• qaz@lemmy.world
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    6 days ago

    I’ve once overheard a conversation in the train where someone said “but cholesterol is good, right? Or are those proteins?” completely unironically. It got a good chuckle from me and several other people in the train.

    I eventually learned he was becoming a PE teacher who made diet plans for schools. That was less funny.

    • _bcron@midwest.social
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      6 days ago

      Perhaps surprisingly, dietary cholesterol has less an effect on blood cholesterol than a handful of other things. Saturated fat intake/balance in diet correlates more strongly, and vitamin D levels negatively correlates (vitamin D deficiency positively correlates).

      Dietary cholesterol is used for a lot of key things such as hormone production, so some people might actually want to increase their cholesterol intake (super active lifestyle people like endurance athletes - can help combat RED-S aka Female Athlete Triad), but the elephant in the room for bad lipid profiles is saturated fats, refined sugars, and sedentary lifestyle

    • kameecoding@lemmy.world
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      5 days ago

      Dietary cholesterol has little to no effect on blood cholesterol, so indeed cholesterol is good or at least not bad

      • SeaUrchinHorizon@reddthat.com
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        5 days ago

        False. Here’s a short 4 minute video with several referenced studies by a renowned lifestyle medicine doctor debunking this myth: Does Dietary Cholesterol (Eggs) Raise Blood Cholesterol?. TL;DR: Even 90% of egg industry funded studies show eggs raise cholesterol.

        I also wrote the below, on how bad studies funded by industry interests can be cherrypicked by journalists who want to conclude “<unhealthy food> is healthy, actually” such that these myths arise in the first place. I explored this particular example of “dietary cholesterol is good” by scrutinizing the first PubMed study I found on the subject, as an example of what to look for in good study design.


        Saying that dietary cholesterol is good is factually insane, eating dietary cholesterol absolutely raises your cholesterol. However, it’s common to hold these false narratives about nutrition. The issue is that it’s incredibly easy to create a faulty study design if you go in trying to prove “eggs are healthy,” for instance. Take, for example, the egg industry, which has something to gain by convincing people that the massively high cholesterol in eggs isn’t bad for you, and oftentimes funds these biased study designs.

        What does a biased study look like?

        • Some examples of biased study design is taking 20 year olds, having them healthy salads vs massive steaks for lunch, then checking back and saying “none of them have heart disease, so steak is healthy” (because they’re 20, the age cohort was too young to be drawing those conclusions).
        • Read a study that compared the intelligence of kids in Africa who got “meat” via an actual meal or “vegetables” via giving them straight vegetable oil (obviously unhealthy); the vegetable oil group still won despite the handicap. Aka choosing to compare something that is unhealthy with also unhealthy alternatives so you can say there was no difference -Even the traditional “a bit of wine is healthy in moderation” bit came from faulty studies which grouped “people who had to quit drinking after developing liver disease” with “people who have never drunk a single drop” in the “never drinkers” category, which made it appear as if drinking no wine was somehow less healthy than drinking some wine.

        What does an unbiased study look like? The best study design, imo, is a meta-analysis of several randomized double-blind placebo-controlled intervention studies.

        • Randomized = people assigned to the control vs the experimental group randomly
        • Double-blind = both the researcher and the subject don’t know whether they’re giving/getting the placebo or the experimental (otherwise the researcher’s expectations can influence the subject to behave in a certain way)
        • Placebo-controlled = giving a sugar pill with no medication control alongside an actual medicine pill, because oftentimes just the act of taking a pill can make people report less pain, that they feel healthier, happier, etc etc etc. In nutrition studies the equivalent of this may be giving tasteless supplements, shakes or muffins made with or without the ingredient to be tested, etc
        • Intervention study = A study where you give group 1 thing A, group 2 thing B, and group 3 a control

        In this case, I’m assuming you’re getting this false information from studies like this Dietary Cholesterol and the Lack of Evidence in Cardiovascular Disease which right off the bat raises red flags due to being written by a single author, saying ‘eggz are helthy,’ the funding section only being funded by some unnamed “institutional startup,” and finally only being a literature review (very easy to cherry pick bad data), not an intervention study of it’s own

        One of the studies linked in that study, Egg consumption and heart health: A review (yet another literature review with no actual study) is mostly just saying 1) “cholesterol is often high in foods also high in saturated fats,” 2) “saturated fat is unhealthy,” 3) “ergo we can’t just conclude because something has cholesterol in it it’s unhealthy,” 4) “eggs are high in cholesterol but low in saturated fats,” 5) “eggs have all these nutrients that are useful,” 6) “therefore, eggs are healthy.”

        The error in this logic is between 5 & 6. We’re starting with the (false) assumption that cholesterol isn’t necessarily unhealthy, but you can’t go from Maybe Not Unhealthy + Cherrypicked Good Components = Healthy, you have to actually test the food.

        However, because everyone wants to convince themselves eating unhealthy food is healthy, faulty studies like this get reported in “health” magazines until when your doctor says “eating eggs is bad for you” you think “but I saw that study one time that says it wasn’t, maybe science just doesn’t know” (it does) and the egg industry is laughing all the way to the bank for successfully convincing you that the whole thing is too complicated for you to know or care.

            • exasperation@lemm.ee
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              4 days ago

              From this summary, The American Health Association still has a very modest recommendation to avoid excessive dietary cholesterol but no longer recommends a daily limit, and notes that foods high in cholesterol tend to be high in saturated fat, which does still show a link to serum cholesterol.

              In other words, foods that are high in cholesterol but low in saturated fat (like shellfish, and to some degree eggs) are still fine.

              I’d trust the American Heart Association over a video by a doctor who advocates for veganism through his books and media appearances. He seems to me to be more of an advocate (and isn’t very open about the fact that nutritionfacts.org is his own marketing website for promoting his specific products). And his books rely partially on data now known to be faulty, about “blue zones” where lots of people live past 100 (turns out each are hotspots for pension fraud so it’s hard to actually know how old people actually live in those places).

              • kameecoding@lemmy.world
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                4 days ago

                I would add that the nutritionfacts guy tries to sell himself as someone of science, but then extremely cherry picked quotes and then when talking about eggs, says something like penguin eggs are half as much likely to kill you.

                Anyone who uses such fearmongering phrases in nutrition cannot be taken seriously in my opinion.

                I think the AHA recommendations are quite reasonable, as they are more about focusing on eating foods known to be healthy less about fear mongering.

                But I would like to add but AFAIK serum cholesterol levels alone are not a good indicator, you need to look at more things for example the ratio of TGL to HDL as it is a good indicator of low density vs high density LDL in your blood, but I think there are even more markers

      • BootyBuccaneer@lemmy.dbzer0.com
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        6 days ago

        Yes.

        You also need cholesterol in cell membrane structures, hormone synthesis (steroids like testosterone & estradiol), vitamin D, bile acids for digesting fat, and insulating neuron sheaths.

        • SeaUrchinHorizon@reddthat.com
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          5 days ago

          Yes, but dietary cholesterol is still unhealthy. Your body makes it’s own cholesterol, getting it from your diet is like pouring water into an already full cup: the cholesterol “overflows” from your cells into your blood and clogs everything up. Video on how cholesterol is unhealthy Who Says Eggs Aren’t Healthy or Safe?

          • BootyBuccaneer@lemmy.dbzer0.com
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            5 days ago

            Your body makes it’s own cholesterol, getting it from your diet is like pouring water into an already full cup

            I don’t think your analogy is right, tbh. For most people dietary cholesterol does not alter their blood cholesterol much because it’s tightly controlled with the pancreas and the liver. If your body detects too much it’ll absorb less and pass through your butt and it’ll synthesize less in your gut. It’s about a 20%-80% ratio of absorbed vs internally synthesized. This means our bodies are able to process, create, store (liver, tissues), release and excrete a reasonable amount of cholesterol with a balanced diet. It’s only when you intake a lot of other fats that it causes the “bad” cholesterol LDL to be delivered to the cells. (Low Density Lips means it’s not just the cholesterol being transported in there.) Curiously enough, some people are more susceptible to cholesterol-related diseases than others, particularly those with higher genetic risks or those with comorbidities.

            your cells into your blood and clogs everything up

            You’re thinking of atherosclerosis, an inflammatory disease. High LDL cholesterol in the blood is only a factor and not a direct cause. The full cause of the disease isn’t known, so it’s not that simple. It’s not like cholesterol is freely floating in the blood plugging holes, but rather packaged with other fats and proteins into water-soluble droplets precisely so that fats don’t plug anything up. That’s LDL, HDL, chylomicrons, etc. There’s something more going on with the body for cholesterol to play a role.

            Interesting video. Definitely not what I was expecting, but mostly because I was expecting the science. Instead, this is a video about a marketing department dealing with red tape around their food products, and it uses that as the evidence for why cholesterol is bad in an ominous “they know they truth”. Dun dun dun. To be honest, I think its approach is deceitful.

            Please note that, although Dr. Michael Greger seems pro-science, he is criticized for pedaling a moderate amount of pseudoscience, claiming that veganism cures illness. I think his content about cholesterol is closely linked to his personal views and is therefore quite biased.

    • Buddahriffic@lemmy.world
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      5 days ago

      Based on the other responses, better to be asking the question than assume he was stupid for asking it.

    • BootyBuccaneer@lemmy.dbzer0.com
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      5 days ago

      High cholesterol is “bad” with too much of other fats in your diet, but you need cholesterol to live so your body makes most of it.

      E: Correcting the science there, whoops.

      • SeaUrchinHorizon@reddthat.com
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        5 days ago

        That small amount of cholesterol you need to live can be synthesized by your own body, which is also why animal products but not plant products have cholesterol (the animals you’re eating synthesized their own cholesterol) and also why vegans aren’t dropping dead of low cholesterol all the time

        • BootyBuccaneer@lemmy.dbzer0.com
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          5 days ago

          Sorry, I had to get a refresher on the physiology of fats in the body. Whew, it’s been a while and I remembered it all wrong. I edited the original to reflect that.