BOLD Indeed: Beef Lowers Cholesterol?

BOLD Indeed: Beef Lowers Cholesterol?
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The beef industry designed a study to show that a diet containing beef was able to lower cholesterol—if one cuts out enough poultry, pork, fish, and cheese to halve one’s total saturated fat intake.

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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.

Imagine you worked in the now defunct Twinkie division of Hostess Foods, and wanted to take the tobacco industry tact of not just downplaying the risk of your product—but actually promoting it as healthy. How do you do that?

Your first problem is it has 2.5 grams of saturated fat. So, that’s going to raise cholesterol—the #1 risk factor of our #1 killer, heart disease. How are we going to get around that?

Well, what if you designed a study in which you took a bunch of people eating your archrival, Little Debbie® Cloud Cakes. Now, they only have one gram each. So, what if you took a group of people eating five Cloud Cakes a day—five grams of saturated fat—and then cut that saturated fat intake in half, by switching them to eating one Twinkie a day? What would happen to their cholesterol levels? Cutting saturated fat consumption in half, their cholesterol would go down. So, technically, they went from zero Twinkies a day, to one Twinkie a day. And, their cholesterol went down.

You publish it, and crank out a press release. New research shows that eating a Twinkie a day can be good for heart health by improving cholesterol levels. The media takes your press release, runs with it: Consumers can eat a Twinkie every day if they choose, and feel confident that science supports Twinkies’ healthy benefits—which now include cholesterol-lowering effects! Twinkies, you just proved with science, have cholesterol-lowering effects. Too outlandish a scenario?

Check it out. This study, bought and paid for by the beef industry, added beef to people’s diets. But, at the same time, removed so much poultry, pork, fish, and cheese from their diet that they halved their saturated fat intake—from 12% of their diet, down to 6% of their diet. So, of course, their cholesterol went down. If your diet goes from 12% saturated fat down to 6% saturated fat, it doesn’t matter if that 6% comes from beef, chicken, lard, or Twinkies. If you cut your total saturated fat in half, your cholesterol will follow—especially if you eat more fiber and vegetable protein, as they did here.

They conclude, “The results of the BOLD study [standing for Beef in an Optimal Lean Diet] provide convincing evidence that lean beef can be included in a heart-healthy diet that meets current dietary recommendations and reduces [cardiovascular disease] risk.” Crisco could be included. Krispy Kreme could be included, as long as you cut your total saturated fat intake. What they fail to mention is that risk would drop even lower if you also dropped the beef—as was pointed out by the chair of nutrition at Harvard, who’s previously pointed out that plant sources of protein are preferable.

The subjects in this study went from a high risk of dying from heart disease, to a high risk of dying from heart disease. Remember, we need to get our LDL (bad) cholesterol down to 50, 60 or 70 to become essentially heart attack-proof. For most people, that means eliminating saturated animal fat and cholesterol intake completely.

This study is really just showing how bad saturated fat is, from any animal source. Yes, based on saturated fat levels, lean beef is often better than chicken (and Twinkies). But, that’s like touting the health benefits of Coca Cola, because it has less sugar than Pepsi. It does—16 spoonfuls of sugar per bottle, instead of 15. Doesn’t mean we wouldn’t be better not consuming soda at all. Reminds me of this study: “Cheese intake…lowers…cholesterol…compared [to] butter.”

Yet, here’s the release. That’s how they ended up with the cholesterol-lowering effects of beef. If you cut out enough poultry, pork, fish, and cheese from your diet, you could get cholesterol-lowering effects from nearly anything.

Please consider volunteering to help out on the site.

Images thanks to readerwalker and jclor via flickr. Thanks to Stephane Lahaye and Ellen Reid for their Keynote help.

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.

Imagine you worked in the now defunct Twinkie division of Hostess Foods, and wanted to take the tobacco industry tact of not just downplaying the risk of your product—but actually promoting it as healthy. How do you do that?

Your first problem is it has 2.5 grams of saturated fat. So, that’s going to raise cholesterol—the #1 risk factor of our #1 killer, heart disease. How are we going to get around that?

Well, what if you designed a study in which you took a bunch of people eating your archrival, Little Debbie® Cloud Cakes. Now, they only have one gram each. So, what if you took a group of people eating five Cloud Cakes a day—five grams of saturated fat—and then cut that saturated fat intake in half, by switching them to eating one Twinkie a day? What would happen to their cholesterol levels? Cutting saturated fat consumption in half, their cholesterol would go down. So, technically, they went from zero Twinkies a day, to one Twinkie a day. And, their cholesterol went down.

You publish it, and crank out a press release. New research shows that eating a Twinkie a day can be good for heart health by improving cholesterol levels. The media takes your press release, runs with it: Consumers can eat a Twinkie every day if they choose, and feel confident that science supports Twinkies’ healthy benefits—which now include cholesterol-lowering effects! Twinkies, you just proved with science, have cholesterol-lowering effects. Too outlandish a scenario?

Check it out. This study, bought and paid for by the beef industry, added beef to people’s diets. But, at the same time, removed so much poultry, pork, fish, and cheese from their diet that they halved their saturated fat intake—from 12% of their diet, down to 6% of their diet. So, of course, their cholesterol went down. If your diet goes from 12% saturated fat down to 6% saturated fat, it doesn’t matter if that 6% comes from beef, chicken, lard, or Twinkies. If you cut your total saturated fat in half, your cholesterol will follow—especially if you eat more fiber and vegetable protein, as they did here.

They conclude, “The results of the BOLD study [standing for Beef in an Optimal Lean Diet] provide convincing evidence that lean beef can be included in a heart-healthy diet that meets current dietary recommendations and reduces [cardiovascular disease] risk.” Crisco could be included. Krispy Kreme could be included, as long as you cut your total saturated fat intake. What they fail to mention is that risk would drop even lower if you also dropped the beef—as was pointed out by the chair of nutrition at Harvard, who’s previously pointed out that plant sources of protein are preferable.

The subjects in this study went from a high risk of dying from heart disease, to a high risk of dying from heart disease. Remember, we need to get our LDL (bad) cholesterol down to 50, 60 or 70 to become essentially heart attack-proof. For most people, that means eliminating saturated animal fat and cholesterol intake completely.

This study is really just showing how bad saturated fat is, from any animal source. Yes, based on saturated fat levels, lean beef is often better than chicken (and Twinkies). But, that’s like touting the health benefits of Coca Cola, because it has less sugar than Pepsi. It does—16 spoonfuls of sugar per bottle, instead of 15. Doesn’t mean we wouldn’t be better not consuming soda at all. Reminds me of this study: “Cheese intake…lowers…cholesterol…compared [to] butter.”

Yet, here’s the release. That’s how they ended up with the cholesterol-lowering effects of beef. If you cut out enough poultry, pork, fish, and cheese from your diet, you could get cholesterol-lowering effects from nearly anything.

Please consider volunteering to help out on the site.

Images thanks to readerwalker and jclor via flickr. Thanks to Stephane Lahaye and Ellen Reid for their Keynote help.

Doctor's Note

How are Americans exposed to saturated fat? Burgers actually fall well below chicken; see Trans Fat, Saturated Fat, & Cholesterol: Tolerable Upper Intake of Zero.

The beef industry is by no means alone in having a corrupting influence on the scientific method. See, for example:

For more on being heart attack-proof, see Eliminating the #1 Cause of Death.

For further context, check out my associated blog post: How to Design a Misleading Study.

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

65 responses to “BOLD Indeed: Beef Lowers Cholesterol?

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    1. Some good points Goldacre makes. But in the end, isn’t he still a vaccine promoting, pharmaceutical industry supporting shill of some sorts, when the truth is that our bodies need to be exposed to the antigens through natural exposure, creating mucosal response, enzymatic response, biliary response, the biggie – the response from the intestinal flora, and then cell mediated response, to effectively create humoral immunity that lasts, where the antibody survives much longer after healthier B cells create the antibody, as well as effective excretion through the colon and urinary tract, and skin, making our diet (with green leafy vegetables being very important) key, with tons of fruits & veggies, excluding bacteria and inflammation forming animal products and the TMAO from them?




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  1. This is one of the best videos I’ve seen to show how information can be misleading. Misleading is a mild descriptive. The BOLD study was down-right deceptive.




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  2. Great video, showing how easy it is to conduct a (lousy) study to prove anything. Actually it is embarrassing to conduct a study like this. Science is not always science.




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  3. Why do some studies show that nut consumption (which have significant saturated fat content) reduces the odds of heart disease? Or more specifically, what is it in nuts that compensates for the saturated fat to make it a heart healthy food?




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    1. I find it difficult to have applicability with the nut studies because they typically involve people consuming a standard American diet and then adding nuts. I would find results more intriguing comparing a very low fat diet to a diet that included a moderate amount of nuts.




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    1. Paypal processes all donations to NutritionFacts.org using the same kind of encryption technology that is used by banks and large retailers, but you do NOT have to establish a Paypal account to support the site. In fact, it seems that using a credit card is the only option for making a donation online (as of now). Or, if you live in the U.S., you could mail a check :) Either way, thank you for supporting this project!




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  4. Dr Geiger always seems to focus on Cholesterol and LDL cholesterol – and conveniently ignores two other major risk factors – tricyclerides and HDL.

    My experience and on the advice of my doctor eating a diet high in saturated fat while reducing carbs raises HDL and lowers my TG, and importantly significantly improves the TG/HDL ratio which is a more powerful indictor of heart disease risk than is total cholesterol. Since I changed my diet my risk factors have decreased and I sure enjoy my food a lot more – which is sort of the point of living, isn’t it?

    I would really appreciate a response from Dr Geiger.




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    1. Hi oderb, I was about comment on the same lines. I know several people who had high cholesterol trying to eat whole grains and veggies, then switched to high fat/low carb, and their bad cholesterol went down, then their good cholesterol went up. Curious about a response :)




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      1. The high fat/low carb diets can indeed bring short-term weight loss and increases in HDL. Minor side effects include constipation, headaches, bad breath, diarrhea, muscle weakness and cramps, and rashes. Some major effects include poorer cognition and mood, gouty blood, more kidney stones, kidney damage, higher LDL levels with long-term maintenance, higher cholesterol and BMI, more adverse vascular effects independent of cholesterol markers, higher C-reactive protein, arterial stiffness, poorer endothelial function, higher cardiovascular disease, more cardiovascular events, more deaths, more deaths, and more cardiovascular, cancer, and overall deaths.

        Its also worth noting that a recent extensive review found no outcome benefit from HDL increasing medications, only LDL seemed to matter. Atkins-type diets don’t appear to help much there.




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    2. Available data suggest that simply increasing the amount of circulating high density lipoprotein cholesterol does not reduce the risk of coronary heart disease events, coronary heart disease deaths, or total deaths. The results support reduction in low density lipoprotein cholesterol as the primary goal for lipid modifying interventions.

      From: Briel, Matthias, et al. “Association between change in high density lipoprotein cholesterol and cardiovascular disease morbidity and mortality: systematic review and meta-regression analysis.” BMJ: British Medical Journal 338 (2009).




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        1. There’s not much else in the way of mortality data or large diet trials, at least according to these two more recent meta-analyses (1, 2). From the first you’ll see that in most diet vs. diet studies, “low-fat” isn’t low at all, dig further and discover dismal adherence in most trials, but I think they still give an idea of the direction if not magnitude of blood marker changes with adherence.

          I omitted fairly consistent evidence that ketogenic / LFHC adversely effect cognition, memory, and mood: 1, 23. I’m pretty sure Dr. Greger has covered this side effect in a prior video.




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      1. Darryl, may I ask, what is your occupation? You are very knowledgeable in nutrition. I myself am a student of nutrition and have much to learn, but I am curious about your field.




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        1. I’m in software, though I majored in biochemistry. Dr. Greger’s videos often inspire me to delve (sleepless nights on PubMed), but I post here from enthusasm rather than credentialed authority. It just helps me organize and remember my own findings. Its a great time to be a casual science fan, as anyone can search the last 45+ years of abstracts without leaving bed, read many papers in full, and listen to graduate seminars while walking the dog. I somewhat regret being on the sidelines, but my past self lacked the persistence for another decade of school & post-docs.




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  5. Diction alert! “tobacco industry tact” — should be “tack”. A common error. This usage of “tack” derives from its nautical meaning of a sailing maneuver. “Tact”, on the other hand, is sensitivity in dealing with others.

    More relevantly.. The BOLD diet reduced SFA intake from 12 g to 6 g, not 12% to 6% of kcal; the percentages went from 27.9 to 15.4. This is per the study table displayed in the video.




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    1. Thank you so much brec! I corrected tact for tack. I think I got the percentage right, though. You can tell the parenthetical number is the grams, because otherwise they would be getting 287% of their calories from carbohydrates :)




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  6. Hi Dr. Greger,
    I thought the American Journal of Clinical Nutrition was a peer-review scientific journal. How did they justify publishing this?




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    1. This is a very reasonable question, since it would seemingly require a conspiracy to publish such a preposterous paper! Yet this paper found its way into a major nutrition journal of respectable impact factor.
      My opinion is that the peer review process for most journals is an imperfect filtration of bad papers. Typically only two scientists in the field have to approve of a paper for it to get published. Sometimes even one positive enough reviewer can persuade the journal editor to accept the paper. In cases where a paper is rejected, the authors are entitled to re-submit their paper to other journals. Each additional iteration of peer review will increase the odds that a favourable reviewer is found. Thus, for persistent enough authors, finding a suitable match is inevitable.
      Furthermore, scientists are rewarded primarily based on the number of times a paper is cited. So, in theory, a paper could be cited 300 times, all citations of which argue that the paper is dreadfully bad and yet this would be of great value to a scientist’s career in terms of grant and award earning potential.
      So now you understand the temptation to become a scientist. You are revered as if you belong to the modern priestly caste and the secret to success is nothing more than persistence.




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  7. Amazing video Dr. Greger. I have to compliment you on your choice of graphics and visuals—true eye candy. They make your videos not only educational, but entertaining as well.




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    1. WOW! With this kind of very strong arguments, backed up by references to countless scientific articles, you will convince everybody…….NOT




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    2. Well, in fact both saturated fat and cholesterol cause heart disease in monkeys, apes, horses, and numerous other animals that are not obligate carnivores or true omnivores (which have the physiological equipment to eat meat, such as dogs). And humans fall into the same category as the other animals–animals in whom cholesterol and saturated fat do cause heart disease, or atherosclerosis. The reason is that meat is not a natural or appropriate food for humans–as evidenced by its causing numerous diseases in humans.

      Those are straight facts. Get yours straight.




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  8. I get the impression that studies on fish eating populations are similiar to this: these people often don’t consume meat or dairy and that might be the reason they live longer not because they eat fish. The traditional okinawan diet was almost 99% vegan with only about 15 grams of fish daily and then people say it’s the fish that makes them live long!




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  9. Dr Greger,

    Thank you for being a continuing source of inspiration.

    Would you consider doing a video about raising pets on vegan food? I imagine this could be quite relevant to a lot of your readers.

    Keep up the amazing work!




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    1. mykamakiri: You may be interested in a talk given by Armaiti May, DVM. She’s been talking about vegan dogs and cats for years. The link below is to page of a bunch of videos. But if you scroll down, you can find Armaiti’s talk from 2011. I saw the most recent version a couple weeks ago and it was great.

      http://nwveg.org/presentations

      FYI: I’ve been feeding my Great Dane a vegan kibble for about 4 years now. He’s 10 years old (which is good for a Great Dane) and is doing fantastic health-wise. One of the tricks is to get the right vegan kibble as they are not all the same in terms of nutrients.

      Hope you find that helpful.




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  10. Dear Dr G: The correct word is “tack,” not “tact.” “Tack” is a nautical metaphor for setting a direction; “tact” is social sensitivity in behavior–not an abbreviation for “tactic.” “…and wanted to take the tobacco industry tact” should be “and wanted to take the tack of the tobacco industry.”




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  11. This is a great piece. Dissecting how the beef industry–and, it should be added, several academics who have deplorable scholarly standards and should be ashamed of themselves–lie with statistics and tell a whole lie with a partial truth.




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  12. You apparently did not read what I wrote. I said that my HDL went up as a result of diet, not medication. The two should not be equated.Just look at diabetes drugs that bring down glucose while doing nothing for mortality, unlike diet which can lower glucose and mortality.

    And you neglected to mention that the side effects you list are found in mice. Are you aware of any high quality studies that show similar effects in humans? I’d like to see them.




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  13. I think your analysis of the Beef study is wrong, They were comparing HAD and DASH to BOLD and BOLD+. I realize that the funding draws into the question the results, but I think you’re interpretation is equally misleading. For real insightful and unbiased views, I would check-out Dr Attia and NUSI. They, as far as I can tell, the only objective sources of nutritional information.




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        1. Some people are better at working around their biases than others when arguing about matters of fact. If Colpo is the most prominent critic of Plant Positive that comes to mind for you, that’s a sign that Plant has little to worry about in terms of competent counterargument.

          Referring to a rambling post from Colpo would be like me referring to you to an extended rant by durianrider. Neither of them are academically skilled and neither are focused enough on a careful discussion of scientific claims.

          Attia’s disclosure has some parts which are covered by plausible deniability, but even then when he only states that with respect to Generation UCAN, “I occasionally discuss or mention them in my posts”, he’s being less than fully accurate. He has given an entire presentation promoting the product, complete with carefully compiled testimonial statements from people who he has trained:

          https://www.youtube.com/watch?feature=player_detailpage&v=KZA-Ik58WcI#t=3347

          Note that part at the end about another presentation planned. The UCAN website also has this blogpost with this question and response by athlete Christopher Kelly:

          “What attracted you to SuperStarch and Generation UCAN?

          This year it finally dawned on me that first step to optimal athletic performance is general health. A yearly routine blood test had always shown low haemoglobin and hematocrit and I decided it was time to find out why. More test revealed chronic inflammation, a leaky gut, and gluten sensitivity. Adopting a strict autoimmune diet protocol fixed these issues, and extensive reading into the hows and whys lead me to a better understanding of how blood glucose affects our health and athletic performance. I found Peter Attia’s presentation on UCAN and exchanged a few emails with my coach and the Ph.D. medical researcher that fixed my leaky gut. On paper, Superstarch was clearly an improvement over maltodextrin.”

          So though the internal link is now broken for some reason, the company previously hosted a resource which Kelly thought was a presentation by Attia about the merits of UCAN. The website also has a stray tagging structure for Attia-related content:

          http://generationucan.com/blog/tag/peter-attia/

          I wouldn’t call this evidence of a little blogging here and there, and no more.




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  14. I thought when conducting scientific experiments, the control variable is the only variable that isn’t kept constant, in this case beef consumption, and all other variables must be kept constant? Isn’t this a fundamental criterion for conducting scientific studies?




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  15. A friend keeps trying to convince me that Grass-fed pasture-raised beef has a better fat ratio than conventionally raised beef, and is therefore healthier. I replied that whether a cow is grass-*finished* could be hard to prove, anyway, but I’m wondering if the data backs up her assertion? Is grass fed healthier?




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    1. Daniel: While I haven’t seen the actual data, I’m willing to concede that grass fed cow might be healthIER than factory farm grain fed cows, but only in the sense that a Snickers is healthier than a Milky Way because a Snickers has real peanuts in it. (Hope you are form America and know that those are candy bars.) Or another example would be that it might be similar to the way in which “fluffy” LDL is healthier than non-fluffy–which just means that foods which produce fluffy LDL cause slightly fewer heart attacks. Not that those foods are actually healthy. http://nutritionfacts.org/video/does-cholesterol-size-matter/
      .
      So, why do I think this same analogy could be applied to cows? Because the reasons that we know that beef are bad for us would apply to any cow, no matter how it is raised. Those cows are still going to be full of saturated fat, animal protein, high levels of contaminants (compared to organic plants), etc. It is like people who say that certain kinds of eggs have less saturated fat. Even 1/3 less saturated fat leaves you with waaaay too much saturated fat. It’s still bad for you…
      .
      What do you think?




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      1. I think that’s a fair assessment. I mean, if one is going to eat beef or eggs, better to make it from more humane sources, and make it marginally better quality overall. But yes, the same problems remain.




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