[mjlangiii]

Heart disease is America's biggest killer. There is a lot of data that eating cholesterol effects disease rates including heart disease, cancer, etc.

If you study disease rates for those eating cholesterol and those replacing it with a plant based diet, eating cholesterol is higher.

While you have a particular point about eating cholesterol, measuring cholesterol, and related disease rates - are you suggesting people's health is not negatively affected by eating cholesterol?

Here's a simple study eating an egg versus not, it compares stopping eating cholesterol to stopping smoking. [0]

[0] https://www.ncbi.nlm.nih.gov/pubmed/21076725

[simonsarris]

Did you actually read that paper? It's an article, not a study. The article is here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2989358/

The USA is obsessed with cholesterol because of years of bad science. Here's a 2015 Japanese Supplementary Review on Cholesterol and Mortality Rates: Higher Cholesterol = Longer Life

https://www.karger.com/Article/Pdf/381654

It concludes:

> Our fervent wish is that, through this supplementary issue, people can see that the cholesterol hypothesis relies on very weak data—and sometimes considerably distorted data. Indeed, many studies in Japan actually show that cholesterol plays a very positive role in health. We hope that JAS, and the government authorities that defer to JAS’s recommendations, will move toward recognizing cholesterol as a friend not an enemy. In the meantime, we will continue pushing for acceptance of the anti-cholesterol hypothesis, to reverse what we see as the biggest mistake made by medical science in the previous century.

[mjlangiii]

I agree with many of the critical points they make in this Japanese review. There should be higher standards for nutritional research.

The main idea seems to be that in Japan because there are some positive patterns observed regarding all causes of death and high cholesterol levels and because other studies showing high cholesterol is bad were all flawed, therefore it is warranted to recommend eating more cholesterol.

Well, the notion that eating cholesterol effects your cholesterol level goes against your first comment.

Then the sentiment that you can throw the baby out with the bath water seems extreme, if you can find a flaw in studies that disagree with you then your studies that agree with you prove the point. I mean, I agree that when there is no un-flawed data it is hard to draw conclusions, but are their studies all really as so unblemished. A main criticism of theirs is studies citing rates of death for certain diseases without mentioning the rate for all causes of death, but a lot of their cited studies do the exact same, only some of them reported rates for all causes of death.

Finally, and I know you're surprised, I am not persuaded by them that eating cholesterol or having high/"normal" cholesterol levels is neutral or positive in affecting your health. I agree with them that we need much better data. I understand that in Japan they observed lower rates of date from all causes. But the only question I really have is what should I eat to avoid dying as an American, and this article just doesn't really cover that one way or another. I'm very grateful for sharing it, there are a lot of good insights in there.

[AstralStorm]

The notion that direct intake of cholesterol is bad is itself problematic. Off the top of the head I can recall at least 3 studies getting null results. Can't link you then on mobile, maybe late if you're still interested. (There are very rare genetic exceptions where body does not automatically balance intake with less internal production.)

The problem is likely that cholesterol itself is a coincidence, and that intake of too much red meat, sugar, heavily processed foods and also just to many calories in are the major problem.

And likely trans fats are much more damaging. Plus not enough vegetables or vitamin D or B12 in diet.

It just so happens that there's cholesterol in three of these four.

Right now there is more emphasis on lipid ratios (including IDL and VLDL) rather than total number anyway. Those seem much better correlated to cardiac endpoints.

[mjlangiii]

I read it a few years ago. Thanks for the link, I'll take a look.

[mjlangiii]

And I think, I've seen a lot of studies that compare eating "normal" amounts of cholesterol to eating more than normal. But "normal" cholesterol levels in your blood still leave you with a "normal" American rate of heart disease, read, still very high. Those studies might not show much of a difference in disease rates. But studies on eating cholesterol versus no cholesterol are much clearer in showing a significant difference. On a plant based diet people can get their cholesterol below 60 and the disease rates for people with that low of cholesterol are much lower.

[taurath]

I firmly believe that its the sugar/insulin response that creates most of these health problems due to the inflammation. There's a few studies that scratch the surface of just how bad sugar is, but with all the focus on cholesterol, there's been no focus on how much sugar is in people's diets who also happen to consume high cholesterol.

I've been off and on a keto diet for the better part of 12 years. I don't eat like crap when I'm "off", but my entire body gets inflamed and I blow up like a balloon, compared to being on it. My resting heart rate rises. This should be impossible, according to the dietary cholesterol theory. My health should get worse, and blood cholesterol should raise. This does not happen. We've lived for 50 years under low fat high carb dietary recommendations, primarily because its so much easier to scale grain production. Now there's grams and grams of sugar in everything we eat.

[mjlangiii]

I don't think there is one smoking gun for a chemical in food.

To me, I see a clear pattern. Reducing nutrition to consuming more of a specific chemical/molecule or consuming less of a specific chemical/molecule is always way more complicated than that. The best way to get the complicated combination/form of chemicals is to just eat as low on the food chain as possible in a minimally altered form.

Naturally occurring sugar in plants, say an orange, or rice, is good for you. Extracting sugar doesn't ever seem necessary for the American diet. The oil in a nut is good for you, extracting oil and using it to cook doesn't ever seem necessary for the American diet.

So I don't think it is controversial to say eating plans is good for you, especially say broccoli for your inflammation. The more broccoli you eat, the healthier you are; its really simple.

The second part of what I said, to try to eat low on the food chain is more controversial. But as soon as you combine that rice with meat, that sugar starts interacting in new more complicated ways and the it is no longer as simple as, the more rice you eat the healthier you are. It becomes, if you combine it with meat you have to limit the amount of rice you eat because together they spike your blood sugar level [0] study, image of that spike [1]. And I rarely hear, "the more meat you eat, the healthier you are".

So to me it seems like you can try to walk a tight-rope of eating the right amounts of the right processed and meat foods, or you can just eat things that generally make you healthier when you eat more of it.

That is a simple baseline that you adjust based on atypical differences you have, celiac disease, etc.

Regarding cholesterol specifically, and how you mentioned it conflicting with current theories that are being questioned (fairly enough) in this thread - here's some summary thoughts from the editor-in-chief of the American Journal of Cardiology on it. [2] They might be helpful providing some color to the conversation.

[0] https://www.ncbi.nlm.nih.gov/pubmed/2679037 [1] https://imgur.com/ZqHpEzv [2] http://www.webedcafe.com/extern/program_media/ajconline.org/...