What's the best way to stay healthy in the face of so much conflicting nutrition information? Well, ideally you would go to the source, the gold standard the pure reviewed medical literature and read through the stacks of the latest medical journals. But who's got time for that? I do welcome to the nutrition facts podcast. I'm your host dr. Michael Greger today. We hope to settle the debate once and for all for the role of cholesterol in heart disease.
He's
the cholesterol controversy is over, in fact, you can argue was over a century ago. It seemed obvious in 1920 that high cholesterol levels in the blood. Infiltrating your artery walls, was the cause of coronary heart disease. The number one, killer of men and women confirmed as unequivocably as the Revelation that blood circulated throughout the body or that the tuberculosis bacteria causes tuberculosis.
The question is, why did it take so long? What is so puzzling? Is that why we have to work so hard to sell the message given what seems to be an unbeatable amount of Hard Evidence? Many rejected the cholesterol heart disease linked because so many patients were dying of coronary heart disease despite so-called perfectly normal cholesterol levels. Of course as I've detailed before having normal cholesterol levels in a society where it's normal to drop.
Out of a heart attack isn't exactly saying much. Ideally, we want to get our total cholesterol. Well under 150 since having high cholesterol levels in your blood is thought of as the only direct atherosclerosis risk factor all the other things, smoking, high blood pressure, diabetes inactivity. Obesity just exacerbate the damage caused by the high cholesterol. Another Factor may be the preoccupation of cardiologist with all the new fancy gadgets and procedures out there. It's like we trained them to be
Highly skilled high-tech fighter pilots to fight a war but then sent them on some boring preventive, diplomatic Mission, but the reasons may be even more personal than that as an editorial in the Journal of the American Heart Association. Asked, nearly 50 years ago. Why do we pretend the cause of heart disease is mysterious? There is no mystery as to why the incidence of heart disease like that of lung disease and of veneer.
Disease sexually. Transmitted disease. Continues to rise for many decades after the cause is established. Why? Because human beings including Physicians are eager for excuses. Not to face annoying facts. And so they continue to do things which are agreeable, but has it is people tend to reject new ideas even when they don't impose any change in our way of life. And it's almost impossible for most men to accept any suggestion and I might be wise to give up.
Agreeable habits such as smoking, unsafe sex or eating their favorite foods. This continuing challenge is represented by a senior professor of medicine, who question, whether an alteration of died, would really affect the course of heart disease. These professors know the facts. The problem is that they like, so many patients will not allow themselves to believe the message eating rich food. Just means too much to too many people. Even when it's our gravest mortal.
Threat.
Scientific consensus panels going back decades established Beyond a reasonable doubt that lowering LDL cholesterol. Reduces the risk of heart attacks. Consistent evidence. Unequivocally establishes that LDL causes our number one killer, after sclerotic cardiovascular disease and what raises LDL cholesterol. Saturated fat, where is cholesterol? Raising saturated fat found the number one source is dairy number two sources chicken, then pastries.
Is pork and burgers and it's not just saturated. Fat dietary cholesterol has been known as a dominant factor in the Genesis of atherosclerosis since 1908, which is why we should lower our intake of saturated fats, trans fats and dietary cholesterol as much as possible. This is consistent with how our biology evolved extensive evidence, clearly indicates that a plant-based diet was the traditional eating pattern of our distant ancestors and so dietary cholesterol. And
These were typically very low while the same time we were packing in whole plant foods, containing components, like fiber, to help us eliminate cholesterol, where is dietary cholesterol coming from? Now overwhelmingly eggs with number two, Source chicken, then beef, Dairy and pork. So wait a second, The Institute of medicine recommends that individuals consume as little dietary cholesterol as possible. Presumably that would mean cutting out Foods.
Like eggs entirely, but does eating cholesterol actually raise your blood cholesterol, we'll find out next. The question does egg feeding in other words dietary cholesterol affect the level of cholesterol in the blood was answered 40 years ago give some 1/2 a cup I exit day and within two, three, four weeks. Their cholesterol keeps going up and then stop the eggs by switching to an egg.
And the cholesterol comes down or start people on the egg substitute and not much happens, but then start feeding eggs and their cholesterol shoots right up. Put people on cholesterol, free diet and their cholesterols drop. But then add some egg, yolk, cholesterol, and their cholesterol goes up, take it away and their cholesterol goes down. You could do this all year and it's within days. 10 days of X and cholesterol shot up 50 points. Take the eggs away in it.
It comes back down. You can reproduce this effect over and over and over and over though evidently penguin. Omelets are only about half as deadly switch people from a high cholesterol diet to a cholesterol free diet and you can drop blood cholesterol levels as much as 100 points, okay? But that was giving people more than a half a cup of egg yolks a day, but even just a single egg,
A can increase people's LDL cholesterol 12%, put all the studies together in this 2020. Meta-analysis more than 50 or randomized, controlled trials, feeding people eggs and egg consumption. Significantly increases LDL cholesterol period. Now studies funded by the egg board. Use a variety of methods to try to minimize the reported negative health effects of eggs. By for example, claiming the dietary cholesterol affects only certain people that's actually
He been put to the test and only 3%, or even potentially non-responders to dietary cholesterol and even these probably evidence some adverse response. Wait, then, how was the egg board able to design a study in which egg intake did not change blood cholesterol, by feeding them, sufficiently large quantities of dairy and meat. See, there's a plateau effect, though, all lines of evidence converged indicate that
Dietary cholesterol is a major factor in promoting hardening of the arteries. Confusion about dietary cholesterol has arisen because above a certain ceiling, you basically max out, cholesterol absorption. Check it out. If you're eating, a strictly plant-based diet with a baseline of zero, cholesterol intake and you start adding meat dairy or eggs to your diet, you can get a dramatic rise in blood cholesterol. But as your diet starts out more and more meaty you can saturate your system and makes
Actually max out to on the additional effect. So no wonder the egg board packed in the extra meat Dairy to mask the egg effect. A systematic review of egg industry funding and cholesterol research sought out to see. If industry-funded studies were more likely to report conclusions that were not supported by their own objective findings of the non industry-funded studies on the effect of egg ingestion. On cholesterol. Cholesterol increases were reported in
Ninety percent among industry-funded studies cholesterol increases were reported in about 90%. In other words, even the egg industry, funded study showed eggs, increased blood cholesterol, and not a single study funded by anyone showed a significant decrease, okay. But here's the crazy part about half of the industry-funded studies reported conclusions that were discordant with their own results. In other words, they found that cholesterol went up, but if you read their
Illusions. They exonerated eggs. That's why you can't just read the abstract. You actually have to see what they found. Readers, editors in the public, should remain alert to funding sources in interpreting study findings and conclusions.
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