Avocados Lower Small Dense LDL Cholesterol

Avocados Lower Small Dense LDL Cholesterol
4.8 (96.09%) 87 votes

What are the effects of oatmeal, walnuts, extra virgin olive oil, and avocados on LDL cholesterol size?


Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

When one sees headlines like, “Avocados Could Improve Your Cholesterol,” they’re largely talking about substitution experiments, where avocado is added to the diet by replacing animal fats. So, no wonder cholesterol goes down. So, for example, if you take people eating a standard North American diet, including animal fats—dairy and poultry are the two greatest contributors of cholesterol-raising saturated fat intake—they may start out with an LDL up around here. Just add avocado to their diet without doing anything else, and cholesterol does not go down. But, add avocado while reducing saturated fat intake, and cholesterol falls—but no more than just reducing saturated fat while adding nothing.

Okay, but what if you eat no meat at all, versus no meat with avocado added? They took people with sky-high cholesterol—up around 300—and switched them to a relatively low-fat vegetarian diet, with about 20% of calories from fat, versus a vegetarian diet with added avocado—bringing it up to more of a typical fat content: 30% of calories from fat. This group started out with LDLs through the roof, and while cutting out meat may have helped, cutting out meat and adding avocado seemed to help even more. And, it may help best with the worst type of LDL.

As I’ve touched on before, all LDL cholesterol is bad cholesterol, but large, fluffy LDL may only increase the odds of cardiac events—like heart attacks—31%, whereas small, dense LDL is even worse.

Feed people lots of oatmeal and oat bran, and not only does their LDL go down overall, but it specifically brings down the worst of the worst. Add walnuts to a low-fat diet, and not only does LDL go down, but the size distribution of the LDL shifts to a little more benign as well. And, if you put people on a plant-based diet with lots of fiber and nuts, you can get a massive 30% drop in LDL, comparable to a cholesterol-lowering statin drug. And, this includes the small, dense, most dangerous LDL. Note: this does not happen with extra-virgin olive oil. So, it’s not just a monounsaturated fat effect.

In the famous PREDIMED study, those randomized to the extra nuts group got a significant drop in the smallest, densest LDL, but those randomized to the extra virgin olive oil group did not. So, there appears to be some special components in nuts that lowers the worst of the worst. Do avocados offer similar benefits? We didn’t know…until, now.

“…[t]he first randomized controlled feeding trial” to look at avocados and LDL size; what they did was remove animal fat from people’s diet, and replaced it with either carbs, or avocado, or vegetable oils that had a similar fat profile to the avocado. So, the two latter diets were very similar diets, but one had the nutrients unique to the avocado, and the other didn’t. What happened?

Well, any time you drop saturated fat, you’re going to bring down LDL—whether you replace animal fat with plant fat (oil, in this case) or with carbs. But, what if you replace animal fat with the whole plant food avocado? An even better effect. And, to see why, they broke the LDL down into large versus small. They all brought the dangerous, large LDL down, but the avocado had the additional effect of also bringing down the super-dangerous small LDL. That’s where that extra drop came from.

So, it’s not just a matter of replacing animal fat with plant fat; there are additional benefits to the fiber and phytonutrients of whole plant foods, like avocados.

Oh, there’s something good in avocados? Well then, let’s just add avocado extracts to the meat! Incorporating avocado extracts into pork patties evidently reduces cholesterol oxidation products, “well documented” to be toxic, carcinogenic, and atherosclerotic—but less so, apparently, with some avocado mixed in.

Please consider volunteering to help out on the site.

Icons created by Blair Adams, Setyo Ari Wibowo, Numero Uno, and Ropyyan Wijaya from The Noun Project.

Image credit: Fanni Blake. Image has been modified.

Motion graphics by Avocado Video.

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

When one sees headlines like, “Avocados Could Improve Your Cholesterol,” they’re largely talking about substitution experiments, where avocado is added to the diet by replacing animal fats. So, no wonder cholesterol goes down. So, for example, if you take people eating a standard North American diet, including animal fats—dairy and poultry are the two greatest contributors of cholesterol-raising saturated fat intake—they may start out with an LDL up around here. Just add avocado to their diet without doing anything else, and cholesterol does not go down. But, add avocado while reducing saturated fat intake, and cholesterol falls—but no more than just reducing saturated fat while adding nothing.

Okay, but what if you eat no meat at all, versus no meat with avocado added? They took people with sky-high cholesterol—up around 300—and switched them to a relatively low-fat vegetarian diet, with about 20% of calories from fat, versus a vegetarian diet with added avocado—bringing it up to more of a typical fat content: 30% of calories from fat. This group started out with LDLs through the roof, and while cutting out meat may have helped, cutting out meat and adding avocado seemed to help even more. And, it may help best with the worst type of LDL.

As I’ve touched on before, all LDL cholesterol is bad cholesterol, but large, fluffy LDL may only increase the odds of cardiac events—like heart attacks—31%, whereas small, dense LDL is even worse.

Feed people lots of oatmeal and oat bran, and not only does their LDL go down overall, but it specifically brings down the worst of the worst. Add walnuts to a low-fat diet, and not only does LDL go down, but the size distribution of the LDL shifts to a little more benign as well. And, if you put people on a plant-based diet with lots of fiber and nuts, you can get a massive 30% drop in LDL, comparable to a cholesterol-lowering statin drug. And, this includes the small, dense, most dangerous LDL. Note: this does not happen with extra-virgin olive oil. So, it’s not just a monounsaturated fat effect.

In the famous PREDIMED study, those randomized to the extra nuts group got a significant drop in the smallest, densest LDL, but those randomized to the extra virgin olive oil group did not. So, there appears to be some special components in nuts that lowers the worst of the worst. Do avocados offer similar benefits? We didn’t know…until, now.

“…[t]he first randomized controlled feeding trial” to look at avocados and LDL size; what they did was remove animal fat from people’s diet, and replaced it with either carbs, or avocado, or vegetable oils that had a similar fat profile to the avocado. So, the two latter diets were very similar diets, but one had the nutrients unique to the avocado, and the other didn’t. What happened?

Well, any time you drop saturated fat, you’re going to bring down LDL—whether you replace animal fat with plant fat (oil, in this case) or with carbs. But, what if you replace animal fat with the whole plant food avocado? An even better effect. And, to see why, they broke the LDL down into large versus small. They all brought the dangerous, large LDL down, but the avocado had the additional effect of also bringing down the super-dangerous small LDL. That’s where that extra drop came from.

So, it’s not just a matter of replacing animal fat with plant fat; there are additional benefits to the fiber and phytonutrients of whole plant foods, like avocados.

Oh, there’s something good in avocados? Well then, let’s just add avocado extracts to the meat! Incorporating avocado extracts into pork patties evidently reduces cholesterol oxidation products, “well documented” to be toxic, carcinogenic, and atherosclerotic—but less so, apparently, with some avocado mixed in.

Please consider volunteering to help out on the site.

Icons created by Blair Adams, Setyo Ari Wibowo, Numero Uno, and Ropyyan Wijaya from The Noun Project.

Image credit: Fanni Blake. Image has been modified.

Motion graphics by Avocado Video.

Doctor's Note

What about the effects on cholesterol of people not consuming plant-based diets? See my video Are Avocados Good for Your Cholesterol?.

For more on avocados, check out:

For more on large, fluffy LDL versus small, dense LDL, see Does Cholesterol Size Matter?.

If you haven’t yet, you can subscribe to my videos for free by clicking here.

201 responses to “Avocados Lower Small Dense LDL Cholesterol

Comment Etiquette

On NutritionFacts.org, you'll find a vibrant community of nutrition enthusiasts, health professionals, and many knowledgeable users seeking to discover the healthiest diet to eat for themselves and their families. As always, our goal is to foster conversations that are insightful, engaging, and most of all, helpful – from the nutrition beginners to the experts in our community.

To do this we need your help, so here are some basic guidelines to get you started.

The Short List

To help maintain and foster a welcoming atmosphere in our comments, please refrain from rude comments, name-calling, and responding to posts that break the rules (see our full Community Guidelines for more details). We will remove any posts in violation of our rules when we see it, which will, unfortunately, include any nicer comments that may have been made in response.

Be respectful and help out our staff and volunteer health supporters by actively not replying to comments that are breaking the rules. Instead, please flag or report them by submitting a ticket to our help desk. NutritionFacts.org is made up of an incredible staff and many dedicated volunteers that work hard to ensure that the comments section runs smoothly and we spend a great deal of time reading comments from our community members.

Have a correction or suggestion for video or blog? Please contact us to let us know. Submitting a correction this way will result in a quicker fix than commenting on a thread with a suggestion or correction.

View the Full Community Guidelines

    1. I couldn’t find much about that reviewer besides her blog. She is just some 20-something year old with no credentials whatsoever. I don’t think that warrants a serious response from somebody like Dr. Greger.

      1. I agree. Checking the website and the about page reveals a seemingly investment oriented site looking to capitalize on our hunger and interest in health news and information.

      2. Minger is a “star” in the low carb/paleo/keto/Weston Price Foundation firmament. She is regarded as a heroine for criticising Campbell’s China Study book based on her own statistical analysis of the original data. However she is not a statistician let alone a bio-statistician. I think she was an English major but I am not sure if she ever graduated. The Weston Price and saturated fat crowd, and anti-vegetarians generally, desperately want Campbell’s book to be untrue so they lapped up her criticisms. Since no credible scientist let alone anybody from the Chinese Academy of Preventive Medicine, Cornell University or Oxford University that conducted the actual study itself, has disputed Cambell’s description of what the study found, Minger is the best that they can do. She is quite young but she has been doing this kind of stuff for a while and she is feted by the broad paleo/low/carb/WPF community. Plant Positive made a number of videos dissecting Minger’s claims back in 2012. No doubt she is trying to do the same thing with Dr Greger’s book and will use the same techniques. A gal’s gotta make a living after all ……

        I say that because I think that she now makes her living from writing articles and speaking engagements where she tells the alternative health crowd what they want to hear. Of course, she now has her own “nutrition” book for sale if anybody is interested.

        If I remember correctly, the authoritynutrition website was created by a Scandinavian personal trainer who was a passionate saturated fat advocate. Clearly he had a very high opinion of his own nutritional expertise if his decision to call his site “autthoritynutrition” is anything to go by. He gathered a number of like-minded young Scandinavian professionals around him and he began training as a physician. The site now has a number of native English speakers writing for it.

        Neither Minger nor authoritynutrition have any real credibility – except among the Jerry Lewis’ of this world and his ilk where you will find that she is frequently quoted and referred to.

        1. I don’t blame Dr. Greger from not reading ALL of the comments on YouTube, or even on this forum, but uses moderators to read the comments and to give rebuttals. Oh, I am sure he reads some of the comments, but he is a really busy person. What I am thinking is that he is taking criticism from all directions. He takes criticism from paleo people, ketogenic people, Mercola people, and even I take a few pot shots once in awhile, but I still go along with his research. But, he is also taking criticism from Big Pharma, other doctors, Big Food Companies. What I mean is that Dr. Greger is out there swimming with sharks….and I don’t think I could personally take it. I don’t think many people on this forum could personally take all of the criticism thrown at him. So, my hat is off to him and I salute him for being the champion that he is.

          1. He’s taking a well deserved year off? I dispute some of his findings in my ignorance (or not)…mostly issues of biochemical changes seen after age 65 or so….which some claim do not exist. Because I have a lot if inputs. And for the usual “I don’t want to change” reasons. But I always respect his analysis. He has a brain and knows how to use it.

    2. Hello Konrad,
      Thank you for your question, and for the citation. I just read the review, written by Denise Minger on 5/21/17, published by “Authority Nutrition”, which is not a peer reviewed site, but rather a website bought by a company called “Healthline” in 2017. They state that the articles in Authority Nutrition “are based on scientific evidence and written by experts.”

      Although not peer-reviewed, this review is thoughtful, and clearly the author read quite a few studies in writing the review. Her final conclusion is:
      “Readers willing to listen when challenged and fact-check when skeptical will gain much from Greger’s passionate, albeit imperfect, tome.” I would agree with that completely, and I’m sure Dr. Greger would also. With new nutrition publications, I’m quite sure that some of Dr. Greger’s conclusions in How Not to Die will need to be modified or scrapped altogether. That is the way science works. Here is a video by Dr. G that describes HOW he makes his videos, including how he does fact-checking: https://nutritionfacts.org/video/behind-the-scenes-at-nutritionfacts-org/.

      I hope that Dr. G does take the time to respond to this criticism. We all need to be careful to keep an open mind, and not let ourselves be biased by the world-view that we have created about the benefits of a whole foods plant based diet.

      Dr. Jon
      Volunteer moderator for NutritionFacts.org

      1. She wrote a pretty well-known book in the health field called “Death by Food Pyramid”. She is not just some kid out of college with no background. She is appreciative of a lot of the positive work that Dr. Greger does. I think Dr. Jon says it well. We Dr. G fans need to love what he does well and be willing to consider that new research is happening all the time. Dr G is a great man, but he’s not perfect, and I don’t think that he wants us to consider him for sainthood. I think he wants us to consider him with a grain of salt. Besides, he’s way too funny to be a real saint.

          1. Greger doesn’t make jokes about life and death, he dedicates his life to helping people understand how to avoid premature death and illness. His sense of humor is well appreciated and it makes watching his videos and lectures much more engaging and easier to pay attention to. humor is healthy and a very important aspect of life. To even mildly suggest that a man who gives his time so we can all be better off makes light of death is grossly unjustified.

        1. Dr G is a great man, but he’s not perfect, and I don’t think that he wants us to consider him for sainthood. I think he wants us to consider him with a grain of salt. Besides, he’s way too funny to be a real saint.

          I think you are spot on about Greger being funny, meaning he has a great sense of humor and doesn’t take himself absurdly too seriously. I remember reading that Bob Hope was dying and his wife asked him where he wanted to be buried… his answer? “Surprise me.”

          For me, levity is that quality that allows me to forget those who transgress against me… and to forgive myself when I transgress against others. If they still have graveyards and tombstones when I finally do die, I hope someone puts that on my holographic tombstone. ‘-)

    3. Perhaps someone like Plant-Based News or Mic the Vegan will address/debunk this review of Dr. Gregers work. I will post here if I come across any video from them in the next few weeks

      1. I watch all of Mic The Vegan’s videos on YouTube and he has NEVER disagreed with Dr. Greger. Now, Vegetable Police on the other hand disagrees with Dr. Greger on a few points, mainly on the issue of eating cooked vegetables. Vegetable Police eats only raw vegan food.

        1. Hi John
          If as we read or watch what Dr. Greger posts we think first, “It is based on the most current nutrition research.” Basically he (his group) just reviews a bunch of articles and publishers a video. When we come at this website or the first part of his book from that point of view you wouldn’t make a comment like “disagrees with Dr. Greger.” Do you see my point?

      2. I think TG and others have got the nail on the head. This is nothing new and nothing special, it’s expected and as per usual, debunks itself by making statements contrary to the greatest evidence.
        The only reason this person is getting any attention at all is because she’s saying things that people WANT to hear. I could get attention and make some good money from doing the same if that were the kind of person I was… not too difficult to feed the masses what they want, and it comes with praise.

    4. I’m curious to know and a little confused about avocados now because I believe I watched one video on here that said avacado carcinogenic. So should we are should we not eat avacado ?

      1. Dr. Greger has a lot of Avocado videos. This is the only one he has that shows any positive aspects of eating avocados. Because of his previous negative videos on Avocados I am avoiding avocados.

      2. Moddy, that was never confirmed but just showing what happened to healthy cells being covered in avacado in a petri dish, a far cry from ingestion. He recently came out with another video in regards to the previous, giving avacados the green light again. Though I personally still have concerns about the use of avacados for topical skin care due to the petri dish thing.

    5. Denise Minger is a professional whinger. Minger the whinger is a great rhyme. She has been debunked by many, but she is such a time waster, and an egotist who thinks she’s pretty smart. When people actually dissect her stuff, it is shown up for the garbage and misleading twaddle that it is. Frankly, read one thing, then avoid her. She is unqualified, but takes on people of vast experience and depth of knowledge, believing she knows more. I believe Garth Davis has debunked her once, and I also recall – I think – T. Colin Campbell sorting her out. However, she never stops, and would nave good people spending endless hours on her, with more comebacks from her – all without substance or even understanding of basic research protocols. When people work in banks, they are taught to recognise real money. They become familar with the real thing over and over again. They are NEVER shown fake notes. Their absolute familiarity with the real means they will recognise the fake very quickly. Minger is a fake note. Listen to those whose expertise is demonstrated in changed lives, and then you will recognise the twaddle when you see it.

    6. Denise Minger… this Denise Minger, the puppeteer is back in town, wow!
      When I read the China Study years ago I had a little discussion with a man, here in Germany, who sad: The China Study lacks of evidence, it’s clear, have you heard of the criticism of Denise Minger – she said Dr. T. Colin Campbell has set so much lies on the folks…. give up this stupid vegan diet.

      So I wend to the web and put some researches, with my poor English… and found the great reply of Dr. T.Colin Campbell on the criticism of Denise Minger the puppeteer…. That we understand us right – everybody should read and try to understand studies and if somewhat not clear her has the right and the duty to ask – but not to read all the studies they lead after 28 years to the book China Study and set some public criticism on such a sientist is…. silly. ;-)

      So, I suppose Dr Greger will not answer to her in no way. I think, he will take her words in consider to make more good videos to inform us… ;-)

    7. partly this is due to the limitations of the book, you cannot address every detail of every study or it will not be a book but a scientific review. For example her criticism of his review of an article mentioning the positive effects of plants based diet but not mentioning that in that article fish was associated with an even greater benefit, is due to her unfamiliarity. Dr Greger elsewhere reviewed all the problems with the fish in great detail, so he didnot mention fish in this case, I assume, to avoid getting into too much detail and losing the cohesiveness of the book format.

    1. I hear the cash register ringing! Higher prices!

      My old college roommate and her husband have, or had, an avocado ranch in that area, east of Ventura, and it’s probably one of many. That area probably has the ideal growing conditions. This should be a boost to Florida growers, though I wonder if the hurricane affected them.

    2. California’s 2018 avocado crop is still expected to be greater than 2017’s. 2017 was about half the size of 2016’s harvest in part because of the seven year drought. Roughly 1000 acres of avocados burned per the California Avocado Commission.

    3. I graduated from Fallbrook High (I won’t say when but a long while ago :). That area (North San Diego County) still produces more avocados than Santa Barbara by a lot. It’s called the Avocado highway for a reason. Florida tends to grow a different type of avocado as well. The Caribbean version, not the Mexican/West Coast varieties like Haas, Fuertes, Bacons.

      To give you an idea, California produces about 90 percent of the nation’s avocado crop.
      San Diego County is the Avocado Capital of the U.S., producing 40 percent of all the avocados grown in California.

  1. I would be happy with any of the LDL values shown on the first chart. I have trouble keeping mine below 120 going into year 3 wfpb diet, no oil etc, and using 1 tbsp flax and 1 walnut per day aka Dr Ornish. Interesting to see Dr Jenkins remarks in one of the sources posted saying that the greatest lipid reduction occrred after 1 week. https://www.ncbi.nlm.nih.gov/pubmed/11288049 Similar scenario happened with me. Total cholesterol dropped initially close to 40% at start of wgpb diet, but crept back up in spite of stringent adherence. It’s as if the body struggles to maintain that level.

    As a post menopausal woman who is NOT interested in hormone replacement, I would like to see Dr Greger address this issue and possible options to consider. I have had bypass surgery and hs-CrP was last 0.31 when checked. Thank you Dr Greger for all that you do !

    1. Thanks Wegan and swarren for your replies to my comment on stubbornly resistant cholesterol levels. Wegan, I did research the iodine and selenium connections at one point. I take selenium since I am in selenium deficient farm zone, but the iodine was ok, and my doc was totally against taking any supplement. My TSH is good. (and oddly, became perfect with wfpb eating, a plus! )

      swarren, thanks for the video link, it’s good! I got organized with a self styled portfolio diet when I first went wfpb. High fiber, apples, brazil nuts 1 x month, soy milk, beans daily, oatmeal/oatbran, quality vegies, no oil or fat, only whole foods, amla, inulin, and psyllium, lots of exercise. Total cholesterol went from almost 6.5 to 4.5 mmol (canadian) or roughly 180. My doctor was thrilled. It does work.. but the lower estrogen levels in post menopausal women can cause higher cholesterol. Maybe I should just keep eating well, be thankful and not worry !

      1. Hi Susan,
        much words are spoken… I’m a German Registered Naturopath and very familar with the whole food, low fat, plant-based diet. First of all, let me say, the TSH can be good but despite this, your body isn’t getting enough iodine – Dr. Greger also made some videos to that point. The theme coffee, all words have spooken are right, coffee can increase blood pressure – have you ever tried to use a filter with really hot (100°C) water (not a coffeemachien or coffee maker?) It is also a big different by coffee roasting – if you use a coffee from a “normal” shop, this coffee will be roasted in 20 seconds, not removing much toxic stuff…. try to get some hand-roasted coffee (slowly, mostly over open fire about 20 minutes) I guess you will enjoy the greater taste (not the price, sorry).
        An another thing is, it’s not only the food – our world isn’t reductionistic to understand, the world is holistic – that means for example also brain clearing with praying or meditation or simply a forest walk (for example, if you have the radio on during the day, all this shit and bad news set some response on your subcouncious mind and your body can response it with a higher blood presure – I know what I talking from)
        On the end – I think, even the cholesterol is not going under 150 mg/dl – the inner lines of your arteries will be thankful by not building new plaque. May it is also a point of where and when we start this kind of diet and what is our own history… stay healthy, Steffen from Germany

        1. Heilpraktiker_Ju, ty for your comments! I will consider the iodine question again since I don’t use iodized salt, seaweed, seafood etc. The coffee is something I am experimenting with. Though now I rarely drink more than a cup or two, I have noticed that using paper filters and a good brand of coffee makes a difference. We have small artisan coffee roasting companies here that sell nice coffee. I have been drinking more camomile tea in recent months and noticed a difference in bp also.
          I had neglected in my previous comments to mention prayer/meditation and exercise but am happy to see you summed it up well. There is no question that wfpb eating has made a major impact on my health destiny, but my daily meditation and exercise practice has been no less life-altering. Both have had a positive effect on blood pressure I’m sure, but also on the overall quality of life I now enjoy. Again, ty for your comments and your encouragement. All the best to you !

      2. when Drs want to destroy a thyroid using radioactive iodine they must first put the patient on a low iodine diet to clear the thyroid of iodine so that it will absorb the radioactive iodine. That diet is basically a vegan diet minus the seaweed. The thyroid is not the only part of the body that needs Iodine. If you don’t supplement or eat seaweed regularly you may not be getting enough. Some people can handle excess iodine and apparently some can’t, selenium is needed to get rid of excess hydrogen peroxide in the thyroid cell and it facilitates T4 to T3 conversion in the body.
        I found this interesting.



        1. I used to belong to a facebook iodine group a few years ago. I was amazed at how much iodine these ladies would take. Some would take up to 50 mg per day with no side effects. I’ve taken up to 30 mg a few times. Now, I just occasionally take about 9 mg once a week. I remember David Wolfe ( the avocado wolf man ) who once said in one of his seminars that he took 450 mg of iodine when Fukashima had the nuclear melt down. But, you can’t believe anything the “avoado wolf man” says.

    2. Your experience on a whole food plant based (WFPB) diet is quite interesting. I’m coming up on 1 1/2 years on a plant based, oil/nut free diet and while my cholesterol has dropped to 150 total and 80 LDL (and remained there), my changes in blood pressure are puzzling. Initially, my blood pressure in the evening dropped into the 115 to 120 range and I was both surprised and delighted. However, over time, and with absolute strict adherence to the diet (Dr. Esselstyn heart disease reversal program), my blood pressure slowly crept back up to the 135 to 140 range which is where it was before I began the WFPB diet. It’s almost as if my body got used to the change and reverted back to it’s previous status. It also brings up additional questions such as……if the change in blood pressure was temporary, is the diet really halting further developing of coronary artery disease???

      1. Michael Moritko, very interesting comments! I have had good (low side) blood pressure but did experience a rise again after starting wfpb. This may have been due to new doctors (white coat syndrome) though I have experimented a bit to see if food influenced it. I have noticed I am now sensitive to coffee – the less I habitually drink, the more sensitive I am. And sugar of all things. (even unsweetened applesauce). Maybe Dr Greger or NF moderators has experience with this and can offer you an explanation.

        Otherwise, congrats on doing so well with your cholesterol and healthy eating! From all that is going ‘right’ I have no doubt that this is the best plan to be on.

        1. I take my own BP using a self-inflating arm cuff….it usually takes me 3-4 tries before I’m fully relaxed and see a stable BP level. This is with no white coats around. If you are serious about BP…DIY? Just buy a quality cuff.

          Mine is in the 116 / 66 range usually. Starts out at maybe 120 / 70 or so at first….I guess I think I’m a doctor and I’m afraid of myself?

          1. Hi Norm, I too have started taking my own blood pressure. This is because my endocrinologist (Head of endocrinology at Brigham & Women’s in Boston, a 20 year relationship after having thyroid cancer) has caught me with 150 BP the
            last couple of annual visits. So I went out and bought a cuff and record my pressure couple times a week. It has been in the 120 range, so I march into his office with my data and calibrate my cuff with his and I have won that argument. One more med I don’t have to take. But I am certainly interested to know what foods and other factors that will temporarily affect BP.

      2. There are some things on a WFPB diet that can raise BP and cholesterol. For example, black coffee and black tea – or any caffeinated drink for that matter – can raise BP

        And coffee can be a potent raiser of cholesterol eg
        “The results from this study suggest that short-term consumption of coffee may increase the total serum cholesterol and LDL cholesterol levels. It is therefore possible that long-term consumption of coffee may lead to clinically significant alterations in serum lipid profile and could be important in the aetiology of atherosclerotic vascular diseases such as coronary heart disease.”

        This is a pain because i enjoy tea and coffee. However, I am moving towards consuming more hibiscus tea, cacao and decaffeinat/herbal teas in place of these but it is difficult when travelling since water, tea and coffee are the usually the healthiest drinks available.

        1. Thank you Tom again for this information regarding coffee. Because my health is fragile I am trying to err on the side of caution. I have never been a coffee drinker, so I am glad that I have never been a coffee drinker after reading your post. As far as our little debate over distilled water goes, I simply squeeze a lemon into my distilled water, and add a little bit of liquid magnesium to my distilled water in order to make it more of a solute like regular drinking water, except I don’t have to worry about flouride, pollution, and other stuff that is hiding in the water pipes. I am pretty sure that the scientists at the World Health Organization would approve of my distilled water upgrade. By the way, do you support the World Health Organization in it’s recommendation for all types of immunizations including yearly FLU vaccinations?

          1. Hi John

            By and large, I am a believer in vaccinations generally. For a long time, though, I avoided flu vaccinations because I had the worst flu in my life three days after getting my first flu vaccination. And because a Cochrane Review at the time showed that flu vaccines had no or limited effectiveness in otherwise healthy people eg

            Now I am over 65, I have started getting flu vaccines again but the evidence for this being beneficial is apparently of poor quality. However, I reckon that even a 2 or 3% reduction in flu risk could be worthwhile as we get older, and there is no good evidence of harm. I have also had a pneumonia vaccine

            Flu kills many older people directly or indirectly

            1. I just had a bout of “flu” or whatever. Caused some “runs”…so intestinal related. Wasn’t doing a lot for a few days. Don’t get the flu shot. Didn’t die…that I know of. Though this reality could be some kind of “construct”…like a VR game of some type. Pretty sure someone will let me know…but then….maybe not….

              Did go through a process of “reality adjustment”…which is a positive thing…about the best you can say for getting sick. An illness like the flu CAN be a positive event…one can learn from everything. It was a healthy re-boot….forces one to sit down and shut up for a while.

              I occasionally sit down a drink a bottle of wine…something like re-booting your Windows computer…sure it’s a bad…bad…thing…but now and then I just do it for the hey of it.

            2. Well said, Tom. My (non-smoking) cousin died of flu in her 40’s and when I was in high school, a non-smoking dad of a friend of mine died of flu in his 50’s. So now that I am over 65, like you, I get a flu shot, too, in case it helps.

        2. There are some good reasons not to consume tea,coffee or chocolate . I will not bore you with my belief’s , however they are all stimulants . Secondly they may gave been harvested by child or slave labor . We always keep a drink in the fridge made from berries and fruit . Take a container and fill about a third to quarter of the container with berries like cranberries , blueberries ,strawberries, raspberries and or the traditional red or black currents which goes back to my great great great grandfathers time so I.m told , maybe cut up some citrus either lemon or orange , we always peel the citrus and fill with water and leave for a day in the fridge . You end up with a flavorful drink that seems like it keeps colds and flues away .. Kids love li .
          Oh I forgot crush the berries with a potato masher .

          1. buster, terrific idea with the berry punch! I will definitly give that a try.
            I have always enjoyed the taste and aroma of coffee (fair trade is available here) , but in recent years have experimented with abstaining for over a year at a time. I hate to admit that I feel better without it!

        3. Tom, no green tea? I gave up coffee after testing my BP at work, drinking a coffee, and going back after an hour or so to be retested, just out of curiosity. Wow! My BP was really elevated by coffee, as I recall, by about 20 points. But green tea reputedly has benefit, no? Green tea gives me the extra oomph to get things done during the day!

          And Dr. Greger seems to be giving a huge green light to tea: https://nutritionfacts.org/?fwp_search=green+tea&fwp_content_type=video

          1. I think green tea is beneficial on balance. Certainly, it has much less caffeine on average than either coffee or black tea. Caffeine may be the prime culprit in the association between coffee consumption and raised BP.

            And green tea consumption seems to be linked to lower mortality (which is a good reason to drink it). However, I prefer the tasteof black tea.

            1. Tom, thanks for the study listings. Lately I have been adding room temperature green tea to my green smoothies with a bit of soy milk, too….. That seems to be working well for me. The one I am having right now has a mix of kale, lettuce, cilantro, fresh strawberries, a lemon wedge w/ peel, cranberries, amla, turmeric, a turn or two of freshly ground black pepper, a bit of soy milk, and half a bag of frozen mango.

        4. This is a pain because i enjoy tea and coffee. However, I am moving towards consuming more hibiscus tea, cacao and decaffeinat/herbal teas in place of these but it is difficult when travelling since water, tea and coffee are the usually the healthiest drinks available.

          Tom, maybe you should follow the Queen’s regimen and drink Earl Grey tea… after all, that bunch has a history of longevity. The Earl Grey as you probably know, contains Bergamont, a citrusy fruit.

          But just maybe it is because the tea is drank hot. Tried to find it but I guess I didn’t save it, but I read just recently of a study where they came to the conclusion that drinking hot tea is healthy in some sort of ailment or another, while coffee and/or iced tea is not. And of course, there are a number of studies that show coffee to be a preventative for Alzheimer’s so I wouldn’t throw that out in the dust bin just yet.

          If I run across the hot-tea-for-your-health article, I will post it here.

              1. I don’t like the taste of Earl Grey tea so that’s a no-no for me.

                Heh, one of those who are controlled by their taste buds, eh?

                Well, to some extent, so am I. While I can live with the taste of plain green, black, or Earl Grey, something like the hibiscus or Jiaogulan are a bit difficult to drink with no amelioration such as monk fruit (Lo Han Sweetener) or even eating ginger snaps with the tea.

                Your last link was an interesting read (Irish Times.) 16 cups though? I struggle to remember or find the time to drink more than three or four of the many different types of tea I have on hand, like the chamomile for instance before bed time.

                Got a kick out of one of the side bar stories to the article, about a woman’s embarrassment for farting during orgasm. ‘-) What did we ever do before we had the Internet?

  2. The problem with any study involving extra-virgin olive oil is that that there’s usually no way way of knowing what kind of extra-virgin olive oil the study used. This is important because most of the olive oil sold in the US is fake.

    1. For 20 years I had a business that kept me out of the house for 10 hours or more per day. I became a fast-food junkie and could easily recite the menus from any fast food restaurant. It was burgers, chicken sandwiches, fries and soda for this guy. Then, in 2007, I was stopped in my tracks with a heart attack. My right arterial artery was 100% blocked. I underwent emergency double bypass surgery and came out of it relatively unscathed. Post surgery I was put on a couple of different heart medications including a statin for my cholesterol. Over the next several years I changed my diet to include more veggies and fruit and less meat. Now, ten years later we are about 95% (or more) plant-based. My breakfast 5 days a week consists of steel-cut oatmeal with walnuts and blueberries. I also eat 3 to 4 avocado’s per week and all kind’s of legumes. The point here is that I stopped taking all heart and blood medications 2 years ago, much to the chagrin of my cardiologist. He ordered my yearly blood test in September and the nurse called me with the results. She said that there is no need for any heart or blood medications, your blood tests came back perfect. Then she said, “whatever you’re doing, keep doing it.” I feel so thankful for my dietary changes and believe they have been a lifesaver. I’m also thankful for Dr. Gregor and others like him who continue to do research in the field of plant-based nutrition. For the record, my son became vegetarian after meeting he vegan girlfriend 6 years ago, who he recently married.

        1. Blair,

          Oncologists don’t ask patients how they cure cancers without drugs or radiation, either. I guess they’d rather not know. Perhaps it would shake up their world too much. They would rather tell you there are sometimes spontaneous remissions, despite all the things patients DO to help their bodies heal. There’s no spontaneity to it at all. It takes a dedicated effort.

          1. Right!! My ophthalmologist didn’t ask me what I was doing when my pre-Glaucoma pressure and dry eye condition completely disappeared!! Those things just don’t happen out of the blue. But this was one of the first positive health benefits from going WFPB. What’s wrong with these people? If you were a doctor wouldn’t you want to know?

            1. I admit some older doctors probably get a little jaded and having lost much of their curiosity just maybe go through the motions in a rote-like manner.

              On the other hand, I’ve had experiences with my VA personnel that is different.

              And while the older doctor on one visit was overwhelmed by the paper work that had been put on him when they took one of his assistants away. The next time I visited he was much better organized and while a younger doctor saw me first, the older doctor when able came in and was apprised of my results and discussed them with me.

              The younger doctor seemed more curious of what I do, while trying to not betray his position of authority in the doctor/patient relationship.

              My nurse, who spent considerable time going over my supplement regimen was very attentive and knowledgeable in her own right about supplementation and we had a very good back and forth.

    2. George – when a formal study is done they “secure” the olive oil by knowing and purchasing EXACTLY the olive oil (or whatever food) they are studying. They do not EVER buy oil off the grocery shelf like you and I do. So your comment that “they” don’t know what kind of olive oil they are using is a nonissue and false accusation from you. Unless, of course, you can tell me and all of us on this site how you might KNOW that scientists don’t know what material they are accurately working with??

      Science makes sure what it is dealing with at the get-go. Your accusation that the studies don’t know what they are “dealing with” is an accusation with no merit. Unless of course you can PROVE that the scientists don’t know and understand what their products are that they measure.

      The “proof” is on you at this point. Prove that scientist don’t vet their products before undertaking a study. Show us THAT proof and perhaps we will “listen” to you.

      Signed – a Scientist with YEARS of scientific research.

      (people like you who have no scientific basis do nothing but add to the opinion of the uneducated)

      1. RBG

        To be fair, I think that George has a legitimate point. Olive oil fraud is reportedly common and some popular EVOOs sold in the US, Europe and Brazil for example apparently do not meet the standards required to be classed as EVOOs. One would hope that professional researchers would take steps to ensure that only genuine high quality oils are used but how can one be sure if the papers do not identify how the oil was sourced? Also, I think in Predimed and some other studies, the oils wee simply provided (free) by the producers.

  3. “Just add avocado to their diet without doing anything else, and cholesterol does not go down.” It goes up according to the graph. I don’t understand why the first graph showed LDL going up with added avocado and the last graph showed it going down versus grains. Now I didn’t look to see what kind of grains they used, Wonder Bread? Would the addition of the same grains in the first study show
    LDL higher than the avocado group? Is the rise in LDL with avocado enough to warrant restricting avocado consumption?

    1. Wegan,
      That’s a good question. Ill attempt to clarify the results. Looking at the study pertaining to the first graph, the participants were healthy (notice the average LDL was in the normal range at the beginning of the study).Then the avocado was added without decreasing any of their usual saturated fats. So total fat went up.This resulted in a rise in LDL. In the subsequent study the participants were obese and had high LDLs. The saturated fat was reduced and replaced with either grain CHO, MUFA or avocado. This is where the beneficial effects of avocado can be seen. Avocados were superior in lowering LDL, especially the small dense LDL. So my takeaway is that adding avocados to a SAD diet is not helpful. Replacing animal foods with some avocado is very helpful in lowering LDL, even better than other forms of MUFA.

  4. I went to the website and read the article about the book “How not to die”. By the way I am a scientist by training. While she is probably right about some of the fringe conclusions in the book but she has glossed over the main messages. As an example may be the claim about harmful bacteria in meat surviving the temperatures of 270 – 300 F is an exaggeration but the core message that meat is bad for us is proven by numerous studies world over, a fact she conveniently fails to emphasize. The World Health Organization recently listed processed meats as type one carcinogen and red meat as type two carcinogen (Smoking from Tabaco is considered type one carcinogen). My take on the article is that it is trying to create confusion in the debate Meat Vs Vegan diet. The same strategy Tabaco companies employed in the middle of last century with the aim of creating doubts in the mind of the smokers. However in fairness to her Dr G does need to make his book scientifically accurate and address some of the issues she raises. We can not let the meat and dairy industry hijack the debate and keep on feeding us highly toxic products they make money of…………… My two cents worth!

    1. Denise Minger has made a name for herself has a proponent in the Paleo community, despite her lack of formal training as a scientist.

  5. I would look also into pumpkin seeds, not only nuts and avocados, to lower cholesterol when eaten with other foods. Most people avoid raw pumpkin seeds because they are hard but there are other types like dry roasted, etc. You would also gain minerals, serotonin, etc. You may as well get sunflower seeds too.

      1. I think he means that we all die anyway. Whatever diet people eat, they will experience 100% mortality

        However, that ignores the point that many of us would like to hang around for as long as possible in rude good health. And diet does make a difference there.

    1. Yes, diet does have an impact on mortality. Seventh Day Adventists as a group live 7 years longer in general than the general population. Certain groups of Japanese, especially the older population in Okinawa that still eat the traditional Okinawan way live to be into their 90’s and 100’s. I could cite many more studies. Diet makes a difference.

    1. That’s because doctors think eating fat makes you fat. Eating high carbs which raise insulin levels, and/or too many calories is what puts the weight on. A plant based diet low in high carb veggies and fruit but with healthy fats, will not put weight on.

      1. Hi, Marilyn, I’m responding to your nice comment to me from another discussion and thought I’d let you know that, (very sadly,) my insulin-dependent cat did die…. He had a seizure and it was not at all related to his blood sugar level.

  6. As someone with familial hypercholesterolemia, and on a WFPBD for years, I have avoided nuts and avocados and any added oil, following the advice of Dr. Esselstyn and Dr. Pam Popper. I do include a few tablespoons of flax seeds in my shake every day. I’m wondering if it’s time to add some nuts and maybe even avocado, based on the recent findings and Dr. Greger’s general advice. I don’t get my cholesterol checked very frequently, but when I do, my total cholesterol is always over 200. Sometimes it’s just hard to know for sure!

    1. Thank you for your reply I eat one big table spoon of flax seeds a day. My cholesterol is expressed in European units- were 5x higher than max. Are you also on statins?

      My levels get checked every 6 months to a year. Statins were increased 3 times.

      Difficult to cut back on nuts and oils. Esp nuts. How about seeds (apart from flaxseed)?

      I will look for publications of Dr. Esselstyn and Dr. Pam Popper.

      Thank you!!

  7. Hi my name is kenishia. I have a question concerning health but it has to do with going veg. I have tried to go veg. Before, but every time I try my body would feel weak and tired from not eating meat. Do you know why is this happening? My doctor gave me the ok to go veg. He told me if I go vegetarian I won’t need a vitamin because I’m already on a multivitamin. If I go vegan I need a b12. I’m just concerned about why my body does this, and is it safe for me to go veg? I love the food and everything about it and I’ve been doing a lot of research. Please help me? Kenishia☺

    1. Kenishia, one reason some people first trying a vegan diet don’t feel successful is they avoid eating certain foods, like complex carbs or beans. If you are eating a diversity of whole plant foods, staying away from processed foods, sugars and oils, you should not be experiencing weakness. Are you trying to eat the daily dozen list of foods every day. You may need to do more research to discover what foods you may be lacking in your diet. There is so much help out there. You can check out my site, Happy Vegan Couple on Facebook for a lot of educational articles and lectures on plant-based nutrition and you can go to our YouTube page to find our cooking videos. Both may help you. Keep trying; in the end, you will most likely be successful. And yes you should take b12 and vitamin D if you do not absorb from the sun.

    2. Kenisha, has your doctor checked to see if you are deficient in B12? If he did the standard CBC complete blood count, he can tell. One of the tests is MCH. It is too high if you are low in folate (B9) and/or B12. If you had this test done, get them to give you a copy.
      For B12 you can buy sublingual B12, but only the Methyl form Methylcobalamin seems to work for most people. You would also need to eat leafy greens for the folate. The ‘folic acid’ in most multi vitamins is a synthetic form which is not good. Get it from food.

      Another reason you may have this problem is if you are low in iron. Have your doctor run a ferritin test. If you are low and want to be vegetarian, add some higher iron foods like spinach or blackstrap molasses for example, to your diet, and always eat them with a food that has a high amount of vitamin C which helps absorption.
      Actually, one of the benefits of a vegetarian diet is a lower amount of dietary iron which can basically rust out the body, raise heart disease risk and cause cancer. So you don’t want too much of it ever, just enough.
      I am not a doctor, but a biochemist trained in nutrition. So if you can find a doctor who understands nutrition, I encourage you to do so, unfortunately most don’t have much training in that area.
      Hope this helps.

    3. Hi Kenishia,

      A common reason that people tend to feel weak and tired after trying to transition to a WFPB diet is because they aren’t eating enough calories! Try using cronometer.com — it is a free way to track your calories, and I like it because it also breaks down all of the macro and micro nutrients and vitamins, so that you can see if you’re meeting those goals. I don’t use it every day anymore, but it was useful for me when first transitioning. Because plants are naturally lower in calories than animals products, you have to eat more than usual, which can feel strange at first. Also, make sure you take your b12! :)


  8. This has nothing to do with AVACADOS. BUT complying with Dr. greger’s request I have a question about a tea known as Essiac tea
    A friend recently told me to start drinking some canadian tea Called Essiac tea that apparently can cure or prevent all types of cancer
    Dr Greger’s comments please

    1. I doubt if Dr Greger will be able comment on this since there have apparently been no controlled trials of the efficacy or safety of essiac in cancer outcomes in humans. I vaguely remember reading about an animal study where it may actually have promoted breast tumour growth


  9. We have a good supply of avocados throughout the year in Buenos Aires, Argentina. I eat one every day in a salad of leefy greens and seeds.

    I’ve been plant based for more than three years. I got the results of a blood test a few days ago. Finally my cholesterol is the lowest it’s ever been. The worst was in 6/2013 at 232 (HDL 50 LDL 167) when I still ate meat, eggs, dairy, etc. The latest is 174 (HDL 70, LDL 91).

    Glad to hear from Dr. Greger that avocados are good for us.

    1. I heard what Dr. Greger said in a recent YouTube session and implemented the change: instead of just using the juice of a lemon, add the pulp, too. Now I do just that when I make hummus. It’s about whole food.

    2. Kevbo,
      I’m not aware of similar studies with avocado oil. However, considering oil is not a whole food and missing the fiber its doubtful to be as effective. The fiber in the avocado likely contributes to its beneficial effects in lowering cholesterol.

  10. Dr Greger,
    A HUGE Thank you for all you do and your generosity in sharing your knowledge and information!
    You are changing peoples’ lives and are much appreciated.

    I’m curious about your opinion of Vitamin K (K1, K2) and it’s touted effects on atherosclerosis treatment and prevention.
    Good or not so good?

  11. Glad there is some health benefits from it.

    I always hated avocado and when I moved out to California, it was on every burger I ate back then and it was slimy and I didn’t like the taste, but lately I have been closer to vegan and added some to my veggie wrap and found I actually like it now. Funny how tastes buds can swing wildly.

    I also added broccoli sprouts and pomegranate seeds and plenty of kale and arugula and seeds and reds and yellows with the greens and carrots to add to the rainbow effect. Nothing blue, except my mood still is blue and I had gotten better all Summer long so I don’t know if it is SAD or Christmas without some relatives who were dearest to me or if there will be a magical food combination, which might take the edge off.

    Feels like it must be healthier somehow, even though I am still having moody blues and social anxiety and am pretty sure I am getting the B’s and the Omega’s and the seeds.

    It still feels good though to know that I am having oatmeal with flaxseed and walnuts for breakfast (rather than nothing) and I have a low carb wrap with as many color combinations as I can get and the third meal is the wild card.

    I am going to be adding in a banana and pineapple and coconut smoothie, because that is what I had every day of the Summer, so it might help again.

    I am here, because I was so happy about one thing, I needed a Christmas present for a friend who suddenly announced she bought me one and I went from store to store and found nothing at all and then, I remembered her asking me about Curcumin and other things and I have learned so much from this site and she is far away from being a vegan, but I figure a good cookbook will make her healthier even if it is just that she added a few vegan meals.

    Thanks for the present inspiration.

  12. For 6 years I had sky high cholesterol levels.
    I ate nuts, avocados, exercised daily ( cycling and walking 1.5 hrs a day) many raw vegetables but also meat and dairy. As I was also diagnosed with diabetes type I (late onset) I finally accepted be it reluctantly to take statins.
    I became a vegan 6 months ago. For the first time in 6 years I now have normal cholesterol levels but are still on statins. According to my MD I suffer from hereditary hyper cholesterolemia.
    1. I do wonder about nature or nurture in this case. Any info on this?
    2. If there is such a thing as hereditary hypercholesteremia is there any general additional dietary advice or is one convicted to a lifetime use of statins?

    Is there anyone out there who could answer these questions??

    1. Hi Gabs and thanks for your question. As you may know, genetics are certainly important, but they are not our destiny. In your case, following a WFPB diet which may be vegan is advised to keep your cholesterol in check. A vegan diet can be unhealthy (full of processed foods) so be sure that it is WFPB for optimal health effects. As Dr. Greger has said, genetics run in families but so do diets and many of our cases of familial hypercholesterolemia may be due entire families eating similar diets which include too much saturated fat and cholesterol (likely from animal sources) and not enough plant based foods. You say your total cholesterol is normal but I would ask you to sit down with your doctor and determine if this level is less than 150 while also looking at value of LDL, triglycerides and ratio of LDL to HDL. Seems like you are on the right tract and no I don’t believe that you are obligated to a lifetime of medication. Each medical treatment and prescription has a risk:benefit equation that needs to be personalized to the patient. Good luck!

  13. Lowering LDL cholesterol and shifting it’s composition toward away from the small dense particles to large and buoyant is encouraging, but LDL levels are markers for heart disease. Have there been studies that examine the impact of nuts and avocados on arterial plaque in vivo? That’s what we really care about. It’s perplexing because there seems to be a divide between authorities like Esselstyn, Mcdougall who recommend against nuts and avocados for those with atherosclerosis vs Greger and Fuhrman. Ornish, lies somewhere in the middle with his recommendations.

  14. Lowering LDL cholesterol and shifting it’s composition away from the small dense particles towards large and buoyant particles is encouraging, but LDL levels are markers for heart disease. Have there been studies that examine the actual impact of nuts and avocados on arterial plaque in vivo? That’s what we really care about. It’s perplexing because there seems to be a divide between authorities like Esselstyn, Mcdougall who recommend against nuts and avocados for those with atherosclerosis vs Greger and Fuhrman. Ornish, lies somewhere in the middle with his recommendations.

    1. In one study here, the low fat group was 24% fat which is about twice the Esselstyn target. So its perhaps a different regime of blood lipids. I agree with more direct study of atherosclerosis, there are some works using carotid imt studied with ultrasound. Need more of these especially using better technology, there is a big improvement in image quality in the high end ultrasound rigs.

  15. Thank you Dr. Greger for another interesting article! I’m reading “The Obesity Code: unlocking the secrets of weight loss” by Jason Fung and wanted to share this quote with you.

    “The cholesterol in eggs may actually help your cholesterol profile by changing cholesterol particles to the larger, less atherogenic particles. 13 Indeed, large epidemiologic studies have failed to link increased egg consumption to increased heart disease. 14, 15 Most of all, eat eggs because they are delicious, whole, unprocessed foods.”

    I wonder if Dr. Greger or any of the other eminent physicians/nutritionists could offer a comment on this piece of advice. There is so much conflicting information, especially confusing when it comes from physicians with very sound reputations. How is it that people can draw such diverse opinions from the same research or types of research? I do understand about tracing the money and who is conducting the research, but still, it seems completely opposing results can be gleaned from large and frequently quoted studies like the nurses study etc. If anyone requires the links from the book backing Dr. Fung’s claims, which I haven’t read yet, the sources I mean, I can certainly try and supply those if they are available. I assume they are since he is no lightweight in his field. Thank you for your time.

    1. I used to eat 4 eggs per day for a number of years. This resulted in a lot of plaque build up in my arteries and elevated cholesterol levels. From my experience I agree with Dr. Greger that eggs have a tendency to build up plaque in the carotid arteries. As far as all the nutritional confusion that is going on out there ( Nutrition Wars ), your best line of defense is to ERR ON THE SIDE OF CAUTION. Don’t take any chances on eggs. There are twice as many bad reports on eggs as there are positive reports. Eggs have a huge amount of dietary cholesterol. We get enough fat in our diets from plants….and like I mention to Renata, stress and lack of sleep will elevate your cholesterol by causing greater insulin production which in turn causes your liver to make more cholesterol which in turn can stick to your arteries. And, then you come along and add eggs to the mix, and by doing that you raise your risk level. Always play it SAFE when it comes to nutrition. Listen to Dr. Greger.

      1. Thanks for your comment John. I agree as I stepped into the same problem eating eggs and cheese. Not other meat products but for me that seemed to be enough to cause problems. I wanted to post the quote as an illustration of how confusing and contradictory Dr. Google can be. As soon as my ophthalmologist found plaque in my eyes I realised and cut out all eggs and cheese. Now we eat WFPB SOS and no flour since I am also struggling with my weight. Can I ask John did your changes in diet reverse the artherosclerosis?

    2. Hi I’m a nutritionfacts moderator. There is a lot of conflicting information out there and it is hard to know what to listen to. First fat was bad and then it was vindicated. I would not assume that just because a book is written by a highly trained physician, that you can take all the information in it as fact. This is not meant to be ironic given that Dr. Greger is also a best selling author. But keep in mind, that a book is not necessarily peer reviewed data. Proper studies need to be randomized and placebo controlled. All of Dr. Greger’s information comes from properly done, peer reviewed research. Peer reviewed research trumps a book you can get on Amazon. Populations that eat a plant based, low cholesterol diet have far lower rates of disease than those that eat more animal product diets.

      Dr. Greger has a lot of videos on eggs and how there was very misleading studies done that simply added an egg to peoples’ diets who were already eating a high animal food diet. This is different than adding it to a diet that is plant based and low fat. Dr. Greger has compared that to adding a few cigarettes a day to a pack a day smoker and saying that does no harm versus adding a few cigarettes a day to a nonsmoker. These videos explain that a little more:


  16. Hi,
    I have a small problem, I started WFPBD around 3 months ago and I am pretty dilligent about it. I don’t eat any saturated fats (no coconut oil etc), no oils, no animal products, no sugar. I do drink plant milks with decaff coffee (1 or 2 a day). I do make sure they do not contain sugar, salt any any additives. To my huge surprise my cholesterol levels went up from my last test (that was on the lacto ovo vegetraian diet including fish). The worse problem is that my hdl went down while ldl and triglicerides went up. I really believe in the diet and would love to stay on it, it has had miraculous effects on my son’s autoimmune condition and lowering his cholesterol. Is there anything I might be doing wrong or perhaps any ther reason that could impact my results? Did anyone experience something similar? I have searched everywhere but could ot find anything.
    Thanks in advance for the time taken to read and respond.

    1. Renata, there are a few things that Dr. Gregor never mentions about causing high cholesterol. Lack of sleep and Chronic stress can elevate your cholesterol. Lack of sleep or Chronic stress will elevate your insulin. The extra insulin will cause your liver to increase cholesterol production. If you are not getting enough fiber, then your elimination of cholesterol is greatly hampered. Good foods to reduce your cholesterol are oat meal, and Indian Gooseberries. You can buy frozen Indian gooseberries at any Pakistani Indian grocery market. Here in San Antonio we have 6 different Paskistani/Indian small grocery stores to choose from….plus a truck load of Indian Restaurants.

    2. Hi, Renata,

      I am WFPB but do not consider eating animal products. Instead I eat soy or beans. Animal products have a lot of fat in them and even olive oil has saturated fat in it. When I finally gave up oil this past year, my cholesterol levels really dropped and my last check, after running in the high 180’s, was 150-something. I feel that I’m on the right path in avoiding oils and all animal products.

      I also read, “The World Peace Diet,” which I recommend to you, as you will not think fish is so healthy after reading it–and in fact, it’s pretty revolting, although I had once considered eating fish for health.

    3. Renata, when some people eat carbs, especially, but not necessarily, higher glycemic carbs, it raises their blood glucose levels, which raises insulin levels. The insulin takes the carbs and turn them into triglycerides, and then into ldl.
      People differ on how many carbs they can handle before this happens.
      Realize that carbs are not all about sugar, or even foods like quinoa and sweet potatoes. (All fruits and vegetables have carbs, of course, some like leafy greens very low amounts.)
      Those higher carb foods, whole grains, fruit, etc. are healthy for many people, for others it just makes their blood sugar go too high.

      Try adding some good fats, fiber and protein to slow down carb absorption to avoid raising blood sugar levels. Exercise of course, also helps.
      For fats can do avocado, for example, which also is high fiber, beans, particularly organic edamame or black soybeans which have protein, fiber and fat. You get the idea.

      1. Thank you for taking time to answer my post, indeed I eat a lot of fruits and often they are high in sugars (grapes, dates etc), to make my daily calories intake. I will try to change it in to starch. I do eat a lot of fiber though. I myself have never had problems with cholesterol, I went on the diet to support my son and to see what it would do to me. My previous cholesterol was 132 with ldl being 49, hdl 68 and very low triglicerides, but now it raised to 141, hdl dropped to 57 and ldl raised to 71. I must say that was surprising, but I will try to eat mostly berries and add more healthy fats to starchy products.

        1. Renata, yes dates and grapes are especially high in sugars. Many people find they cause a certain amount of insulin resistance. So wonderful to hear your son is doing better.

        1. Liilsa and wegan, what causes insulin resistance is actually very complex. And all the data isn’t in. Basically it is thought that it results from lipid (fat) deposition in the liver, muscles and in visceral fat. But some foods can cause blood sugar levels to rise in that indidvual enough to be a problem. It is already known that a high carbohydrate diet in some people raises triglyceride levels. And what is a high carbohydrate diet in one person can be very different from another.
          That’s because the body takes excess carbs and makes fats out of them.

          So saturated fat is not the only thing that causes insulin resistance,
          People are not all the same. In some people only 10lbs. over what (for them) is an ideal weight can become prediabetic. Fasting blood sugar levels only show this in less than 10% of patients. Even HgA1C’s which I like better are not totally reliable for everyone.
          But when someone’s hdl goes down and triglycerides go up it usually means their after meal glucose levels are going up also.

          It’s a very busy time of year for me, between family visits and illness, but after the holidays I will try to find some studies to post.
          Happy Holidays everyone!

  17. I think some here should give Denise Minger a second look. Sure, she’s lacking credentials and young and inexperienced, but I think she has some good ideas. Her long blog post on the benefit of low fat diets was very informative, and very fair, I thought. Sure, she doesn’t much like Campbell and Keys for some reason (maybe she had to make a name for herself in the HFLC world?), but had very favrable things to say about Kempner, Swank, Morrison, Pritikin, and Esselstyn. Her own diet appears to mostly be WFPB–she has some raw eggs (yuck) in her giant salads, and binges on sushi and sashimi sometimes, but had the courtesy of posting her Cronometer results for all to see. While she’s no expert (like the doctors she cited, or the famous WFPB doctors of today–Greger, McDougall, Fuhrman, Barnard, Davis, etc.), she is probably more knowledgeable about diet than the prominent vegan Youtubers–MIC, Happy Healthy Vegan, Unnatural Vegan, Vegan Gains, et.al…or at least she delves into more nuance than they can. So…no expert, but a gifted amateur?

    I thought that her review of Dr. Greger’s book was a bit superficial, or not very comprehensive, but it was not one-sided; she had good things to say about it, as she did of Garth Davis’s Proteinaholic.

    1. I figure I’ll listen to those who know science and medicine–to those who have spent a lifetime studying the effects of foods on the body–and not waste my time. I only have so much time in my life.

      1. Dr. Greger has done both. He has spent a life time studying and PRACTICING science and medicine, and he has studied the effects of food on the body.
        As far as me and my house we stand with Dr. Greger.

    2. As much as I respect her investigative research, I find it hard to palate and rationalize a diet that includes specific organ meats, seafood (raw fish, raw or cooked “non-sentient bivalves” including oysters), and duck eggs. (She does admit that she eats primarily whole plant foods, raw or cooked. The addition of these expensive animal products makes the diet unaffordable and unachievable for most. Her website also includes affiliate links for products such as activated charcoal, collagen, and a rather pricey vitamin K-2 supplement. She may not have any ties whatsoever to these products, but it still makes you question the site’s credibility. Finally, she notes that as humans we’ve never eaten a single consistent diet. She states: “We’re not adapted to a perfect menu; we’re adapted to adaptability.” If that is the case, which it may indeed be, then rather than trying to achieve a paleolithic or raw-food diet in a completely different world, shouldn’t we adapt to the world we live in now? It’s unaffordable and theoretically not possible to feed the world primarily on animals, whether factory-farmed or “free range” or otherwise. If the best current available evidence from epidemiological and randomized clinical trials suggest that we can live healthy, long lives on whole food, primarily plant-based diets (that happen to be readily available and affordable for most, with some substitutions available for those who live in very low-income areas with lack of fresh foods; diets not unlike those that the vast majority of this world’s inhabitants consume), why must we continue to perpetuate doubt and confusion regarding animal products?

    1. Keep in mind that plant “milks” are not whole foods and therefore not part of a true WFPB lifestyle. That said, many plant milks have minimal to no fat content. In those that do, the fat may already be “dangerous” since the plant has been processed, so fat oxidation could be occurring. We don’t know for sure. The heating will not turn them in to saturated fats if that is what you’re worried about. Best choice is to eat the nut, not the nut milk and not the nut butter. This is what the clinical research points to.

      Dr. Ben

      1. Do you really see harm in some nut or soy milk on oatmeal for example? How difficult does this diet need to be? Many of the studies cited on this site use soy milk to show benefits. Also nut butters are a whole food.

        1. Hi, Wegan. I would say that not all plant-based “milks” are created equal. Some are more highly processed than others, and many commercial products have added ingredients you may not want. It is easy to make your own plant-based milks if you have a high-speed blender, using just nuts and/or seeds and water. I agree with you that nut butters that are made from just ground nuts are whole foods. If you are purchasing them, be sure to check labels, and make sure that is what you are getting. I hope that helps!

      2. Yes, I take your point entirely but such a restrictive focus will lead to procedural failure, if I may put it like that. A person needs to know the joy of food and something like hemp milk has a fantastic nutritional profile filled with good things making it much more likely the WFPB approach will succeed and become a life long fact.

        1. Wegan, I agree with your comments. As far as I remember, Dr Greger has always spoken well of soy milk for example. When I first considered wfpb eating, finding a ‘milk’ for coffee was my biggest priority. It was potentially the deal breaker. Fortunately I discovered soy milk in the 2 L size in the refrigerator section of the store. I use it on oatmeal in the morning, and in coffee or chicory beverage.

      3. Hi
        After having Covid for 6 weeks and a pain in my chest for this period I did a scan and had severe vessel blockage and was immediately given three stents as had 99% blockage in main artery ….. have now spent six weeks on esseltyn diet and reduced ldl by a gram but still have to cut it in two to get down to 70 … my question is : I find the diet hard but can do it if I eat half a bar of dark chocolate 80# cacao every night … am I damned (!) or by some miracle is this ok?

        1. Absolutely nothing high in fat; as per Dr. Esselstyn’s strict advice. This is not a “can negotiate” thing. It’s either this or imminent death and disease. But there’s good news, read on…

          Hear me well because I think you need to hear this (and I’m a nutritionist that specialises in reversing diseases of affluence): You’re no longer at a point of messing around with your health, in case you hadn’t realised.A choice to eat chocolate or to negociate with anything means wondering if you’re willing to have a heart attack, stroke or vascular dementia – for chocolate? or for X or Y item?!
          You have been on good tracks for vascular dementia and everything else above. Do you want to lose your mind? Or die soon? or worse, get a non-lethal stroke and have the rest of your life quite probably deeply impacted and limited by this?
          Hard questions, I know, but sometimes we just need to hit the reality hard to wake up and stop our futile, self-hindering, slow-suicide negotiations for fleeting moments of pleasure that have tragic consequences.

          You kind of already know this, since you’re asking if by any “miracle” you can harm your health and risk your life without harming your health or risking your life. You used the term miracle. Miracles don’t happen with this, and you don’t need one to excel.

          Most likely, it is only hard because you haven’t figured yet how to enjoy this way of eating. Haven’t tried Esselstyns’ recipes (because in full honesty that was never appealing to me) but the cooking I’ve seen done there wasn’t mouth watering.

          It’s easy to integrate the principles into any cooking, and avoid fats (meaning high-fat products and foods) very religiously.

          My father died of cancer and heart disease and couldn’t receive the procedures he needed because of heart disease. I never was at very high risk of heart disease in the short-term but I’ve pretty much been eating the way you should eat if you want to save yourself, and I thoroughly enjoy it. If you’re not enjoying, you got something wrong. This is good news because it means that you’re not stuck there forever. Keep exploring recipes and flavours. There’s much more to it than the Esselstyn recipes, thank Lord for that! I could adapt this way of eating for anyone in any dietary culture or personal preferences. Surely many things need to go and stay away, but that does not mean you can’t thoroughly enjoy food anymore :)

          Also, it gets better with time if you do it seriously long enough (but please find recipes you actually enjoy that are compliant!). Your taste buds start adapting if you stop throwing crap at them regularly and remind them how mindboggling the health-damaging stuff is.

        2. Hi Griffin, sounds like you have been thru a lot! Glad you are on the Esselstyn heart healing diet.
          1/2 chocolate bar, even 80% type contains quite a bit of saturated fat. I do understand craving something sweet and chocolate after dinner.
          Maybe you could try making banana chocolate frozen dessert? There are quite a few recipes. Most require already frozen bananas and using a food processor or high speed blender. I’m a person who likes shortcuts. So I just mash a ripe banana, add a bit of vanilla extract, and pure cocoa powder. Beat it with handheld mixer. If not sweet enough for you can add a bit of real maple syrup.
          Mix, put in freezer and stir every 15 minutes or so till ice cream consistency.
          There on lots of recipes for this dessert on the internet. Am.posting just one. Try a few till you find one you like.


        3. Hi, Griffin! I am sorry you have had to deal with these issues, but congratulate you on making lifestyle changes to improve your health! The problem with chocolate bars is the fat and sugar. My favorite, healthy way to enjoy chocolate is to blend pitted dates, water, and raw cacao powder in the blender, and pour it over some berries. You can find everything on this site related to chocolate here: https://nutritionfacts.org/topics/chocolate/ I hope that helps!

  18. Dear NF team,
    I am afraid you relied heavily on a extremely poorly-designed, industry-funded study, with deceiving disclosures on roles/influences.

    The position in favour of avocado consumption draws mainly from the study (full-text):

    “Supported by a grant from the Hass Avocado Board, which had no role in the design and conduct of the study; in the collection, analysis, and interpretation of the data; or in the preparation, review, or approval of the manuscript. ” <— Remember this claim about having no role in design, I'll call it back later to challenge it.

    Author Contributions
    “The authors responsibilities were as follows—Wang, Fleming, Hill,
    => and Kris‐Etherton: designed the research and wrote the manuscript;
    Wang, Bordi, Fleming,
    => and ***Kris‐Etherton***: conducted the clinical trial;
    => Kris‐Etherton and Wang: had primary responsibility for the final content of the manuscript; and
    => Kris‐Etherton: read and approved the final manuscript. Wang, Bordi, Fleming, Hill,
    => Kris‐Etherton reported no conflict of interest in this study —> Really?

    Who is Penny M. Kris‐Etherton?!


    Dr Kris‐Etherton is a member of the “Avocado Nutrition Science Advisory.”
    Indeed: http://www.avocadocentral.com/avocado-nutrition-center/advisory

    “A group comprised of world-recognized leading nutrition science experts providing expert insights and guidance to the Nutrition Research Program and Scientific Communication Program at the Hass Avocado Board” <— The funders of the study which supposedly "had no role" in the study etc. One author works for the industry funder. (See Funding above).

    There's more to Dr Kris‐Etherton. She is involved in other high-fat industry research (dairy, beef, walnut and oil, etc). She was also a co-author in the (June 2017) American Heart Association presidential advisory statement on CVD, which claimed “Finally, we note that a trial has never been conducted to test the effect on CHD outcomes of a low-fat diet that increases intake of healthful nutrient-dense carbohydrates and fiber-rich foods such as whole grains, vegetables, fruits, and legumes that are now recommended in dietary guidelines.”
    In short a claim that there is no evidence for cardiovascular benefit of a low-fat WFPB diet…She either didn’t hear of Pritikin, Ornish (1990) and Esselstyn’s work, and other low-fat WFPB works, or this is disingenuous.

    How many? => 45, only 45.
    How healthy? => “Healthy, overweight men and women (21 to 70 years old, BMI 25 to 35 kg/m2)”. (…) “they were overweight or obese“.

    “Participants were weighed daily (Monday through Friday) to assess diet compliance and ensure that body weight was maintained
    —> Only overweight to obese people, kept just as overweight or obese, with an excessive caloric intake.

    Table 1: The diets.
    The AV Avocado diet compared to the other ones had:
    40% more fibre (35g instead of 25~26g – per 2,100 kcal) !!!
    13% less low-fat dairy (2.0 cups, vs. 2.3)
    => A cholesterol study that doesn’t control for fibre. That’s very bad science.

    Comment on fibre intake:
    35g of fibre for a 2,100 kcal reference. A professionally-planned 10% fat Whole Food Plant-Based (WFPB) diet easily scores 70~80g fibre per 2,100 kcal.
    That means their diets where high in: animal products and/or refined plant products.

    Control diets:
    The LF (“lower-fat”) diet is at 24% fat (% of energy) <— a high-fat diet by WFPB standards. Where are the 10% Whole Food Plant-Based diets?

    Table 2: Sample Menu.
    • All contains birds and dairy => omnivorous diet.

    This is a partly industry-funded study. Industry support was wrongly said to have had no influence. Member of advisory board for the entity funding the study (Hass Avocado Board) claimed to have no conflict of interest. Study was done without a low-fat (~10%-fat) Whole Food Plant-Based diet. Participants are overweight/obese, overfed, using high-fat carnivorous/refined diets.

    So unless you’re a keen omnivorous, overweight or obese, wanting to keep overfeeding at all cost, would not considering eating a low-fat WFPB diet, see no conflict of interest in industry-funded science, don’t mind extremely poor study design, then perhaps this small study has little to no relevance to you.

    Personal note to NF: This study made it through your filters, but mistakes happen. Regardless, your evidence-based reputation comes with the downside of a followers base that often confesses to lacking healthy skepticism towards NF/Greger content (a.k.a. Gregerskeptopenia). It’s predictable that many health enthusiasts here will just mimic whatever was done a study you highlight.
    To do the public an even bigger service that you already are, it will help to 1) Clearly warn against mimicking aspects of study diets when the data can’t safely be turned into a recommendation 2) by advocating caution with high-fat whole foods at the very least for people with CVD and/or wanting to achieve maximum weight loss.
    Keep up the good work otherwise. Cheers, Youcef.

    PS: Do we agree this is a very poor study and that no practical conclusion/recommendation can be derived from it?

    1. Good investigative work Youcef, and as much as I respect the hard work of the NF.org team, I’ve got to agree with Youcef on this one. Props to this viewer for reading this in the context of the work of Ornish and Esselstyn (especially, the 10% fat WFPB diets – that is insane that in the AHA statement they apparently ‘forgot’ about Dr. Esselstyn’s landmark research). I also believe the above comment was written in a professional and researched manner, and not at all in a condescending or inflammatory tone (which can at times happen here on these threads). Therefore, I believe Youcef’s comment deserves your review and follow-up :-).

      While you are at it, I’d like to also ask for more clarification on this JAMA study (either from the NF.org team or anyone else that has access to the article). Dr. Greger, could you please explain what you meant by the term “carbs” that they used in the study. I’m actually surprised to hear you use this term, because we all know that “carbs” can just as easily refer to whole grain farro or oatmeal without any added fat as much as it can refer to a twinkie or french fry. Knowledge of what exactly the “carb” substitution comprised could easily have impacted the study.

    2. I’ve no doubt with the sheer volume of research that passes the portals of NF such a snaffu could happen. Kudos to you Youcef that you presented this in the best way and the best light rather than a self satisfied rant as so many might have done. Does your research of apparent compromise, important as that is, negate the many healthy benefits of the whole food avocado fruit as presented in the video or should we avoid avocados as a result of the flawed pedigree?

  19. Renata – Try reading Joel Fuhrman, M.D.’s book Super Immunity. Many of the topics and questions you have he discusses in this book. I, too, had my cholesterol and triglycerides increase when going on a WFPB diet (10 years now). What seems to help me is to aim for a lower-sugar-lower-carb diet. So, for me, that means many lentil dishes (higher protein/lower carb and low glycemic load), winter squash (replacing white potatoes), lots of green low carb vegetables (the green and yellow ones), seitan (home made which is really easy :-). I replace bread with corn tortillas. I eat a few nuts each day and tofu or a soy product. I stay away from high sugar fruits. I am post menopause so I know my metabolism has slowed down. Also, I do drink my glass of wine in the evening and I know that can affect the calorie-sugar balance. But I did reduce my A1c down to 4.7 from a pre-diabetic level when I began WFPB diet. HOwever I am still working on the triglycerides. Dr. Greger has suggested the portfolio diet: https://www.youtube.com/watch?v=Y1d0atD6tBA He references Dr. Jenkins portfolio diet which Dr. Jenkins presents here: https://www.youtube.com/watch?v=laSS-zpTshQ
    Also, Dr. Jenkins references the Portfolio Diet which the Heart UK group posted as a How To Do It set of information. There is a little animal food in the accepted diet but it’s easily adapted for a WFPB lifestyle. Here is the link, but be sure to look at the entire site which is filled with great cholesterol lowering information: https://heartuk.org.uk/cholesterol-and-diet/six-super-foods-for-lower-cholesterol

    Since it’s important to be honest, I also have to get my tusch off the couch and get going on a better exercise program which is something every 64 year old needs to do no matter what they eat. Let us know what changes you make and how that works for you. I’m sure we aren’t the only ones wanting to learn from each other :-).

  20. Avocados are whole plant foods which give you a lot of fiber and antioxidants. I think maybe the key is oxidation of lipids seems to be associated in some way with small LDL. Once the LDL is damaged by oxidation it is more difficult for your liver and arteries to deal with. Whole plant foods and nuts have vitamin E and other protection to keep that from happening.

  21. I’ve been following a plant based diet/vegan for the past year (before that I was vegetarian for 13 years).
    Some years ago I wasn’t worried about health at all, I was worried about the animals and that was all.
    Now I am 31 years old, a bit over weight but not thaaat much (173cm and 68kg) and my total cholesterol is 220.
    Can anybody help with a link that would help me loose weight and lower cholesterol?

    My concern is that if I keep on adding avocados and nuts to my diet I’ll get stuck on the weight I am now (this has happened during the past year)
    What should I cut without loosing the benefits of the food that actually helps lowering the cholesterol?
    Any advice will be very welcome

    I am already eating a lot a beans, I am from Brazil, and this is a staple here, I make it from scratch, no added salt, and usually eat a cup for lunch and another one for dinner, my breakfast is mostly tofu and I’ve been adding avocados and nuts on my snacks, should I stop to reduce calorie intake?

    I’ll appreciate if any of you can comment and make suggestions

    1. Yes, if you want to lose weight, you should avoid high fat plant foods like nuts and avocados. These are all calorie-dense foods. Tofu is also high in fat (
      and calories dense and should probably be avoided for the same reason.



      Weight loss should also help to lower cholesterol. There is no good evidence that avocados help with cholesterol lowering. You could try amla instead if it is available where you live (I buy powdered amla online because the fruit is not available where I live).

      “You can tell this review was not funded by the avocado industry, because they point this out: “it is important to note that substituting avocados for saturated dietary fats as opposed to adding avocado to an already established baseline diet poses the greatest benefit.” Just adding avocado may confer no cholesterol benefits at all.”


  22. I’ve been eating plant based for 6 months, including 3 avocados or so a week. My total cholesterol before changing my diet was 234, it has dropped to 200 exactly after changing to no meat or dairy and no oil. LDL was 126 and is now 111. I’m planning to add in exercise, I’m an active 40 year old mom, 5′ 2″ and 105 pounds, so not overweight but I haven’t been doing any cardio either. I’m concerned that my cholesterol levels are still so high while eating plant based. Beyond adding some exercise I’m not sure what else to do, would really prefer to not add statins. Will my cholesterol continue to get lower the longer I eat plant based?
    (I do know that even as a teen my cholesterol was around 230, not sure if that’s helpful information).

    1. Hi there! First, I just want to congratulate you on how much you’ve lowered your cholesterol so far, which is definitely a direct cause of all your hard work! Exercise will certainly be a great addition. Try to emphasize foods proven to lower cholesterol, such as nuts (https://nutritionfacts.org/video/nuts-and-bolts-of-cholesterol-lowering/), oatmeal, and other fiber-rich foods. Other than that, I would say to just be patient. Give it another 6 months to a year, and I’m sure you will achieve the results you are looking for!

      1. Thank you so much for this encouraging response! I will check out the video and try adding even more cholesterol lowering foods along with exercise.

          1. Thank you Liisa! Yes, I do request no oil/butter when we eat out (which isn’t often) but I could perhaps be more diligent with the no oil. Once in a while I love some chips and salsa (never out, those are loaded with oil). The best I’ve found are Garden of Eatin’ blue corn with no salt, but they do still have oil…any chip suggestions?? :) I have found some nut/seed crackers with no oil and very low sodium but have had no chip luck! I eat a ton of fresh greens, veggies, fruits, nuts, grains as well.

                1. Hi, High Chol Mom, the chip substitute I use is what Liisa suggested. I get the ‘Food for Life’ brand sprouted corn tortillas.
                  They are made with no oils. I just toast them in the toaster, sprinkle with garlic and onion powder, pepper and cayenne. Bonus, they are only 10grams of carbs each, as I find my cholesterol numbers go crazy if I eat most grains.

                  1. Thank you so much! I tried it tonight with the food for life tortillas and they were really good! Especially right out of the oven. Now I’m excited to try with the seasonings you mentioned! So, carbs seem to raise your cholesterol? Anything in particular that you are careful to avoid? I do eat Ezekiel bread most every day and whole wheat items occasionally. I wonder if limiting would help…

                    1. Yes, high carb foods, like most grains, raise my ldl and triglycerides, also lower hdl.
                      I am a biochemist also trained in nutrition. I find some people I work with react to carbs that way. Grains, particularly wheat, are the most problem for some, for others they just have to stay away from all high glycemic carbs, even good foods like high carb fruits. Of course all breads are processed down to fine particles which are absorbed very rapidly.
                      Eating a healthy fat, like avocados, along with the higher carb food helps as it slows down absorption and doesn’t raise insulin levels as much.
                      Insulin removes sugars (carbohydrates), out of the blood and puts that energy into cells. If your cells don’t need it, or you are insulin resistant, the carbs get converted to fat.
                      Sorry for the technical explanation, but if you understand the mechanism, it will make more sense that carbohydrates can raise cholesterol, particularly triglycerides.

                    2. Thank you so much Marilyn! I appreciate your expertise and very detailed response! I’ve just recently been trying to add more oatmeal, because of its known cholesterol benefits. Would that be a grain that you’ve seen actually cause an increase in cholesterol? The last thing I want to do is add something I wasn’t eating before that could raise it even higher.

                    3. About oatmeal, it is definitely a better grain. Most people do well on it. Good fiber, and eaten in the early part of the day helps as you can work off the carbs. Brands and types differ wildly on carb content so read labels.
                      Try to add some healthy fat like nuts or soymilk with it to slow absorption.
                      On soy or nut milks, check label to make sure no phosphates like disodium phosphate or calcium phosphate etc. are added. These inorganic phosphates can cause kidney damage and coronary artery calcification according to a 2013 study.
                      They are in so many packaged foods. Another reason whole food so much better.

  23. Marilyn Kay: For some reason I can’t leave you a comment on your comment so I’ll leave it here. I found your explanation on cholesterol and carbs very helpful. It’s counter intuitive to me that something like carbs, which by all the experts, we are designed to eat, should raise cholesterol. I’ve just recently learnt about insulin resistance and it’s effect on the body especially the liver. Also very useful info about grains and especially oatmeal. I love oatmeal but I find I can’t eat it first thing as it gives me stomach ache. I can eat it for lunch though and often do. You are right about the carb content. The gluten free brand we eat has more carbs than the normal organic rolled oats. Any idea why this should be so? If you do have weight loss and/or cholesterol issues, which I’m thinking is fatty liver and/or insulin resistance, where you are trying to eat low fat to clean out the liver, would the addition of berries and other high fibre foods blunt the spike of insulin when eating grains or porridge? I think exercise will either before or after your meal, right? Thank you so much Marilyn for all the information you have given. It’s amazing that often the simplest questions are the hardest to answers via Dr. Google.

    1. Charmaine, on your first question, I don’t know why the gluten free is higher carb. Sorry.
      As to your comment that we are designed to eat carbs, true, but we are also designed to have periods where we go without food, like in winter. Carbs help us gain weight for the lean times when we reset our metabolism. We are also designed to be very active to use up those carbs.
      Nonalcoholic fatty liver disease is not caused by eating fat in general. It is caused by high triglyceride levels, party driven by a high carb diet and by visceral fat.
      The studies that showed fats in general a problem, were done on animals whose normal diet would not include them.
      Studies done with patients show that it’s the ratio of fats, and the type. Omega 3’s have been shown to lower liver fat, as have monosaturated fats.
      In contrast omega 6’s cause the inflammation that characterizes the disease.
      Also this disease is driven by high blood sugars.
      When I counsel someone with it, I recommend getting a glucose monitor. They then check to see what foods are a problem for them.
      Normal blood sugar levels should be about 85 fasting, and never over 120 or so either 1 or 2 hours after a meal.

      So, if you have this problem, you need to avoid omega 6’s, (vegetable oils except monosatured oils as in olives and avocados).
      Leafy greens, at least 3cups per day, and ground flaxseed (which you need to grind yourself right before your meal), will help with getting more omega 3’s. But frankly, if you are having a serious problem, I would go with a high quality supplement.

      And, at least till you are doing better, you would need to eliminate all grains, fast acting carbs like potatoes, winter squash, beets etc., and all fruits except berries and maybe a bit of citrus.

      1. gluten free is only higher carb when people eat unhealthy gluten-free alternatives. That’s true of any diet. Poor choices are available no matter what type of diet a person chooses.

  24. I am 63, female, and I’ve had borderline high cholesterol / LDL since I was in my mid-30s and tested. My diet has been Mediterranean or vegetarian, until Sept when I went vegan (with no coconut or other high saturated fat foods, keeping sat fat below 10 most days). I also try to stay below the recommended calories. While not overweight, I gain weight much too easily I am usually a voracious over-exerciser (for example, I rode my bicycle 7500 miles last year), so cardio and muscle mass is excellent for my age. I am monitoring everything on cronometer and I have been adjusting vitamins and minerals overall. I went vegan because after all of these efforts.. my LDL remained borderline high. But I do not regret it.
    So … if I do all of this, and my LDL is still high .. then I need to know what I can do to stop my liver from making so much LDL. I know doctors think that there is a lot of room for improvement in their patient’s diets.and that’s why they provide this information over and over (not much is new), but if it’s not working, then we haven’t gone far enough. And what if that’s the answer… figuring out how to influence the liver to stop producing so much LDL (outside of statins).. Genetics are usually predispositions.. so now we need to now how to manage this overproduction of LDL. And I can find nothing that addresses this. And I eat avocados on occasion, but I am hesitant to eat them daily, due to caloric content. I do eat nuts daily.

    1. Hi Ginnis, my husband has the same issues…a liver that makes too much cholesterol. we have not found a way around this either. He did end up with a by-pass years ago. I’d be very interested in what Dr. Greger has to say about this condition, if anything. Perhaps the other nutritionists and doctors on the site? It’s been a real problem. Ps. The gluten-free item I was referring too is gluten free oats. I didn’t think that’s an unhealthy option? Or is it?

      1. Hi Charmaine,

        I am a volunteer for Dr. Greger. Thank you so much for your question.

        Yes, some people do have genetically-caused high cholesterol. These individuals do not respond as favorably to lifestyle modifications as other people with high cholesterol. However, they still do typically respond favorably, but just to a lesser extent. Therefore, it would be best to try as many cholesterol-lowering lifestyle changes as possible, such as increasing fruit and vegetable intake, decreasing saturated fat and trans fat intakes, exercising, maintaining a healthy weight etc. They do typically have increased risks of cardiovascular disease, so any effort to lower that risk (using the methods mentioned above and more) would help.

        I hope that helps answer your question, at least in part.

        1. Thanks for the reply. We were vegetarian for many years eating some cheese and eggs but never much. It was more as a condiment than a meal. Then we changed that and now we eat vegan, SOS as often as is possible and no flour products. Like Ginnis I find I don’t do well eating bread….not that I don’t miss a nice sandwich! We excercise too…almost every day. We’ve cut down on nuts and avos which we both love in an effort to alter the cholesterol outcome. So far there has been no joy but we’ll keep going on WFPB and hope eventually it will make a difference. So much good stuff is supposed to happen when you eat WFPB. By my experience it either isn’t working that well for us or it must be a very slow process to get there. Common sense dictates that this is the best way to eat and I’m not saying we don’t love eating like this…we do. It probably isn’t that magic bullit I thought I had found.

          1. Hi Charmaine,

            A handful of nuts every day is recommended by the American Heart Association to decrease total and LDL cholesterol levels. Whole grains such as whole grain bread is also recommended, so don’t feel bad about including foods such as veggie sandwiches! Sometimes diet and exercise are not enough to lower LDL to recommended levels; if his levels are not budging is the case after about 6 months of diet and exercise, talk to his health care provider about adding a low to moderate level statin. Statins, in combination with healthy lifestyle, should help to combat familial hyperlipidemia.



          2. Can someone figure out what’s going on here? It seems based on these forums that cholesterol creeps up on more of us than would be caused by familial Hypercholesterolemia which affects one in 500. Is it lack of iodine/selenium? You need the equivalent of 2 sheets of nori a day, some may need more. Is it toxins? How perfect does one have to eat? Is eating better than 98% of everyone else not good enough? Statins don’t seem to be the answer.

            1. Wegan, beacause you need to check thyroid, crp, homocysteine, especially fasting blood sugar (70-87 normal), A1c, (4.6-5.4) make sure your omega 6-3 balance normal. No more than 2-1, calculate from your usual diet.
              In spite of what pretty much all holistic doctors are saying, whether they are vegan, vegetarian, etc. people are Still eating way too much processed, and high carb food. Any flour is processed, all cereals are processed for instance, and most any ‘gluten free’ substitute is awful nutrition. Rice flour, potato flour, dates, are no different than pure sugar.
              Who is eating the 9 or more serving of vegetables and healthy fruit recommended?
              Oatmeal is ok for some, even helpful, but most people are more insulin resistant in the morning.

              1. I don’t know if your remarks are directed at me. But here is what is true for me. Thyroid is fine and all my bloodwork is great – in “good” ranges. High HDL, low tri, low CRP, low WBC (no inflammation). Omega 6:3 balance is maintained as recommended .. I do that on cronometer. I do not eat any processed food. I eat gluten free (beans, nuts, fruits, vegetables) – no wheat or processed food substitutes. And absolutely no fatty coconut foods. Basically my saturated fat intaks is about 9g a day which all come from peanuts, almonds, and of course many healthy grains and vegetables have a small amount of saturated fat.
                Still LDL is a tad high (borderline) while everything else is fine or great. I suspect I am an over-responder or super-responder. Presently, I am drastically minimizing olive oil with the focus on elimination – and all other stand-alone oils. While I did not over consumer oils, it is the next step in my journey toward lower LDL and reducing my risk for heart attack. Perhaps, small amounts of oil trigger LDL production??? That’s my current self experiment. And increasing fiber from 35mg a day average to 50mg a day. (confound, sorry, but neither is going to hurt me.)

                So I was basically healthy Mediterranean for years (fish once a week; chicken once a month; beef once every two months); then I cut out all cholesterol containing foods (no eggs, no dairy; no fish; no meat) (but for perspective, a chunk of cheese lasted a month or got moldy); then vegan no coconut; now vegan no oil. Every step bought me a 20 point reduction in total cholesterol, mostly due to LDL declines, after 6 months (when my dr tests me). Now, I am taking it step further with increases in fiber; no added oil; and attempting to eat a total fat percentage of about 20%. Only time will tell.

                Of course I rode 400 miles in the last two weeks – and I will keep my mileage at 150+ all summer. Then in the winter, I fat bike and cross-country ski. I am strong and healthy and I do not want to have heart disease, like my parents and so many other people. It’s a work in progress.

    2. Hi Ginnis,

      I am a volunteer for Dr. Greger. Thank you for your question. I will respond in a similar manner to how I responded to the post below yours.

      Essentially you can only modify your diet to become more and more whole food, plant-based, making sure to include specific foods that lower cholesterol. For example, if you ate a diet 90% whole food, plant-based, try to increase it even more if you can. And of course, make sure to consume foods like oats, pears, apples, and other sources of soluble fiber which is potent for lowering cholesterol. We all have a different starting place, or baseline LDL cholesterol level. But some people will do things to increase it, and some people will do things to decrease it. You may genetically start with a higher cholesterol, but you can only go with what you’re given and eat a strict whole food plant-based diet and include physical activity.

      I wish you the best of luck!

      1. Yes.  100%.  Absolutely no dairy, no meat, no fish, no coconut oil and rarely coconut anything.  Heavy legumes, fruit, vegetables, etc.  I am of the opinion that if I don’t try it 100%, then there will always be doubt.  I’m sorry, but it almost sounds like you did not really read my comment.  I rode my bike 7500 miles last year.  Exercise is not my issue.  This is what I mean by dr’s assuming that patients are not listening to them – so they keep repeating the same thing over and over.  I’m not sure how that helps.   sorry I’m tired of hearing the same recommendations over and over – when literally I am following them.

      2. Yes.  100%.  Absolutely no dairy, no meat, no fish, no coconut oil and rarely coconut anything.  Heavy legumes, fruit, vegetables, etc.  I am of the opinion that if I don’t try it 100%, then there will always be doubt.  I’m sorry, but it almost sounds like you did not really read my comment.  I rode my bike 7500 miles last year.  Exercise is not my issue.  This is what I mean by dr’s assuming that patients are not listening to them – so they keep repeating the same thing over and over.  I’m not sure how that helps.   sorry I’m tired of hearing the same recommendations over and over – when literally I am following them.

  25. Hi Charmaine,
    bypass… ugh… I had that coronary calcium score and my scores were 3/0 – which is very low and not a concern. I just want to catch it before it becomes a concern. In an earlier comment, someone said replacing gluten foods with non-gluten foods is unhealthy. I have no idea why people like to pick on people who eat gfree. I’ve been gfree for 12 years … almost before anyone knew what it was .. (another story.. my son struggles with gluten tooo.. and gets the celiac rash.. so it’s very suspicious. .. also makes us sick). Anyway.. any change in diet that results in poor choices is not going to be healthy. Over the years I ‘ve known lots of super unhealthy vegetarians … and I suspect the same thing could be true of vegans… So I dislike blanket claims like gfree diets are unhealthy .. because they assume we are replacing bread with unhealthy options (or something like that). For me, bread just became a non-option, replaced with healthier grains etc. Not necessarily daily, but I eat quinoa, rice, almond flour, sorghum flour, oats of various types instead of wheat. I think it’s so much healthier to eat this way. Wasn’t easy in the beginning.. but 12 years into it, I hardly think about it anymore.

    1. So nice of you to write back Ginnis Yes, people like to pick. I’m the same, get sick from things I used to eat without issues before. After the by-pass Howie was put on statins and left on them for more than twenty years. Recently he rebelled and took himself off them because he has been experiencing such problems with his memory. The doctor was not prepared at all to find alternatives and told him “you need statins. stay on them”. I really am so fearful for my husband not only because he has been on statins for such a long time but also because of the emerging long time usage side effects. If you find out anything about the liver issue in your earlier comment, please let me know what you find. I’ll do likewise. I wish you well Ginnis! May you be blessed and stay safe and well

      1. Charmaine, I am so sorry to hear that this confusion about statins/diet etc., is so problematic for your husband. That is very sad. I am at the stage of trying to do my best to prevent… and hoping I can… And I am probably more than slightly neurotic about it. I agree that we don’t know much about long term use of statins… I’m sorry. ANd thank you for your kind words!

  26. Hello! Could you shed a light on why a chocrane review of the topic concluded no significant benefits for lowering LDL cholesterol by avocado?

    thanks NT

  27. I briefly read through your citation. It does not appear that the review is differentiating the types of LDL like Dr. G was reporting on.

    Dr. Ben

  28. My wife has a cholesterol level of around 220. Shes been vegan for 7 years and her cholesterol has barely budged. Mine on the other hand went from 195 to 104 within 6 months. We essentially eat the same since I do all the cooking. Her brother died of a massive heart attack a year ago and all her brothers have high cholesterol, even higher than hers. Her doctor says her level is OK however I know she has to get lower like 150 to become heart attack proof.

    My understanding there is good and bad components within HDL and LDL cholesterol. Would further testing put her 220 cholesterol into perspective of is it bad really? Or the fact that she is vegan enough to really eliminate the risk for her. I’m considering having her have a test done that would dissect her cholesterol to a more granular level. https://www.privatemdlabs.com/lab_tests.php?view=search_results&show=1561&category=1&search=NMR#1561

    NMR LipoProfile® with Insulin Resistance Markers: Insulin resistance markers; lipoprotein particle number (LDL and HDL); lipoprotein subfractions; standard lipid panel (total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides). Graph is not provided.
    Complete Blood Count (CBC) with Differential: (Hematocrit; hemoglobin; mean corpuscular volume (MCV); mean corpuscular hemoglobin (MCH); mean corpuscular hemoglobin concentration (MCHC); red cell distribution width (RDW); percentage and absolute differential counts; platelet count; red cell count; white blood cell count; immature granulocytes)
    C-Reactive Protein (CRP), High Sensitivity (Cardiac Risk Assessment)
    Comprehensive Metabolic Profile (CMP) (includes eGFR): (A:G ratio; albumin, serum; alkaline phosphatase, serum; ALT (SGPT); AST (SGOT); bilirubin, total; BUN; BUN:creatinine ratio; calcium, serum; carbon dioxide, total; chloride, serum; creatinine, serum; globulin, total; glucose, serum; potassium, serum; protein, total, serum; sodium, serum.)
    – Liver Function test (included within the CMP)
    – Kidney Function test (included within the CMP)
    – Serum Electrolytes (included within the CMP)
    Iron, Serum w/TIBC: Percent of saturation; serum iron; total iron binding capacity; unsaturated iron binding capacity
    Urinalysis, Complete Profile: Color; appearance; specific gravity; pH; protein; glucose; occult blood; ketones; leukocyte esterase; nitrite; bilirubin; urobilinogen; microscopic examination of urine sediment.
    CA-125 (Ovarian Cancer Test)
    Thyroid-Stimulating Hormone (TSH)
    Total Estrogens Test

    I’m curious by looking at the test results it would provide, could it put the high cholesterol results to bed so to speak? She really doesn’t want to do meds but she is kind of at a loss as to what to do.

    Dr Caldwell Esselstyn in his book, Reversing Heart Disease suggest eliminating all fat including nuts and avocados and any added oil whatsoever. Which is doable but it is a rather a real tough regime. Prefer not to go down that road unless it is a last resort.


    1. Hi there. I’m a health support volunteer with nutritionfacts.
      First of all, please congratulate your wife on the healthy lifestyle she has done for 7 years. It is frustrating to be doing things right and not have the desired results. We do get questions like this sometimes so she is not alone.

      First of all, I do not think there is any testing which would make high cholesterol not problematic. Testing like thyroid level is helpful to see if there may be some other issue causing her high cholesterol, but I don’t think there is any evidence of scenarios where high cholesterol is not a risk factor for other problems.

      As far as the nuts question, from what Dr. Greger has said, when Dr. Ornish and Dr. Esselstyn did their heart disease reversal trials, they did them without high fat foods like nuts and avocados. So the data we have to support heart disease reversal did not include nuts. We don’t have data that shows those foods cause heart disease. Newer research has shown nuts and avocados are health promoting which is why Dr. Greger recommends them as part of his daily dozen. But those trials have not been repeated with high fat plant foods so we don’t have the data to support it. I think the thought is, most likely if those trials were repeated with healthy sources of fat, you would get similar results, but this just hasn’t been done. But I would absolutely avoid oil. This is not a whole food plant based source of fat like nuts and avocados.

      So first of all, I would have your wife take a careful look at her diet. Consider following Dr. Greger’s Daily Dozen if she is not. Make sure no unhealthy foods are sneaking in like oil, processed foods, fake vegan “meat”, added sugars, white flour products. Unfiltered coffee is another thing which can raise cholesterol. It’s amazing how things can sneak in. And again, avoid all oils. Even “healthy” oils like olive oil and coconut oil have been shown to cause heart disease and raise cholesterol.

      If she has truly removed all cholesterol raising foods, the next thing to do is add foods which specifically lower cholesterol- soluble fiber, beans, ground flax, brazil nuts, leafy greens. Also exercise is helpful. This blog might be helpful to you:

      All the best to you and your wife,

    2. Patrick and Ginnis… I can totally relate to the frustrating blood work results after a diligent plant based eating plan. I changed to plant based eating about a year ago, no added oils as well. I have continued to include nuts and some avocado up until the last few weeks. This summer I really hit a wall when my cholesterol just wouldn’t budge despite my very best plant based efforts. I was eating TONS of leafy greens, fruits, vegetables, minimal carbs, no added sugar beyond dates. So really I felt I couldn’t be eating much healthier. I was still having almond butter on my Ezekiel bread each morning and a few nut products and avocado here and there. My total cholesterol last year was 234 and after an entire year of being plant based it went down to 226!?!? What?? And my LDL was even higher than the year previous when I was eating pretty much whatever I chose, lots of fried etc. I am quite lean and pretty active so no extra pounds that might be contributing. I decided to eliminate ALL nuts, seeds (except for flax & chia), avocado, and get more strict on checking labels to be sure I’m getting NO oil. (I really hadn’t been consuming much of anything that would have had oil but once in a while an Amy’s burrito or chili.) After about a week of that I had to go in for some other blood work and I decided to just go ahead and get my cholesterol checked even though I knew it probably hadn’t changed much if at all after just a week of change. My total cholesterol went down 36 points after only one week of no nuts or avocado!!!! Total cholesterol was 190, the lowest I have ever seen it!! And my LDL went down from 140 to 115!! I know I still have a long way to go, but WHOA!! I couldn’t believe it!! I’m hoping that given some time the no nuts, avocado, and more strict NO oil will get my numbers down to what they should be. I seem to hyper respond to the fats in nuts, etc. I definitely think I am just more prone to high cholesterol. I would say if my husband ate the way I do his cholesterol would be far below 150. He eats fried foods often, chicken, etc and even right after a meal of fried foods his total cholesterol was 169!!! I work SO hard to just get mine below 200. Everyone is so different. I plan to get my lipids checked again after one full month of no nuts, avocado, and oils just to be sure I’m still on the right track. I was SO hesitant to ditch the nuts because I really like them. For now I’ve even taken out nut milks, but hoping maybe I can eventually add those back in. For me it seems to possibly be a game changer. Might be worth a try of eliminating for a few weeks and then testing again to see if it might help you too.

      1. Thank you.  I dislike having to cut out all nuts.  I think I could cut out the 5 avocados I eat a month, but the nuts – that’s tough.  But maybe I should.  In truth, I think I have 1 or 2 apoe4 genes, and hence, the high LDL in spite of efforts.  But that means I just have to keep trying!!

        1. I agree, Ginnis. The avocados I could definitely do without. I enjoy them, but no biggie to leave out the few I had here and there. But I loathed the thought of giving up nuts…it seemed so extreme to me and I really didn’t know if I could do it, especially nut butters (one of my favorite things!!) But…after a few weeks I have to say I’m really not even missing them. I’ve had to get a little creative with breakfast ideas, but overall I think I could do this long term if I end up needing to. And I did not feel that same way a month ago. I am still using flax seeds and chia seeds. A banana dipped into some ground up flax seeds isn’t quite the same as almond butter, but hey, I’m liking it! I’ve also wondered about the APOE 4 gene that predisposes you to higher cholesterol. I’ve recently gotten a 23&me health screening that tests for that gene. I don’t think it distinguishes between one or two copies of the APOE4, but it does indicate whether or not you have it. It will be a few months before I get those results…

  29. Getting the tests cited seems like a good idea. My thoughts currently, and after reading a ton of scientific articles, is that I have an APOE-4 allele (hopefully not 2) – which is typical of about 11% of the population. I would like to be tested for that next round of testing and go forward with that knowledge. There is no reason, as you imply, for one person to drop 50% and another almost 0% on the same diet. I have not given up nuts and avocados yet.. but they are next on the chopping block as I am at a loss as to what to change. (vegan, high fiber, fruits and veggies, no processed vegan food, minimal oil (none in salads or sauteing)). I wish I knew the answer. And it might be the APOE-4. That said, some believe that health outcomes can be improved through lifestyle even when POE-4 status is present. I am not sure about that, but given that I don’t know what else to do, I am committed to that path. Besides having cvd, I also do not want Alzheimer’s, which is much more likely with APOE-4 status. argph…….

    1. Ginnis & Patrick,

      I just wanted to update on the no nut experiment. I really did not want to go this route either, I LOVED my nut butters and nut milks. And it is hard to make sure there is NO oil in anything (including eating out, etc.) But after an entire year of eating a plant based diet and very little change in my cholesterol, the nuts finally got the chopping block and I’m adjusting! I have still been using flax & chia seeds, but that is it when it comes to nuts/seeds. Total cholesterol just a little over two months ago with a plant based diet that included nuts, a few avocados, and very little oil (in Amy’s products, etc) was 226 and LDL was 140. After going one month with no nuts, avocado, and very strict no oil my total cholesterol is down to 162 and LDL is 99!!!! I’m hoping it may continue improving the longer I follow these changes.
      Just wanted to share, as I would’ve really welcomed this info a few months ago. :)

      1. Wow. That is amazing. I just wonder why some people, like you, and maybe me, respond so intensely to nuts. That’s a cool change. In March, I cut out oils, and like you, I try to eat flax and chia a few times a week. An avo, maybe once a week, but I could give that up. And nuts, maybe a T a day and some days none. I get tested mid September. It’ll be 1 year I’ve been completely plant based at that time .. before that I was mediterranean, but leaning toward vegan heavily . I was almost vegan when I went vegan, but I gave my small bit of cheese, and my yogurt (like every other day). I didn’t realize at that time, that I should give up olive oil, but I did give up coconut oil. At this time, my fat intake overall is extremely low, with saturated fat under 10 grams. (I use cronometer so I know.. most people underestimate their fat intake… cause there’s fat in almost everything, including fruits and vegetables, so it can add up.) I would love to have LDL Of 99. Fingers crossed.

        1. It sure does seem like some people hyper respond to all fats, even the “healthy” ones. I wasn’t eating a lot of nuts, mostly just about a tablespoon or so in the morning each day on my Ezekiel bread. That’s part of the reason I’d put off making the change for so long. It was hard to believe making such a small change could make such a big difference. (Well, that and I REALLY didn’t want to give them up.) I’ve adjusted now and I really don’t miss them anymore. I’ve wondered about the APOE 4 allele myself…I’ve got to send off my 23&me health test and find out (I think it takes a few months to get results). I’d say you are definitely doing all the right things! I know that no oil is hard, for me it is anyway. It requires a lot of planning since you really can’t buy anything pre made. Definitely a healthier choice and what I prefer, but trickier during extra busy times. Getting blood work results always makes me a little nervous, because time and time again I’ve felt like I was doing everything right and my results just don’t show it. It was exciting to finally see some improvement! Good luck to you!!! It’s definitely an ongoing effort!

  30. I have a question about how to change small dense LDL to large fluffy LDL. This is in response to an article ” 7 ways to fix your cholesterol”, in Better Nutrition, 02/01/18. My integrative medical doctor recommended changing from coq10 in standard ubiquinone to ubiquinol. I started with Qunol brand 100mg a day in the AM. After two days my eczema worsened considerably, I felt nauseous and stomach upset. I guess I should go back to standard ubiqionone (Puritan Z-sorb 100 mg). I have been on a whole food plant-based diet for three years, based on training from a plant based cardiologist in NYC. I take 40mg of pravastatin and 10 mg of Zetia. Lipid levels: Cholesterol 128, LDL 53, HDL 50, Triglyceride is 126. I did have a stent in RCA at age 51. I am 67, feel healthy, thin, exercise about 4.5-6 hrs. a week. I went to a integrative MD who said my LDL particle pattern is B and she would like to make it A. I was hopeful that the ubiquinol would make a difference but due to the side effects I unfortunately stopped. I feel healthy and have not had another stent since the one I had at age 51. . I saw the integrative health doctor just to tweak my health to a higher level. My cardiologist thinks I am doing great. He said it was unusual for a man who had a stent at age 51 not to have needed another one in over 16 years. So, I just would like to change my LDL pattern from B to A, but since the ubiquionl had considerable side effects I am baffled what to do. Any suggestions? Thanks. So, I realize you cannot provide medical advice. I provide you with my medical background just for a sense of situation. I am asking you for general advice, and in no way hold you in any way responsible for any advice you give. However, based on your knowledge you might be able to recommend something that can change small dense LDL particles to large fluffy ones. Perhaps it does not matter?. By stopping all animal foods for over 3 years I am sure I no longer make any TMAO which according to Cauldwell Esselstyn MD is worse than cholesterol. He says TMAO is often what drives cholesterol into the artery lining and without out it maybe I am safe?

  31. You’ve obviously done some research yourself and glad you’re viewing this site as well aware that medical advice is not given out here. I think paying attention to your own symptoms when it comes to a change in medication makes sense but I understand that leave you wondering if since changing to ubiquionl didn’t work, what else you might try. You’ve already seen the information on avocados. There does not seem to be agreement from research on other approaches and certainly not specific foods https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5441126/
    Small Dense Low-Density Lipoprotein as Biomarker for Atherosclerotic Disease
    So your supposition that the best approach now is indeed continuing to good efforts you are already following and consider yourself doing what you can to keep yourself safe. Worrying obviously will only make you less healthy when you are taking appropriate protective measures.
    You may wish to view this other NFO video on LDL size congratulating yourself that you no longer eat eggs and feeling good about that :

Leave a Reply

Your email address will not be published. Required fields are marked *

Pin It on Pinterest

Share This