Fatty Meals May Impair Artery Function

Fatty Meals May Impair Artery Function
4.94 (98.75%) 16 votes

We finally discovered why a single high-fat meal can cause angina chest pain.

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The phenomenon of postprandial angina was described over 200 years ago: chest pain that occurs after a meal, even if you’re just sitting down and resting. The question is, why? It could be intuitively attributed to redistribution of blood flow away from the heart to the gut during digestion; however, such a mechanism could not be demonstrated experimentally. We now know the problem appears to be within the coronary arteries themselves.

The clue came in 1955, when researchers found they could induce angina in people with heart disease just by having them drink fat. This is what was happening in their bloodstream in the six hours after the meal. This is a graph of so-called lactescence, which means milkiness. Their blood became increasingly milky with fat over the next five hours, and each of the ten attacks of angina was found to occur about four-and-a-half to five hours after the fatty meal, right when blood milkiness was at or near its peak. Here’s the curve after a nonfat meal, same bulk and calories, but made out of starch, sugar, and protein. And no anginal pain was elicited in any of the patients they tested after the ingestion of the nonfat meal.

How could just the presence of fat in the blood affect blood flow to the heart? To understand that, we need to understand the endothelium: the inner lining of all of our blood vessels. Our arteries are not just rigid pipes, they are living breathing organs that actively dilate or constrict.   Depending on what’s needed, they thin or thicken the blood, release hormones, and it’s all controlled by the single inner layer, the endothelium, making it the body’s largest endocrine organ, the largest hormone-secreting organ, weighing a total of three pounds all gathered up, with a combined surface area of 700 square yards.

We used to think the endothelium was just an inert layer lining our vascular tree, but now we know better. The endothelium is directly involved in peripheral vascular disease, stroke, heart disease, diabetes, insulin resistance, chronic kidney failure, tumor growth, metastases, venous thrombosis (blood clots), and severe viral infectious disease. Dysfunction of the vascular endothelium is thus a hallmark of human disease.

Researchers found that low-fat meals tend to improve endothelial function, and high-fat meals tend to worsen endothelial function. And this goes for animal fat, as well as isolated plant fats—sunflower oil, in this case.

But, maybe it’s just the digestion of fat rather than the fat itself? Our body can detect the presence of fat in the digestive tract and release a special group of hormones and enzymes to deal with it. So, researchers tried feeding people fake fat. The real fat deprived the heart of blood; the fake fat didn’t. But maybe our body is smart enough to know the difference?

This is the study that really nailed it. They tried infusing fat directly into people’s bloodstream through an IV, so the brain wouldn’t know if you’re eating fat or not. And indeed, within hours, their arteries stiffened, significantly crippling their ability to relax and dilate normally. This decrease in the ability to vasodilate coronary arteries after a fatty meal, just when you need it, could explain the phenomenon of after-meal angina in patients with known coronary artery disease.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Images thanks to The Hamster Factor via Flickr.

The phenomenon of postprandial angina was described over 200 years ago: chest pain that occurs after a meal, even if you’re just sitting down and resting. The question is, why? It could be intuitively attributed to redistribution of blood flow away from the heart to the gut during digestion; however, such a mechanism could not be demonstrated experimentally. We now know the problem appears to be within the coronary arteries themselves.

The clue came in 1955, when researchers found they could induce angina in people with heart disease just by having them drink fat. This is what was happening in their bloodstream in the six hours after the meal. This is a graph of so-called lactescence, which means milkiness. Their blood became increasingly milky with fat over the next five hours, and each of the ten attacks of angina was found to occur about four-and-a-half to five hours after the fatty meal, right when blood milkiness was at or near its peak. Here’s the curve after a nonfat meal, same bulk and calories, but made out of starch, sugar, and protein. And no anginal pain was elicited in any of the patients they tested after the ingestion of the nonfat meal.

How could just the presence of fat in the blood affect blood flow to the heart? To understand that, we need to understand the endothelium: the inner lining of all of our blood vessels. Our arteries are not just rigid pipes, they are living breathing organs that actively dilate or constrict.   Depending on what’s needed, they thin or thicken the blood, release hormones, and it’s all controlled by the single inner layer, the endothelium, making it the body’s largest endocrine organ, the largest hormone-secreting organ, weighing a total of three pounds all gathered up, with a combined surface area of 700 square yards.

We used to think the endothelium was just an inert layer lining our vascular tree, but now we know better. The endothelium is directly involved in peripheral vascular disease, stroke, heart disease, diabetes, insulin resistance, chronic kidney failure, tumor growth, metastases, venous thrombosis (blood clots), and severe viral infectious disease. Dysfunction of the vascular endothelium is thus a hallmark of human disease.

Researchers found that low-fat meals tend to improve endothelial function, and high-fat meals tend to worsen endothelial function. And this goes for animal fat, as well as isolated plant fats—sunflower oil, in this case.

But, maybe it’s just the digestion of fat rather than the fat itself? Our body can detect the presence of fat in the digestive tract and release a special group of hormones and enzymes to deal with it. So, researchers tried feeding people fake fat. The real fat deprived the heart of blood; the fake fat didn’t. But maybe our body is smart enough to know the difference?

This is the study that really nailed it. They tried infusing fat directly into people’s bloodstream through an IV, so the brain wouldn’t know if you’re eating fat or not. And indeed, within hours, their arteries stiffened, significantly crippling their ability to relax and dilate normally. This decrease in the ability to vasodilate coronary arteries after a fatty meal, just when you need it, could explain the phenomenon of after-meal angina in patients with known coronary artery disease.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Images thanks to The Hamster Factor via Flickr.

Doctor's Note

This effect could certainly help explain the findings in Low Carb Diets and Coronary Blood Flow. What about so-called healthy fats like extra virgin olive oil? That’s the subject of my next video: Olive Oil and Artery Function.

For more on angina, that’s the topic I started my 2014 year-in-review talk with: From Table to Able: Combating Disabling Diseases with Food.

Another consequence of endothelial dysfunction is lack of blood flow to other organs. Check out: Survival of the Firmest: Erectile Dysfunction and Death and Atkins Diet: Trouble Keeping It Up

Fat in the bloodstream can also impair our ability to control blood sugar levels. See:

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

205 responses to “Fatty Meals May Impair Artery Function

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  1. At 2:56 you say that isolated plant fats cause impairment of endothelial function. Is this related to omega-6 content? Does flax oil have this effect? How about plant foods high in fat, e.g., nuts? If they have deleterious effects on the epithelium, how can they still have a net beneficial effect on cardiovascular health?




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    1. It was sunflower oil. You’d have to check out the entire paper in the “sources cited” section to what the other isolated plant fats were used. Let me know if you need help doing so. It seems higher fat whole plant foods are a better choice than oil, like nuts. Interestingly, a great video by Dr. Greger explains the research between nut intake and body weight. Make sure to checkout the bottom of the video’s “Doctors Note” to see more links and resources. Lastly, a follow-up to that video is solving the mystery of the missing calories, which may also help.​ Too much of anything can be a bad thing. Yes, even too much healthful food like broccoli (over 14 cups of raw) or turmeric (greater than a tsp per day in some cases) can be harmful. Certainly too much fat can be detrimental to health, as evidence by this video and others.




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      1. How about dairy consumption in the seventh day adventists? Is the information and science reliable on this, as well as egg consumption. It is hard for me to believe what percent consume dairy and or eggs, and how many don’t, and how this plays out. I’d like to trust the science but simply not sure….




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      2. How does this tie in with the impairment in endothelial function related to endotoxin ingestion as described in the video “Dead Meat Bacteria Endotoxemia?” Is it thought that it is just an added insult on endothelial function – both effects through insult via inflammatory mediators? Fat and Endotoxins = inflammation?
        So plant oils bad but animal fat + endotoxin from dead bacteria even worse? How do fats derived from whole foods instead of processed plant oils figure in?




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    2. I’d like to see some studies where the fat comes from whole foods such as avocado and nuts/seeds. I eat a lot of both, so my fat as % of cals is not low (25-27%) typically but none of it except the small amount(~ a tsp or 40 cals) of EVOO in my low sodium spaghetti sauce. Dr. Fuhrman supports higher fat as long as it comes from whole foods, especially nuts/seeds and one has a desirable BMI (mine is 19). He has never mentioned the possibility of this having a deleterious effect on endothelial function. Would be nice to have that confirmed.




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      1. correction: none of it except the small amount(~ a tsp or 40 cals) of EVOO in my low sodium spaghetti sauce ==> none of it from extracted oil except the tsp of EVOO.

        Sorry but I am one of those who really needs an edit button,




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      2. Available evidence supports most of what you say. I have not seen any studies that have evaluated endothelial function after nut ingestion. This would be very enlightening. Feeding studies with nuts have been performed. The lack of weight gain with the addition of nuts to an isocaloric diet seems to demonstrate that the fat in nuts mostly “passes on through” and is not absorbed. Only 8% of the expected weight gain seems to occur.

        Dr. Ben




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  2. So even a super good meal like a salad but full of Olive oil may couse angina?
    Why a obese person may have angina whidowt having a coronary desease? A family member is in this situation . Even eating now recently wfpb thank you!!




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    1. It’s not “super good” any time it is “full of” any non-whole plant product. Oils are derivatives, a product of processing. Also I only heard sunflower oil singled out in this video, but all are calorie-dense non-whole foods. I only use them now to protect my iron cookware.




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      1. Yes of course I mean by a good meal a good salad.. With no oils.. But if it posible that to much oil make a good thing became negative for the body.




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        1. I would add that on top of that even just a “drizzle” of olive oil can be something like 5-10grams of fat, and then things like nuts and avocados, which are “whole”, are still very fatty if you look purely at fat content – so I think your question is very valid and Darryl’s answer seems to make some good points.




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        2. This is why Esselstyn keeps repeating, ad nauseum: “No oil! NO oil!” ;)

          Should YouTube a few Esselstyn lectures… They’re pretty good. :) Been following his work for a few years now. Intermittently trying to find the right dietary middle ground…




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        3. There is no “good oil”. Removing the rest of the plant from the oil makes it a non-whole food. THIS IS NOT GOOD. Some are worse than others, but none should be consumed for “health”.

          Keep ALL OILS, no matter how much they cost or how carefully they were extracted and no matter (especially) how many EXPERTS are expounding their great benefits, to a MINIMUM if you want to experience optimum health.

          Whole-Food-Plant, is really all one needs to know.




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          1. Cocoa powder is touted here as a useful food here, and yet is not a whole food.

            “… no matter (especially) how many EXPERTS are expounding their great benefits”. We’ll just take your advice as the last word on it then? If only it were that simple, huh.




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            1. By “experts” I am referring to SALESMEN who inhabit the commercials and only benefit if they MOVE a product or idea in a way that is profitable to them. Sorry if you didn’t hear my sarcasm. By all means my word is nothing, never rely on my word. Question and seek.

              Folks often post here with questions or comments that appear to be from left field and sometimes I reply with the “general knowledge” as I have compiled it from here and other sources-as I understand it.

              Claiming that cocoa is not a “whole food” and yet is beneficial, even if true, does nothing to invalidate the general principal that WHOLE PLANT FOODS are best and should make up the BULK of ones diet for optimum health and longevity.

              Maybe cocoa is just “whole enough”.




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              1. Fair enough. But when you mean salesmen you might try to distinguish that meaning from experts, who, as you point out, already have their expertise diminished by the salesmen. Maybe olive oil is just “whole enough” too.




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      2. What about sunflower oil that is Premium High Oleic – Cold Pressed Certified Organic Sunflower Oil like “Century Sun Oil” does using carefully selected & grown breeds of sunflower seeds resulting in oil low in omega-6 and scientists testing this select oil to show this sunflower oil higher in the GOOD fat monosaturated fat percentages of even Olive oil, and less saturated fat than Olive oil plus less polyunsaturated fat then Olive oil. This oil is also Higher in Vitamin E & a Higher Smoke point remaining stable in cooking over 400 degrees. These tests are showing High Oleic oils to be premium to all oils!




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    2. I am not sure olive oil was tested, as Wade pointed out it was sunflower oil. Bottom line is that if you use oil, use it sparingly! If you can find an alternative (lemon juice, water, broth, vinegars, mustard) that’s even better. Oil is not a health food it just tastes delicious and can be satiating. Using whole plant foods with their fiber intact is the best option. So this means no oil on a salad, but a sliver of an avocado, 1 ounce of toasted nuts or seeds, or a few kalamata olives, etc. We still need a bit of fat, but many of us obtain enough fat in the diet without really trying. Based on this new video endothelial function is jeopardized by even one high-fat meal. A cool infographic lays out an example of what happens after consuming a high fat meal. Warm thoughts for yuor family member going through a tough time right now.

      Sincerely,
      Joseph




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      1. Can you explain why a relatively high fat Mediterranean diet had been found several times now to be on par with a low fat high carb diet? Also why good cholesterol send to rise on such a diet, and why those who consume this diet are some of the longest lived people with lowest rates of heart disease?




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          1. It’s not cherry picking, It’s relevant data regardless of how old. He also talks about Walter Kempners rice and fruit diet that’s over 50+ years old science, still relevant today.




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            1. Yeah I agree. The science doesn’t get outdated like smartphones do in a few years or even decades. They are relevant until they are disproved.




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        1. Hi Chris. I am happy to look into further, but can you tell me what data you’re referencing? A guest posted a link to Dr. Greger’s video on Mediterranean diets. He has many more, and even touches on longest living populations in his video on flexitarian diets.

          “That’s one of the things all the so-called Blue Zones have in common, the longest living populations, not only social support and engagement, daily exercise, but nutritionally they all center their diets around plant foods, reserving meat mostly for special occasions – and the population with perhaps the highest life-expectancy in the world, doesn’t eat any meat at all, the California Adventist vegetarians.”




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        2. After a long time debating proponents of low-carb diets, and tracking down the sources they use to discredit low-fat diets, what I quickly learned was that virtually all studies supposedly about “low-fat” diets are really about diets with 25-37% calories from fat (and they are not whole food diets). I once looked up every study in a meta-analysis claiming that “low fat” diets don’t work, and something like 24 of the 26 studies were on diets with 25-35% fat.

          Truly low-fat diets are in the ballpark of 6-12% calories from fat. So here’s how the world gets fooled: The well-publicized PREDIMED study in 2013 supposedly showed a Mediterranean diet outperforming a “low-fat” diet, and in the NYT coverage of that study Dr. Steven E. Nissen, chairman of the department of cardiovascular medicine at the Cleveland Clinic Foundation (the #1 cardiac care place on the planet) said “Now along comes this group and does a gigantic study in Spain that says you can eat a nicely balanced diet with fruits and vegetables and olive oil and lower heart disease by 30 percent,” he said. “And you can actually enjoy life.” The LA Times coverage was “The study’s findings “blow the low-fat diet myth out of the water,” said Cleveland Clinic cardiologist Steven Nissen, who was not involved in the current research. Nissen, an expert on the effects of drugs and nutrition on cardiovascular risk, called the study “spectacular” and touted the findings as impressive.”

          Then, thousands of misleading blog posts and minor media stories sprang from this misleading main coverage say a “low-fat” diet didn’t work. So what’s the problem here? The “low-fat” straw man diet in the PREDIMED was 37% calories from fat, roughly 3 to 3-1/2 times as much fat as what you’d be eating with a whole food plant-based diet such as recommended here or by Esselstyn, McDougall, etc. That diet wasn’t really a whole food plant-based diet, and folks were still eating lots of processed food, and the “low-fat” part was so weak they told subjects to do things like skim the surface fat off the top of their soup. The “low-fat” group only cut their fat 2% from before the study began. Meanwhile, people in the Mediterranean diet made several positive changes–more fruits, veggies, whole grains, nuts, and less processed food, and these changes more than compensated for the fact that the Mediterranean diet was a bit higher in fat content.

          Since there are dozens of big studies out there on seemingly “low fat, high carb diets” but where people didn’t anywhere close to a whole food plant based diet, or anywhere close to 8-12% calories from fat, confusion is inevitable.




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          1. I agree that the mainstream media are experts at misleading the public in not only nutrition but other fields as well, taking advantage of people’s lack of time and knowledge to investigate things at a deeper level. Thank goodness we have dedicated people like Dr. Greger, Esselstyn, Campbell, McDougall, etc. to provide us with unbiased, science-based findings. And you are to be commended for taking the time to investigate the “Low-carb, Low-fat issue”.




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        3. Basically there was a mediterranean diet back in the 1950s that was really healthy and another mediterranean diet that is promoted as healthy and they bear little resemblance to one another. The original, healthy diet was low-moderate fat. They didn’t eat a lot of Olive oil so much as they ate a tiny amount of most other oils. They also only ate meat about once a week.




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        4. The Mediterranean Diet is better compared to a SAD, because it includes fruits and vegetables in larger doses than the SAD (standard American diet). But the Mediterranean diet is still a high fat diet (30% + of calories from fat)compared to a plant based, whole food, low fat diet (8-15% of calories from fat) The plant based diet wins by large margins all the time.




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      2. But…I read that oils/fats mediate the uptake of sugars in food and can possibly reduce hunger….possibly helping to reduce blood sugar spikes?




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        1. Oils actually contribute to insulin resistance in the long run because as oils get absorbed into muscles the muscles become less responsive to insulin.

          They may help to reduce hunger, but likely reducing simple carbs is the simplest way to do that.




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      3. I just now came across this, Joseph, and have printed it out as a reminder. Thank you for posting it. And YIKES! You might want to consider linking this on your RD pages, as well. A very clear message about how “cheating” impacts our bodies.




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    3. The free fatty acids responsible for post-prandial inflammation, oxidative stress, and impaired endothelial response appear to be the longer saturated fats palmitate and stearate, found primarily in animal fats.

      However, even olive oil is 12% palmitic and stearic acid, and appears to impair post-prandial endothelial function. This suggests the ideal cooking fat is minimal amounts of very low-saturated fat oils like canola (6% saturated). Numerous phytochemicals like those in salad greens and berries appear to reduce postprandial endothelial inflammation, oxidative stress, and dysfunction.

      Unfortunately, obesity also increases these free fatty acids, and systemic inflammation.

      Adding full references til I set off the spam filter.




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      1. Oh wow just saw this comment – this is great info Darryl!

        Where do you see percentage of “palmitic” and “stearic” acid in foods? A label obviously would never mention this..

        And where did you see ” Numerous phytochemicals like those in salad greens and berries appear to reduce postprandial endothelial inflammation, oxidative stress, and dysfunction”? Because that’s EXACTLY the sort of information I was looking for.




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        1. According to the study cited below, top dietary inhibitors of fatty acid synthesis include:

          apigenin: chamomile and parsley

          EGCG: green tea

          kaempferol: arugula, capers, ginger, kale, mustard, greens, saffron,watercress

          luteolin especially: artichoke, bell peppers, carrots, celery, dandelion, lots of herbs, olive oil,
          parsley,pomegranate, radicchio

          quercetin: capers, cilantro, dill, fennel and other herbs, some berries, lots of plants

          taxifolin: milk thistle (and thus artichokes It’s in the silymarin. )

          See http://www.sciencedirect.com/science/article/pii/S1550413113002076. Hmmm…olive oil is on the list.




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      2. I have to tell you Darryl I now prefer my salads with no oil. Just a squeeze of lemon or lime. Funny how the tastebuds change. And I always thought I needed oil to sauté. Nope. Just keep an eye on the pan so things don’t burn and the veggies turn out beautifully.




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            1. I don’t think so for B-vitamins as they’re water soluble. And again the fat you need to absorb fat-soluble vitamins and antioxidants is very little.




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                1. It really depends on how much fat you’re obtaining in a day. Generally I don’t see a need to have “added fat” in the diet like coconut oil. Avocado is a whole food and much better choice! Let me know if this helps? You can always tell me more about your diet and I can give suggestive advice.




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      3. The problem with cooking with oils high in omega 3s such as canola is that omega 3s are extremely fragile when exposed to light or heat.

        Olive oil is rich in oleuropein and other phytonutrients that protect against oxidation and inflammation. Oleuropein is bitter; you can taste its tang in a good oil. Consuming olive oil cold will obviously ensure best preservation of phytoactives, but you can also heat it a little when you saute vegetables (or steam-saute, my favorite method). Olive oil is primarily monounsaturated fat, which is more stable with heat than polyunsaturates (including omega 6s and 3s–and saturated fats are even more stable with heat. )

        For olive oil’s phytos, see http://www.translational-medicine.com/content/12/1/219 and http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3002804/

        For oxidation of PUFAs, especially omega 3s, see http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3118035/ and http://drfairchild.blogspot.ca/search?q=coconut+oil




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        1. Good points. Also, there is a widely held misconception that extra virgin olive oil should not be heated. In fact, good quality extra virgin olive oil is quite resistant to oxidization when heated – much more so than most other plant derived cooking oils.




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  3. Wonder if this explains the very slight but real discomfort I felt the last time I threw all caution out the window and ate a fully fatty meal (a restaurant/work situation), which was a twinge of pain in my left chest and in the carotid area as well. This happened within 30 minutes of eating and gradually faded over the next few hours. Never felt it before or since. It happened a few months after going WFPB.




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  4. Speaking of arterial function, in Wednesdays’ video on chocolate, in the comments section there were a lot of pro’s and con’s for eating cocoa (as opposed to chocolate), but I saw no mention of the positive effect that cocoa has on arterial function as indicated by a previous NutritionFacts .org video (http://nutritionfacts.org/vide…. In this video, between 2 g and 5 g of cocoa powder will dilate the arteries having the greatest effect 2 hours after ingestion and then waning back to normal after 6 hrs. Question: would it be a good idea to eat, say, 3 g of cocoa 3 times a day to relax arteries? And would doing this perhaps lower blood pressure, too?




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    1. Perhaps there should have been more discussion about the benefits of cocoa on arterial function. I’m not sure the proper dose. You may want to read thru some of the literature (sources cited) from the chocolate and artery function video. If you’re doing a lot of cocoa power I advise finding a safe brand. Many site users have alluded to the findings by ConsumerLabs about heavy metals found in cocoa products. You’ll see the links and comments on Wednesday’s video on chocolate and weight gain. Let me know if that helps or if you cannot find the information about dosage?




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      1. Thank you, Joseph, for your response. I obtained the dosage right from Dr. Greger’s video, for which you gave the correct link (chocolate and artery function). The video contains bar-graphs of the dose – response between cocoa and Flow Mediated Dilation. I believe the data came from this study: “Dose-dependent increases in flow-mediated dilation following acute cocoa ingestion in healthy older adults” Here’s the link: http://www.ncbi.nlm.nih.gov/pubmed/21903881




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  5. This phenomenon in association with my doctor’s recommendation that I take statin drugs to reduce my cholesterol levels from 203 mg/dL was the impetus for me to rethink my relationship to diet and eventually lead to the adoption of a WFPB diet (a.k.a. vegan). I passed on the statins because of the contraindications & side effects, and was still able to realize a host of benefits by treating the causes with diet instead of the biomarker symptoms with medications. This course of action was highly discouraged by my physician by the way. His admonition was that treating cholesterol with diet never works… Well folks, I’m here to say that in at least my on experience, it does.




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    1. Joe: Awesome story! Thanks for posting this. I love it when people take their health into their hands in such a positive way. Let’s hope your doctor learned a thing or two.




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      1. It’s difficult to say. When data is at variance with beliefs, one tends to disregard the data. Regardless, I found a doctor who was more in alignment with my own desires to avoid pharmacological interventions and favor lifestyle modification.




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        1. A lot of money finds its way from the pharma companies to the doctors, one way or another. I’m not suggesting this was the reason your former doctor attempted to dissuade you, but that the incentives are set up in a way such that we shouldn’t be surprised when drugs are pushed in preference to lifestyle changes.




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          1. My former doctor was passionate about what he believed was health promoting. I believe in his situation that the only tool in his toolbox was a hammer making every problem look a lot like a nail from his perspective. There is a partnership between the AMA and Big Pharma which has set the training curriculum regarding acceptable practice. My former MD has yet to transcend his training.




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    2. Good for you for turning down a medication. Stains only cover up a cholesterol problem. In “the Tomato Effect” Dr. Greger describes how Asia suffered a terrible epidemic of heart disease without the rice bran upon the introduction of modern milling. Perhaps America’s current Cholesterol epidemic is related to our large use of milled and untreated corn, which provides no Niacin, known to lower bad cholesterol and raise good. Some have said that Rome failed due to lining pipes and wine caskets with lead. Perhaps America needs to learn from the Native American cultures that thrived, those that treated their corn with lime to make the Niacin bioavailable. Niacin can immediately improve blood lipids and, as a food additive regulated by the government, many people are deficient. Why are modern diets leading to so many deficiencies? One might ask if our plants and animals are sick as well.




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      1. We as a nation are over fed and under nourished. There is a lot shouting going on in the blogs by SF supporters calling SF the healthiest kind of fat. There are also people claiming that TF from animal sources are natural and healthy while those created from hydrogenating vegetable oils are the culprits to our health woes. This seems relatively new, and whether this is some kind of grass roots movements or people being manipulated into towing the agribusiness line, the fact remains that we are getting too many calories and not getting adequate nutrition from our food. We need a food revolution in this country that favors whole foods over industrial product, and we can be part of the vanguard with the battle cry of greens, beans, fruits and whole grains… ;-)




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        1. I do not see how saturated fats could be the healthiest fats. Thank you for some perspective that many people are searching for healthy alternatives. Dr. Greger has talked about the enormous subsidies on meat. You put it well, what this site says, that eating the most nutrient dense foods the most often can put you to health.




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          1. And neither do I. Eating a diet high in meat which means a diet high in SF with some TF thrown in for bad measure put me in the predicament in which I found myself, and eating a WFPB diet was the cure. It made me feel so good that it stopped being a numbers game, and became a journey to see just how good I could possibly feel. My point was more to demonstrate just how large the disparity between the best unbiased research that is available, and the current collective consciousness concerning diet and nutrition.

            It is my observation that people get very emotional and defensive about this issue. It is analogous to the response one elicits in an addict when one has the temerity to suggest that the addictive agent is the cause of a number of problems and perhaps they should consider putting it aside. I find myself torn between treading lightly while suppressing the urge to share some sense into people. I would like to help these people avoid the deteriorating health that they are sure to experience if they continue on their current course, and it seems the best I can do is to plant the notion that when they do start to suffer, there is a better way to health than popping pills to mask symptoms.




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          1. Are you saying that naturally occurring TF’s found in animal products, if not healthy, may be healthier than hydrogenated vegetable oils?
            I suppose that’s possible, although, as a package deal, meat, especially in the way it is produce, and in the quantities and frequency that it is currently being ingested seems a risky proposition.




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      2. There are many reasons why Rome failed (but so too has every other ‘great’ civilization). We will never know precisely how important each of contributing factors was, but lead use is probably way down the list. I take your overall point though.




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        1. Thank you. World War creates a paucity of men in science as well as some surprising breakthroughs (The Haber process was and is to make explosives, allowed for our current population with fertilizer). I wonder how the current global situation is affecting civilization.




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  6. Another nail in the coffin for dangerous high-fat diets. Hopefully the keto crowd will wise up to the damage they are causing their endothelial lining before it’s to late. Thanks again Dr G for another great video.




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  7. Had an EndoPat test done recently
    http://arterialhealth.net/physicians/physician-information/

    Green Zone. Score between 2.1 and 3.

    Your endothelium is functioning optimally, and you have maximum protection. Keep up whatever it is that you are doing, because the foods that you have been eating and the physical activity you have been performing regularly have affected a number of risk factors implicated in vascular health and longevity, particularly blood cholesterol levels, hypertension, and obesity.

    My score was 3.56

    I eat foods and take supplements which are good for the endothelium BUT I also eat SFA, MUFA, PUFA.

    Could the statin be a contributory factor?




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    1. No, they are whole foods. See any of the dozen or so Nut videos and articles available here. Lil’ search window right up there^




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      1. mr smith is correct – nuts do contain much fat. Simply saying – “No, they are whole foods” does not answer the question.

        I have seen, in this very thread, cocoa suggested as being healthful, and yet it is not a whole food. Mushrooms are widely considered a health promoting whole food, but eating A. phalloides will likely result in a brief but agonsing illness concluding with untimely death.

        Reducing everything to whole foods versus foods in some way incomplete is far too a simplistic treatment of something that is a complex system. Sure, we need some ‘rules of thumb’, but that is where the usefulness of it ends.




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        1. Well sir, I respect your right to have your angle. I have mine. First of all a toxic plant is not considered a “whole food” from any rational angle of thought whatsoever. Seeds and nuts (which are seeds you know) are actually quite capable of creating new whole plants and are WHOLE in that manner (whole embryonic plants I say). Which may be why you cannot find anyone anywhere suffering from nutritional maladies related to eating too much whole plant foods which in my guesstimations includes seeds and nuts (and I think that includes cocoa).
          Peace be with you.




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          1. It does include cocoa, but does not include cocoa powder, which is the solids remaining of the cocoa bean after the cocoa butter has been removed.




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    2. It appears not, at least with walnuts. Other nuts and seeds have similar effects. Whole plant foods, even the fattier ones like nuts and seeds, are beneficial for heart health. However, many folks try to limit these foods in extreme disease cases. Elite athletes on the other hand, and wannabe hockey players with good cholesterol levels, may benefit more from the higher calorie load. It’s all relative. Total diet matters most!




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  8. Wow this study really needs more analysis….especially on a site such as this one. I’d LOVE it if Dr. Gregor can add a summary at the end such as “never eat fat – never eat more than X grams at once, never eat X sources of fat”, etc, as he’s done with other videos (“my favorite was “if you’re gonna make pancakes, make sure they’re blueberry”).

    A tablespoon of olive oil, a half fillet of salmon, and an ounce of walnuts, all have about 13-15G fat, and an ounce of avocado has 4grams of fat, and you usually eat more than an ounce at a time. These are all pretty much the same as sunflower oil gram for gram, even the same as a 1/4 pound of plain ground beef (12grams fat per 4 ounces).

    So you’re saying all the above foods, which even if you’re a vegan, still includes olive oil, walnuts and avocado – and things like flax/chia seeds (8-9grams of fat per ounce), can cause this negative impact on the endothelium? I see a few have already asked this and while the video did indeed only mention sunflower oil, why would that be different than salmon, nuts, chia seeds, or flax feeds, in terms of fat?

    The potential issue is compounded FURTHER if someone is trying to make a ‘healthy’ salad so they add some crushed nuts, some avocado (say half) , and even a drizzle of olive oil – let’s even skip the salmon and keep it vegan, and now they have something like 30 grams of fat in their salad, or or 50% DV, so that salad can potentially have the same negative endothelial as 3 quarter pound burgers? There’s GOTTA be more to it…please tell me there is..

    Are there any studies where one group drinks pure fat, and another drinks pure fat BUT also eats some plant foods (small salad) to see if the endothelial effects are any different among the two groups? Perhaps a third group that eats known beneficial foods (such as cocoa I think someone below mentioned) in addition to the fat? Would love to the see the results, it would be similar to the white bread and white bread + blended berries study.

    The other thing I was wondering is why did the studies keep emphasizing “in people with heart disease”, what about everyone else? There is NO negative effect in terms of endothelial function, or healthier people just don’t FEEL it as much?




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    1. I’d like to see the questioned you raised addressed more fully too. I suspect the last one is easiest to address – the people with heart disease are the only people this has been studied on and so we don’t know for sure how the healthy might be affected.

      You don’t, by chance, happen to be an author of several mathematics self teaching guides, do you?




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  9. High fat foods usually have elevated AGEs. High AGEs levels damage the endothelial layer.

    Table of measured AGEs in foods:

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3704564/table/T2/

    For example, olive oil is reported high:

    AGES Total MG nmol/100 mL Total CML kU/100 mL

    Olive oil, fresh (Colavita, Linden, NJ) 7,700 5,852
    Olive oil, heated at 100°C for 5 min (Colavita, Linden, NJ) 9,700 6,295

    But olive oil also has other beneficial compounds that may tilt the health balance the other way. Pistachos have low AGEs.
    With the exception of maybe figs, most fruits and vegetables have very low levels.




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    1. Also, olive oil aint olive oil, and AGEs measures from extra virgin olive oil versus so-called ‘pure’ (which really means not pure) olive oil will differ substantially.




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  10. Took a few seconds and quickly found this study:

    European Journal of Nutrition April 2013, Volume 52, Issue 3, pp 1223-1231

    Date: 08 Aug 2012

    Beneficial effects of polyphenol-rich olive oil in patients with early atherosclerosis.
    Seems to advocate the exact opposite. Says olive oil improved endothelial function. Huh?
    The stress of what to believe is worse than a fatty diet.




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    1. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3915409/
      Beneficial effects of polyphenol-rich Olive Oil in patients with early atherosclerosis

      “In conclusion, OO supplementation in patients with low to intermediate risk improves endothelial function through mechanisms possibly related to improvements in inflammation. We did not observe any additive benefit of EGCG, the main component of green tea. Therefore, olive oil supplementation may be beneficial for most individuals and might theoretically reduce cardiovascular events. These benefits are consistent with the prominent role of olive oil in the Mediterranean Diet.”




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    2. Olive oil is a controversial topic since it has different good (ie. oleuropein) and bad compounds (ie. AGEs). Interested parties will show you only the good. You could get the benefits of the polyphenols with olive leafs instead of oil. Olive leaves have no fat and could be used in smoothies. However, some fat is good for the brain/hormones and maybe a little olive oil does not hurt.




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  11. I have a couple of questions:

    1) Have they pinned down SPECIFIC fats (mono- poly- omega or saturated) as primary culprits in endothelial dysregulation? Is any of them more dangerous or less dangerous or neutral in this regard? Or are they all equally bad?

    2) Has anyone studied the role of fructose in endothelial dysfunction? We know that fructose isn’t really utilized pretty much at all by the body and gets converted to cholesterol and fatty acids by the liver. Yes?

    So, if fructose gets converted to fatty acids, do those fatty acids in the blood similarly dysregulate endothelial cells and arterial function? That is, if fructose is basically just “fatty acids in disguise” (for all intents and purposes), does it have a similar deleterious effect on blood vessels? If so, how much fructose / sugar must one eat in order to mimic the same endothelial dysregulation? Is there a “safe limit” of fructose or dosage over time to avoid dysregulation?

    An interesting question of equivalence, methinks… Can fructose conversion to fatty acids mimic the same blood “milkiness” as after a high-fat meal? How quickly, at what levels of intake?




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    1. Saturated fat and even more so trans fats can do the most damage. Of course polyunsaturated fats like omega 3 and 6 are essential so those tend to be of focus in the diet.

      Fructose does not necessarily create fatty acids. Sugar (glucose or fructose) is digested in the liver, to glycogen or fat , or
      converted to energy. The biochemistry is complex, but the research on those who eat tons of fruit seems to be positive, as the negative effects of fructose stem from added industrial sugars such as sucrose (table sugar) and high fructose corn syrup.




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      1. …and crystalline fructose, which seems to be popular in certain “sports drinks” or “vitamin waters.”

        Yes, mostly the “added sugars” I’m concerned with. Not so much fruits & such, which still have all the vitamins, minerals, antioxidants, fiber, pectins & whatnot…




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        1. I have reasons to believe not only added sugars can do a great damage to the body. I gained a lot of weight and developed liver steatosis (grade 1 fat liver) at a time I was drinking lots of fruit juices (no sugar added). I was also eating a lot of saturated fat, so both might have had a role here… One year after I ditched the juices (not the whole fruit) and the saturated fat (not the olive oil), I lost all the weight I had gained, and my liver went back to normal. My triglycerides and cholesterol also dropped significantly, by the way… to ideal levels, where they had never been before.




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          1. If drinking “fruit juices,” to be frank, they don’t NEED to “add” sugars. Some fruit juices, especially blended “juice drinks” or *from concentrate* drinks, have MORE sugar than sodas…

            Seriously, try looking at the actual nutritional information on the labels of juices and juice drinks and smoothies/protein drinks. It may shock you… Some I’ve seen are as much as 25g or even 60g+ per serving… Whereas sodas can often vary from like 12-30g per serving. Just saying…

            But, yes, fats are more calorie-dense and can can also lead to significant weight gain, etc.

            In my opinion, there’s probably some hybrid or middle-ground approach that’s even more effective than JUST eliminating one or the other macronutrient (dropping fat and upping carbs, or dropping carbs and upping fats). Methinks, that increasing the amount of veggies in order to dilute the number of calories from both sugars & fats may be the more optimal route, whilst also getting more fiber. Still need a tiny bit of fat for certain fat soluble vitamins to get absorbed in quantity. But, methinks it doesn’t have to be a “major” amount of fat?




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    2. You’ve been listening too much to Robert Lustig who has not kept up on the science.

      Fructose metabolism in humans – what isotopic tracer studies tell us

      http://www.nutritionandmetabolism.com/content/pdf/1743-7075-9-89.pdf

      A great deal of fructose gets converted by the liver into fat…in rats! In humans, it’s very different.

      In our livers, fructose is converted mostly to glucose and lactate, which further gets processed to glucose further down the line. Only 1% gets converted to fat in the liver of humans, and that does not get stored without a caloric excess.




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      1. kudos dude. That is an issue I have not gotten around to trying to address. Your points fit more into my expectations but I did not know,, until now.




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      2. So, fructose’s apparent role in NAFLD & weight gain is “just a fluke”? Color me dubious…

        And, please, don’t try to tell me who I do and don’t listen to (making assumptions). Yes, Lustig is amongst them (way back when), but also Richard Johnson, David Gillespie, Caldwell Esselstyn, and plenty of others. I don’t limit myself to a single-source echo chamber. Which is precisely why I ask these kinds of questions. I’ve heard various arguments from both side of the fat / carbohydrate debate, none of which seem to ever be the “final word” on the issue.

        But anyway…

        There seems to be plenty of literature in support of fructose being processed into cholesterol & triglyceride and contributory to hypertriglyceridemia, hyperuricemia, higher weight gain and/or more central adiposity vs. say glucose/starch ingestion, etc.




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        1. Even this site points out fructose’s known or suspected bad behavior in the body:

          http://nutritionfacts.org/video/how-much-added-sugar-is-too-much/

          Especially “industrial” or “concentrated” / “added” fructose:

          http://nutritionfacts.org/video/if-fructose-is-bad-what-about-fruit/

          And, again, fructose is pointed to in hyperuricemia, high blood pressure, exacerbating gout, etc.:

          http://nutritionfacts.org/video/flesh-and-fructose/

          Though, it doesn’t seem to deal explicitly with fructose’s conversion to fatty acids & cholesterol in the liver, despite mentioning it in passing WRT NAFLD, etc.




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        2. I can understand your point of view. I remember throwing out everything in my house with HFCS on the basis of a rat study in Princeton. That was 5 years ago. 2010.

          Many reputable doctors sounded the warning. It got printed in books and spoken on videos which are still being distributed and viewed till this day.

          It was reasonable (though some scientist would say premature) to do so then.

          However, isotope tracer studies (dated 2012) in humans trump rat studies. It trumps observational data which can suggest but not prove causation.

          So I have stopped repeating inaccurate information. Not everyone has made such an adjustment. That’s unfortunate.

          Is free fructose associated with NAFLD? Yes. That’s because it’s a prime component of processed junk foods, which are themselves easy ways to consume excess calories.

          It’s overconsumption which is the prime culprit in NAFLD.




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    1. that was an isolated fat. Don’t isolate your fats for best results. Isolation = non-whole plant food.

      I’m aware that’s not the answer you are seeking, but it’s how/why I don’t have to fret over “which” oils.




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      1. I’m with you Wade! You can get so bogged down in specifics it gets overwhelming. I simplified dramatically by eating a variety of whole foods…as they come from the earth, and avoid anything processed, of course including free oils…no labels to interpret, no major question marks. My nonexistent income actually helped me here, as I now grow much of what I consume, and go on nature walks and forage the abundant healthy freebies. The added enjoyable exercise is a bonus, plus VERY gratifying to know what goes into and on it. I know one person isn’t going to affect the market, but if everyone would grow SOME of their own food, even if in pots, or sprouts in a jar, it would make a statement to the powers that be that we don’t desire their crappy junk. It is a lonely wish from my end, but I hope it snowballs! I skimmed through a flier in the mail today from a local grocery chain, and other than the few produce selections, there were pages and pages of “food” that wasn’t…very disconcerting and actually scary what passes as a consumable! I freak out when people tell me they can’t afford to eat healthy. I can’t afford not to, for lots of reasons!




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  12. Study: No-fat, low-fat dressings don’t get most nutrients out of salad.

    The vegetables in salads are chock-full of important vitamins and nutrients, but you won’t get much benefit without the right type and amount of salad dressing, a new study shows.
    In a human trial, researchers fed subjects salads topped off with saturated, monounsaturated and polyunsaturated fat-based dressings and tested their blood for absorption of fat-soluble carotenoids — compounds such as lutein, lycopene, beta-carotene and zeaxanthin. Those carotenoids are associated with reduced risk of several chronic and degenerative diseases such as cancer, cardiovascular disease and macular degeneration.

    The study, published early online in the journal Molecular Nutrition & Food Research, (2012) found that monounsaturated fat-rich dressings required the least amount of fat to get the most carotenoid absorption, while saturated fat and polyunsaturated fat dressings required higher amounts of fat to get the same benefit.

    “If you want to utilize more from your fruits and vegetables, you have to pair them correctly with fat-based dressings,” said Mario Ferruzzi, the study’s lead author and a Purdue associate professor of food science. “If you have a salad with a fat-free dressing, there is a reduction in calories, but you lose some of the benefits of the vegetables.”

    In the test, 29 people were fed salads dressed with butter as a saturated fat, canola oil as a monounsaturated fat and corn oil as a polyunsaturated fat. Each salad was served with 3 grams, 8 grams or 20 grams of fat from dressing.

    The soybean oil rich in polyunsaturated fat was the most dependent on dose. The more fat on the salad, the more carotenoids the subjects absorbed. The saturated fat butter was also dose-dependent, but to a lesser extent.

    Monounsaturated fat-rich dressings, such as canola and olive oil-based dressings, promoted the equivalent carotenoid absorption at 3 grams of fat as it did 20 grams, suggesting that this lipid source may be a good choice for those craving lower fat options but still wanting to optimize absorption of health-promoting carotenoids from fresh vegetables.

    “Even at the lower fat level, you can absorb a significant amount of carotenoids with monounsaturated fat-rich canola oil,” Ferruzzi said. “Overall, pairing with fat matters. You can absorb significant amounts of carotenoids with saturated or polyunsaturated fats at low levels, but you would see more carotenoid absorption as you increase the amounts of those fats on a salad.”

    The findings build on a 2004 Iowa State University study that determined carotenoids were more bioavailable — absorbed by the intestines — when paired with full-fat dressing as opposed to low-fat or fat-free versions. Ferruzzi; Wayne Campbell, a Purdue professor of nutrition science; Shellen Goltz, a Purdue graduate student in food science; and their collaborators, Chureeporn Chitchumroonchokchai and Mark L. Failla at Ohio State University, are the first to study different types of fats in differing amounts in human subjects.




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    1. Thanks for you study but I just eat salad greens and raw veggies without oil. I don’t need to “maximize” every nuance of plant nutrition. A bucket full of “un-dressed” salad vs. a little bowl with oil (making it all greasy)? I’m going for the bucket.




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        1. I eat nuts every day and avocado whenever I want-but usually with black beans and salsa and tortillas. No need to try to cram everything into one particularly perfect meal.




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          1. Nobody is saying you need to. Do as you wish . Nothing wrong with having some nuts with your salad, given that the benefits are fairly well studied now, so too is the cost of eating a salad without any fat.




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            1. I was replying to MacSmiley who suggested that I add nuts to my salad. That is who was indicating that there was some sort of need. I don’t like greens and nuts mixed. I eat my nuts separately from my greens, that is all. I eat way more than enough greens to get plenty of nutrition from them. There is no need to “extract maximum benefit”-which appears to be the “point” of the discussion with regard to fats and salads. I find it irrelevant for the reasons noted.
              That’s how I roll.
              Roll your own.
              Namaste.




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  13. I can attest to “lactessence.” Several years ago, I made a plasma/platelet pheresis donation about an hour and a half after a delicious meal of leftover linguini and clam sauce (olive oil in glorious quantity). After a few minutes on the machine, the technician looked at my product and gasped, wanting to know what I had had for lunch! The plasma, usually a clear light amber, looked exactly like well-shaken italian dressing. The donation stopped because they were afraid the goop would gum up the machine or the tubing, and it was not something they would want to infuse in another person. I was able to imagine what this could do in the small arteries of my brain and heart! Very embarrassing and an incredible visual lesson I have never forgotten. Immediately remembered it when watching this video!




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    1. As a whole-plant-food ground flaxseed is mega good. The only way this changes is if contamination ever were an issue. The only plant product damned in the video was an ISOLATED oil.

      Don’t take things apart and they work better.

      I’d grow my own if that became the case, and may start doing that anyway. Can use the plant in other ways too.




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    2. Daisy if you go up to the top of the page and click on health topics there are a bunch of videos on flaxseed. That is the best place to start.




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  14. Vitamin E was used by the Shute brothers to cure Angina. http://www.doctoryourself.com/heartdisease.html It’s a really sad story that their results have been so categorically rejected by the medical establishment. Or at least that they have been shelved for the millions of sick patients. Vitamin E is missing in the diets of many Americans. Based on its ability to reduce the oxygen requirement of many cells, it can improve endothelium function. Nuts are rich in Vitamin E and have been recommended for heart disease prevention. Perhaps their Vitamin E content is one component of the benefit. I think that many diseases have a nutrient deficiency component. The whole foods plant based dieters have probably the least deficiency of plant phenolics, which could be a real health concern. The diet used to contain many more species of plants. Was there politics in the ones we domesticated?




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  15. I think that if you are serious about the health of your heart (and every western adult should be), Dr. Caldwell Esselstyn’s dietary recommendations for stoping/reversing heart disease (which we all have in one form or another) is the best recommendation I can find, and therefore adhear to:

    The Esselstyn Rules:

    No meat, no poultry, no fish–not even salmon
    No dairy of any kind–not even skim milk or non-fat yogurt.
    No eggs–not even egg whites or Egg Beaters.
    No oil–not even virgin olive oil or canola oil
    Aim for 100% Whole Grain products. Ingredients must say, Whole Wheat, or Whole Buckwheat, Whole Rye,etc. 100% stone-ground wheat is notWhole Wheat unless the word Whole appears. Forget about semolina flour in pasta. Forget about white rice. I thought my Barilla Plusmultigrain pasta was fantastic–turns out, semolina is the number one ingredient.
    Do not drink juice. Fruit is fine. A little juice used to saute, or season recipes or for salad dressings is fine
    Do not eat nuts, even walnuts, unless you do not have heart disease.
    Do not eat avocados, if you have heart disease.
    Do not eat coconut, if you have heart disease.
    Eat soy products cautiously. They are high in fat (40% +) and many are highly processed. Only use Lite Tofu (like Mori-Nu or NaSoya Lite Firm Tofu). I also use Soy Boy Organic 5 Grain Low Fat Tempeh.
    Reduce sugar as much as possible. When you do use it for recipes, stick to the more unprocessed varieties. But don’t fool yourself, maple syrup, agave, and honey are still sugar. I use stevia.
    Read all labels, especially THE INGREDIENTS!!!
    The Rest of the World of Vegetables, Fruit, Legumes, and Whole Grains is Yours.




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    1. Yeah, I was with you until he went “nuts”… Soy is okay in my book too. Never use sugar or any sweetener (is where I’m radical) save a teaspoon of honey or molasses (or such) no more than 2x daily. Stevia has limits too. If it has a label, don’t eat much of it.




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  16. Would this apply to a paleo or mediterranean diet that includes lots of plant oils like olive oil?

    2015 – Virgin olive oil rich in phenolic compounds modulates the expression of atherosclerosis-related genes in vascular endothelium: “Our results suggest that the consumption of virgin olive oil rich in phenolic compounds may reduce the risk of atherosclerosis development by decreasing inflammation and improving the antioxidant profile in the vascular endothelium.”

    2015 – Exclusive olive oil consumption has a protective effect on coronary artery disease; overview of the THISEAS study: “Exclusive olive oil consumption was associated with lower risk of coronary artery disease, even after adjusting for adoption of an overall healthy dietary pattern such as the Mediterranean diet.”

    2015 – The role of olive oil in disease prevention: a focus on the recent epidemiological evidence from cohort studies and dietary intervention trials: “Recent epidemiological research has shown that regular consumption of olive oil is associated with increased longevity. This benefit is partly due to the olive oil’s unequivocal cardio-protective role”

    2015 – Olive Oil Polyphenols Decrease LDL Concentrations and LDL Atherogenicity in Men in a Randomized Controlled Trial: “The consumption of olive oil polyphenols decreased plasma LDL concentrations and LDL atherogenicity in healthy young men.”

    2015 – PON1 and Mediterranean Diet: PON1 is a major anti-atherosclerotic component of high-density lipoprotein (HDL). “Extra virgin olive oil, the main source of fat, has been particularly effective in increasing PON1 activity”

    2015 – Effects of high phenolic olive oil on cardiovascular risk factors: A systematic review and meta-analysis: “High phenolic olive oil should be considered as a nutraceutical in cardiovascular prevention.”

    2015 – Benefits of the Mediterranean Diet: Insights From the PREDIMED Study: “a vegetable-based MeDiet rich in unsaturated fat and polyphenols can be a sustainable and ideal model for CVD prevention.”

    2015 – Dietary Supplementation with Olive Oil or Fish Oil and Vascular Effects of Concentrated Ambient Particulate Matter Exposure in Human Volunteers: “Olive oil supplementation has been shown to improve endothelial function and lipid profile and lower the risk of coronary heart disease events. Furthermore, in a clinical trial in healthy young adults, supplementation with 4 gram/day of olive oil led to an increase in FMD. Our finding suggests that 4 weeks of dietary OO supplementation attenuate PM-induced reductions in FMD, possibly due to effect of OO protect against the adverse effects of PM exposure on endothelial function”

    2014 – The association between carotid intima media thickness and individual dietary components and patterns: “Olive oil is inversely associated with carotid intima media thickness, with a benefit seen when >34 g/day is consumed. While there are many epidemiological studies exploring the association between dietary intake and cIMT there are few intervention studies. Intervention studies show that a Mediterranean diet may reduce cIMT progression, especially in those with a higher cIMT.”

    2014 – Diets to prevent coronary heart disease 1957-2013: what have we learned: “The Mediterranean-style diet, with a focus on vegetables, fruit, fish, whole grains, and olive oil, has proven to reduce cardiovascular events to a degree greater than low-fat diets and equal to or greater than the benefit observed in statin trials.”

    2014 – Olive oil polyphenols enhance high-density lipoprotein function in humans: a randomized controlled trial: “Olive oil polyphenols promote the main HDL antiatherogenic function, its cholesterol efflux capacity. These polyphenols increased HDL size, promoted a greater HDL stability reflected as a triglyceride-poor core, and enhanced the HDL oxidative status, through an increase in the olive oil polyphenol metabolites content in the lipoprotein.

    2014 – Foods and food components in the Mediterranean diet: supporting overall effects: “Using a number of statistical models, analyses were conducted to show around a 35% cardiovascular disease risk reduction in the highest consumers of olive oil”

    2014 – Cardiovascular mortality: how can it be prevented?: “the most important finding was the 30% reduction in the relative risk of major cardiovascular complications (heart attack, stroke and cardiovascular mortality) in both Mediterranean diet groups compared to those who followed a low-fat diet.”

    2014 – The effects of the mediterranean diet on biomarkers of vascular wall inflammation and plaque vulnerability in subjects with high risk for cardiovascular disease. A randomized trial: “inflammatory biomarkers related to plaque instability such as C-reactive protein and interleukin-6 were reduced by 45% and 35% and 95% and 90% in the MD+EVOO and MD+Nuts groups, respectively (P<0.05; all) compared to the low-fat diet group."

    2014 – Olive oil intake and risk of cardiovascular disease and mortality in the PREDIMED Study: "Olive oil consumption, specifically the extra-virgin variety, is associated with reduced risks of cardiovascular disease"

    2014 – Dietary fats and cardiovascular disease: putting together the pieces of a complicated puzzle: "nut and olive oil intake is associated with reduced CVD risk."

    2014 – Mediterranean diet and cardiovascular health: "a high-unsaturated fat and antioxidant-rich dietary pattern such as the MeDiet is a useful tool in the prevention of CVD."

    2014 – Mediterranean diet reduces 24-hour ambulatory blood pressure, blood glucose, and lipids: one-year randomized, clinical trial: "MedDiets supplemented with extra virgin olive oil or nuts reduced 24-hour ambulatory BP, total cholesterol, and fasting glucose."

    2014 – Effect of the Mediterranean diet on heart failure biomarkers: a randomized sample from the PREDIMED trial: "Individuals at high risk of cardiovascular disease (CVD) who improved their diet toward a TMD pattern reduced their N-terminal pro-brain natriuretic peptide compared with those assigned to a low-fat diet."

    2013 – Beneficial effects of polyphenol-rich olive oil in patients with early atherosclerosis: "olive oil significantly improved endothelial function"

    2013 – Olive oil has a beneficial effect on impaired glucose regulation and other cardiometabolic risk factors: "The results show that consumption of olive oil has a beneficial effect on different cardiovascular risk factors"

    2013 – Primary prevention of cardiovascular disease with a Mediterranean diet: "a Mediterranean diet supplemented with extra-virgin olive oil or nuts reduced the incidence of major cardiovascular events"

    2013 – Extra-virgin olive oil consumption reduces the age-related decrease in HDL and paraoxonase 1 anti-inflammatory activities: "Extra virgin olive oil consumption increased the anti-inflammatory effect of HDL and reduced the age-related decrease in anti-atherogenic activity."

    2012 – Hypolipidimic and antioxidant activities of virgin olive oil and its fractions in 2,4-diclorophenoxyacetic acid-treated rats: "Extra virgin olive oil may be a potential functional food source of antioxidants that can decrease the frequency of cardiovascular diseases"

    2012 – HDL-related mechanisms of olive oil protection in cardiovascular disease: "Cumulative evidence suggests that high density lipoprotein (HDL) cholesterol, and its main apolipoprotein A1, may be increased by consuming olive oil when compared with carbohydrate and low fat diets in humans."

    2012 – Olive oil polyphenols decrease blood pressure and improve endothelial function in young women with mild hypertension: "the consumption of a diet containing polyphenol-rich olive oil can decrease BP and improve endothelial function"




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  17. For those wondering about whole food sources of fat such as nuts. Does consumption of nuts result in postprandial triglyceridemia? Yes, it does. Does consumption of nuts result in postprandial impairment of endothelial function? Yes, it does. Is extracted oil worse than whole food for endothelial function? It depends.
    If you focus only on postprandial endothelial function, then walnuts are better than olive oil, but… walnut oil is better, than walnuts!

    “Flow-mediated dilation (FMD) was worse after the olive oil meal than after the walnut meal” — http://www.ncbi.nlm.nih.gov/pubmed/17045905
    “Acute consumption of walnut oil preserved endothelial function compared with whole walnuts and walnut skins” — http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3652880/

    What question we should ask: is nut consumption harmful for endothelial function in the long-term? No, it is highly beneficial. We know that nut consumption is protective against CVD. Nuts elevate postprandial triglycerides, but they lower triglyceride levels in the long-term. Should we worry about temporary impairment of blood flow? No, if we are healthy and this impairment is not physiologically significant. We know that coffee consumption impairs blood flow, but coffee consumption is not linked to heart disease and death because of it (as I remember).

    What if we already have impaired endothelial function (e.g. atherosclerosis) and have a high chance of dying because of insufficient blood flow? In my conslusion, we should follow low-fat diet and avoid all food that impairs blood flow even temporarily, including nuts, until we can consume them without risk. So, now I agree with The Esselstyn Rules that lgking have posted.




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    1. Leonid: Great post. Nice summary on why a healthy person might do well to eat nuts, but a person with advanced heart disease might do well to avoid them. Thanks!




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  18. Hmm, I spent a couple hours looking into the published scientific journal literature to offer some other relevant perspectives on olive oil consumption and the relation betweens its consumption and endothelial function, coronary blood flow, and arterial health. I pulled out a little under 40 relevant articles. Fairly soon after posting my comment on here, my research was immediately marked as spam and removed. Way to keep the conversation one-sided — Nice.




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    1. Hey, I still see it. Check your “sort by” selection, top right under your name/handle to see how it’s set. My got tweaked to “best” once and that shuffles everything out of chronological order. So I too thought my posts were getting nipped once, but they weren’t. Not that some shouldn’t be!

      As to that subject, I don’t find a nutritional need for oils so I only use them to protect my iron cookware. Using olive or canola and only fractions of teaspoons per application.




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        1. Sonofagun, I reloaded the page. Gone. What had happened was new posts had popped up and pushed it down, but I hadn’t done a full page reload. Be gone you spammer! 8-p Appeared to be at least as relevant as the long Esselstyn posting. Wasn’t me.




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          1. Oh well, maybe it’ll come back. I’m kind of biased on the other side, because I dig the taste of raw olive oil over vegetables. I usually get mine from a shop that lab-tests all of their oils and tags them with harvest dates, polyphenol counts, free fatty acid content, peroxide values, etc, where I tend to go for award-winning oils that are in the highest category of phenols. Some days, I might throw a couple spoonfuls over my vegetables, and I some days I might eat something like 6-8 servings of vegetables in a day, where it can add up. The vegetables take the place of some other higher-caloric foods, where the oil keeps the calories up where I need them.




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            1. I think the deep down underlying common thread of all this nutritional information is that the less animal products one eats the healthier he/she will likely be. We can quibble over the optimum plants all day long, but that eating a wide variety of them covers all the bases-barring contamination and “engineering” of course. buen provecho




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    2. Hmm. Something must have gone wrong or someone accidentally marked it as spam? I looked into your comment it was totally appropriate we have no quarrels with respectful folks posting relevant research on our site. I mean that’s the point, for everyone to learn! Your comments should be back. Let me know if you ever experience this again?

      Thanks for your contributuons,
      Joseph




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      1. If you were able to look into the comment, as you say, then can you not just remove the spam flag and have it reinstated? If not, then perhaps that is a flaw in the site’s functionality that could be addressed.




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  19. I’m still trying to wrap my head around olive oil – for one it is used quite liberally in Mediterranean Blue Zones. As always the overall health effect is more complex, for example monounsaturated fat is good for testosterone which is generally good for vitality (at least in some groups of people, I remember reading about it in Healthy at 100, don’t know the full picture though), and I remember reading a few studies demonstrating that olive oil does have certain neuroprotective qualities. And more generally it is a part of generally approved Mediterranean diet, even though probably a little overhyped one (I mean oil part).
    Still, form my personal experience I can tell I did feel certain vasoconstriction after a meal with olive oil when I had my issues with blood circulation (thanks to injury). Now when I feel better I can have some olive oil without any noticeable effects. And at the time when I did feel adverse effects they were gone once I had a clove of finely chopped fresh garlic with my meal, infamous Mediterranean combo again.
    Even better with a glass of red wine (also remembering the French paradox). Of course still not recommended to those with condition. After all it might well be a matter of how much vasoconstriction one can have without any issues for a sake of other beneficial effects.




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    1. Somedays, I eat a pretty high fat paleo / mediterranean-esque diet, where I might not combine fats with protein or carbohydrates, getting down on a mostly vegetable meal by volume (or a particularly fatty meal by calories.) Looking down at my arm afterwards, usually looks about like this: http://i.imgur.com/qAFbJAd.png with blood pressure around 95/55 – 105/65. I’m not sure these high fat meals necessarily disrupt cardiovascular function for those who are used to eating these foods regularly. These are the articles I pulled out (I tried posting them to these comments, but it was marked as ‘spam’): http://pastebin.com/iGRhWW0E Looking into other benefits with neuroprotection and cognitive function over a bigger timeline, I could easily have doubled the number of relevant articles showing benefits (or at least, a lack of clear harm.)




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      1. Heart health also seemed quite good in observational studies from rural India, if memory serves me correctly, where relatively high amounts of fat from oils and dairy were consumed.




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  20. When I share information like? this people say things like “I’m not eating high fat. I only eat about 30% of my calories as fat.” They all think that “high fat meal” means someone else’s lunch, not theirs. I kept waiting to hear the relative levels of fats in these studies. Other than the “fat free meal” I didn’t hear – or missed – it. At what level does a “low fat” diet start to improve endothelial function? At what level does a “high fat” diet start to impair it? Anyone know what the studies say?




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    1. Isn’t the better question at what point does the fat you eat impair endothelial function? The answer is, of course, any amount of fat that is not part of a whole food that you’re consuming. Fats in nuts, fruits, grains, or vegetables can have a positive effect on your endothelial function, but processed fats, even plant fats are not particularly good for you. Proof of this can be found by looking at Dr. Greger’s recommendation for the the best level of cholesteroll to aim for: http://nutritionfacts.org/video/optimal-cholesterol-level/ This video explains that our normal cholesterol in the developed world isn’t so normal after all.

      Next look at the other effects that are found when eating saturated fat that comes from animals. You can see that is causes lots of problems but the most stark on comes from the problem of leaky gut syndrome: http://nutritionfacts.org/video/the-leaky-gut-theory-of-why-animal-products-cause-inflammation/

      Science shows us that no amount of processed fat is good for you. The less you eat the better off you are. No one yo talk to is going to like hearing this, but it is as it is.

      A whole food plant based diet is the best low fat diet you can eat.




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    1. Who publishes a 2 week diet study? They selectively restricted dietary carbohydrate versus fat for a mere six days — If we’re looking for the optimal diet for losing weight in just 6 days, it would be a water fast. That doesn’t mean a water fast is a better diet than a low carb or low fat diet.




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      1. This was a meticulously designed study with results that were backed up by the researchers’ mathematical model. Testament to its quality it got into an excellent journal with an accompanying editorial that says it is the best study yet on low carb vs low fat. It was short in duration because it was a metabolic ward study, but such a setting offers complete control over diet and state of the art biomedical measurements. Critics of the study don’t like its findings, or have not read it.




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        1. I’m glad you pointed that out, Kate. plantypants seems to be judging the study based on criteria that the researchers did not intend the it to encompass, and seems to have missed the point.




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    1. Hi Eric. It’s due to the giotrogens, which can disrupt thyroid function. Dr. Greger mentions is in this video. See if this helps?

      Thanks for your question,
      Joseph




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  21. Love the title: “Fatty meals MAY impair artery function”. So, that means they MAY NOT, as well. And we’re back where we started; it could be either, and we already knew that. So why read the article? Way too many headlines stick the word MAY in as a qualifier that destroys it’s own premise. The general population MAY be led to believe all kinds of nonsense as being true due to bad judgement of the article writers.




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    1. nitestar95: Your comments do not make sense to me. If someone wrote a headline of, “Smoking Will Cause Lung Cancer”, I would call them on it. There is no guarantee that a smoker will get lung cancer. We just have a lot of great evidence linking lung cancer to smoking. We have good reason to believe that people who smoke will greatly increase their risk of lung cancer. But we can not say that someone who smokes WILL get lung cancer. Just because we can’t say “WILL”, does that mean that we shouldn’t tell people about smoking and cancer? My answer is: Once you have enough information, you have an obligation to tell people that information. And you have an obligation to be accurate and clear about what is known and not known.

      In the same way, the title on this NutritionFacts page is the responsible way to communicate the information about fat and artery function. We have enough evidence to communicate the information. (I found the set of studies laid out to be pretty compelling.) If you only want to hear news when we are 100% sure of something, I don’t think you will be getting much news about anything in the nutrition world. And you would be missing out on learning about links that we really do know a lot about.

      My understand is: In general all we can say most of the time in the world of nutrition is: We have good evidence that says bla bla bla. And thus your risks go up and this bad thing may happen to you if you ignore bla bla bla. Do what you want, but note that you takes your chances.




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  22. Are we really heading towards the notion that humans should not be eating any fat or cholesterol at all? I just cannot in good conscience recommend this to any patient or friend. Even healthy vegan products such as avocado or olives contain lots of fat. Fat that our body (and brain) are very good as using for energy and other functions. We should also be focusing on human physiology and not just picking out studies, because in many cases, I can probably find studies that prove exact opposite hypotheses. Human physiology doesn’t lie. Studies are very difficult to get correct and unbiased, 100% of the time.




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    1. Andrey Yusupov, MD: re: “Are we really heading towards the notion that humans should not be eating any fat…” Fat? No. No one is recommending a diet completely free of fat. On a whole plant food based diet, that is pretty much impossible to do. Even say broccoli has fat in it. And this site highly recommends including some nuts and seeds in a person’s diet. Nuts and seeds are high in fat. The point is, oils are not the only place one can get fat. Rather oils are an unhealthy way to get fat. But just because (free/processed) oils are bad for us, doesn’t mean that anyone is recommending a fat-free diet.

      But you also wrote, “…or cholesterol at all?” There is no reason to eat any dietary cholesterol. Human bodies make all of the cholesterol that we need. And no one eats cholesterol by itself. They eat foods which contain cholesterol – specifically animal products. Plants, even fatty plants, do not contain cholesterol. Even if you were convinced that dietary cholesterol posed no problems (though I think the evidence does not support such a stance), there is a huge, giant, TON of evidence on this site showing how animal foods contribute to the major diseases of our time, such as diabetes, heart disease, cancer, ETC. So, it is quite reasonable to tell people not to eat any cholesterol at all, because that is the same as telling people not to eat animal products. And that is very good advice.




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      1. Thea, I understand what you are saying. But ponder this scenario for a second. A person gets some basic labs (cholesterol levels – LDL, HDL, LP(a), etc.), BP, 1 and 2 hour fasting glucose test — all markers of health as we would all agree. She then goes on a ketogenic diet (70% of all calories from fat, <<5% from carbs). She eats beef, fatty and muscle, grass fed butter, coconut and avocado oil, with some select veggies EXCLUSIVELY for 3 months. She does all the same tests and guess what? All improve. And this is a very common scenario with this diet.
        The point is, Dr Greger (who by the way do respect) does a good job is scouring the literature for the available studies. You can define a variable such as "endothelial function" in a hundred different ways, and these are artifically created parameters, even when studied in vivo (which most studies are not). Open your mind past studies which all have flaws that we can point out. Sometimes, taking even anecdotal evidence (reproduced many times), and understanding human physiology goes farther with this stuff. The above scenario is there for your to open your mind and think a bit broader and outside of the box. I'm not sure what your training and experience is, but I would avoid some of the blanket statements as you have made above. In any case, awesome discussion and would be great if Dr. Gregor can comment as well.




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        1. I can’t say I agree with you Andrey, and many here would agree as well that ketogenic diets based around animal protein/fat are a dangerous fad and should be avoided if one is concerned with long term health. This is a very educated group of people on this forum, we understand that many of the studies you are speaking of in favor of high fat diets were performed by the meat, egg and dairy industry with outcomes already predetermined to fit an agenda driven by profit over good science. I invite you to review the videos I will list here so you can pick up to speed on the education level of the audience you are speaking to.

          These are 2 good videos that speak directly about what I call animal industry ‘junk-science’.

          here ~~~> http://nutritionfacts.org/video/how-the-egg-board-designs-misleading-studies/

          and this one as well ~~~> http://nutritionfacts.org/video/the-saturated-fat-studies-set-up-to-fail/

          Did you know that ketogenic diets cause insulin resistance? I would be interested to see if you accept or reject this data.

          as seen here ~~~> http://nutritionfacts.org/video/lipotoxicity-how-saturated-fat-raises-blood-sugar/

          and here ~~~> http://nutritionfacts.org/video/diabetes-as-a-disease-of-fat-toxicity/

          Lipid profiles are only one consideration when discussing overall long term health. We as a species are evolutionary herbivorous and Ketogenic diets go directly against our evolutionary physiology.




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          1. I have reviewed the videos on this website extensively over the last 3 months. Being a ‘very educated’ group, you should know that we can find studies simply based on design “proving” the totally opposite hypotheses. Also useful would be the proper way to analyze a scientific study, i urge you to real the text “Bad Science”, although again that is written for laypeople.

            Where you have to be careful Eric, 98% of the people on this site unfortunately have a knowledge of physiology and pathophysiology based on things what they read on the internet, nothing more. So its easy to assume that any study with a 2 sentence snippet cut into a video is automatically valid. Don’t want to get into the evolutionary debate, just look at your own anatomy.

            Do you think maybe, its actually the LACK OF PLANTS rather than the presence of meat in a diet that causing many of these modern diseases? Ponder that for a second. Lack of the benefit of plants in the modern American diet.

            Last thing, collectively blood pressure, cholesterol, and blood glucose tolerance are VERY representative of overall health, at least if I had to pick 3 things to do at any one time, it may be those. Now explain to me, that after a diet consisting of >70% fat, how are we able to see these improve in a patient? I’ll wait. It has a lot to do with how well our brain and heart can use fatty acids as fuel. I suspect this fat does not have a chance to become atherogenic or converted into glucose because in a state of ketosis your body would use each and every fatty acid for fuel. Would I do this kind of diet? No, too hard and I like other food too much. Merely using it as an example to illustrate that human physiology is a lot more complex than you think. I can do a study and define “endothelial function” in 12 ways and get 12 different results. And to recommend only 4-7% of calories from fat, is frankly asinine (ie. just get fats from the whole veggies you eat and not any oil). Again, this come back to understanding how the body works beyond the internet.

            Ok now the really last thing, which will illustrate several points. I can find studies showing the negative effects of soy protein (in moderate to high amounts) on health, especially in men. Gynecomastia, subcutaneous fat deposition, and even neurosis and other effects. I can also find studies showing that these things are not true. So which side should the average person believe? Not a biased person, but a hardwording, honest average person. Personally, I wouldn’t risk it. We all know studies will seem to be more valid to someone named “veggie man”. “Bad Science” is a great place to start.

            I come to find that people that make the largest impact on the world, think Jeff Bezos, Elon Musk, etc. among these folks I never find to be vegans. I respect folks who can impact the lives of millions or billions of people the most. These are driven, crazy smart, and overall impressive folks. I would have to think if they thought they can function better on a vegan diet, they would have become vegan, but none of these truly impactful people did. Remember, these folks are looking for every edge to improve performance. Where are the vegans among them?




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            1. I’ll have to respectfully disagree with you again on a few points…

              “98% of the people on this site unfortunately have a knowledge of
              physiology and pathophysiology based on things what they read on the
              internet, nothing more”

              This type of blanked dismissal of the education level of contributors on site is typical of those defending ketogenic diets. We have many good doctors, RDs, nutritionists, medical researches as well as extremely well researched and educated individuals here. Thea being one of those top notch people. I believe your blanket dismissal of the collaborative efforts put forth by this wonderful group is trivializing the issue and does not add weight to your argument. Might I say that most ketogenic proponents could alternatively be labeled as “uneducated bro-science enthusiasts” as well with the same level of ignorance you propose the good people here on nutrition facts have?

              “Don’t want to get into the evolutionary debate, just look at your own anatomy.”

              Oh but yes please, I would be happy to debate our predominantly plant based evolution”. I stand by my statement that humans are evolutionary herbivores. Just as you stated, “look at our anatomy” the evidence is clear we are designed to processes primarily plants. That is a debate I do not shy away from.

              “Now explain to me, that after a diet consisting of >70% fat, how are we able to see these improve in a patient? I’ll wait”.

              Why thank you so much for waiting, very nice of you. If you could please link to these studies you speak of so we can examine them. I bet that the markers of improvement you speak of are nothing more than calorie restriction and subsequent weight loss disguised as improvement in health. We have known for a long time that weight loss by any means will improve health bio-markers and that the improvement is “in spite” of the fat, not “because” of the fat.

              “Do you think maybe, its actually the LACK OF PLANTS rather than the
              presence of meat in a diet that causing many of these modern diseases?”

              Yes, I agree… lack of plants in the diet is a large factor in declining health but that doesn’t give ketogenic diets a free pass as health promoting, two very different things. There is no ketogenic diet that can reverse atherosclerosis. There are no studies showing reversal of heart disease on ketogenic diets. On the other hand a WFPB diet can reveres heart disease, unclog arteries as seen in this video

              here ~~~> http://nutritionfacts.org/video/low-carb-diets-and-coronary-blood-flow/

              and this one ~~~> http://nutritionfacts.org/2015/05/19/low-carb-diets-and-coronary-blood-flow/

              Can you make that same claim for ketogenic diets? Can you find a study showing blockage reversal on a high-fat ketogenic diet? Please don’t blanket dismiss this question. I ask you good sir…Can you find a single study showing arterial plaque regression on a ketogenic diet like what has been documented on a WFPB diet?




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              1. The 2nd link is just a transcript of the first. I personally interpret nuclear medicine myocardial perfusion studies in my radiology practice (the “SPECT” scan incorrectly labeled in the video you posted). SPECT is just a general term for something beyond the scope of what I can type to you here, related to nuclear medicine but not the correct terminology by Dr. Gregor for those studies of the heart you see in the above video. After I saw the photos displayed in the video, which do not even match up with how that study would look like in a patient, I ceased to pursue that piece further.

                Why are you so fixated on the ketogenic diet? A study like you mentioned would be close to impossible to perform as it is very very difficult and would be prohibitively expensive to ensure that the subject remain in ketosis 24/7. Its actually very hard to do for consecutively for even 1-2 weeks. I am just illustrating a point that before believing a statement put up on a video consisting of a chart or 2 lines from the study, you need to have the ability to interpret said study.




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                1. I noticed that too. My mistake, I re-linked another video. Thank you for pointing that out. I understand about your SPECT scan issue with above video. Are you saying the information is invalid and that arterial stiffening does not happen directly after a high-fat meal?




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                  1. Good discussion. But it appears that some comments have been deleted as I don’t see them anymore. A high-fat meal may stiffen arteries.. but I would think we would be evolutionarily capable with dealing with it. ie. it would be a transient phenomenon.
                    It can be shown that eating a meal high in cholesterol will boost your testosterone level 12-18 hours after the meal (ie. sex drive). My question is, do you want physical performance (very difficult to acheive with a 18-19 BMI with decreased muscle mass typical of vegans), performance in intimacy, and your mind?
                    Wouldn’t it suck to find out you wake up at age 60, and by some dumb luck you end up with pancreatic cancer or in a car accident even though you ate vegan your whole life? While some random Italian mom who ate meatballs and pasta her whole life lived to age 100? See my point. Thanks :)




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                    1. I think we are both arguing a stance from different perspectives. Many people on this site including myself are trying to heal health problems from years of a crapitarian high fat/animal products SAD diet. For those of us, we are looking to eliminate foods that have been shown to hinder or work against the healing process. Athletic performance is not the main goal for those people…although I would argue that a high-carb plant based diet works better than you believe for athletics, You just haven’t been exposed to the information yet. Remember Michael Arnstien the ultra marathon runner I mentioned earlier? He is crushing it powered by plants. Have you seen the BBC doc on the two brothers who did a side by side of low-carb vs low fat? Guess who had better athletic performance? The brother who fat-loaded or the brother who carb-loaded?

                      Watch fat vs carbs brothers here ~~~> https://www.youtube.com/watch?v=_nT-vACI-jg

                      Once you hit the magic “40” anything goes. My health problems started in my late 30s, early 40s. At that time I made the decision to ditch the oils, meat, eggs and dairy after studying this site and others. It was the best decision I ever made to regain my health. Yes, it took time to learn to do a WFPB diet correctly but the results speak for themselves and many here will agree and can share similar. stories of regaining health.

                      a little story for ya…

                      Back in the 90s, when I was in my yolo 20s, I was bodybuilding. Hit the gym 6 days a week, read all my Wieder mags and pounded down as much protein as I could because the magazines told me to. I would drink whole gallons of milk with raw eggs and protien powder every day. I followed the montra of staying away from the evil carbs. I remember my fav breakfast was burger patties and egg omelets. So I know where you are coming from as an athlete looking to increase size and strength and raise IGF-1 levels to promote muscle growth. (IGF-1 also promotes tumor growth).

                      Here’s the kicker Andrea, You seem to not be up to speed on how well plant based athletes perform if they study up and do the diet correctly. There are plenty of Vegan bodybuilders killing it these day. Many long distant athletes that are out performing there omnivore counter parts. Much of what you say about plant based athletes is not true. That’s to bad because I think you would be amazed at how well plant based high-carb athletes do… The ultra marathon runner Michael Arnstien being only one example. Did you have a moment to check out his story?

                      Another story for ya…

                      Also, during the golden age of bodybuilding in the 90s, there was a keotgenic diet doctor named Dr Depaquale who was putting IFBB pros on this new cutting edge ketogenic diet. It appeared in the magazines and underground anabolic publications. That year a few competitors followed the diet in prep for an upcoming pro show… Those that followed Dr DePasquales ketogenic diet came into the contest looking smooth and sickly, no energy and in the worst shape of all the bodybuilders competing… It was the last time the ketogenic diet was seen in a bodybuilding magazine or used again by any competing IFBB pro bodybuilders. If you are saying high-fat diets are better for athletic performance I’ll have to disagree with you on that. Have you heard of the term ‘bonking’? It’s when you have depleted the glycogen in your muscles and you literally gas-out. High-fat diets do a great job of producing the bonking effect when used for athletic performance and endurance.




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                    2. I was off the keto diet discussion like 3 posts ago, but you love to bring it up in all your posts. :) I was using it simply to illustrate the point to not believe a study because it was cherry picked and put on a video here, without properly analyzing the statistics and validity of said study.
                      I’ll repeat, I was not/am not advocating a keto diet because it would be next to impossible for the average person to stay in ketosis for a significant period of time. You would need to test your blood more than a diabetic to ensure you were actually in ketosis.

                      What I am trying to point out, is the DOSE RESPONSE relationship to protein intake with muscle strength, endurance, and recovery. This cannot be argued as has been validated in many studies, up until a certain level. An ultra-marathon runner is about as far away from a useful comparison as you can get. They represent what, 0.0001% of the population? I am talking about the average person who wants to be fit, strong, and physically perform. Whether its strength training to improve mental and physical health or the weekend warrior in their 40s. That is a WAY more common and useful scenario.
                      The vegan body builders that are good I can count on one hand, and they are on amounts of drugs you cannot imagine. When you talk to any sports or strength coach and mention “can this be achieved with a vegan diet?”. They almost universally say “I’VE NEVER SEEN IT. But please try.” What does that tell you?

                      I’ll ask the question one more time: prescribe to me a 3500 calorie/day vegan diet that can 1. reasonable be eaten with a typical busy schedule and 2. maintain muscle mass. I’ll patiently wait.




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              2. I always enjoy an educational debate. Its the close-minded and one-sided nature of many vegetarian males specifically (vegan women don’t seem to be this way) that make it hard to discuss even non-diet related issues. That’s just my personal experience, and I don’t have any “scientific” studies to prove that one. ;) I don’t see a 80-90% carb diet as the solution, I’m sorry. That’s exactly whats being recommended with this “no oil” diet. Since it would be hard to get more than 10% of protein eating a WFPB diet, then add in 4-9% of fats from whole plants. If you are interested in any sort of athletic performance, robust sex drive, etc. I just cannot see a 80-90% carb diet of any kind, being a solution.




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                1. As do I Doctor… so just a few comments, and I ‘ll try to keep it non-close minded and genuinely try to “understand your point of view with regards to high-fat diets.

                  “Since it would be hard to get more than 10% of protein eating a WFPB diet”

                  Can I ask where you came to the conclusion that humans need more than 10% protein? Dr T Collin Campbell of the ‘china study’ states that humans need no more than 6% protein and that cancer can be switched on and off with animal protein above +/-20%. Getting enough protein is very attainable on a plant based diet. Have you read the china study yet? Did you know broccoli has more protein per 100 calories than beef? Protein deficiency on a plant based diet is not a problem as long as you are eating enough calories. These are common misconceptions many people have from years of misinformation about protein requirements.

                  “I don’t see a 80-90% carb diet as the solution, I’m sorry.”

                  And yet you feel a >70% fat diet that causes insulin resistance via lipotoxicity would be a solution to what? Depends on what you’re calling a solution. Have you heard of Walter Kemptner? He was curing diabetes and other degenerative diseases with a rice and fruit diet decades ago. The exact opposite of a low-carb diet.

                  Here ~~~> http://nutritionfacts.org/video/drugs-and-the-demise-of-the-rice-diet/

                  Would you be willing to look at his work as well? It sounds like you are
                  making assumption about protein that are not backed up in the
                  literature. Just because you don’t “see” high carb diets as a solution
                  doesn’t make it so. Sounds like much of your criticism of high-carb
                  diets is based on personal preference and that’s fine but lets not mix
                  those opinions with facts like your “over 10% protein” statement.

                  “no oil” diet.”

                  Yes, no oil is correct when talking about reversing atherosclerosis. Are you familiar with Caldwell B Esselstyn MDs work?

                  Here ~~~> https://www.youtube.com/watch?v=b_o4YBQPKtQ

                  There is a reason why this site and other plant based site advocate “no oil”. Oil damages the endothelial lining. if you are trying to repair endothelial damage oil should be eliminated. Can you be as open minded as you request of others with regards to Dr Esselstyn’s work (featured in the movie forks over knives).

                  ” If you are interested in any sort of athletic performance, robust sex drive, etc. I just cannot see a 80-90% carb diet of any kind, being a solution.”

                  And this is where new information might change your mind if you too would be open minded… Have you heard of Michael Arnstein the ultra marathon runner? Have a listen to Rich Rolls pod cast on the subject of high carb diets and athletic performance.

                  Here ~~~> http://www.richroll.com/podcast/rrp26-fruitarian-ultra-runner-michael-arnstein-the-rich-roll-podcast/

                  Don’t want to overload you with to much information but you seem to have many misconceptions about high-carb diets that are simply not true in the face of new and emerging data.




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                  1. Here is the thing, Eric. I have no doubt that humans don’t need more than 6% of protein from calories to live. I am not talking about living and surviving. I am talking about thriving and performing. See below for protein requirements in active people:
                    http://www.ncbi.nlm.nih.gov/pubmed/18577776
                    http://www.ncbi.nlm.nih.gov/pubmed/22150425
                    Thousands of studies over the last 40 years have shown a dose-response relationship between protein intake and strength, endurance, and more. Up to about 2-2.5g/lb (1g/kg) bodyweight. Lets say you are moderately active and shoot for 1.5g/lb, or 225g. Thats almost 1000 calories from protein, or 33% of calories from protein if you are eating a 3000kcal diet (active person, remember).
                    If you are just trying to survive, sit on the couch, hang out at the office, then the 6% is probably fine. Lose of lean muscle mass in > 60yo is a risk factor for early death, especially in men. Will you continue to eat 6% (and you WILL loss lean mass doing this) when you are 50? 60? Interested to hear your thoughts.
                    I am 5’11.5″ 165. I have to eat 3500-4000kcal to maintain my weight. How do you expect me to do that not eat any oil, or poultry, or seafood? I eat a lot of lentils, beans, etc. I love to drink a lot of green tea and started doing crossfit again (these raise metabolism further). I have to drink 2-3 extra protein shakes to even maintain my weight. Real question: if I was eating vegetarian, how realistically would I be able to get those calories on a vegan diet? The fiber and water content alone would be prohibitive. And being vegetarian automatically means you would have to prepare more of your own meals, due to lack of veggie options as compared with non-veggies, in any setting, which takes more time.




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          2. I do accept the basic data in all the videos you posted. But again, here you are oversimplifying the complexity of the human body. Eating a diet high in saturated fat as part of any already crappy American diet (processed food, no legumes, packaged carbs), no surprise increases insulin resistance. We all agree there.

            That diet literally turns the way our body uses energy to a radically different way. Those videos don’t even mention a ketogenic diet; I was excited to watch them because I thought they would.




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        2. Andrey: Thank you for your nice response. I appreciate it.

          I agree that probably all studies have various flaws. And that endothelial function is just one measure. But that doesn’t mean that we can’t get very good, very actionable information by considering all the studies together – ie, the body of evidence – while properly weighing the strengths and weaknesses of each study. And Dr. Greger has supplied lots of ways in which eating animal products are unhealthy. In other words, far more than just endothelial function has been addressed.

          I took some time to think about your ketogenic diet scenario. But in the end, I didn’t find it compelling at all. First, it is my understanding that people who go on the diets you describe are often losing weight, at least at first. And anyone who looses weight gets better cholesterol readings. But that doesn’t mean that that person is any healthier. In other words, you can have healthier stats/numbers on paper and be more unhealthy if say, you are losing weight (and getting better cholesterol numbers) for unhealthy reasons. Dr. Greger has a video somewhere where he lists all the ways in which cholesterol numbers can go down and those reasons include various diseases. In other words, your statement that their number improvements is proof of improved health is not in and of itself compelling to me.

          Second, we have some good reason to believe that such diets are very unhealthy long term, even if people are losing weight and getting better say cholesterol numbers short term. In other words, even if you wanted to argue that those people are marginally better off short term, I think most people would only consider a diet to be healthy if it is good for them long term. But I don’t think you can argue that a ketogenic diet is healthful even short term. Here is a post from Rami showing the incredible evidence we have against ketogenic diets even short term:
          http://nutritionfacts.org/video/fighting-inflammation-in-a-nut-shell/#comment-1093732992
          Having better cholesterol numbers is not worth say, “significant drop in cognitive performance”, etc.

          I understand that you are hoping that Dr. Greger will jump in here with his reply. I think the set of videos on this site are already an answer to your post, but for your sake, I hope he does answer you. (I.e, I’m not trying to come between you and Dr. Greger. Just conversing with you myself.)




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            1. Sorry everybody. Here is the original post under the proper login.
              ——————
              Andrey: Thank you for your nice response. I appreciate it.

              I agree that probably all studies have various flaws. And that endothelial function is just one measure. But that doesn’t mean that we can’t get very good, very actionable information by considering all the studies together – ie, the body of evidence – while properly weighing the strengths and weaknesses of each study. And Dr. Greger has supplied lots of ways in which eating animal products are unhealthy. In other words, far more than just endothelial function has been addressed.

              I took some time to think about your ketogenic diet scenario. But in the end, I didn’t find it compelling at all. First, it is my understanding that people who go on the diets you describe are often losing weight, at least at first. And anyone who loses weight gets better cholesterol readings. But that doesn’t mean that that person is any healthier. In other words, you can have healthier stats/numbers on paper and be more unhealthy if say, you are losing weight (and getting better cholesterol numbers) for unhealthy reasons. Dr. Greger has a video somewhere where he lists all the ways in which cholesterol numbers can go down and those reasons include various diseases. In other words, your statement that their number improvements is proof of improved health is not in and of itself compelling to me.

              Second, we have some good reason to believe that such diets are very unhealthy long term, even if people are losing weight and getting better say cholesterol numbers short term. In other words, even if you wanted to argue that those people are marginally better off short term, I think most people would only consider a diet to be healthy if it is good for them long term. But I don’t think you can argue that a ketogenic diet is healthful even short term. Here is a post from Rami showing the incredible evidence we have against ketogenic diets even short term:
              http://nutritionfacts.org/video/fighting-inflammation-in-a-nut-shell/#comment-1093732992
              Having better cholesterol numbers is not worth say, “significant drop in cognitive performance”, etc.

              I understand that you are hoping that Dr. Greger will jump in here with his reply. I think the set of videos on this site are already an answer to your post, but for your sake, I hope he does answer you. (I.e, I’m not trying to come between you and Dr. Greger. Just conversing with you myself.)




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          1. Isn’t endothelial dysfunction and inflammation more important than
            cholesterol levels? I have always understood cholesterol is a “patch”,
            so it is higher when/where something needs repair, like the arteries,
            for example.




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            1. dorange: I’m not an expert, but I can say that cholesterol levels are only one part of the bigger picture. So, to some degree, I agree with you. But cholesterol levels really do matter for heart health since the one key ingredient people need to have heart attacks is the build up in the blood: ie: from the Editor in Chief of the American Journal of cardiology, “As shown in Figure 1, most of the risk factors do not in themselves cause atherosclerosis…The atherosclerotic risk factors showing that the only factor required to cause atherosclerosis is cholesterol.”
              Figure 1: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3603726/figure/F1/
              Full text: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3603726/

              Again, I’m not an expert, but I also wanted to address your comment about a “patch” and higher = needs repair. It is my understanding that those analogies generally refer to the “good” or HDL type of cholesterol, not the LDL. I could be wrong about that. But either way: People are generally heart-attack proof with a total cholesterol below 150 and LDL below 70. So, I think even if the patch idea is somewhat relevant, that doesn’t mean that we can dismiss the importance of cholesterol levels for heart health.

              The question/point I was addressing above was that cholesterol levels can be brought down multiple ways and not all of them are healthy. If cholesterol levels are brought down in unhealthy ways (like through a ketogenic diet), you could be trading one problem for a host of worse ones. What do you think?




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              1. Thanks for the links, Thea.
                It seems there’s enough evidence that SFAs consumptions after a meal stay longer in the blood than MUFAs and PUFAs. Changes in my diet towards a WFPB made not only my cholesterol levels drop (including HDL), but also had my inflammation markers drop to the “ideal” levels (except fibrinogen). I don’t know which came first, but am feeling much better this way!




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                1. dorange: re: “Changes in my diet…” Great story! I never seem to tire of hearing stories about how people have changed their lives in such positive ways by changing to WFPB eating. Thanks for sharing!




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  23. Hey @disqus_wnYOIlS4ks:disqus and the rest! I think you should bring up the subject of pathogens and cholesterol in a video!

    Here’s the reasoning; when we get high cholesterol, the immune system attacks the fatty streaks, but unfortunately it doesn’t do a very good job at this
    “A key event in atherosclerosis is a maladaptive inflammatory response to subendothelial lipoproteins”
    http://www.ncbi.nlm.nih.gov/pubmed/19960040

    It seems the body is not evolved to handle high cholesterol, so the response i maladaptive, and the inflammation that was supposed to remedy the situation makes it worse.

    Hunter/gatherers have low cholesterol, so it is understandable that we did not evolve to high cholesterol;
    “The normal low-density lipoprotein (LDL) cholesterol range is 50 to 70 mg/dl for native hunter-gatherers, healthy human neonates, free-living primates, and other wild mammals (all of whom do not develop atherosclerosis). ”
    http://www.ncbi.nlm.nih.gov/pubmed/15172426

    They have low cholesterol despite eating meat and saturated fat.

    It seems like many parasites and bacterial infections can lower the cholesterol of the host. Here is one example:
    “Giardiasis is the most common waterborne disease in human, which is caused by an enteric flagellated protozoan Giardia lamblia. […] Because Giardia is unable to synthesize cholesterol it obtains the same from upper small intestine”
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1142336/

    This explains why high cholesterol results in such a bad response. With improved hygiene, we lack the pathogens to keep our cholesterol down when eating meat.

    The implication is that with our current lifestyle with improved hygiene, eating saturated fat is not a good choice.

    I think this is something overlooked in the discussion about meat. It seems few vegans mention this connection, which would be the answer to the question “how can it be bad for us when we have eaten it for millions of years?”




    1
      1. Cool, I was thinking especially about the evolutionary perspective and how it explains how high saturated fat consumption today is detrimental despite it being part of a more ancestral diet. Thanks!




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  24. I am dumbfounded by learned debates with paleo friends (low carb, high fat, ketogenic). I have come to the conclusion “for argument sake” that LCHF is a viable alternate “reality” (and that only excess calories and processed foods are causes of epidemics) for otherwise I must investigate and untangle every counter-article and conflict of interest. Dr Greger, could you imagine debating with some high-fatter in segments (argument, counter-argument x2, investigate, repeat)? How can there be such disconnect? Is there intentional deception and manufactured doubt a la climate change denial? Who are the Koch brothers of nutrition?




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  25. Fantastic video. Thank you! I just learned of this report, issued by Credit Suisse, capitalizing on the trending demand for animal fat as an investment opportunity. This needs wide exposure and debunking. Maybe a video going through this point-by-point…I would post and share widely within my industry (plant-based ecosystem-enhancing land investment) https://www.credit-suisse.com/us/en/news-and-expertise/economy/articles/news-and-expertise/2015/09/en/fat-the-new-health-paradigm.html?aa_cmp=socm_coco_fb_s00333




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  26. After lunch which consisted of a double-decker cheeseburger top with a fried egg, French fries and a beer I had a VT (Ventricular Tachycardia). This VT of 227 lasted for 40+ minutes. After a heart MRI it was decided to implant a ICD (Implantable Cardioverter Defibrillator). The Cardiologist thought I would never get shocked and maybe this VT was a one-time occurrence. 9-Days after implant, I ate an entire pizza and a beer and you guessed it another VT and the ICD shocked me. This time my heartrate went from 60 bpm to 250bpm. I no longer have fatty meals and haven’t had alcohol since. Is this related to article ?




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  27. How about ALGAE-BASED DHA as an “isolated plant fat” affecting arteries? I know you are a fan. Is there a certain threshold amount it doesn’t meet?




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  28. How much fat (even non-isolated) is detrimental? Are the 10/10/80 principles irrefutable? Is there any problem to go from 10% to 20-25% fat?




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  29. It seems that the assumption that only isolated plant fats have the effect is just that – an assumption. Have high-fat whole food meals *actually* been tested in regard to epithelial function? Of course the fiber will slow absorption, but the sheer amount of fat is going to get into the blood and is still going to have the same effect.




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  30. Sure, the endothelium is temporarily impaired by fat. But is it actually damaged by fat? I think that is the the bigger question, since a healthy endothelium protects against atherosclerosis.




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  31. Have there been any reversals of aortic stenosis on a purely plant based diet (with no added oil)? I have heart valve disease.




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  32. Hi Lisa: to maybe answer your question I would suggest the work of Dr. Caldwell Esselstyn. I am quoting from the summary available at https://nutritionfacts.org/topics/dr-caldwell-esselstyn/ :
    “Dr. Esselstyn is best known for his landmark clinical study and follow-up book (Prevent and Reverse Heart Disease) involving patients with advanced heart disease from his practice as a heart surgeon at the Cleveland Clinic. He put the patients on a low-fat, whole-food plant-based diet. All of those who followed the diet experienced significant improvement, in some cases actual reversal of near end-stage heart disease”
    I hope this helps, have a great day.




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  33. Also, on 10 March, an action that had been brought before the US District
    Court for the Southern District of New York by
    Rothschild was settled by LED maker Philips Lumileds of San Jose,
    CA, USA, giving the firm a non-exclusive license.




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  34. How about coconut oil, unprocessed, centrifugal extraction? Also, does the bodies ability to digest fats come in to play. If my liver is creating enough bile is this a problem for me?




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  35. John,

    I just heard an interesting reply by Joel Kahn MD on this subject yesterday…. In essence oils should be considered just that, a refined food and be avoided or limited significantly, as both an extra unnecessary caloric source and because of there limited nutrient density.

    The emphasis on the heart disorders consistently seems to be that the addition of coconut oils and/or other oils, regardless of how they are processed is another addition of a processed food to be avoided. His and Dr. Esselstyn’s approaches very much mirror these statements.

    With that said remember you will be getting oils from nuts and seeds along with avocados, as an example of non-refined intake.

    Dr. Alan Kadish moderator for Dr. Greger http://www.Centerofhealth.com




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  36. Jason,

    The paper quoted is about those with “Intra-arterial infusion in treatment of obliterating atherosclerosis of the lower extremities” a preexisting medical condition that would be exacerbated by a number of insults….such as the referred to carbohydrates, hormones, lower perfusion rates due to decreased vessel size and the list goes on.

    For a deeper dive into what tests and measurements mean and are available…..see:wiki/Endothelial_dysfunction and recognize that this is still an art with science not at the 100% level of accuracy.

    The takeaway is that situation for these individuals from the 1977 study probably had only little correlation with the references to the “healthy” populations quoted in Dr. Greger’s video. Will there be additional influences to endothelial fucntion ….absolutely.

    Dr. Alan Kadish moderator for Dr. Greger http://www.CenterofHealth.com




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  37. While yours is an interesting question, Ryo, I could find no specific research back up the idea that fatty meals are related to baldness. Yes, fatty meals affect arteries, but blood flow doesn’t appear to be a major reason for baldness. Most baldness is caused by hereditary hair thinning with diet seen as only a minor cause and this is due to either low iron, thyroid or protein.
    See: Int J Trichology. 2015 Oct-Dec;7(4):156-66. doi: 10.4103/0974-7753.171573.
    A Marine Protein-based Dietary Supplement for Subclinical HairThinning/Loss: Results of a Multisite, Double-blind, Placebo-controlled Clinical Trial.

    J Am Acad Dermatol. 2006 May;54(5):824-44.
    The diagnosis and treatment of iron deficiency and its potential relationship to hair loss.
    • Inadequate protein or iron in the diet, or eating disorders such as anorexia and bulimia.
    Certainly you want to avoid fatty meals because they lead to all sorts of health problems, including artery impairment, as you’ve noted, but baldness there doesn’t seem to be research showing a direct link between a high fat diet and baldness. .
    Good whole food plant-based diets can help your skin and hair look better, but alas it may not be prevent you from surcombing to heriditary baldness.




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  38. Hi Ryo and this is Dr. Daniela Sozanski PhD and Moderator with nutritionfacts. The answer to your question is yes, as you probably noted in own experience.
    There are several reasons, all working synergistically. First is that a big meal will keep the body occupied with digestion for a long time, therefore, in energy saving mode, the parasympathetic system signals the body to slow down and focus on digestion; second the starches and sugars that usually accompany a big meal call for an insulin spike which in turn calls for production of neurotransmitters such as serotonin and the hormone melatonin… these substances also have the calm down effect; the spike of insulin is naturally followed by a sugar low, which also causes sluggishness; finally the psychological effect of being in a safe environment, on a short break from work, surrounded by people we love, may also cause calm and relaxation. I hope this helps, Daniela




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