[HN Gopher] New model could explain old cholesterol mystery
___________________________________________________________________
New model could explain old cholesterol mystery
Author : shadykiller
Score : 104 points
Date : 2021-02-12 15:30 UTC (7 hours ago)
(HTM) web link (sciencenorway.no)
(TXT) w3m dump (sciencenorway.no)
| qw3rty01 wrote:
| So the new model seems to be suggesting that high LDLs are not a
| cause for heart disease, but rather a symptom. Have other studies
| tying high LDLs to heart disease taken this into account, or did
| their main findings just show a correlation with high LDLs and
| heart disease?
| j16sdiz wrote:
| I just love how the author use a few paragraphs to explain the
| weakness of this model and why it need more research.
|
| Most pop science articles just dont have it
| mrkeen wrote:
| A: saturated fats B: LDL cholesterol C:
| heart disease
|
| studies show saturated fats increase LDL cholesterol
| A => B
|
| People who get heart disease are more likely to have high LDL
| cholesterol C => B
|
| > Researchers have thus drawn a logical conclusion: a lot of
| saturated fat in the diet produces more cholesterol, which in
| turn increases the risk of heart disease. A =>
| B /\ B => C
|
| > But this has been surprisingly difficult to prove.
|
| You don't say?
| rafaelero wrote:
| I can't help but think that there is active effort to halt our
| understanding of nutrition. I mean, if we still can't say at
| least that saturated fat is causally related to heart disease,
| then this whole field is in a very bad place. My hypothesis
| though, is that this finding has already been established but
| people keep coming back to this subject to try to adjust it to
| their lifestyle choices.
| nradov wrote:
| Your hypothesis is incorrect, or at least not justified by the
| data. The whole field of human nutrition actually is in a very
| bad place. Most of what we think we know comes from low quality
| observational studies which don't rate well on the evidence
| based medicine scale.
|
| By all means let's continue research. But people generally
| shouldn't rely upon most of it when making dietary choices. A
| better approach is to conduct your own n=1 informal experiments
| and determine empirically what works best for you.
| chihuahua wrote:
| I find this article quite fascinating. It provides a bit of a
| glimpse into how science can work, and how difficult it is to
| gain valid knowledge on some topics. It's also a reminder that
| "science" isn't just a simple process that you follow to find the
| truth. Sometimes people ask the wrong question, or draw the wrong
| conclusion from experiments. It seems that research related to
| nutrition and health has a fair amount of this.
|
| It reminds me of my own experience earlier this week where I
| needed to call a certain service. The API has 2 parameters. I
| thought that one was required and one was optional. But whenever
| I called the service with 1 parameter, it failed. Eventually I
| thought "maybe both parameters are required" and called the
| service with 2 parameters, and it worked. So I concluded "both
| parameters are required". But later I discovered that the service
| was just flaky and it was a coincidence that it started working
| just at the moment when I added the second parameter. After that
| experience it's difficult to know what to trust, when everything
| could be due to randomness and unreliability.
| [deleted]
| PragmaticPulp wrote:
| I think it was a mistake to focus public health discussions
| around the finer details of work in progress research.
|
| The ambiguities and unknowns have opened the door for fitness
| gurus and health product grifters to turn this into a sort of
| holy war. It's sad to see how many people have been convinced
| they are "healthy" because they follow a couple out of context
| fragments of the overall health picture.
|
| I know too many people who think they are doing everything right
| because they avoid gluten, or don't eat dairy products, or
| minimize saturated fat. Yet they go on to consume excessive
| amounts of sugar, or drink copious amounts of alcohol, or eat
| 4000+ calories per day of their chosen healthy foods.
| flowerlad wrote:
| The idea that it is inflammation, not cholesterol, that is
| causing heart disease, is not new. See here:
| https://www.bloomberg.com/news/articles/2008-04-15/heart-dis...
|
| Also see collection of links at bottom of this article:
| https://medium.com/@petilon/cholesterol-and-statins-e7d9d8ee...
|
| Cholesterol reduction is big business. Pfizer's Lipitor alone
| raked in $125 billion between 1996 to 2012. This amount of money
| can be very corrupting. It's almost impossible to find experts
| who are not influenced by money from industry.
| mark-r wrote:
| I've always wondered if the reason a daily aspirin prevents
| heart attacks isn't because it prevents clotting, but because
| it's an anti-inflammatory.
| doganengin wrote:
| Good article, thanks for sharing
| ncmncm wrote:
| We have known for many decades that it is _oxidized_ blood
| cholesterol that correlates with heart disease. Fred Kummerow
| showed this back in the '50s, 60+ years ago. But you can't get a
| blood test for oxidized cholesterol.
|
| Fred Kummerow spent his whole working life getting trans fats out
| of the US food pipeline. He proved trans fat was poison in 1957,
| and finally in 2009, under compulsion of a lawsuit, the FDA
| declared it toxic. Then, they issued no regulations restricting
| their use until forced by another lawsuit, in 2014. Then, they
| gave vendors _3 more years_ to put poison in stuff being sold as
| if it were food. In 2018 it was supposed to be illegal to sell
| trans fats as food, but a number of companies still do, under
| waivers.
|
| He died in 2017, at age 102. He spent the final two years of his
| life working on Parkinson's, which had taken his wife, since
| trans fats had (he thought) finally been outlawed. He was a great
| hero of experimentally-grounded health science.
|
| https://www.drmirkin.com/histories-and-mysteries/fred-kummer...
|
| India and Brazil are still struggling to get it outlawed. The big
| corporations have resisted because selling poison as if it were
| food remains profitable.
|
| We are still confused about fats. But a takeaway should be that
| nobody has ever found any evidence of harm from eating saturated
| fat, or benefit from eating unsaturated fat, despite decades
| trying.
| hpoe wrote:
| This is why I have three things I never trust the experts in. -
| How to be healthy - How to educate - How to raise kids
|
| It seems like every decade we find out everything we did last
| decade was bad and wrong but now we've finally for sure got it
| figured out, and this time we know we are right because we have
| fancier gadgets and more citations in our name.
|
| From Frued to the Food Pyramid it seems that the experts always
| have just finally figured it out.
| arkitaip wrote:
| So who do you trust on these matters?
| hpoe wrote:
| Generally common sense, good wisdom, and my own understanding
| of the situation as well as my personal investigation.
|
| Like everything I need to know about nutrition is "eat food,
| but not too much, try and get a variety, generally plants are
| better for you than sugar, fast regularly and get exercise."
| tomkat0789 wrote:
| I've personally be satisfied with what I'll call "informed"
| common sense. An example from health is the documentary "In
| Defense of Food" where the journalist uses a little science
| and history to create the heuristic: "Eat food, mostly
| plants, not too much." None of those insights are really
| surprising, the only exception maybe being the "mostly plants
| part".
|
| A downside of depending on complicated theories from experts
| is that it makes a "priesthood" of people telling you what to
| think all the time. I think there are enough examples from
| health, environmental, and privacy policy making to
| demonstrate that the "priests" don't always have the public's
| best interests in mind.
| 2OEH8eoCRo0 wrote:
| Whoever sells the most books.
| didibus wrote:
| > It seems like every decade we find out everything we did last
| decade was bad and wrong but now we've finally for sure got it
| figured out
|
| I think you're being unfair. Most of the time, it's not a major
| 180, it tends to be smaller course corrections, refinements
| over current understanding of data, and the discovery of even
| more correlated complexities.
|
| The issue is people want simple answers, easy to follow
| guidelines, and guaranteed results. The science just isn't at
| the point where it can deliver those. So people make up best
| guesses for them each decade based on where the science is at
| that point.
| munificent wrote:
| _> - How to be healthy - How to educate - How to raise kids_
|
| I think it's interesting that all of three of these hinge on
| the same problem: human variability. I strongly suspect that
| humans are _much_ more variable internally than conventional
| science and journalism accounts for.
|
| The scientific method uses statistics which is important for
| showing aggregate effects but can also obscure variability. And
| journalists have an incentive to offer simplified guidance that
| is as widely applicable as possible.
|
| The end result of a lot of information like "Do X" when what it
| should really be is "If you are like Y do X, if you are like W
| do Z."
|
| This is a pattern I think of as "the missing parameter" that I
| see just about everywhere people give advice once I started
| looking for it. Examples:
|
| - "(Static/dynamic) types don't help programming." For what
| kinds of programs? Developed by whom? At what scale and
| timeframe?
|
| - "You (should/should not) use a schemaless database." How big
| is your dataset? What is the relative fraction of reads/writes?
| What kind of data? How many users? How much money do you have?
| What are your failure modes?
|
| - "People should move (to/out) of cities." Which cities? What
| is the city's transit like? Which people? What activities do
| they prefer? Do they have kids? What's their economic status?
| Age? How important is it to be near a hospital?
|
| - "You should eat less salt." For people of what age? Activity
| level? Diet?
|
| - "Teach by example not generalities." Teach what material? To
| whom? How important is their understanding? How long should
| they retain it?
|
| - "Children should go outdoors on their own more." What age?
| What personality do they have? Where do they live?
|
| Whenever I see people arguing about some generality, what is
| often happening is that each party has implicitly filled in
| those parameters with different values, so they are all correct
| but talking past each other. When I see this happening now, I
| try to take a step back and figure out what implicit parameters
| they are assuming and see if there's a higher-level
| parameterized stance that unifies their arguments.
| throwaway2245 wrote:
| I learned recently that the Food Pyramid was created by the
| Department of Agriculture in the US, i.e. not by the Department
| of Health.
|
| So, not experts. (Not in the field they were claiming).
| ncmncm wrote:
| It's worse. It was created by the Dairy Council as a way to
| promote dairy products, and then distributed to schools by
| the DoA.
| wnevets wrote:
| I'm always confused when I read/hear people say things like
| this. Do people think there is a skyscraper downtown with a
| giant sign on it that says Expert HQ on it or something where
| they release their findings from?
| hpoe wrote:
| I understand that science is multi-facted discipline and
| there are a lot of people who have dedicated their lives to
| their craft and discovering truth because of their desire to
| solve human suffering and figure out how the world works.
|
| I also think there are a bunch of "scientists" that like the
| veneer that comes with the title like to spend their time
| talking on TV, going to parties, chairing committees and
| stealing credit from people doing work. They are aided and
| abetted in this endevour by the popular media and politicians
| who just want to slap out some new "discovery" to get clicks.
|
| The first group is anxious for their work to be peer
| reviewed, tries to explain things simply, and will do what
| they do even if there was no reward and no one appreciated
| their work. They have qualifications.
|
| The second group uses jargon to try and confuse people, hate
| when people call them on things, use their influence to
| restrict funding to others and publicly deride their
| opponents who disagree with them. They have credentials.
|
| Unfortunately, society generally listens to the 2nd group
| over the first group because they often tell them what they
| want to hear.
| Retric wrote:
| Doctors learn the results of science, but generally aren't
| scientists. People doing science outreach are generally in
| that same category where their knowledgeable, but speak
| outside their specialty. Simply because being able to do
| original research today means a very narrow focus.
|
| Beyond that, the best available information isn't always
| that clear. Low salt diets for example where prompted based
| on very limited information that suggested they where
| slightly more likely to be useful than pointless.
| Unfortunately, we rarely have unambiguous data which gives
| clear guidance. Vitamin C for example is mandatory, but you
| can have zero vitamin C for 2 weeks without issue or
| quickly excrete excess. For more subtle interactions it's
| just difficult to figure out what's going on.
| sgtnoodle wrote:
| I think a lot of people think that sociopaths and narcissists
| have a tendency to rise to power in politics, business and
| media over time, as well as have a tendency to lie and cheat
| to the general population to advance their agenda. "Science"
| is one of the topics that the average person reveres but
| doesn't really understand, and so is readily weaponized for
| less than altruistic reasons.
|
| As a recent relevant example with the pandemic, there was a
| widespread effort by the media and politicians to discredit
| various well understood, several decade old drugs known to
| effectively regulate inflammatory problems. The primary
| objection was an appeal to "science" claiming that the drugs
| were untested for their effectiveness specifically against
| covid, and sensational claims that they are dangerous.
| Meanwhile, you have pharmaceutical companies injecting mRNA
| purposefully designed to essentially cause a temporary auto-
| immune disease into anyone they can, enjoying the fact that
| they were able to skip a decade of best practices for vetting
| new treatments. It just seems like maybe there's some
| unscientific human bias in there...
| MPSimmons wrote:
| You're describing several feedback loops that are decades long
| to test. I suspect that's why they all have problems with
| conclusive results.
| didibus wrote:
| > saturated fat in the vast majority of people increases their
| LDL and that this in turn will increase their risk of
| cardiovascular disease
|
| I still don't understand this. I thought the cause and effect had
| never been proven, but only the correlation.
|
| Like people who have heart disease often have high cholesterol.
|
| But was it shown that if they lower their level of cholesterol
| they can revert their condition?
|
| Or was it shown that it was the increase which led to heart
| disease?
| dpoochieni wrote:
| High cholesterol, low thyroid function. Simple, but the details
| and how this maps to lifestyle and diet changes it gets very
| tricky. That's why we have vegan and vegetarians with high
| cholesterol, (extremely hard to keep a healthy metabolism, let
| alone on a plant-based diet, most people confuse the temporary
| surge in stress hormones with an sustainably energetic
| metabolism.)
| [deleted]
| Geee wrote:
| This guy has been arguing for years that it is sugar (fructose
| actually) that increases the "bad" LDL in your blood stream
| https://www.youtube.com/watch?v=dBnniua6-oM
| ncmncm wrote:
| Robert Lustig is right that fructose (half of common sugar) is
| responsible for a variety of ills: exactly the ones Americans
| die of, by the millions. There is a lot of Lustig material on
| youtube, all of it excellent, all thoroughly grounded in
| rigorous experimental science. We need more Robert Lustigs.
|
| The normal metabolic route is that excess fructose, beyond what
| the liver can afford to process immediately or store itself, is
| carried wrapped in cholesterol to fat cells to be stored.
|
| If you take statins, excess fructose gets dumped into your
| bloodstream _not_ wrapped in cholesterol, which is much worse.
| It causes oxidation of blood lipids, which have long been known
| to cause heart and circulatory problems.
| josefresco wrote:
| I have an auto-immune disease. The medication prescribed has the
| side effect of making my "bad" LDL cholesterol skyrocket. I tried
| everything from diet, to exercise to bring it back down but
| nothing worked. I'm now on a Statin medication which solved the
| issue but I'm not thrilled about yet another medication.
|
| Before my disease I ate like an average American (sugar, meat,
| dairy etc.) and my LDL cholesterol was high. I was diagnosed,
| changed my diet and my LDL dropped to healthy levels. Later I
| started a new medication (JAK inhibitor) and it jumped back up,
| but my diet did not change.
|
| I read this article twice and have no idea how it applies to my
| situation.
| wtetzner wrote:
| The idea that animal products are unhealthy seems to be
| misguided.
|
| It seems more likely that the supposedly "heart healthy" seed
| oils are causing heart disease.
|
| The Carnivore Code has some very good insights (at least in my
| opinion) [1]
|
| And this talk on how seed oils are destroying our health is also
| pretty interesting: https://www.youtube.com/watch?v=7kGnfXXIKZM
|
| [1] https://www.amazon.com/Carnivore-Code-Unlocking-Returning-
| An...
| dang wrote:
| We detached this subthread from
| https://news.ycombinator.com/item?id=26115815.
| didibus wrote:
| > The idea that animal products are unhealthy seems to be
| misguided
|
| From my personal sifting through research, it seems there's a
| lot of correlation with different diets which shows people with
| more health problems often have an animal based diet and people
| with less health problems often have a more pesceterian diet.
|
| What is absolutely not clear is any of the cause/effect. It's
| also unknown of the nuances.
|
| For example, what else correlates with those? It often is true
| that people with pesceterian diets are from specific isolated
| genetic lineages. It is also often true that when they're not,
| they tend to be individuals that pay much more attention to
| their overall health, making sure they don't eat too much, eat
| high quality produce (organic, wild caught, etc), exercise
| more, and often are more financially wealthy.
|
| Personally I agree with you, but I also agree with the
| opposite:
|
| > The idea that vegetables/fruits/nuts/seafood products are
| unhealthy seems to be misguided
|
| Historically, we've always consumed all these things. Meat,
| seafood, vegetables, fruits, nuts, grains, seeds, human lineage
| ate all of this for a very long time. Why would any of it be
| bad for us?
|
| More recently as I've been thinking about this, I'm wondering
| if it's more related to our modern production of those things,
| and our changing consumption habits.
|
| Take meat for example, the meat we eat today is very low
| quality. The animals are themselves unhealthy, fed garbage
| food, and have a lifestyle unlike their natural one. Can we
| compare the effect of eating unhealthy meat to healthy meat? We
| know grass fed beef has way more nutrition than non grass fed
| beef for example, so there's clearly major differences between
| eating one or the other.
|
| Now take vegetables, we've not been hard pressing canola into
| an oil extract and consuming it in high quantity before. This
| is a modern change.
|
| In fact, I don't even think canola is a plant we would have
| eaten the seeds off in the past.
|
| So my current thoughts are that low grade produce and processed
| foods might have a lot more to do with it. And all of the
| "diets" no matter if you think they are a fad or which affinity
| you have will emphasize this point: Avoid processed foods and
| try to get the highest quality ingredients.
|
| In the past, we'd probably eat an animal that had eaten canola
| itself and processed it for us, and we'd get the canola
| nutrients through eating the animal.
|
| But also, we wouldn't be eating animal all the time at the
| quantities we do now. Because winter, and hunting is hard, and
| lack of preservatives. But also because once we became
| sedentary, meat was expensive and most people could afford very
| little of it.
|
| And like I said when we did, it would be this very high quality
| meat. Very different from what we eat today.
|
| We also wouldn't be consuming all these processed vegetables
| byproducts, like oils. Appart from those that were very easy to
| extract, like Olive oils. Everything else that requires modern
| industrialization to extract it was probably consumed in much
| less processed forms, such as eating the seeds themselves, or
| grinding a much smaller amount and getting much smaller amount
| of oil out of them.
|
| Modernity has brought major changes in that all foods are now
| of a lower quality, and come in a much more processed form. It
| made a lot of foods more accessible which mean eating as much
| as we do is also a modern change. And it allowed us to modify
| the proportions of what we'd eat, like way more sugar and salt,
| way less veggies and fruits. In my opinion these are the more
| consistent factors. So from my readings, I currently conclude
| the best course of action for your average healthy person is to
| eat less food overall, eat unprocessed foods of the highest
| quality (organic, grass fed, wild caught, etc.), In mostly
| equal quantity of each kind (based on calories), like consume
| the same calories of meat, fish, veggies, fruits and grains.
| curryst wrote:
| > Historically, we've always consumed all these things. Meat,
| seafood, vegetables, fruits, nuts, grains, seeds, human
| lineage ate all of this for a very long time. Why would any
| of it be bad for us?
|
| Because evolution trends toward living long enough to
| reproduce. People often die of heart disease once they're old
| enough they weren't having kids (although exceptions
| certainly exist).
|
| Evolution doesn't give a fuck if fruit suddenly becomes
| poisonous to you on the day you turn 65. Youve passed on your
| genes, your survival is now irrelevant.
|
| So the things that will help us live a long time are not
| driven by evolution. "We've always eaten it" is a terrible
| argument because it should be followed by "but the average
| lifespan was like 40 up until a few decades ago".
| didibus wrote:
| You're right, the evolutionary argument is just one
| dimension.
|
| I don't think it's irrelevant, because logically we should
| have evolved to process what we eat so it doesn't kill us.
| But evolution could have settled on a compromise between
| availability to the food and some "good enough" health and
| lifespan like you say, live at least 40 years, healthy
| enough to have and raise offsprings.
|
| It just seems a good starting point to start refining from.
|
| I've alluded to other dimensions, like how it seems plant
| and seafood heavy diets correlate to longer healthier lifes
| and meat heavy ones don't. But I also wanted to point at
| the uncertainty exactly in those. We don't really have data
| of people on very good meat quality diets versus your
| typical large scale meat production. So it can be
| premeditated to just blame meat.
|
| Similarly more modern forms of vegetable based byproducts
| also have studies showing correlation with inflammation and
| other issues. And again I think it be premeditated to just
| blame vegetables.
|
| In the end, when I consider multiple dimensions that I've
| read about, the diet most consistently appearing
| "healthier" in the average is what I said. A varied source
| of nutritions from different foods, all of high quality,
| with no excess in any one of them over the others, with
| overall eating less of it all, with minimal processed food
| consumption. For which I was just showing that even the
| evolutionary dimension corroborates.
|
| Another way to look at it, we don't know enough about any
| single food and their risk, so a diversified portfolio is
| the best strategy to mitigate the risks, similar to
| financial investments.
| wtetzner wrote:
| > Because evolution trends toward living long enough to
| reproduce.
|
| I'm not sure it's that simple. Given that humans tended to
| live in tribes, it was in the tribe's best interest if
| people were healthy and vital beyond reproduction, for
| hunting, protection, care of young, passing on wisdom, etc.
|
| > People often die of heart disease once they're old enough
| they weren't having kids (although exceptions certainly
| exist).
|
| There are cultures where heart disease is nearly unheard
| of. So I don't think this explanation is very satisfying.
| wtetzner wrote:
| I think you're probably right.
|
| > Historically, we've always consumed all these things. Meat,
| seafood, vegetables, fruits, nuts, grains, seeds, human
| lineage ate all of this for a very long time. Why would any
| of it be bad for us?
|
| In terms of fruit, it would have been seasonal, and it would
| have been good for us to put on weight when we got the
| chance. So some fruit is probably fine, but I suspect people
| eat too much of it.
|
| There's also a theory that we only resorted to seeds if we
| couldn't get anything better. Which would explain some of the
| research that shows seed oils tell fat cells to stay "open"
| and keep growing. It was a signal that we were on hard times,
| and needed the extra energy stored.
|
| For vegetables, I guess it comes down to "which ones". I
| guess the same would probably be true of fruits and nuts,
| too.
|
| > And like I said when we did, it would be this very high
| quality meat. Very different from what we eat today.
|
| And we would have eaten nose-to-tail, meaning we'd have eaten
| the liver, spleen, heart, etc.
|
| > Modernity has brought major changes in that all foods are
| now of a lower quality, and come in a much more processed
| form.
|
| Yeah, I think that's where our biggest problems are likely
| coming from. It looks a lot like the seed oils might be the
| worst offenders.
|
| > So from my readings, I currently conclude the best course
| of action for your average healthy person is to eat less food
| overall, eat unprocessed foods of the highest quality
| (organic, grass fed, wild caught, etc.), In mostly equal
| quantity of each kind (based on calories), like consume the
| same calories of meat, fish, veggies, fruits and grains.
|
| I'm not sure about equal quantities, but I'm also not sure
| what the right quantities are either. I'm not convinced we
| should be eating grains at all, and we should probably be
| careful about fruits. Maybe only eat them when they're in
| season? I dunno.
|
| Fish is tricky, just because you have to be careful of
| mercury, even if they're wild caught. So I guess just try to
| find the types with the lowest mercury levels?
|
| In terms of vegetables, it can also be tricky. Nearly all
| plants have some kind of toxins to protect themselves (they
| obviously can't run or fight back with teeth and claws). Our
| livers have mechanisms to deal with toxins, of course, but
| which ones we can handle and how much is not clear (to me). I
| guess it might be one of those cases where you have to
| experiment and figure out what seems to work for you, at
| least until we have better understandings of them.
| 2OEH8eoCRo0 wrote:
| It's what the science says so far. It's amazing that since
| there are gaps in our knowledge people readily jump over to woo
| woo fad diets.
| pjkundert wrote:
| If the epic, explosive scale of obesity, diabetes and heart
| disease under the modern government recommended high-
| carbohydrate, low-fat diet doesn't give you pause, then.... I
| just don't know what to say.
| boatsie wrote:
| It makes you wonder what would happen if they recommended
| the opposite for a generation, what would happen. Would
| recommending a ketoish diet improve health outcomes? Or
| does the recommendation mean almost nothing and people will
| just eat whatever is sold by big food.
| nradov wrote:
| The science in this area is actually pretty low quality from
| a strict evidence-based medicine standpoint. It mostly
| consists of poorly controlled observational studies, which
| are only one step above the woo woo fad diets. We still don't
| have a solid theoretical framework for how all the pieces fit
| together.
| Pulcinella wrote:
| We (and by we I mean the government) just need to bite the
| bullet and and pay for a multi billion dollar study where
| we pay tens of thousands of people to control* and monitor
| what they eat, exercise, etc for 20 years and just figure
| this out. None of this "well we had 20 grad students
| journal what they did for 6 months and this is the result"
| low quality studies.
|
| *Morally correct and ethically of course. I'm not saying we
| force people into large hamster cages.
| nradov wrote:
| Unfortunately such a study still wouldn't produce valid
| results. The problem is that study subjects don't report
| accurate data. They lie because they're ashamed of their
| choices, or they forget, or they just don't know how to
| accurately count what they eat.
|
| Consider a hypothetical study subject who goes to watch
| the game at his local bar, drinks 7 beers, eats a plate
| of hot wings, and then stops at Taco Bell for nachos on
| the way home. When he wakes up the next morning what do
| you suppose he'll enter on the form?
| wtetzner wrote:
| > It's what the science says so far.
|
| No, it's what _some_ interpret the science to mean. It 's not
| like the Carnivore Code is just a nonsense fad diet. It's a
| book describing the science behind it. You may or may not
| agree with its conclusions, of course.
|
| And I'm not even suggesting to start eating a carnivore diet.
| I don't. I just think it's worth reading for some valuable
| insights.
|
| Additionally, I would argue that the science on seed oils
| points to them being bad for our health. If you watch that
| video, the conclusions are all based on research.
|
| There's no such thing as "the science", as if there's only a
| single conclusion that can be derived from experiments.
| That's not how science works.
| blakesterz wrote:
| It'll be interesting to see how this theory stands up. It seems
| like they're on the right path, tying together several things
| that seem to be problems.
|
| The homeoviscous adaptation to dietary lipids (HADL) model
| explains controversies over saturated fat, cholesterol, and
| cardiovascular disease risk
|
| https://academic.oup.com/ajcn/article-abstract/113/2/277/610...
|
| "Corresponding with the model, we suggest alternative
| contributing factors to the association between elevated LDL
| cholesterol concentrations and ASCVD, involving dietary factors
| beyond SFAs, such as an increased endotoxin load from diet-gut
| microbiome interactions and subsequent chronic low-grade
| inflammation that interferes with fine-tuned signaling pathways."
| sradman wrote:
| PROBLEM #1: High saturated fat diet correlated to high serum
| cholesterol
|
| ANSWER #1: Serum cholesterol is transferred back-and-forth
| between the blood and cell membranes to maintain a constant cell
| rigidity; normal behavior
|
| PROBLEM #2: High serum cholesterol correlated to cardiovascular
| disease
|
| ANSWER #2: Chronic inflammation associated with metabolic
| disorders upsets the various regulatory systems
|
| I find the second answer unsatisfactory. Any chronic condition
| that damages arteries leads to plaque and this, in my opinion,
| accounts for all the other associations. The arterial wall damage
| can be due to excess blood sugar, oxidation, or pathogens (SARS-
| CoV-2?). The damage causes an inflammatory response and extra
| serum cholesterol is needed to repair the damage (forms the
| plaque). The chronic plaque formation reduces the arterial cross-
| section and reduces elasticity which both increase blood
| pressure.
|
| The underlying cause is arterial wall damage. This can be
| measured non-intrusively using the Ankle-Brachial Pressure Index:
|
| https://en.wikipedia.org/wiki/Ankle-brachial_pressure_index
| beowulfey wrote:
| I think it is more:
|
| PROBLEM #2: high serum cholesterol is correlated to
| cardiovascular disease, _but eating high saturated fat-diets is
| not_.
|
| ANSWER #2: It appears that studies that assess the effect of a
| particular diet depends a lot upon the health of the individual
| prior to the study start; thus, using a random population
| results in non-significant results.
|
| Note that I agree with you otherwise. I would suspect that a
| diet high in saturated fats without any supplemental
| unsaturated fats would result in cell walls becoming so stiff
| that removal of cholesterol can no longer benefit the cell
| walls; if this happens in arteries, you get hardened arteries
| that can lead to heart disease.
| sradman wrote:
| My key takeaway is that the ratio of saturated:unsaturated
| fat in the diet does control the concentration of serum
| cholesterol but any ratio between 1:0 and 0:1 (provided you
| get enough essential fats) is perfectly normal and does not
| impact health negatively either way. The function of serum
| cholesterol is maintaining cell rigidity throughout the body,
| not just in arteries. I have never heard this explanation
| before; it makes sense. This claim should be easy to verify
| experimentally.
|
| The question then turns to the underlying cause of
| atherosclerosis. The arguments, to me, seem circular.
| Ultimately, the important question is how much of the plaque
| is due to a damaging agent like sugar and how much is due to
| a hyperactive inflammatory response. Measuring inflammation
| independent of arterial wall damage seems incomplete.
| woeirua wrote:
| Problem #1 is not actually observed though. We know from many,
| many studies that dietary cholesterol is not directly
| correlated with serum cholesterol. The article even alludes to
| the point that the body regulates cholesterol on its own
| regardless of diet.
| brianjunyinchan wrote:
| On the different pathways that inflammation might lead to
| arterial wall damage, here is a good read:
|
| https://harvardmagazine.com/2019/05/inflammation-disease-die...
| graeme wrote:
| > This can be measured non-intrusively by measuring the Ankle-
| Brachial Pressure Index
|
| Huh. Is this something one's GP could do or does it require
| specialized training? The article says it's unpopular at
| general practitioner's offices.
| jpxw wrote:
| Most GPs (or at least all GPs I've ever visited) don't have
| ultrasound machines.
|
| However I imagine they'd be able to perform a simplified
| version, just measuring the BP at the arm and the ankle and
| dividing.
|
| Presumably using the ultrasound just allows you to get a more
| precise reading.
| sradman wrote:
| You can do it at home with a standard blood pressure monitor
| with an arm (brachial) cuff but not a wrist one. Ask your GP.
| ve55 wrote:
| I'm glad to see new approaches to this problem being discussed,
| because even after researching about lipids for quite awhile, I
| was unable to come to a full conclusion on them myself. There's
| so many confounding variables, and attempting to control for all
| of them just isn't really feasible in an RCT (not to mention most
| studies are correlational and nowhere near an RCT to begin with).
|
| I think it's likely the case that sometimes high LDL is good, and
| sometimes it is bad, and this may depend on many other factors
| related to yourself and your diet. But disentangling these cases
| is very difficult, and the food supply of nations has changed so
| much that we keep seeing very misleading correlations. These
| misleading correlations are why we sometimes hop onto bandwagons
| like 'fat is bad for you', 'high salt is bad for you', or 'animal
| products/red meat are bad for you', and then after more research
| and RCTs, we realize that this is not the case (if the press
| would stop reporting correlations to everyone as important
| research that you need to act on right now, that would certainly
| be nice).
|
| I'm looking forward to more progress here, but until then I don't
| mind eating saturated fats myself, although I do avoid certain
| sources of them, such as in fried oils high in linoleic acid. I
| also don't focus a ton on LDL precisely, but rather some other
| related measures (different types of cholesterol, low
| inflammation, and coronary calcium scans if possible)
| imsofuture wrote:
| I believe the focus on LDL as 'bad' has been misguided. It's an
| improvement from 'all cholesterol is bad', but we just don't
| understand very much about how it all works, and so as we
| discover more, we slowly refine our understanding.
|
| A lot of the theory about why LDL is 'bad' is based on the fact
| that arterial damage is repaired with the stuff, causing
| plaque. There's no evidence that LDL is _causing_ the damage,
| just that it has a role in how it 's fixed (in an ultimately
| detrimental way).
| superqd wrote:
| So much nutrition research is all correlation and no causation.
| Statements like this, which over-infer, kill me:
|
| "There is little doubt that people with high cholesterol have an
| increased risk of disease."
|
| It's just as valid to say that people with heart disease are more
| likely to have high cholesterol. When all you have is
| correlation, there is a heart disease group, and a high
| cholesterol group, and all you shown with correlation is that
| there is a third overlapping group of people with both. With only
| correlation, you don't know how/why, or even if, members of one
| group transform into the other. Which is partly the underpinning
| of the article.
|
| It's possible that high cholesterol is a result of underlying
| heart disease (which the article says is possible), rather than a
| cause. But what shocks me is that people, even researchers, seem
| surprised to realize such possibilities.
| chiefalchemist wrote:
| Correct me if I'm wrong, but wasn't one of the founding /
| influencial "cholesterol is bad" studies found to be bad science,
| and that ultimately it was the result of "financing" by Big
| Sugar? They were Harvard profs / researchers I believe.
|
| The point being, much of collective knowledge on this subject is
| based on misleading / false assumptions. That is, you're going to
| struggle to find results that align with conventional wisdom
| because that wisdom is flawed.
| elhudy wrote:
| I am close with someone who has chronic high cholesterol, in
| addition to a 6-pack abs. She exercises 5x/week and eats .5kg of
| animal products/week at most, usually white meat. She just
| visited her heart Dr and was told that her cholesterol is too
| high and that she needs to cut out animal products entirely as a
| next step.
|
| I am thinking...is this really the modern answer to someone's
| high cholesterol if they consistently exercise, are nearly
| underweight, and rarely eat animal products to begin with? It
| doesn't add up to me.
|
| It's amazing how little we still know about heart disease - the
| #1 killer in the US. As someone who will inevitably inherit
| chronic high-cholesterol as well, I'm excited to read and share
| this ongoing research. Thank you for posting this.
| nofnziti wrote:
| There are many more dietary sources of saturated fats than just
| meat.
| elhudy wrote:
| Edited to say "animal products" rather than meat.
| nofnziti wrote:
| I wasn't trying to nitpick your comment. Even excluding
| animal products it's still possible to eat a diet high in
| saturated fat.
| elhudy wrote:
| No worries, I should have just said she "eats healthy".
| nradov wrote:
| Saying that someone "eats healthy" is so vague as to be
| meaningless.
| elhudy wrote:
| can't please everybody :)
| hn_throwaway_99 wrote:
| But dietary cholesterol itself only comes from animal
| products, which is probably why the Dr. said to cut out
| all animal products.
| nofnziti wrote:
| And saturated fats are linked to higher LDL. What are we
| disagreeing about?
| UncleOxidant wrote:
| Did the doc do any kind of test to determine current levels of
| plaque in the arteries? There's a test that's done via
| ultrasound (IIRC) on the carotid artery that can give a pretty
| good idea of current plaque levels.
| MisterBastahrd wrote:
| My grandmother has been diagnosed with high cholesterol since I
| was a toddler.
|
| She's 104 years old and survived COVID this summer.
| simonhughes22 wrote:
| Similar - my grandfather is my only grand parent with high
| cholesterol, he's now 93 and has out lived all my other grand
| parents and his sister. It's clear to me that there's a lot
| here that we still don't understand.
| jandrese wrote:
| For one it's a statistical risk factor, not a guaranteed
| death sentence. There will always be outliers.
| wirrbel wrote:
| In my family all the cooking/frying is done with clarified
| butter. Butter, cheese, definitely no margarine/crisco, plant
| oil only for salads. So far no cardiovascular problems.
| dv_dt wrote:
| The interesting side effect to me here is using butter one
| might keep the cooking temperatures a little bit lower.
| Butter burns at a lower temp than many plant oils.
| ominous_prime wrote:
| The solids in butter are what burn quickly. Clarified
| butter burns at 230degC, which is at the higher end of
| cooking oil smoke points.
| draw_down wrote:
| Not clarified butter; it's clarified so that it can be
| cooked at higher temps (it also keeps longer). Clarified
| butter has a higher smoke point than several plant oils.
| viraptor wrote:
| Could be also something like
| https://en.wikipedia.org/wiki/Familial_hypercholesterolemia
| where it's just due to genes and bad luck. You can do generic
| tests for it, but they're relatively expensive. Statins mostly
| help bring the numbers down.
| TimedToasts wrote:
| > She exercises 5x/week
|
| What kind of exercise: cardio, yoga, resistance/weight
| training, other? There have been a number of studies showing
| that regular weight training improves cholesterol numbers (1,2)
| and I have seen it personally. Regular weight training causes
| cells to repair/recycle their cholesterol, removing it from the
| bloodstream. (Cardio may or may not do this as well but I'm a
| proponent of weight training as the foundation of health.)
|
| Also: after reading the article, I think that cholesterol
| turnover rate is the key here. Cholesterol that is regularly
| used up and replaced does not have time to damage your vascular
| system like cholesterol that hangs around and hardens on your
| walls.
|
| 1) https://pubmed.ncbi.nlm.nih.gov/24174305/ -- Differential
| effects of aerobic exercise, resistance training and combined
| exercise modalities on cholesterol and the lipid profile:
| review, synthesis and recommendations
|
| 2) https://pubmed.ncbi.nlm.nih.gov/33343671/ -- Regular
| training has a greater effect on aerobic capacity, fasting
| blood glucose and blood lipids in obese adolescent males
| compared to irregular training
| omgwtfbyobbq wrote:
| It may not. Her doctor could be erring on the side of caution.
| Also, cutting out animal products completely could demonstrate
| that her high cholesterol is due to something besides her diet
| which should open up referrals to a specialist and other kinds
| of testing.
|
| In my experience, as a patient with some unknown problem, the
| less experienced a physician is, even if they are a specialist,
| the more likely they are to try to match up your issues with
| what they know and hand wave away any inconsistencies. When you
| get to an expert, if there are inconsistencies they will
| straight up say they don't know what's going on and will start
| looking into it (running tests, trying different meds, etc).
| josefresco wrote:
| Both my parents are vegan, thin, active, eat basically the same
| things but one has "bad" cholesterol numbers and one has good.
| We know so little!
| Ekaros wrote:
| It could be entirely genetic. Worst case could be that some
| groups just tend to die earlier from these diseases... There
| could be some somewhat invasive medications to fix thigs. But
| they are likely very far away...
| Matrixik wrote:
| We know a lot about heart disease but it looks like most look
| for magic drug instead of underlying process.
|
| Check Dr. Malcolm Kendrick long series on "What Causes Heart
| Disease" (list of all posts from drmalcolmkendrick.org):
|
| https://www.emotionsforengineers.com/2018/01/dr-malcolm-kend...
| mywittyname wrote:
| I'm in a similar situation (granted, I do eat meat 5-6 days a
| week). And I have no idea what to do about it except go vegan.
|
| I suppose there's a genetic component, as no man in my known
| family lineage has made it past 60.
| wtetzner wrote:
| Well, if the theory in the article is correct, then high
| cholesterol may not be a bad thing.
| finnh wrote:
| My paternal grandfather and great grandfather both died of
| cardiac arrest in their 50s. My Dad has always had high
| cholesterol but went on drugs as soon as they were available
| - first Niacin, then statins. He's still doing great at 75
| and very much thinks the pills are to thank.
| airstrike wrote:
| Does she eat a lot of sugar?
| dcolkitt wrote:
| It's an interesting hypothesis. But it seems contradicted by
| Mendelian randomization studies, which find that LDL cholesterol
| levels to be causally associated with heart disease.
|
| https://pubmed.ncbi.nlm.nih.gov/26780009/
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