Podcast: Is This the End of the Cholesterol Controversy?

The correlation between high cholesterol and heart disease is settled once and for all. This episode features audio from:
Visit the video pages for all sources and doctor's notes related to this podcast.

[dackhornbold]

Hey Doc, I know plant based is the way to go but it's always been hard for this lifetime carnivore. Well about a month ago I started eating mostly whole food plant based and I've lost 7 lbs and blood pressure dropped from 148/82 to 124/80. Next month I'm shooting for 100% plant based.

[natalietannerblogger-theed]

My cholesterol was always high, my dad's was high, and my grandfather's was high. I was told that it was genetic and there was nothing I could do. So, for 25 YEARS I tried everything in an effort to avoid statins. Exercise, diet (I though switching from beef to chicken was the way to go at the time.) apple pectic, Metamucil, and so on. NOTHING happened. Then we went vegan. I thought for sure this was it, but NOTHING happened until we found whole food plant based nutrition. THAT WAS THE MAGIC bullet. After almost. 30 years of trying my cholesterol fell into normal ranges and continues to fall. The dr didn't believe it so he ran the test again at his own expense. LOL!

[vfran]

I ate meat and fish and a standard American diet for 58 years and then went Plant Based. Lost 50 lbs and lost my arthritis pains in my knees (and other aches and pains). Plant Based Diets (eating non processed plant based foods) is the ultimate anti-inflammatory diet. It was hard in the beginning but after I got passed the first month it wasn't hard.

[anthonyromano]

Didnt eat red meat, pork. I ate turkey, chicken and fish, and some cheese. But mostly ate carbs for bike racing and training. Low fat with moderate chicken and fish. Then went plant based. Lost 10 lbs. Blood pressure is 113 over 70 and I could probably get that lower at 59. But its fine. I have spring in my step. I thought people keeled over at this age. My dad did any way. My nephew at 48. My sisters was in temporary convalescent care at 65. You have to watch what you eat and drink. Avoid alcohol and saturated fat.

[lisarussom]

Always looking for good news, to support our bad habits.

[paul_burney]

The actual facts (the study cited in the video is 20 years old):
We confirm from the review of the literature on epidemiological data, meta-analysis, and clinical interventions where dietary cholesterol challenges were utilized that there is not a direct correlation between cholesterol intake and blood cholesterol. This lack of correlation is mainly due to the compensatory mechanisms exerted by the organism to manage excess dietary cholesterol, including decreases in cholesterol absorption and down-regulation of cholesterol synthesis. A great number of epidemiological studies and meta-analysis indicate that dietary cholesterol is not associated with CVD risk nor with elevated plasma cholesterol concentrations. Clinical interventions in the last 20 years demonstrate that challenges with dietary cholesterol do not increase the biomarkers associated with heart disease risk. Further, in the specific circumstances where eggs are the source of dietary cholesterol, an improvement in dyslipidemias is observed due to the formation of less atherogenic lipoproteins and changes in HDL associated with a more efficient reverse cholesterol transport. However, if the cholesterol sources are consumed with saturated and trans fats, as happens in the Western diet pattern, increases in plasma cholesterol may be observed. The most recent epidemiological data and clinical interventions for the most part continue to support the USDA 2015 dietary guidelines that removed the upper limit of dietary cholesterol.

[kathryntokarska]

Been plant based for years and Cholesterol was good, forget the numbers, I think it was 138. In 2022, lots of stuff going on and I started eating a lot of oatmilk ice cream, some tofurky sandwich meat, and just before having blood drawn a few Burger King impossible meals in the days prior. I tested 209! Never seen it so high. Also VLDL up to 30! Liver enzymes elevated. Shot me back into reality. Never had such bad numbers. I got back on whole plant based, not 100% compliant as far as "whole" goes, always animal free though, retested, even had some wine a few days before test, cholesterol down to 166, no more elevated enzymes. VLDL still slightly up at 23. Cleaning up my act some more, I was reading that high saturated fat can also raise cholesterol. Basically, I'm thinking coconut fat used in impossible and ice cream jacked me up.

[matthewphares]

Liver makes all the cholesterol you need thus it is not essential in your diet unless you want a heart attack. If you’re eating a whole food plant based diet and your LDL is still high you most likely are not eating a whole food plant based diet, but if you are then get checked for familial hypercholesterolemia.

[johnborges]

I have familial hypercholesterolemia, and even on a strict low-saturated-fat, low-cholesterol diet, my natural cholesterol level (in the absence of medication) is quite high -- the level rose with age from what was considered marginal at 220 in my 20's to well over 300 in my 50's. Consumption of dietary never seemed to affect my cholesterol level (i.e., dramatically restricting it never improved my numbers) and now, thanks to this video, I feel like I have a better understanding of why, given the comment about absorption saturating at high levels. Now that my levels are better under control with statins it's good to learn that I may be able to further improve my numbers by again restricting dietary cholesterol input.

[adamp]

It’s not controversial so much as everyone is wrong to some to degree but are biased in their own personal experiences to admit they don’t know everything.

There is some correlation with LDL and cardiac events and clotting, but high ApoB is failure of the lipoprotein system not cholesterol itself.

[MrEroshan]

People love to hear good things about their bad habits.

[goku]

I need more of this kind of videos Dr Greger! It's sometimes tough to argue when the other side also shows some studies.

[jasminblouin]

Always good and useful informations to see more clearly in all the confusion about nutrition! Thanks

[deg]

My uncle ate 2 soft boiled eggs/day for many years and died at age 52. Was it the eggs?

[nstvkot]

Almost WFPB for ten years: cooking without any oil, eating loads of legumes, using whole grains in almost every dish- only exceptions the occasional restaurant (1-2 times per month), and some occasional vegan junk (pseudo cheese etc).

LDL=167. Then left out the junk, completely, although it had been only exceptions, and LDL went down to 140, after three months.
Hubby puts vegan oily mayonnaise on every other dish and buys a vegan muffin, every other day, and is way lower than I am.
It can be frustrating! 😭

[reganjo]

Sugar? Small dense LDL vs larger LDL? Triglyceride => insulin small dense

[mu]

Много споров о холестерина. В моей жизни был случай, который помог мне осознать правду. Бабушке поставили диагноз закупорка сонных артерий на 95% и ей предстояло умереть, так как операцию врачи делать отказали, сказав, что она умрёт на операционном столе. Тогда предложила бабушке убрать весь холестерин, через 3 месяца УЗИ показали закупорку на 60%, она ела салаты с маслом, фрукты и овощи, сухарики грызла с мёдом и иногда уху с зеленью.

[tomedwards]

The naysayers just go on to argue that higher LDL cholesterol does not correlate to increased risk of heart disease.
People will just believe want they want to believe. Check your ApoB regularly.

[johnwilliam]

Dr. Why do you have a big, bloated belly yourself? Please answer this question.

[CitizenTurtleIsland]

I have an upcoming visit with a dietitian associated with my doctor's practice. My HDL is too high, though not super high. Through 40+ years of adult living, my eating habits have been moderate, not much animal protein... less and less processed foods of any kinds and I now exercise 20 to 30 minutes per day. It's just a lot of stress... chasing after these numbers... that probably have a lot to do with aging and genetics. Is walking around with these little clouds of worry that great... when a person does what they can do but it's not enough?