Optimal Phytosterol Dose

Optimal Phytosterol Dose
5 (100%) 5 votes

Those eating plant-based diets get the most phytosterols, but there’s still room for improvement to maximize cholesterol reduction.

Discuss
Republish

If our enterocyte trash recovery bins are half-filled with phytosterols, might vitamins get crowded out, too? We didn’t know, until last year. But the answer is no, even with a whopping nine-gram dose. Vitamin absorption was unaffected. Plant stanols dose-dependently decrease bad cholesterol concentrations, but not antioxidant concentrations in our blood.

Now, nine grams is like ten times what we would expect from even a healthy diet. There’s a plateau effect. At that nine grams a day, you’re way out here at the end; but, as you can see, the cholesterol-lowering curve starts to flatten out at about two.

So, we can pretty much maximize cholesterol-blocking at around two grams—2000 milligrams. The Standard American Diet has been measured as low as 78 milligrams a day.

Here’s like a model American Heart Association diet, and this is how high folks get eating a plant-based diet—higher than any other diet pattern reported. That could get you a good five percent cholesterol reduction. But there’s definitely room to bump that up further, if necessary.

Those who have improved their diet so much they’re no longer eating any cholesterol should be acing their cholesterol tests. But, in rare cases, your body might not be able to get rid of enough endogenous production. And so, doubling phytosterol intake could easily double LDL reduction down to ten percent, which could double heart disease risk reduction.

In terms of whole foods sources to maximize cholesterol reduction, seeds provide the most (especially sesame), then nuts (especially pistachio), then legumes (like peanuts).

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 Kerry Skinner.

Please consider volunteering to help out on the site.

Images thanks to: Dbenbenn, Zscout370, Jacobolus, Indolences, and Technion via Wikimedia

If our enterocyte trash recovery bins are half-filled with phytosterols, might vitamins get crowded out, too? We didn’t know, until last year. But the answer is no, even with a whopping nine-gram dose. Vitamin absorption was unaffected. Plant stanols dose-dependently decrease bad cholesterol concentrations, but not antioxidant concentrations in our blood.

Now, nine grams is like ten times what we would expect from even a healthy diet. There’s a plateau effect. At that nine grams a day, you’re way out here at the end; but, as you can see, the cholesterol-lowering curve starts to flatten out at about two.

So, we can pretty much maximize cholesterol-blocking at around two grams—2000 milligrams. The Standard American Diet has been measured as low as 78 milligrams a day.

Here’s like a model American Heart Association diet, and this is how high folks get eating a plant-based diet—higher than any other diet pattern reported. That could get you a good five percent cholesterol reduction. But there’s definitely room to bump that up further, if necessary.

Those who have improved their diet so much they’re no longer eating any cholesterol should be acing their cholesterol tests. But, in rare cases, your body might not be able to get rid of enough endogenous production. And so, doubling phytosterol intake could easily double LDL reduction down to ten percent, which could double heart disease risk reduction.

In terms of whole foods sources to maximize cholesterol reduction, seeds provide the most (especially sesame), then nuts (especially pistachio), then legumes (like peanuts).

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 Kerry Skinner.

Please consider volunteering to help out on the site.

Images thanks to: Dbenbenn, Zscout370, Jacobolus, Indolences, and Technion via Wikimedia

Doctor's Note

Are there diminishing returns associated with other phytonutrients? See Maxing Out on Antioxidants, and Kiwifruit and DNA Repair. The “enterocyte trash recovery bins” of which I speak are an analogy I introduced in How Fiber Lowers Cholesterol—the second of a loose five-part series on the cholesterol-lowering effects of nuts and seeds (see Nuts and Bolts of Cholesterol Lowering). How Phytosterols Lower Cholesterol offers a bit of phytosterol background, and Optimal Phytosterol Source explains why whole food sources (nuts and seeds) are superior to phytosterol-fortified foods and supplements. Which other foods lower cholesterol levels? See New Cholesterol Fighters. And, why should one worry about cholesterol in the first place? See Blocking the First Step of Heart DiseaseCholesterol and Lower Back PainCholesterol and Female Sexual Dysfunction; and Heart Attacks and Cholesterol: Purely a Question of Diet. I also have dozens of other videos on cholesterol

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

73 responses to “Optimal Phytosterol Dose

Commenting Etiquette

The intention of the comment section under each video and blog post is to allow all members to share their stories, questions, and feedback with others in a welcoming, engaging, and respectful environment. Off-topic comments are permitted, in hopes more experienced users may be able to point them to more relevant videos that may answer their questions. Vigorous debate of science is welcome so long as participants can disagree respectfully. Advertising products or services is not permitted.

To make NutritionFacts.org a place where people feel comfortable posting without feeling attacked, we have no tolerance for ad hominem attacks or comments that are racist, misogynist, homophobic, vulgar, or otherwise inappropriate. Please help us to foster a community of mutual respect. Enforcement of these rules is done to the best of our ability on a case-by-case basis.

  1.  Are there diminishing returns associated with other phytonutrients? See Maxing Out on Antioxidants and Kiwifruit and DNA Repair. The “enterocyte trash recovery bins” of which I speak are an analogy I introduced in How Fiber Lowers Cholesterol, the second of a loose five-part series on the cholesterol-lowering effects of nuts and seeds. Yesterday’s video-of-the-day How Phytosterols Lower Cholesterol offered a bit of phytosterol background and tomorrow’s video-of-the-day Optimal Phytosterol Source explains why whole food sources (nuts and seeds) are superior to phytosterol-fortified foods and supplements. Which other foods lower cholesterol levels? See New Cholesterol Fighters. And why should one worry about cholesterol in the first place? See Blocking the First Step of Heart Disease, Cholesterol and Lower Back Pain, Cholesterol and Female Sexual Dysfunction, and Heart Attacks and Cholesterol: Purely a Question of Diet, a few of the five dozen videos I have on the topic. Then, of course, there’s a thousand other topics—enjoy!




    0
    1. It looks like Chocolate has the best Beta-Sitosterol (Black part of bar graph) to total sterol content ratio.
      ;-}
       
      This is what we want because it is the Beta-sitosterols that have been well know to reduce cholesterol levels.  Here is a link to one of them but there literally are over a hundred of these articles.
      http://www.ncbi.nlm.nih.gov/pubmed?term=Woodgate%20D%2C%20Chan%20CH%2C%20Conquer%20JA.%20Cholesterol-lowering%20ability%20of%20a%20phytostanol%20softgel%20supplement%20in%20adults%20with%20mild%20to%20moderate%20hypercholesterolemia.%20Lipids.%202006%3B41%3A127-132 

      In fact I have used Beta-Sitosterols to not only reduce cholesterol but Benign prostatic hypertrophy (BPH) between 2-5 grams per day. I have had mixed results with the BPH and Beta Sitosterol usage though.

      But why take a pill when you can eat Vegan?!

      Especially, Chocolate!!

      ;-}

      One caveat, however, is the fat you eat is the fat you wear–so if you go overboard of the nuts and seeds you might start to look like one–that unsvelte pear shape.




      0
      1. Literally – If you are fat because of eating pork, lard, butter, cheesefat, trans fatty acids, bacon etc – that is what you will find on your belly in the fat cells – yikes….




        0
    2. When I eat walnuts and seeds like pumpkin and sunflower, i get serious pain, diarhea and fever.  What is the next best way to go for phytosterols and omega 3?




      0
    3. While searching for my favorite plant phytosterol package, Soybeans, which were not included in this nut and seed survey ;-( I found out, sadly, that 100g of Soybeans only contain 50 grams of Phytosterols, lower than the lowest of the low in this study Brazil Nuts.  http://nutritiondata.self.com/facts/vegetables-and-vegetable-products/2621/2,
      but I also came across this fantastic study:

      “A single daily dose of soybean phytosterols in GROUND BEEF decreases serum total cholesterol and LDL cholesterol in young, mildly hypercholesterolemic men”
      http://www.ajcn.org/content/76/1/57.short

      You’ve heard of Tofurkey but how about Tofeef.
      ;-}




      0
      1. Egg-yolk years – I like that!

        As a doctor I always ask my patients about alcohol consumption and tobacco – maybe I will start asking about egg-yolk abuse…..




        0
      1. There is lots of evidence showing that egg yolk cholesterol need not be harmful. However given the average appalling Western diet where atherosclerosis has commenced at a young age and lots of animal fats are consumed, then egg yolks add insult to injury. The comparison with cigarettes is invalid except in a trivial total correlation. The causative factors and contexts are quite different.
        In some cases egg yolks may improve health by adding to low cholesterol or adding much needed choline. Cigarettes never improve health. Sofie was quite right in decrying the incorrect use of total correlations being used to equate cigarettes with cholesterol.
        There is a total correlation of gasoline consumption with road deaths by country, but gasoline does not cause road accidents.
        The equation of cholesterol with cigarettes is pure vegan propaganda although I would still avoid them in most cases.




        0
        1. I understand your point, R Ian Flett.  Maybe the message about the harmful effects of eggs was not made very eloquently in the original video or article. Still, for the most part it seems that staying away from egg yolks makes a lot of empirical and nutritional sense.




          0
        2. R Lan Flett, there is not “lots” of evidence showing egg yolk being unharmful. In fact, there is only one study showing this, funded by the egg industry. The egg industry has claimed that cholesterol from eggs is not important and is not harmful. The fundamental flaw
          in the study the egg industry has used to make this claim is that they measured fasting   lipid levels at night and not levels through out the day after egg consumption. “Diet is not all about fasting lipids; it is
          mainly about the three-quarters of the day that we are in the nonfasting state. Fasting lipids can be thought of as a baseline; they show what the endothelium was exposed to for the last few hours of the night.”

          http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2989358/?tool=pubmed




          0
          1. The issue of dietary cholesterol versus endogenous cholesterol (from the liver) has been debated for decades in hundreds of papers. Shellfish were on the nose for years until their cholesterol was found to be relatively harmless – if not beneficial. The jury is still out on dietary cholesterol because it’s all very complicated. Some people cope with lots of dietary cholesterol and others don’t, depending on many other variables. Cholesterol is critically important to the body and some people don’t produce enough – including some on statins. The various cardiology institutions issue regular bulletins on this and their recommendations wax and wane, but currently at least two eggs per week are considered safe by most institutions. I eat none, despite having my arteries checked and being totally clean. Basically, I agree with Dr Greger that most animal products are nutritionally damaged during processing – purely for profit.
            There is a big difference between being a committed Vegan for ethical reasons and practising VeganISM, versus adopting an animal product free diet for purely scientific, health reasons as I tend to. The committed Vegan often believes it’s their ethical duty to proselytise and so ‘cherry picks’ their science. This happens a lot in this forum. I respect your ethical choice, but can we please keep the science separate. It’s sounding uncomfortably like the tactics used by fundamentalist, anti-evolutionists. Eggs are not ‘evil’, however they may well be unhealthy in their current supermarket form. It’s not your duty to find fault with them at every opportunity. The gross abuse of statistics in this valuable forum, by some, reveals an excessive emotional commitment that distorts the complex science involved.




            0
            1. I have already posted this elsewhere, but here it is again. Current levels of omega 3 in eggs are highly
              inadequate and one must consume around 30 eggs to reach an acceptable
              level of omega 3 for the day. A male needs around 1.6 grams of omega 3
              per day, a female needs around 1.1 grams a day. Omega 3 processes to
              EPA which is also processed to DHA, which is highly anti inflammatory.
              Omega 6 processes down to arachadonic acid which is highly
              inflammatory. The fact that eggs are the top source of arachadonic acid
              nulls and voids benefits received from the omega 3 in the egg itself.
              High intake of arachadonic acid is linked to autoimmune diseases such
              as  rheumatoid arthritis, ulcerative colitis, as well as a clear link
              with  cancer development.http://www.ncbi.nlm.nih.gov/pubmed?term=20950616[uid]http://www.ncbi.nlm.nih.gov/pubmed/18774339http://www.ncbi.nlm.nih.gov/pubmed/21139128 The
              Harvard physicians study followed 20,000 doctors for 20 years and
              those that ate just one egg a day had significant increase in all cause
              mortality.http://www.ncbi.nlm.nih.gov/pubmed/18400720 In
              fact, David Spence, director of stroke prevention/atherosclerosis
              research center and one of the worlds leading stroke experts, said that
              based on the latest research, you can eat all the eggs you want IF your
              dying of a terminal illness. Eggs are not considered health promoting
              nutritionally speaking.http://www.ncbi.nlm.nih.gov/pubmed/18400699 Eggs have been linked with heart failurehttp://www.ncbi.nlm.nih.gov/pubmed/18954578 As well as type 2 diabetes.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2628696/?tool=pubmed  Furthermore,
              in the Canadian Journal of Cardiology, David Spence, David Jenkins
              (the inventor of the glycemic index) and Jean Davignon (director of
              atherosclerosis research group) posted a review on eggs claiming that
              the egg industry has been downplaying the health risks of eggs through
              misleading advertisements. As soon as you eat one egg, you expose
              your body to several hours worth of oxidative stress, inflammation of
              ones arteries, endothelieum impairment (what keeps you blood running
              smoothly) and increases the susceptibility of LDL cholesterol to
              oxidize (beginning stages of heart disease).http://www.ncbi.nlm.nih.gov/pubmed/21076725http://www.ncbi.nlm.nih.gov/pubmed/9001684If you can provide counter evidence claiming that eggs are beneficial to ones health please do so, but otherwise I see no logic in claiming that eggs are safe to eat twice a week, and to make the statement that we have a dietary need for cholesterol, this is simply untrue.




              0
            2.  I have already posted this elsewhere, but here it is again.

              Current levels of omega 3 in eggs are highly inadequate and one must  consume around 30 eggs to reach an acceptable level of omega 3 for the  day. A male needs around 1.6 grams of omega 3 per day, a female needs  around 1.1 grams a day. Omega 3 processes to EPA which is also processed to DHA, which is  highly anti inflammatory. Omega 6 processes down to arachadonic acid  which is highly inflammatory. The fact that eggs are the top source of  arachadonic acid nulls and voids benefits received from the omega 3 in  the egg itself.

              High intake of arachadonic acid is linked to autoimmune  diseases such
              as  rheumatoid arthritis, ulcerative colitis, as well as a  clear link
              with cancer development.
              http://www.ncbi.nlm.nih.gov/pubmed?term=20950616%5Buid%5D
              http://www.ncbi.nlm.nih.gov/pubmed/18774339
              http://www.ncbi.nlm.nih.gov/pubmed/21139128

              The Harvard physicians study followed 20,000 doctors for 20 years and   
              those that ate just one egg a day had significant increase in all cause mortality.

              http://www.ncbi.nlm.nih.gov/pubmed/18400720
               In fact, David Spence, director of stroke prevention/atherosclerosis research center and one of the worlds leading stroke experts, said that based on the latest research, you can eat all the eggs you want IF your dying of a terminal illness. Eggs are not considered health promoting nutritionally speaking.
              http://www.ncbi.nlm.nih.gov/pubmed/18400699

              Eggs have been linked with heart failure
              http://www.ncbi.nlm.nih.gov/pubmed/18954578
              As well as type 2 diabetes.
              http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2628696/?tool=pubmed  

              Furthermore, in the Canadian Journal of Cardiology, David  Spence,  David Jenkins (the inventor of the glycemic index)  and Jean Davignon  (director of atherosclerosis research group) posted a  review on eggs  claiming that the egg industry has been downplaying the  health risks of  eggs through misleading advertisements. As soon as you  eat one egg,  you expose your body to several hours worth of oxidative  stress, inflammation of ones arteries, endothelieum impairment (what  keeps you  blood running smoothly) and increases the susceptibility of  LDL  cholesterol to oxidize (beginning stages of heartdisease).
              http://www.ncbi.nlm.nih.gov/pubmed/21076725
              http://www.ncbi.nlm.nih.gov/pubmed/9001684

              If you can provide counter evidence claiming that eggs are beneficial to ones health please do so, but otherwise I see no logic in claiming that eggs are safe to eat twice a week, and to make the statement that we have a dietary need for cholesterol, this is simply untrue.
              http://www.nap.edu/openbook.php?record_id=10490&page=542




              0
            3. Allowing the consumption of eggs even twice a week does not make sense to me one it is understand what health detriments come with egg consumption.

              current levels of omega 3 in eggs are highly inadequate and one must
              consume around 30 eggs to reach an acceptable level of omega 3 for the
              day. A male needs around 1.6 grams of omega 3 per day, a female needs
              around 1.1 grams a day. Omega 3 processes to EPA which is also processed
              to DHA, which is highly anti inflammatory. Omega 6 processes down to
              arachadonic acid which is highly inflammatory. The fact that eggs are
              the top source of arachadonic acid nulls and voids benefits received
              from the omega 3 in the egg itself. High intake of arachadonic acid is
              linked to autoimmune diseases such as  rheumatoid arthritis, ulcerative
              colitis, as well as a clear link with  cancer development.http://www.ncbi.nlm.nih.gov/pubmed?term=20950616%5Buid%5D
              http://www.ncbi.nlm.nih.gov/pubmed/18774339
              http://www.ncbi.nlm.nih.gov/pubmed/21139128

              The
              Harvard physicians study followed 20,000 doctors for 20 years and
              those that ate just one egg a day had significant increase in all cause
              mortality.
              http://www.ncbi.nlm.nih.gov/pubmed/18400720

              In
              fact, David Spence, director of stroke prevention/atherosclerosis
              research center and one of the worlds leading stroke experts, said that
              based on the latest research, you can eat all the eggs you want IF your
              dying of a terminal illness. Eggs are not considered health promoting
              nutritionally speaking.
              http://www.ncbi.nlm.nih.gov/pubmed/18400699

              Eggs have been linked with heart failure
              http://www.ncbi.nlm.nih.gov/pubmed/18954578

              As well as type 2 diabetes.
              http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2628696/?tool=pubmed

              Furthermore,
              in the Canadian Journal of Cardiology, David Spence, David Jenkins
              (the inventor of the glycemic index) and Jean Davignon (director of
              atherosclerosis research group) posted a review on eggs claiming that
              the egg industry has been downplaying the health risks of eggs through
              misleading advertisements. As soon as you eat one egg, you expose
              your body to several hours worth of oxidative stress, inflammation of
              ones arteries, endothelieum impairment (what keeps you blood running
              smoothly) and increases the susceptibility of LDL cholesterol to
              oxidize (beginning stages of heart disease).
              http://www.ncbi.nlm.nih.gov/pubmed/21076725
              http://www.ncbi.nlm.nih.gov/pubmed/9001684

              The
              egg industry has claimed that cholesterol from eggs is not important
              and does not raise cholesterol levels. The fundamental flaw in the study
              the egg industry has used to make this claim is that they measured
              FASTING lipid levels at night and not levels through out the day after
              egg consumption. “Diet is not all about fasting lipids; it is mainly
              about the three-quarters of the day that we are in the nonfasting state.
              Fasting lipids can be thought of as a baseline; they show what the
              endothelium was exposed to for the last few hours of the night.”
              http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2989358/?tool=pubmed

              In addition, there is no dietary need to consume cholesterol, this is simply nonsense to make such an assertion.
              http://www.nap.edu/openbook.php?record_id=10490&page=542
               




              0
      1. I am astounded that someone who would be intelligent enough to be
        reading Dr. Greger would be myopic enough to through the baby out with
        the bath water, and throw scientific research out with it. In
        Psychology, we call that cognitive dissonance.




        0
  2. Very interesting. After the previous video, “How Plant Sterols Lower Cholesterol, I had been wondering whether, as a conscientious vegan (plants, beans/legumes, grains, seeds/nuts, fruits, no processed oils or sugar) I was running a risk of flushing out too much cholesterol. Thanks, SJ M.D., for your response. And now from today’s video, I gather that there is no such thing as having too much cholesterol flushed out of your body? 




    0
  3. The table of best food sources is confusing to me.Could you explain the grey/black portions of the individual lines – what do they signify individually. I see where pumpkin seed looks so unlike the other sources. I’ve been eating walnuts like there is no tomorrow but now feel I should switch to sesame seed.




    0
    1. @Ellen, perhaps consider rotating these good nuts and seeds instead of only eating walnuts? I usually alternate organic raw pumpkin seeds with walnuts from day to day for a snack or in a salad and perhaps I need to also rotate in sesame seeds (which I adore, I just don’t eat them that regularly but heck, they are easy to throw into a green salad!)




      0
    2.  The black part of the bars represents the amount of beta-sitosterol plus campesterol plus stigmasterol, the three most common type of plant sterols, and so, often the only ones that are measured and reported. The grey bars represent other rarer forms of sterols which are not commonly reported.

      This chart is limited to the amount of sterols in mostly nuts and seeds and by the weight of the food, about 3 1/2 ounces- more nuts and seeds than is healthy to eat in one day.

      I’d be more interested in the amount of phytosterols we can get on a per calorie basis. In that case, lettuce, capers and sour pickles would be the top choices, followed by sesame seeds with asperagus, beet greens and unpeeled cucumbers not far behind, nosing out sunflower seeds.Okra, cauliflower, bamboo shoots, lemons, beets, Brussels sprouts, grapefruit, sprouted mung beans, tomatoes, oranges, pumpkin, cabbage, sweet peppers and radishes are also decent sources for the calorie-conscious.

      I’m also concerned that most nuts and seeds may throw of your omega 6/3 ratio and that they’re highly concentrated in calories. Seems to me that veggies are a better option.




      0
      1.  Paulc: Nice reply.  I’m wondering where you got your data for the amount of phytosterols in various plants.  For example, how did you figure out that “…lettuce, capers and sour pickles would be the top choices…”  I’m interested in trying to understand how all of this translates into practical eating and seeing a table with the data you are talking about coold be really helpful.  Thanks.




        0
        1.  Hi Thea, did you know your name is Greek for “Goddess?” I used the search tool for nutritiondata.com but I’m not sure about the accuracy of all foods. It seems to me that some foods are rated at zero phytosterols because there was no data on them at the time, but which may actually be rich sources. I’m looking for alternative sources of information.




          0
        2.  Hi Thea, looks like my previous reply to you didn’t take. I got the info from nutritiondata.com, using the search tool. Trouble is that some food items that are good phytosterol sources are listed as having zero because their value was unknown. So, I’m looking for a more up to date reference.

           I don’t know how this all works out in practical terms since it appears that we need at least two grams, it may not be very easy to get that much from diet alone. So, I think it best to avoid cholesterol in foods- which all vegans do anyway, and to concentrate on veggies including salads, fruits, some legumes and just a few servings of whole grains with occasional nuts and seeds.

          http://www.raysahelian.com/phytosterols.html promotes taking phytosterol supplements but some people have reported disturbing side effects. And you would have to take quite a number of pills to get two grams.




          0
      2. I find your calorie interest so fascinating. Since tweaking my diet I find I can’t get enough calories. If I don’t include nuts and seeds in my diet I end up losing weight. 




        0
        1.  I imagine you’re very physically active so that you can get away with eating a few nuts and seeds. I tend to gain weight with them and have to be careful and have to diet a couple or three days a week to avoid gaining weight.




          0
              1. Well actually no. 60 minutes of cardio is the best. (on most days)  The heart loves to beat at a moderate training rate for a prolonged time. 

                http://nutritionfacts.org/topics/exercise/

                But what I tell my patients is that if it gets you moving its good. What is your high intensity work out? You get your HR up high (180 ) and hold it there for how long? 




                0
              2. And strengthening exercises of course. (bodyweight exercises?). I think stretching is kinda overrated unless you have a joint with a decreased range of motion. There is actually quite a bit of research that demonstrates stretching might encourage injury. Plus who has that kind of time! 




                0
        1. According to Dr. Greger’s gluten videos, unless one has a gluten allergy or intolerance gluten should not be an issue. If gluten is an issue, luckily there are other items that one can pick from the chart.

          Gluten IS good for 99% of people (but not for the 1% who have celiac disease):
          http://nutritionfacts.org/video/is-gluten-bad-for-you/

          In fact, if there is no good medical reason to go gluten free; it may even be bad for an individual’s good gut bacteria to go gluten free:
          http://nutritionfacts.org/video/update-on-gluten/




          0
          1. Sorry, but there is lots of evidence that the extra gluten bred into the endosperm of modern grains is a low level problem for many people irrespective of whether they are technically ‘gluten intolerant’.
            The amount of gluten now consumed is much higher than any traditional grain diet over the past thousands of years. Obviously I made the post to warn those who had a known gluten problem, but were unaware that wheat germ is one of the highest sources. Gluten intolerance is much higher than 1% and you don’t have to have celiac desease to have a problem with it. I also never used the words “gluten free”.




            0
            1. Maybe I missed it in some other part of this discussion/thread, but given the brevity of your initial comment in this thread (the one after Paulc’s comment), I don’t think your intention was obvious at all. In any case, I was simply pointing out Dr. Greger’s videos on gluten since you raised the topic of gluten. (To be clear, I never attributed the term “gluten free” to you. “Gluten free” is term that I used to summarize the second video that I referenced.) 

              I look forward to learning more about the wheat/gluten issue as more empirical information about it rolls out.  At the moment, it seems to me to be a bit over-hyped.  I think that in due time, science will reveal more, but for now I think the science on the matter is still too young to be broadly applicable (or, at least, applicable to me).




              0
              1. Hi Wholefoodchomper

                So I have spent the last 1/2 hour looking for this research article but I can’t find it. So you have to take my word for it. One of my patients is a gastroenterologist. He knows gluten gives me a stomach ache and fatigue. So he gives me this article from JAMA published 2011 (I think) regarding gluten intolerance. 

                The message was that there are people who are not actually testing positive for celiacs but have symptoms. The bottom line was to do an elimination diet and challenge gluten after 6 weeks. And then to be careful because it is in a lot of processed foods as thickeners. It even went so far as to suggest a diet. 

                I can’t tell you how refreshing it was to read the research article. Was the medical profession finally coming on board? Was my patient finally going to address it and stop recommending the “little purple pill?” 




                0
                1. Thanks for sharing the info, veganrunner. If you happen to find that JAMA citation, could you please share it with me. (Do you remember any key words in the title? Maybe I could do some research on my end as well.)

                  I have had the Celiac blood test done, and I’m in the clear. Thankfully, I don’t experience any symptoms after eating wheat either. (Although, I know that there are people who do, and I do not mean to discount their experiences.) Still, I would like to read about it to learn some more. Heck, I may even try the elimination diet to see if I feel better in some way.




                  0
  4. So are pistachios, almonds, pine nuts, macadamia nuts, and cashews all better to eat instead of walnuts to lower cholesterol?  I’m a bit confused.  I thought walnuts were the magic nuts to pop.




    0
    1. We have to see the bigger picture – as well as there are no magic pill to cure the diseases from the SAD (and european) there are no single nut, seed, vegetable, fruit, legume, nutrient etc who will do the trick. The message is to eat a variety of plant foods, not just one kind of nut, one kind of vegetable etc.

      So eat a variety of plant foods and avoid meat, eggs and dairy – my advice would be to enjoy the great taste of plant food, and stop thinking that this nut lowers cholesterol, this vegetable lowers the risk of cancer, this berry fights infection – this way of thinking spoils the pleasure of eating great tasting plant foods.




      0
    2.  Walnuts are promoted for their omega-3 content, so the phytosterols are just a bonus. Flax seeds also a good source as Dr. Greger has noted in several videos.




      0
  5. Maybe you help me check some studies on guggul. It’s the main Ayurvedic herb for “cholersterol” (and arthritis). There are other herbs that have cataloged phytosterols but who knows if they matter ; they are more used for other conditions. Ashwanganda is also sometimes used for cholesterol. As far as grains, I’d guess barley is best for this, and it’s also recommended by Hippocrates for the summer.




    0
  6. Reading some of these posts, I have formed the impression that many vegans are unclear on how many nuts we can consume before exceeding guidelines. To remedy this problem, I am performing a calculation below on how many walnuts a day someone on a 2000 calorie diet can consume before they would exceed the Institute of Medicine recommendations.

    The Institute of Medicine recommends that adults get 20 to 35% of calories from fat. Source: http://www.iom.edu/Reports/2002/Dietary-Reference-Intakes-for-Energy-Carbohydrate-Fiber-Fat-Fatty-Acids-Cholesterol-Protein-and-Amino-Acids.aspx
     
    For this calculation I am assuming that the fat contribution of grains, fruits, legumes  and most vegetables are generally so low that they make a negligible contribution to our daily fat intake; correction for these sources of fat should not alter my calculation substantially. 

    Let’s adopt the upper limit of 35% set by the Institute of medicine and see how many walnuts that equals. 
     
    For a 2000 calorie diet this amounts to 2000 x 0.35 = 700 calories from fat. 

    Since fat has 9 calories per gram, therefore, 700 calories of fat equals 78 grams of fat.

    Since each ounce of walnut has 18 grams of fat, the number of ounces of walnuts we can eat is 78g / 18 g = 4.3 ounces.

    Please note that 4.3 oz of walnuts equals 120 grams of walnuts, which is just over one cup.

    Please also note that saturated fat for this serving would be around 7 grams, which is 36% of daily value, well within guidelines.

    Of course, some of us have higher calorie needs due to our energy output. Therefore, the number of nuts that we can eat would go way up!

    I am not suggesting that we get all our fat from eating walnuts. I simple want to give people an idea of how many nuts one can eat before exceeding standard recommendations.




    0
    1. The problem is that the “recommendation” of 35% of calories from fat is hopelessly wrong; the same guidelines accept 10% of the calories from refined sugar! If you want to stay healthy – wich nature intended – it is 10% calories from fat and 0% calories from refined sugar.




      0
      1. Actually nature doesn’t have any intentions, nor does evolution. Neither nature nor evolution take sides on dietary issues. 
        If we humans want to optimize our diets, then we have to understand the underlying physiological mechanisms that are relevant to nutrition and adjust our diet accordingly.
        By all means, go ahead and challenge the standard recommendations on fat, but I think you would be more convincing to readers of this website if you backed up your claims with peer reviewed scientific studies.




        0
        1. BPCveg, I like your physiological perspective. I’m also quiet wary of evolutionary explanations or justifications based on nature (whether they are for plant-based eating or not).  

          Historically (and possibly nutritionally) speaking, much harm  has been justified using this sort of logic and reasoning. As far as I am concerned, appeals to evolutionary and natural explanations are a slippery slope.  Sticking to the empirical evidence and physiological reasoning, is the way to go.




          0
    2. Wow that’s a lot! Nuts and seeds are probably pretty close in calories so 1 cup of seeds and nuts per day. That would be really hard to do and I eat them both everyday. I have sesame, hemp, flax, sunflower, chia in the fridge and I use probably 2 Tbs in either my oatmeal or smoothy depending on which I feel like. Then throughout the day I may have walnuts, almonds, or pistachio nuts. Maybe 2 oz.

      John when I watched Forks Over Knives I know the overwhelming message was no fat, no nuts. But didn’t you (if you watched the video) think that message was directed at the population of obese people and/or suffering for heart disease? And that makes since. People who need to lose weight or have heart disease need to really limit their fat intake from nuts, seeds, avocados etc. but Dr. Greger has demonstrated through various research articles that nuts and seeds are rediculously nutritious for us. But 1 cup per day? That doesn’t even sound appetizing!




      0
      1. Veganrunner: I completely agree with you that diversifying sources of all nutrients is important. I think my back-of-the-envelope calculation suggests that those who center their diets around fruits and vegetables shouldn’t need to worry about having an extra handful of nuts, if they feel like it.




        0
  7.  Looking at the chart at the end of the video , it appears one would have to seriously increase one’s intake of nuts and seeds to make a difference in the amount of phytosterols consumed. 
     Flaxseed, for example, has just 200 mg of phytosterols per 100 grams of flaxseed.  100 grams is 10 tablespoons of flaxseed!!  I usually eat about 1 tablespoon a day.

    Seeds like sesame, sunflower, pistachio, pumpkin are very high in the ratio of omega 6 to omega 3.  It would appear that increasing one’s consumption of those nuts greatly would very negatively affect the omega 3 ratio, especially if one was eating a low fat diet.

    By the way, Dr Esselstyn “prescribes” NO nuts for his advanced heart disease patients.




    0
    1. Good-morning John,

      OK everyone correct me if I am wrong–I can take it! :-)

      The SAD is filled with processed foods. Crackers, cookies, chips etc. And they are very high in omega 6 because they are generally cooked with soy oil or the like. Again high in omega 6 (and trans fat) 

      But for most of the people on this website I will would guess do not eat those products. Therefore our omega 6 to omega 3 ratio is not upside down. 

      We know that whole foods are key. Whole nuts and whole seeds. And maybe the ratio of some are scued towards Omega 6 but don’t you think the health benefits outweigh the paranoia I keep reading about in these comment sections? For the general population who eat all that crap yeah they better stay clear. 

      Maybe I am wrong. Maybe people watching these videos are still eating all the processed stuff, as long as it animal free. So please help me understand this. 

      Dr. SJ what do you think? Are you in bed yet? Denmark right? 




      0
      1. Yes – Denmark (late afternoon right now).

        I must emphasize that this is just my opinion: Don`t focus on one single nutrient, one single fruit, nut, legume and don`t focus too much on one single ratio (omega 6/3). If you go for whole foods, plant based and eat a variety of different foods, I don`t see a problem. Personally I also take 200-400 mg  vegan omega 3 pr day though.




        0
      2. I agree with you, vegan runner.  And, it seems that Dr. G. does as well.  Here is what he says about omega-6:

        “I try to think in terms of whole food sources rather than nutrients (have you read The China Study? It has a whole chapter trying to make that point). I’d be happy to talk with you about ratios and percentages, but in terms of practical advice I’d encourage people to minimize their intake of the omega-6 rich oils (such as safflower, sunflower, and cottonseed, and all of the processed garbage manufacturers make with them), and try to eat healthy omega-3 rich whole foods such as walnuts and flax seeds every day. And especially for men as well as women who are expecting, breastfeeding, or even thinking about getting pregnant I would encourage consideration of taking an algae- or yeast-derived long-chain omega-3 supplement.”

        http://nutritionfacts.org/2011/09/18/ask-the-doctor-qa-with-michael-greger-m-d-week-2/




        0
  8. It’s difficult to understand how much 2000mg is, of nuts/seeds; I wish he would have given us a measurement in which we could relate. Nevertheless, I’ve learned more from Dr. Greger, MD, than anyone, than, perhaps, Dr. McDougal. Thanks, Dr. G.




    0
  9. How did they test up to 9 grams of phytosterols, if the foods containing the highest amounts of it (wheat germ and sesame seeds) contain only about .4 grams per 100 grams( about 3 1/2 ounces) of food weight. From these figures to get 9 grams of phytosterols per day they would have to eat about 5 pounds of wheat germ or sesame seed a day!




    0
  10. My LDL is 144. I don’t eat meat, eggs, dairy, fish, oil. I want to try 2 g of plant sterols to lower my LDL, but commercial products get bad reviews. I eat nuts and wheat germ every day. Now what? I am soooo discouraged. Statins were affecting my liver.




    0
    1. Sharyl: That is indeed a frustrating situation. Some plant based doctors will tell you not to worry about your cholesterol levels if you are eating a whole plant food based diet as you are. The logic is that you will not have a heart attack if your cholesterol does not oxidize. Your cholesterol levels will not oxidize on a plant based diet (so they say). And thus someone in your situation does not have to worry about cholesterol levels that would normally be considered in the danger zone.
      .
      However, I don’t know how much actual evidence supports that theory. So, while the above theory is great for keeping someone from panicing and feelng a bunch of stress over the situation, it still seems like a good idea to me to try to get your levels down (using diet) if you can. The safe levels of cholesterol are <=150 total and <=70 LDL. There are several videos/articles on this website that would give you ideas of foods you can eat to help your situation. You mention nuts, but what if you made a point of including a handful of foods which have been clinically shown to lower cholesterol levels?
      .
      I'll also point you to the following page on NutritionFacts: "What Can I Do To Lower My Cholesterol? It Seems I've Tried Everything!" http://nutritionfacts.org/questions/what-can-i-do-to-lower-my-cholesterol-it-seems-ive-tried-everything/
      .
      I'm not encouraging the following tip, but letting you know in case you feel it would be very helpful. If you want a well-known and respected and highly experienced plant based doctor to help you through this problem, Dr. Klapper does phone consultation. That's just one more idea that may or may not be good for your situation.
      .
      I hope this helps. And I hope you don't give up.




      0
  11. So, I’ve had high cholesterol all my life that is not diet impacted. In fact I’m on both max statin (crestor 40mg) dose AND a pcsk9 inhibitor and only then do i get to an LDL of 50. However, since becoming becoming the Boston Heart Labs test says my Beta-Sitosterol and Campsterol are way way way too high (> 400, whatever units they measure). And in fact since I have gone vegan this value has gone up.

    Is it true that this value is too high and the consequences are negative? What more can I do other than take Questran (third cholesterol lowering drug I’d be on) to reduce the sterols?????

    help!!!! :)
    thx!




    0
  12. Kkaljan,

    What’s being said by the two results is that your absorption of cholesterol, probably due to your genetics, is elevated. The typical addition to impact this is ezetimibe ( a prescription drug) or other absorption blockers, such as the Questran. As an alternative, you might discuss the use of niacin with your provider. If you choose to try this approach make certain its niacin, not niacinamide. Dr. Alan Kadish moderator for Dr. Greger




    0
    1. Tx Dr Kadish!

      Are the high beta-sitosterol and campsterol levels unequivocally bad? I have read that there might be some ambiguity, so just wondering how much I should panic :). thx!




      0

Leave a Reply

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

Pin It on Pinterest

Share This