”

Alzheimer’s disease victims have higher levels of copper in their blood and in the fluid that surrounds their brain, as well as inside their brain. Researchers found that in a slice of Alzheimer’s-diseased brain tissue, the amyloid plaques correspond to copper hotspots. Copper may then make these amyloid plaques more toxic, “leading to increased oxidative stress.” “Free Cu [copper] is extremely efficient in the generation of free radicals,” and when copper is removed with a chelating (metal-binding) drug, the free radical oxidation drops.

Unfortunately, when researchers gave that drug to nine Alzheimer’s patients in a pilot study, it did not seem to have any effect on slowing the clinical progression of the disease. Perhaps we need to prevent the copper buildup in the first place?

“Organ meats and shellfish are the richest food sources of copper,” but should we also consider cutting down on plant sources, such as nuts, seeds, legumes, and whole grains? Copper intake only seems to be a problem when consumed with saturated fat or trans fat. In the Chicago Health and Aging Project, thousands of elderly Chicagoans were followed for six years. Those who were getting the highest copper doses, largely from multivitamin supplements, combined with a diet high in saturated fats, lost cognition as if they had aged 19 years in a period of 6 years, tripling their rate of cognitive decline. However, copper intake “was not associated with cognitive change when the diet was not high in saturated fats.”

Diet-induced high cholesterol “has been shown to increase the formation and progression of [amyloid] plaques in the brain.” As well, “dietary copper may interfere with clearance of [amyloid] from the brain and may further promote [the plaque] accumulation that results from elevated cholesterol levels.” Copper has been shown to interact badly with amyloid, causing its clumping and the production of hydrogen peroxide, a potent pro-oxidant neurotoxin.

This may explain why the higher the levels of copper, the quicker Alzheimer’s disease may progress, particularly among people with high cholesterol levels. What do we think may be happening? As cholesterol and copper levels rise, cholesterol is incorporated into the nerve cell membrane, causing it to stiffen. The amyloid protein in the membrane detaches to form plaques, at which point iron and copper generate neurotoxic free radicals. Inside the cell, similar havoc is created. Finally, cholesterol-enriched diets can lead to nerve cell death, DNA damage, and blood-brain barrier disruption.

“In conclusion, the present systematic review suggests that a diet rich in [copper and iron] might aggravate the detrimental effects of a high intake of cholesterol and [saturated fat] on the risk of developing [Alzheimer’s disease].” So, diets rich in saturated fat and deficient in antioxidants appear to promote the onset of the disease, while more plant-based diets would likely suppress its onset. There are compounds in plant foods that not only scavenge free radicals and prevent oxidative damage, but are also known to chelate, or bind up, metals, potentially making them additionally protective against the onset of Alzheimer’s. Therefore, the practical implications could be to eat lots of fruits and vegetables, avoid copper-containing supplements, and avoid high intakes of saturated fat and excessive iron intake.


Isn’t Alzheimer’s genetic? What about the “Alzheimer’s gene”? Just because we’ve been dealt some bad genetic cards doesn’t mean we can’t reshuffle the deck with diet. See The Alzheimer’s Gene: Controlling ApoE.

If the relationship between cholesterol and dementia is new to you, see Alzheimer’s and Atherosclerosis of the Brain and Cholesterol and Alzheimer’s Disease for more.

What else can we do to protect our brain? Check out:

It’s never too early to start eating healthier, because Alzheimer’s May Start Decades Before Diagnosis.

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.


55 responses to “Alzheimer’s Disease and Dietary Copper

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  1. Darn! I was wondering about that 2 mg (100% DV) of copper contained in my zinc supplement. Looks like I’ll have to go with just zinc next time.

      1. Nav,

        It depends what you eat.

        According to veganhealth.org, women need a minimum of 9 milligrams of zinc per day, while males need 11.

        Look at the list and see if you eat the foods with it.

        https://veganhealth.org/zinc/

        I don’t always eat enough. They say things like 2 tablespoons of Nutritional Yeast gives 20%, but I don’t always use 2 Tablespoons. Oatmeal gives about 25%, but I eat it well for 3 months and then don’t eat breakfast for the next 3 months. 15% from beans and I get those most days. Another 12 to 15% from nuts and lately I am inconsistent with the nuts. I probably haven’t had nuts in 2 months, partly because the month before that I was eating 3 or 4 handfuls rather than one serving. I didn’t gain weight with it, but I could see the day coming where I might be eating half a jar of peanuts per day and that was not in the spirit of what I have been doing. Yes, I switched to Pistachio nuts because 123 would probably not cause weight gain, but 123 also would not cause weight loss and I have been losing weight, not wanting to plateau. So I lost that zinc source.

      2. I check my nutrient intake on cronometer from time to time and have noticed that I sometimes miss the zinc RDA for a male (11 mg) despite the fact that I eat lot of nuts and seeds every day. There are studies showing zinc is often lower in vegans (or perhaps it was vegetarians, can’t recall exactly).

    1. Matt,
      If you consume raw shelled pumpkin seeds (aka Pepitas) you will get all the zinc you need along with other nutrients. I use two tablespoons in my morning smoothy and another tablespoon on my evening salad. very tasty as well.

    1. I would stay away from it- it’s in your body after all next to a place just bursting with nerves and blood vessels- I can’t imagine some of it doesn’t get absorbed.

      There are much safer alternatives to IUDs like fertility awareness. Totally natural just observing your fertility signs and deciding whether or not to have intercourse. There are tons of great methods out there now (not like our Grandma’s guess method). I use one that uses temperature and cervical mucus. No pills, metals, latex, shots, surgery, etc….!!! Just you and your man! Eco friendly, good for your body and the Earth. I love it- and feel like such a real woman knowing everything about my cycle and getting to see how my body is working each month- it’s a crime more women don’t know about it- so empowering!

  2. I would think that copper water pipes must have some bearing on copper levels in the body? And how about the wearing of copper bracelets etc for arthritis?

    1. Barb,

      I took this from Minnesota’s drinking water page:

      “Copper works its way into the water by dissolving from copper pipes in the household plumbing. The longer the water has stood idle in the pipes, the more copper it is likely to have absorbed. (Newer homes with copper pipes may be more likely to have a problem. Over time, a coating forms on the inside of the pipes and can insulate the water from the copper in the pipes. In newer homes, this coating has not yet had a chance to develop.) Thus, anytime the water has not been used for more than six hours-overnight, for example, or during the day when people have been gone to work or school-it should be cleared from the pipes before being used for drinking or cooking.

      This can be achieved by letting the cold water faucet run until you can feel the water getting colder-usually 30 to 60 seconds. This must be done before taking drinking water from any faucet in the house.

      In addition, hot water dissolves copper more quickly than cold water; as a result, water to be used for drinking or cooking should not be drawn from the hot water tap. If you need hot water for cooking or drinking, take water from the cold tap and heat it. It is especially important not to use the hot water for making baby formula.

      What is my local water supplier doing about copper?
      Water supply systems that have exceeded the federal “action level” of 1,300 parts per billion of copper are taking a number of steps to deal with the problem. These include testing the source water for contamination and treating the water to make it less corrosive or less likely to absorb copper from the plumbing.”

  3. In the nether recesses of my memory (maybe from Nutrition Facts), there was a theory that copper chronologically followed AD plaques, and may even be preventive of AD. I found this scientific article, with some quotation from it below. Question: has this theory been disproven?

    Copper prevents amyloid-β1–42 from forming amyloid fibrils under near-physiological conditions in vitro (Scientific Reports, Feb, 2013)

    “Recent evidence has indicated that not only is the copper content of human brain tissue lower in AD17,18 and in congophilic amyloid angiopathy (CAA)19 but that there is a negative relationship between brain copper content and amyloid pathologies in AD and CAA20. Lower copper leads to more extensive and more aggressive amyloid pathology. Herein we have thoroughly investigated the affect of Cu(II) on the propensity for Aβ42 to form ThT-positive β sheet rich amyloid fibrils and we have found no evidence under near-physiological conditions to support an accelerant effect of Cu(II) on fibril formation by Aβ42.”

    “In particular the question has been raised if sub- and super-stoichiometric concentrations of Cu(II) act in opposing ways in respectively accelerating and preventing amyloid fibril formation by Aβ42.”

    https://www.nature.com/articles/srep01256#abstract

    (The whole article is displayed, scrolled to the abstract.)

    1. Hi, Karen! Intake of metals such as copper and iron only seems to be a problem when consumed with high amounts of saturated fat or trans fat. Leafy greens such as kale and collards contain no saturated or trans fat, and should not in any way increase the risk of developing Alzheimer’s disease. As stated in the post above, “diets rich in saturated fat and deficient in antioxidants appear to promote the onset of the disease, while more plant-based diets would likely suppress its onset. There are compounds in plant foods that not only scavenge free radicals and prevent oxidative damage, but are also known to chelate, or bind up, metals, potentially making them additionally protective against the onset of Alzheimer’s. Therefore, the practical implications could be to eat lots of fruits and vegetables, avoid copper-containing supplements, and avoid high intakes of saturated fat and excessive iron intake.”

      Furthermore, research indicates that the bioavailability of heavy metals may be lower in plant-derived foods than in animal-derived foods, despite the fact that plant foods sometimes contain higher amounts (see here: https://nutritionfacts.org/video/cadmium-and-cancer-plant-vs-animal-foods/).

      Leafy greens are considered to be one of the healthiest vegetables and offer numerous benefits! For more information, check out these links:
      https://nutritionfacts.org/topics/greens/
      https://nutritionfacts.org/topics/collard-greens/

    1. Cynthia,
      Copper intake along with saturated fats appear to be the primary problem in causing the free radicals that do damage in the brain. Dr. G noted that the intake of nuts and seeds in a plant based diet, that is naturally low in saturated fat, appear to be protective. Check out some of these videos on the health benefits of nuts. https://nutritionfacts.org/topics/nuts/

  4. Below are comment from a biochemist interested in copper…
    ————————
    A study of the brains of sixty people with Alzheimers found the areas highest in copper were the healthiest.

    Is the person who wrote this seriously educated in science?

    Look at https://www.mdpi.com/2076-3425/7/2/20/htm

    3.2. Copper Deficiency, Dementia, and Nerve Dysfunction Copper is an essential component of important anti-oxidant proteins such as SOD (copper zinc superoxide dismutase), ceruloplasmin, and Atox1 (human antioxidant protein 1). Copper deficiency has been postulated as a causative factor in a variety of gene diseases such as Alzheimer’s [25–30], myelopathy [31], motor neuron diseases and amyotrophic lateral sclerosis [32], Huntington’s [33], Lewy bodies and Creutzfeldt Jakob diseases [34]. More importantly, analysis of actual human brains from deceased patients with dementia has found the damaged areas to have very little cellular copper. In plaques from persons with Alzheimer’s disease, iron and aluminum appear to cause plaque formation while copper and zinc may be protective [26–28,35–37]. Copper deficiency caused by bariatric surgery or gastrointestinal bleeding led to myelopathy (human swayback), paralysis, blindness and behavioral and cognitive changes. Mice born and maintained on a copper deficient diet had 80% reduction in brain copper level at 6-8 weeks and had neuronal and glial changes typical for neurodegenerative disorders [25,31,38,39]. 3.2.1.

    Supplying Copper to Nerve Cells
    Though copper deficiency appears linked to major nerve diseases, the use of copper supplements as a treatment has been disappointing. A placebo-controlled study of 68 Alzheimer’s patients (34 control, 34 copper) with a treatment of 8 mgs of daily copper (a high level) for 1 year produced no negative findings. This seems to rule out excessive copper levels as a causative agent for the development of Alzheimer’s. The predictive protein marker, CSF Abeta42, is lower in persons developing Alzheimer’s. Subjects given extra copper supplementation maintained this protein at a higher level, a possible positive effect, but there was minimal improvement in the disease [40].

    Also, look at Int. J. Mol. Sci. 2018, 19(7), 1987; https://doi.org/10.3390/ijms19071987

  5. Great information on Dr. Gregor’s website. Zinc “competes” with copper in the body and basically pushes it aside when it is in excess. This reduces the damage that it can do.

    Why not investigate aluminum and its possible role in Alzheimer’s? One source could be vaccines, as well as the cookware. How about the doctors in old age homes and hospitals who prescribe vaccines for people entering the hospital without asking the patients or their caregivers if they want it or need it?

    Or this this no-go zone even for Dr. Greger?

    1. I am fascinated by how many people think that Dr. Greger and his 19 researchers are trying to withhold information from us.

      I am thinking that there are so many topics generated by the 100,000 studies released every year that it is hard to fit everything into the 260 slots (between the blogs and the videos) The 52 audio pods are rehashed information.

      You can either put your questions here or try to toss them into the live Q&A’s.

      I don’t think the extra questioning of him gets the topic answered faster, but if you ask something and he has a video ready, he is really good at posting it.

  6. How about copper pipes? I had my old lead water pipes replaced by copper… I am really worried now about cooking and drinking the water

    1. YR,

      I am going to say that Dr. McDougall suggested 12 weeks of Fiji Water to get rid of aluminum and it got rid of my hallucinations. My mind has been more sound. Yes, I have also been dealing with blood sugar and homocysteine and balancing the copper/zinc ratio and everything else I could think of, but I had already done that whole list and the hallucinations didn’t go away until the Fiji Water.

      Maybe a respect for Dr. McDougall led to some sort of placebo effect? Could be, but I had been working on the brain work for a year and a half at the time and had seen improvement from each thing, but I was sitting on this site in the middle of the night because I was terrified from the hallucination and now I am only on the site because of insomnia.

        1. YR,

          I think the same thing. That is how I remember the initials. If it weren’t for that subliminally placed acronym, I would spell it wrong.

          Easier to remember than methylenetetrahydrofolate reductase

          When you say they have the problem, I am going to ask did they do a genetic testing AND are they high in homocysteine and do they have deficiencies in folate, choline, or vitamins B-12, B-6, or riboflavin?

          Meaning did they find out because they are having problems or did someone talk them into 23and me?

          Here is a version of what I read where they think it is all hype. Not saying it is. Just saying that I have read how important it is and I have also read that people end up going wacko about Methyl donors and give themselves other problems. Interestingly, I listened to Dr. McDougall talk about supplements for about an hour 1:30 in the morning and I can’t remember what he said about it. I guess it was still this morning, even though we are edging toward midnight here.

          But this I do remember:

          https://sciencebasedmedicine.org/dubious-mthfr-genetic-mutation-testing/

      1. The part where they talk about Ben Lynch who is the voice of that movement says:

        “Lynch didn’t do any sort of residency, fellowship or any post-undergraduate education or training in genetics (or anything else, as far as I can tell). He is not a member of any reputable organization of genetic experts that I could find. According to my PubMed search, Lynch has never published any genetics research. In fact, I can’t find that he’s published any peer-reviewed research at all.

        Instead, his “research” seems to consist of collecting anecdotes from individuals in blog format and posting them online. These posts, which are sometimes identified by name, have all sorts of personal medical information in them, both of the writer and others who could be identified by their connection to the writer. What he is doing with this “research” is unclear, other than it is not being published in a reputable journal. Nor do I find that he is, or has been, involved in research listed on clinicaltrials.gov. There is no reference indicating that any of his research has been approved, or exempted from approval, by an Institutional Review Board, even though it obviously involves human subjects.”

        I have mixed thoughts about Naturopaths because people do seem to be happy with them. In many ways, I am treating my dog with diet and Medicinal Mushrooms and CBD Oil and medical people usually poo poo those as scams, but my dog is still alive.

        Tonight, he just stared at me all night smiling. He hates that I leave him to go to work and he literally won’t take his eyes off of me when I get home.

        1. If your friend is deficient in B6 or B12 adding in a Methyl donor isn’t a big deal.

          I do like this sentence from that article:

          “As a real geneticist, Charis Eng, MD, PhD, points out, none of this means genetic testing is necessary. For some problems, there are cheaper alternatives that give better information. If high homocysteine levels are suspected, the simple solution is a blood test. If the blood test bears this out, supplementation with vitamins such as B6, B12, and folate or folic acid can be recommended. If the levels are normal, nothing need be done, whether the mutation is present or not.”

          1. Okay, I remember now.

            Dr. McDougall says to eat foods with Folate and that Folic Acid supplements are dangerous and that treating Homocysteine with vitamins fails.

            He said http://www.nealhendrickson.com/mcdougall/040200pufavorite5.htm

            “Multiple studies have shown a correlation between elevated levels of the amino acid homocysteine and various diseases common in people who follow the Western diet (stroke, heart attack, deep vein thrombosis, Alzheimer’s disease, etc.). The “medical” way to solve this problem is to find a pill – in this case a multivitamin. Unfortunately, as in most cases where dietary problems are treated with drugs, the results are a failure. The reason is the high homocysteine is not the problem, but only a sign (also called a “maker” or risk factor) elevated by the real problem: an unhealthy diet. Other signs of an unhealthy diet that are treated with drugs include cholesterol, triglycerides, glucose, and blood pressure. The results from lowering these signs with drugs are also disappointing and far less than would be seen by correcting the cause. Therefore, if you wish to lower your homocysteine (as well as other risk factors) and improve your health (at no cost and with no side effects), consume a diet based on starches with the addition of fruits and vegetables. ”

            He is in favor of B-12 supplements and food sources of B-6, but when he says food sources, it is foliage that he says to remember. Plants. (Versus the foods where Folic Acid is added.)

            I believe Dr. Greger spoke about lowering it with B-12 and I am suddenly confused remembering that video, because they lowered it using cyanocobalamin and the people were eating enough plant foods to have enough B-6. They didn’t need a Methyl Donor to lower it? Oh wait, that is for people without the mutation. Okay. I think the people with the mutation DO need one.

            I think this might actually be a case where Dr. Greger would say that they need a Methyl Donor and that the Methyl version of B-12 might be a good concept versus the Methyl version of Folic Acid. I don’t know what the other Methyl Donors would be. Is MSM one? It has the initials.

            The problem would still be that Methyl may not be enough and it may need to be taken with Cyano or Adeseno to keep your friend out of deficiency if your friend is indeed in deficiency.

            1. Here is another page about it from Dr. McDougall. https://www.drmcdougall.com/misc/2005nl/oct/051000folic.htm

              “Cardiologists are fond of recommending vitamin pills to treat elevated homocysteine in hopes of preventing further heart disease in their patients. One of the most commonly prescribed preparations is called Foltx – a combination of 2.5 mg of folic Acid, 25 mg of vitamin B6, and 2 mg of vitamin B12. A recent study showed a similar preparation reduced the homocysteine levels of patients with a history of stroke by 2 units (umol/L), but found no difference in risk of future strokes, heart attacks, or death compared to a control group.5”

              1. “Taking supplements with as little as 0.8 mg/day of folic acid has been shown to increase your risk of dying of heart disease and cancer, according to the results of the first large randomized treatment trial to carefully examine this issue.1 The Norwegian Vitamin Trial (NORVIT) of 3,749 patients, who were followed for 3.5 years was designed to show the benefits of taking supplements—but the results were contrary to expectations. Folic acid supplementation was found to lower homocysteine levels by 28%., but to increase relative risks of heart attack, stroke, and death by 20%, along with a more than a 30% increase in cancer.”

                1. Sorry that it always takes me several tries to figure out what to say. Sometimes I actually re-read what I wrote and can barely read it, even though the concepts were so clear in my brain before I typed them.

                  I had that happen today…er….yesterday….

                  I listened to WNPR and Colin said something, which I wanted to respond to and he always answers his emails, which is consistently surprising to me. He is very polite and he is also someone who just says whatever he is thinking, which is what he and I have in common. Anyway, today he just said two sentences, but it was something like Fantastic email. Amazing! Which caused me to re-read my email and it was so clunky and hard to read and long-winded, like my comments here. He gave me credit for sincerity, is what I am going to say. He could just as easily have said, “Wow, that was long-winded and challenging to read.” But he genuinely tends to be gracious, even though he and I have not always agreed on every single subject. But he is nice when people don’t agree.

                  1. Deb, thanks for all your (inevitable!) research. I think it’s still a WIP with her — she’s seems to feel a lot better so far, is all I know. Was having various problems…..

                    I don’t know where she sent her DNA swab, but am pretty sure it wasn’t to that 123 outfit.

                    1. My friend’s sister has it and the doctor has suggested that the rest of the family gets tested.

                      She is being given a doctor prescribed pill of some sort.

                      The fact that you can affect the Homocysteine levels by lowering meat intake and upping plant-based foods intake and adding a Methyl Group when you take B-12 makes me wonder what the risks of the pills the doctor gave to her are.

  7. I am a pharmacist and independent researcher of the scientific literature for many years. I enjoy the information provided on Nutritionfacts.org but sometimes the quest for research keeps people from seeing the forest for the trees. I’ve been trained in chemistry and anthropology and I see things differently than most. Almost all of our copper stores are stored in our liver. Copper is supposed to work intracellularly with little quantities in the serum. That means that testing blood levels can be misleading. Copper is released as part of our immune response and helps reduce pathogenic load. If copper levels are high, immune activation and the cytokine cascade have occurred. If copper levels are low, the copper stores have been depleted due to long term immune activation often from from chronic inflammation. Both of these situations are dependent on normal environmental copper exposure. There are many environmental exposures that can alter copper levels. Over time in chronic infection/inflammation, the body down regulates immune response. This could show up as a decrease in both intracellular and extracellular copper levels, reductions in important substrates like Mg, Cu, Zn, Mb, and Mn to name a few, or it could show up as epigenetic shifts in MTR, MTRR, MTHFR, CBS, BHMT, SOD, MAO, and COMT to name a few. Alzheimers is a complete immune dysfunction over time. The increase in oxysterols is only one of many examples of systemic biological pathway dysfunction. It starts with dysbiosis in the distal illeum and the proximal colon and ends with amyloid plaques in the brain. Copper is only 1 component of many issues that must be corrected.

    1. Matt,

      I think most of the doctors I have listened to agree that Copper is only one component of many issues that must be corrected.

      Dr. Greger has already talked about clogged arteries and other things. This is one of the topics. Grateful to have you add to the list.

      1. If you look up PubMed thete are studies saying that IUD’s don’t raise Serum Copper levels.

        They were also studying if it raised cholesterol and also whether it changed the gut microbiome. I don’t think they have found real problems with it so far, except the risk of PID.

  8. My sleeping is about 2 hours farther off after trying to fix it. I have to go back to the jet lag video and try to make it even worse and see if that eventually fixes it.

    My brain really is still far off. I don’t know how many people here have noticed. And no I am not far off in a way that my stories are fiction.

    But I have ridiculous brain processing and executive function problrms still.

    I am still so happy that it feels like it doesn’t matter but it matters for work and home and for taking care of my dog.

    Lack of sleep doesn’t feel like it is harming me eithet, but I know I am probably missing all of my autophagy or something.

    1. Even though I am a Creationist, I am pretty sure that I am evolving to not need sleep anymore.

      And that would be fine except that I also think I am naturally selecting to not accomplish things properly. Perhaps an adaptive function similar to our government where we try to make sure that nobody in government can get anything done because we are pretty sure it is safer that way.

  9. Does this relationship between dietary copper and Alzheimer’s have any implications for women who have a copper IUD implant for contraception?

    1. Hi, Michelle! I could not find any studies specifically looking at the use of copper IUDs and Alzheimer’s risk. Considering the evidence discussed above, showing that copper intake is only problematic in increasing Alzheimer’s risk when consumed with high amounts of saturated or trans fat, use of copper IUDs is likely safe as long as a healthy diet is being consumed. Consuming a plant-based diet, rich in antioxidants and low in saturated fat and trans fat, is very protective against Alzheimer’s.

    1. Hi Irina – Thanks for your question! Yes, we do have strong evidence that a diet high in saturated fat is associated with increased LDL cholesterol levels. It is therefore recommended to limit saturated fat intake and choose unsaturated fat sources instead (ex. nuts, seeds, avocado, flaxseeds).

      I hope this answers your question!

      Janelle, RDN CD
      Registered Dietitian Nutritionist & Health Support Volunteer

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