How Do We Know that Cholesterol Causes Heart Disease?
16
September

By Adem Lewis / in , , , , , , , , , , , , , , , , , , , , , , , , , , /


it is well accepted that coronary atherosclerosis is a chronic progressive disease it begins early in life and slowly progresses over several decades before symptoms arise however the average age in cholesterol-lowering drug trials is 63 and therefore people had already been exposed to a lifetime of circulating LDL cholesterol so no wonder pharmaceutical therapies typically reduce cardiovascular disease risk by only 20 to 30 percent we know LDL so-called bad cholesterol plays a central role in the initiation development and progression of our number one killer over a hundred perspective studies involving more than a million people have demonstrated that those with higher LDL levels are at higher risk it seems reasonable to assume that if lowering cholesterol later in life can help then keeping LDL levels low early in life may prevent our arteries from getting clogged in the first place but let’s not just assume it would be considered unethical to set up a controlled clinical trial which young adults with elevated serum cholesterol levels were treated or not treated over their lifetime and just like you couldn’t ethically set up study in which half the kids are made to start smoking to see if smoking really does cause lung cancer that’s where observational studies come in you can follow people who already smoke and compare their disease rates to those that don’t it’s like 40 years ago when the president of the American Heart Association tried to argue that we should all stop smoking even though there were no randomized controlled trials look those who smoke have a higher risk of heart attack the more we smoke the higher the risk and after we stop our risk drops the same can be said for high cholesterol if you look at young men aged 18 through 39 and follow them for up to 34 years cholesterol levels even when you’re young predicts long-term risk of heart disease and death men in their 20s and 30s who ever a total cholesterol even just under 200 have a substantially longer estimated life expectancy around four to nine years longer than those over 240 evidence from observational studies however is vulnerable to so-called confounding factors eating a diet plant-based enough to lower cholesterol below average may add years to our lives regardless of what our cholesterol is ideally we’d have a long-term randomized control trial and nature may have actually set one up for us each of us at conception gets a random assortment of genes from our mother and our Father and some of those genes may affect our cholesterol levels just like there’s rare genetic mutations that result in unusually high cholesterol there are rare genetic mutations that lead to unusually low cholesterol providing an ideal system to assess the consequences of low LDL cholesterol levels independent of confounding diet and lifestyle factors let me show you what I mean about 1 in 40 African Americans have a mutation that drops their LDL cholesterol from up around 130 down towards more optimal levels now this group didn’t eat healthy to get there it’s just in their genes more than half at high blood pressure there are lots of smokers and diabetics yet those with genetically low LDL levels still had a significant reduction in the incidence of coronary heart disease even in the presence of all these other risk factors how significant how much less heart disease how about 88 percent of heart disease gone the astounding finding was that the heart disease risk and these individuals was reduced by more than 80 percent where’s the same 20 to 40 point decrease in LDL from drugs only reduces risk like 30 percent make sense though right the folks with the mutation had low levels like that their whole life they didn’t just start taking some pill when they were 60 years old the magnitude of the effect of long-term exposure to lower LDL cholesterol concentrations observed in each of these studies represents threefold greater reduction in the risk of heart disease compared to drug treatment started later in life for you fellow research nerds out there check out that p-value you’d have to do like a quintillion studies to get that kind of result by chance there for a primary prevention strategy they promotes keeping LDL cholesterol levels as low as possible beginning as early in life as possible and sustaining those low levels of LDL throughout the whole of one’s lifetime has the potential to dramatically reduce the risk of coronary heart disease and that’s just what a healthy diet can do you [Music] you


100 thoughts on “How Do We Know that Cholesterol Causes Heart Disease?

  1. Merch Request:
    Evidence
    Based
    Eater

    On a tee and tank – I would buy the heck out of those! ( especially in an athletic cut 😊)

  2. Hi Vegan Footsoldier – I'm a volunteer moderator who helps Dr. G answer questions. An important consideration in trying to determine who to believe is the credibility of the person supporting a viewpoint and the quality of the information/studies they are basing their opinion on. Authors of books may not be health professionals with the qualifications to evaluate and interpret the evidence and in fact, many authors do not cite science at all! That's why I'm happy to affiliate with Dr. G. He knows his stuff, reviews tons of articles on a given topic before making a video. He explains all of this in an introductory video, "Behind the Scenes at Nutrition Facts.org" that you can access by searching this title on his website. I encourage you to check it out and in future, if you don't mind, consider posting questions on his website so other people with the same questions can benefit. Thanks in advance! Hope to hear more from you on the website!

  3. I wish there could be a discussion on this with Dr. Greger and Dr. Jack Kruse, or  Dr. Eric Westman. One of the things I admire about Dr. Greger is, he is not in it for the money. But truly how can doctors like Kruse, Westman, Davis, Perlmutter and many,many others be allowed to give out wrong information? Are they protected by the money and industry? Why have there not been malpractice lawsuits against these people? When I worked in CVICU (cardio vascular intensive care unit) doctors would have patients eat a very low carb diet prior to doing surgery on them, so they would drop weight rapidly, this is where I first heard about low carb diets outside of the Atkins groups.
    I use to do a Keto diet, but recently have changed my way of eating to a plant based diet, as I find it more sustainable. I lost weight on Keto. I actually did it for brain health, as I was convinced by so many professionals, that it was the route to go because of autoimmune disease and Alzheimer running in my family.
    I am not dogging anyone here and actually I am here to learn more. I have listened to many, many talks, videos and read many plant based doctor's books. I do believe in looking at facts and science, but as well people….Blue Zones for example. How do the healthiest longest living people eat and it is plant based for the most part. This is what has convinced me, as it seems we have a polarization when it comes to the medical fields and the science they seem to be using as well.

  4. Dr. Greger, can you please expand upon the claim made by Dr. Roberts that only herbivores develop atherosclerosis?
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1312295/

  5. SOooo glad this video is out. I am 41, my Dr. just tried to put me on Lipitor!!! my LDL WAS 59 HDL 41 Cholesterol 150, and glucose was 96, but…my triglycerides were high at 296!!!! I was skeptical over the Lipitor because I had a sweet tea and a Bacon sandwich (yes…I know BACON), on white (usually its wheat whole grain), with mayo an hour before my labs….Didn't know I was going to have them done. She said fasting labs and me eating wouldn't make a difference because if its that high after a sandwich, she's "sure it was high before" (triglyc level) so what do I do? I am overweight by 40 pounds ( was 80 lbs from steroid shots until I stopped getting them). Don't want to take that med…heard a lot of bad things about it. input anyone?

  6. Doc, you need to post a response to the news this week about curcumin/tumeric being overrated as having health benefits. Various recent reports are based on latest studies published in the Journal of Medicinal Chemistry. The study actually concluded that curcumin has little to no benefit. This is an extreme opposite to your many raving videos about this spice.

  7. Why not a debate between Greger/Ornish/Esselstyn and Dom D'Agonstino/Peter Attia/Rhonda Patrick to come to the bottom of this cholesterol saturated fat issue.

  8. it's difficult to convince the millions of people taking statin drugs to just change their diet. Many of them routinely have impressive blood test results. they eat everything they want, never exercise, are overweight, and still have very low cholesterol. and their insurance pays for the drug. almost seems unfair for those of us who work harder with diet and exercise just to keep our numbers in the acceptable range. but at least we are not fat. . .

  9. ""Woman died from superbug resistant to all available antibiotics in U.S."" I was able to copy the URL but u can find it w/ that title. Please note: there is noooo mention of animal agriculture being responsible……!!!!!!!
    Sorry…off topic……I never comment but wanted to put the information out there

  10. ""Woman died from superbug resistant to all available antibiotics in U.S."" I was able to copy the URL but u can find it w/ that title. Please note: there is noooo mention of animal agriculture being responsible……!!!!!!!
    Sorry…off topic……I never comment but wanted to put the information out there

  11. Dr. Greger, I'm not sure if you have covered this but wondering what your opinion or research shows regarding theories presented by individuals such as Linus Pauling regarding vitamin C deficiency and heart disease? Also L-lysine? It makes a lot of sense to me considering the only species who get heart disease are the ones who cannot make their own vitamin C.

  12. In all honesty, as a 6 year medical i'm confused. How Come come so many MD's reccomend low carb diet?. I mean , the content of this video is a 3d year medschool stuff

  13. Funny, just went through "cardio-rehab" post MI – and got conflicting views. The nutritionist was all about low-fat, low cholesterol. The pharma instructor said that the lipid hypothesis has been disavowed by Heart Association recently. Listening carefully to the first part of this presentation, I hear a lot of correlations, but no causations. Theoretically, people with high levels of LDL get more atherosclerosis. But – the causation is not discussed. In fact, it appears that inflammation is the problem. In my own case, I had a cholesterol of 186 with an "excellent" HDL, yet still had an MI. Yet, I was prescribed a statin which appeared to lower my cholesterol down to 156, no change in HDL. Post MI, the pleiomorphic effect of statins is in itself, debatable as well. I started experiencing several deleterious side-effects, and have stopped taking the statins. This presentation sounds like a desperate plea to keep statins relevant, when their main cholesterol-lowering effect appears to be BAD for patients.

  14. Elevated LDL is protective against microbial burden, which suggests that heart disease is caused my microbes:

    https://www.amazon.com/dp/B01G48A88A

  15. Yeah it is all good, and of course we should eat healthy and keep our LDL low and all. BUT this study does not really solve the problem of confounding factors, as it has it's own confounding factor, that gene/mutation. It is theoretically possible that the gene which is responsible for these people's lower LDL levels also contributes to their lower risk of disease through some other mechanism independent of LDL's effects.
    Still, I am eating my vegetables and such.

  16. Is it really cholesterol that's the villain in heart disease, though? I thought the endothelial cells of the blood vessels first had to be damaged for cholesterol to stick to them, and then plaques develop. If the arteries were healthy, deposits wouldn't form, no matter if you had a high cholesterol level or not, right? Is this correct?? I really want to understand this. Thanks.

  17. Dietary cholesteol or the same that our bodies produce does not cause LDL. Stress, smoking, chronic inflammation, lots of sugar refined carbs, damaged arteries cause heart disease. People like Vince Gironda as an example has ate much cholesterol and fat his whole life and lived long. Look at the whole picture.

  18. Haha to all the science nerds that p-value at 4:19 is the lowest I've seen from the results of a statistical t-test basic on real research data!

  19. Saying cholesterol is responsible for atherosclerosis is like saying firemen are responsible for starting fires. Just because it is at the scene of the crime doesn't mean it's responsible.

    Sounds like Dr Greger's been bought by the pharmaceutical companies.

    Inflammation causes heart disease. It's even likely that high levels of cholesterol are caused by the body trying to fix itself, as that is what cholesterol does. It repairs (amongst other things) Most of the cholesterol in my body was made by my body considering I eat a vegetarian diet and yet I have a high cholesterol level. Obviously my body is trying to save me, not kill me.

    Most of my brain is made of cholesterol and your body depends on it for healthy survival and there are even suggestions that high cholesterol leads to longevity, not heart disease.

    Statins not only cut the body's cholesterol production it also cuts the production of other essential enzymes such as Coenzyme Q10 essential for healthy muscle function. The heart being a muscle too.

    I'm getting sick of this. Medication does nothing more than hide symptoms, create side effects and make industry richer.

    There was a time when this doctor was recommending people take cinammon to lower blood sugar. Then he discovered that the amount you had to consume daily had a negative impact on the liver so he had to backtrack. Fair enough. But obviously the cinammon manufacturers were not paying him enough.

  20. Dr. Greger and the Nutritionfacts.org team,

    First off, thank you for your work. I follow the site, and would have been floundering for good information without it. I am studying physiotherapy at university and have come across a couple of professors who deride vegan and vegetarian diets in lecture. These are people of science, and I am a rational guy (at least as rational as a 23 year old male can be). I do not want to make any emotional arguments for veganism and plant based dieting as a clinical tool. I want science. I have opened a google drive folder where I am getting together a list of studies to eventually print out and carry in a binder which I can then use to reference if someone spouts some incorrect or downright antiscience nonsense about humans being incapable of thriving on a plant based diet. I will add to it as I go, but I was wondering if perhaps you all have something of this kind already? A sort of primer, aimed more at scientists, clinicians, and students of those types of fields? Anyway, even if you don't, and don't have time to answer this, keep up the excellent work.

    It is much appreciated.

  21. I'm introducing in a plant based diet and for me at least the most difficult part is to keep Omega 3-Omega 6 in a good ratio. I throw up all kind of oils, limit nuts to 1 handful of hazelnuts a day for being the nut with less omega 6 per 100gr, and i'm also eating avocado and making an avocado sauce for salads, vegetables, and add 2 flaxseeds tablespoon. I would know if anyone knows mustard as sauce, not as oil, has a good Omega 3-Omega6 ratio to add in to my diet, it would be important to have more variety, and what other sauces you use to keep this ratio? Thank you.

  22. I'm a vegan and recently checked my cholesterol and triglycerides levels in the lab and turns out my HDL is even higher than my LDL. Yay.

  23. from https://www.drmcdougall.com/misc/2012nl/jun/paleo2.htm

    "Teachers of Paleo nutrition claim our ancient ancestors
    were hunter-gathers with an emphasis on hunting, regardless of what the
    bulk of current scientific research reports. They base their hypothesis
    largely upon a flawed review of contemporary hunter-gathers.
    Primates, including humans, have practiced
    hunting and gathering for millions of years. I know of no large
    populations of primates who have been strict vegans (ate no animal foods
    at all). However, plants have, with very few exceptions, provided the
    bulk of the calories for almost all primates. This truth has been
    unpopular in part because of a well-recognized human trait, sexism.
    Grandparents, women, and children did the gathering, while men hunted.
    Glory always goes to the hunters.
    When asked about the commonly held idea that ancient people
    were primarily meat-eaters, the highly respected anthropologist,
    Nathanial Dominy, PhD, from Dartmouth College responded, “That’s a myth.
    Hunter-gathers, the majority of their calories come from plant
    foods…meat is just too unpredictable.” After studying the bones, teeth,
    and genetics of primates for his entire career as a biological
    anthropologist, Dr. Dominy, states, “Humans might be more appropriately
    described as ‘starchivores.’”
    Paleo diet proponents spare no effort to ignore and distort
    science. The general public is at their mercy until they look for
    themselves at recent publications from the major scientific journals:
    * Research published in the journal Nature (on June 27,
    2012) reports that almost the entire diet of our very early human
    ancestors, dating from 2 million years ago, consisted of leaves, fruits,
    wood, and bark—a diet similar to modern day chimpanzees.
    * According to research presented in a 2009 issue of
    Science, people living in what is now Mozambique, along the eastern
    coast of Africa, may have followed a diet based on the cereal grass
    sorghum as long as 105,000 years ago.
    * Research presented in a 2011 issue of Proceedings of the
    National Academy of Science shows that even the Neanderthals
    ate a variety of plant foods; starch grains have been found on the
    teeth of their skeletons everywhere from the warm eastern Mediterranean
    to chilly northwestern Europe. It appears they even cooked, and
    otherwise prepared, plant foods to make them more digestible—44,000
    years ago.
    * A 2010 issue of the Proceedings of the National Academy of
    Science reported that starch grains from wild plants were identified on
    grinding tools at archeological sites dating back to the Paleolithic
    period in Italy, Russia, and the Czech Republic.
    These findings suggest that processing vegetables and starches, and
    possibly grinding them into flour, was a widespread practice in Europe
    as far back as 30,000 years ago, or even earlier.
    Falsehoods leading the general public to choose foods that
    threaten our very existence have been challenged for decades,
    but as I have said before, people like to hear good news about their
    bad habits; so the Paleo Diet continues to get a highly visible platform
    with too little public debate."

    AND in agricultural times

    "Paleo Nutrition Contradicts the Obvious: Most People Have Lived on Starch-based Diets
    All large populations of trim, healthy
    people, throughout verifiable human history, have obtained the bulk of
    their calories from starch. Examples of once-thriving people include
    Japanese, Chinese, and other Asians eating sweet potatoes, buckwheat,
    and/or rice; Incas in South America eating potatoes; Mayans and Aztecs
    in Central America eating corn; and Egyptians in the Middle East eating
    wheat. There have been only a few small isolated populations of
    primitive people, such as the Arctic Eskimos, living at the extremes of
    the environment, who have eaten otherwise.
    Therefore, scientific documentation of what people have eaten over the past thirteen thousand years convincingly supports that starch, not animals, is the traditional diet of people.
    Men and women following diets based on
    grains, legumes, and starchy vegetables have accomplished most of the
    great feats in history. The ancient conquerors of Europe and Asia,
    including the armies of Alexander the Great (356 – 323 BC) and Genghis Khan
    (1162 – 1227 AD) consumed starch-based diets. Caesar’s legions
    complained when they had too much meat in their diet and preferred to do
    their fighting on grains. Primarily six foods: barley, maize (corn),
    millet, potatoes, rice, and wheat, have fueled the caloric engines of
    human civilization.
    The longest living populations on planet
    Earth today live on starch-based (low-animal food) diets. These include
    people from Okinawa, Japan; Sardinia, Italy; Nicoya, Costa Rica; Ikaria,
    Greece; and the Seventh Day Adventists in Loma Linda, California, who
    live in what are called the “Blue Zones.”
    The most effective diets ever used to cure
    people of common day illnesses, like coronary heart disease, type-2
    diabetes, hypertension, hypercholesterolemia, arthritis, and obesity
    minimize animal foods and require people eat the bulk of their calories
    from starches, including grains, legumes, and potatoes (foods forbidden
    to Paleo eaters). Medical giants in starch-based diet-therapy, include Walter Kempner MD, the founder of the Rice Diet at Duke University; Nathan Pritikin; and Roy Swank, MD, founder of the dietary treatment of multiple sclerosis at Oregon Health & Science University. "

  24. this is a fairly useless video because you should have looked at all cause mortality of people with pcsk9 not just cardiovascular disease. Another problem with your video is that taking statin drugs may reduce cardiovascular disease but it makes very little different to all cause mortality. given the side effects of statin drugs it's questionable whether the benefits are worth it. unfortunately most people trained in medicine are unable to analyse complex systems and have to dumb everything down to one cause and effect and that's not how the system works. many people trained in medicine don't understand the difference between a risk factor and a cause. Way too often doctors try to reduce risk factors artificially by using drugs which may increase or reduce life expectancy instead of getting to the root cause of the problem.

  25. Dr. Greger chooses to ignore the last twenty years of research on cholesterol and posts a video that is patently false.

  26. https://www.ncbi.nlm.nih.gov/pubmed/19641727         Yet another study showing largely improved lipid panels and weight loss on a high fat diet.  Higher HDL and lower LDL and plummeting triglycerides.

  27. What a wonderful bit of serendipity, nature as a research assistant. Great video, and for my money closes the door on any argument about the role Low-Density Cholesterol in heart disease. As a long term vegan, my Low-Density Cholesterol always tests in the normal range. However, in my last blood test, my Hight Density Cholesterol also tested low, which was flagged for continued review. It would be useful for you to touch on the issue of a lower than normal level of high-density Cholesterol and related topics.

  28. this is why when my vegan grandma got a stroke from stress ( had a stroke directly after bad news over the phone) the Drs ran all these tests including her LDL. they couldn't figure out why she even had a stroke to begin with. In her case it was mental but even mainstream Drs know cholesterol links to heart disease otherwise they would test it to find the cause. know anyone who's had a heart attack? what do they test? blood pressure & cholesterol. the Drs said her cholesterol was so good they didnt understand so put it down yo mental trauma.

  29. all those people who say cholesterol isn't relevant in this just have a hard time admitting that their habits are bad and they don't wanna change anything so they try to convince themselves that it's good for them

  30. a glaring omission on this video was that you didn't report all cause mortality for variations of pcsk9. if having the pcsk9 variation means that you're more likely to die at a younger age of cancer or something else then it may not be such a good thing.

  31. your logic is wrong. until you find out exactly everything the pcsk9 gene does and why it's produces lower ldl then ldl is still a confounding factor. for sample the gene might do something that's puts a higher priority on preserving the collagen in your blood vessels than other parts of your body and hence maintain healthy blood vessels and so there is less need for ldl cholesterol production.

  32. Another awesome video!!! Could you discuss this (see link) please? The fact that carnivores can NOT get heart disease – meaning we aren't meant to eat meat at all, etc, etc… (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1312295)
    Thanks! :o)

  33. Love these videos! Solid based facts! And to think some are still preaching paleo from authors who cherry pick studies to back their claims and spin the truth by leaving out all the facts. Plant Based Starch based worked great for me so to each their own.

  34. There are still some fools that think that grains and potatoes clog your heart. Or buy into weird conspiracy theories that conveniently take the blame away from meat and animal products.

  35. My professor says that it's the carbs and eating dietary cholesterol doesn't raise blood cholesterol, he's sooo biased and I'm vegan…sigh

  36. Hey Dr. Greger … I think it would be interesting if you could comment (either in a video or on a Q and A live) on all the doctors that refute the cholesterol data on what appears to be valid grounds … like Mercola, Cousens, Malhotra etc. They sight Harvard reviews that find no significant correlation between saturated fat and heart disease, and smack down cholesterol research from Keys on forward based on statistical manipulation of data etc. And if you add to this Malhotra's data that I saw, you can develop quite an argument against the cholesterol scare … for example, 75% of admissions for heart attack patients in hospitals have normal cholesterol and normal LDL … and Malhotra's research of people over the age of 60 showed no increased risk of heart attack due to high LDL, and in fact, longevity increased the higher it went. These are some confounding contradictions found by sincere doctors like yourself. Is there no relevancy to what they are saying?

  37. Great argument… suggesting that we feed statin poisons to kids. Given that it is believed that diet has minimal effect on LDL levels anyway

  38. By the way, this is basically clickbait. The video does not even really pose let alone attempt to honestly answer the question, why it is believed that cholesterol causes heart disease. As cardiologists often say today, blaming cholesterol for heart disease is like blaming firefighters for fires. Both are present at the scene of the disaster. But ("oxidative") arterial damage is the cause of heart disease, not cholesterol.

  39. Or or or… it could be that those who are at a higher risk for heart disease and have higher LDL, have higher LDL precisely because their body is trying to repair a pre-existing inflammatory response. I mean, that is one of the primary roles of LDL/cholesterol, right? To patch up underlying damage from inflammation in the arteries/wherever else there is a chronic inflammatory response within the body? And is it not also true that our liver determines the vast majority of serum cholesterol levels at any given time depending on the current needs of the body? This video strikes me as a classic case of " if there are more fire men at the scene of larger fires, it must be the increased number of fire men causing the fire to grow!" argument, as many other viewers have already pointed out. Your "causality" is bass ackwards. Just because someone has a genetic tendency to have lower LDL does not mean they have lower rates of heart disease/mortality BECAUSE of the lack of LDL. I have an alternative theory: those with naturally lower LDL levels may have experienced slightly lower levels of heart disease mortality, but not a significantly lower incidence of all cause mortality. Oh hey, here is a quote from the study you so conveniently omitted:

    "Moreover, it is not known whether the beneficial effect of decreased LDL cholesterol levels on cardiovascular disease results in an overall reduction in mortality rates. The number of deaths observed during the follow-up period was slightly lower among carriers than among noncarriers both in black subjects and in white subjects, but the difference did not reach statistical significance"

    Soooo my conclusion from that statement is that we should lower LDL cholesterol at all costs in order to reduce heart disease risk, even if it means we aren't actually significantly changing mortality rates? Hardly. This video is just another example of a doctor missing the forest for the trees. If lowering LDL doesn't reduce mortality, then why the hell are we focusing so much on it? Clearly there is something else at play here, and the tunnel vision approach of " lower LDL at all costs" has a potentially more deadly outcome than not focusing on it at all.

  40. Could it be, there might be more?

    "Most heart attack patients' cholesterol levels did not indicate cardiac risk"

    http://newsroom.ucla.edu/releases/majority-of-hospitalized-heart-75668

    The test can be cheated by eating more cholesterol-an inversive effect?
    https://youtu.be/jZu52duIqno

    Could it be Vitamin K2 Deficiency?
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4566462/

  41. You dont your just speculating, well speculation is the mother of all fuckups, more than half the people who die of heart attacks have normal to low Choloestertol. So this is all B.S. people who live into there 80s and 90s on average have high cholesterol. So you stupid asses can say all you want and lie like idiots but true facts are in. Choloestertol helps protect and build tissues not harm it. Everything he says is cherry picked biased B.S. now thats the truth

  42. Before going on ketogenic diet, my tryglycerides were 400 and thats danger level, now that im ketogenic and eating high fat and high greens its dropped dramatically to 46, have another test in 2 weeks, cant wait

  43. Any thoughts on this study? It says it excudes cross-sectional studies. "Evidence from prospective cohort studies does not support current dietary fat guidelines: a systematic review and meta-analysis" http://bjsm.bmj.com/content/early/2016/10/03/bjsports-2016-096550.full

  44. I'm getting all conflict information such as https://www.youtube.com/watch?v=C6SVB99mJHA and https://www.youtube.com/watch?v=yX1vBA9bLNk&t=2973s and https://www.youtube.com/watch?v=1pfGTBXkq3g All claim that cholesterol, good or bad, has LITTLE to do with heart disease. It is the carbs and sugar the really criminals. How do you explain that??

    And thank you, Internet.

  45. I've looked at one pubmed study on TMAO. Now, this is just my theory based on what I read. It appears that TMAO increases the risk of clots forming in our arteries. Now, TMAO is formed in our bodies with consumption of animal products, like fish, meat and eggs which when our gut bacteria eat it, they produce TMAO as a by-product. This is not produced when eating plant products. So what may have happened here is we have blamed cholesterol for clogging our arteries, when it was TMAO all along. However, whichever it is, eating animal products is indicated of cause, so this part has not changed. It doesn't matter which one(TMAO or cholesterol) you want to believe is the bad guy, it doesn't change anything on the risks of eating animal products and artery clogging. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4862743/

  46. It doesn't. Sugar does.
    https://bjsm.bmj.com/content/51/15/1111
    https://academic.oup.com/ajcn/article/91/3/535/4597110

  47. My dad doesn't drink milk because he knows it's bad for you and gross but he still eats cheese, yogurt, cream and butter…I asked him why he still eats butter as he was buttering his toast because ''it takes a lot more milk to make it and has more concentrated amounts of saturated fat, cholesterol and puss'' and he said ''cholesterol is good for you''. I face palmed my head so hard i went back in time!

  48. As the body regulates the cholesterol level itself (the body produces it's own cholesterol), it would be interesting to know, if people who deviate by genetic nature from the (by nature) intended cholesterol level (like those mentioned in the video) also have a lower mortality overall (not just for heart disease). For if they die of fewer heart disease, there might be an other downside to the low cholesterol levels they have. That might be the reason, why evolution reacts with a certain cholesterol level to a certain diet. Cholesterol could be just the fire fighters who happen to be at the scene of the "crime" – and what we're observing is, that "fire fighters" are always there, if there is the fire (/if there is atherosclerosis), so they must be the cause of the fire, right? This is why mere correlation is not very convincing, and I think the comparison with tobacco consumption doesn't help much.
    In three of the blue zones, lard consumption is very common around the centenials! I am absolutely convinced that animal protein and isolated components of natural foods (like sugar, white flour, vegetable oils – as Dr. Esselstyn has shown) are extremely dangerous. But is this also the case for saturated fats and cholesterol? The bad effects from animal products could also come from the animal protein (see China study), that usually comes in a pack with the animal fats. That's why the answer given in the viedo is a bit disappointing.

  49. 20 yrs ago i ate whatever i wanted and my cholesterol was lower then, than now being on a plant based diet. I don't get it. 😔 Granted i was more active then by far but due to a back injury i can no longer do cardio exercise. Food vs food though i eat much better now than then and my cholesterol is much higher now. 😔

  50. The establishment is LYING when they say cholesterol CAUSES heart disease. It is caused by SUGAR AND CARBS NOT CHOLESTEROL. The cholesterol/plaque in your arteries is produced by YOUR OWN LIVER and NOT from the food you eat. The American medical establishment is the most conniving and corrupt of any medical establishment on EARTH. They have a well established track record of telling us the °180 opposite of the truth for many many decades now – SHAME ON THEM. America is saturated with lying and liars.

  51. Though you did not cite your sources at the end of your video, you showed them so I could copy them to look up the studies and juried articles that you used in your argument. I find it shocking at how many health professionals have done YouTube videos and don't show or cite their sources. It's interesting at how comments say you didn't prove your arguement: it was done very well. Thank you…

  52. Elevated levels of cholesterol is there because of chronic inflammation. There's no such thing as bad or good cholesterol, cholesterol is good. It's only bad when it becomes chronic and starts congesting your bodily tubes. In such case, lower the inflammation. When you get rid of the cause, you also get rid of the effects.

    My "ldl and triglycs" levels skyrocketed after my left cranial (facial) nerve got inflamed and caused Bell's Palsy. And it's still high because it is still inflamed I can feel it, and I'm not sure what the cause of the inflammation is but I think it has something to do with my left tooth which was infected but left untreated for months. Even after treating the dental cavity, it still hurt for two to three months which is quite rare. The infection has probably spread… I'm considering to remove the tooth now. Going to my dentist soon to get a full jaw check up to see whatsup.

  53. "cholesterol is as necessary for human health as water or air." https://www.health.harvard.edu/blog/panel-suggests-stop-warning-about-cholesterol-in-food-201502127713

  54. I dono I’ve been vegan 100% for 7 years and my total cholesterol was 178 according to my blood test two days ago.
    Triglyceride 65
    HDL 60
    LDL 105
    Clearly my body makes its own cholesterol just fine
    I eat mostly whole food plant based
    My b12 is 30 points below the lower limit.

  55. Desperate lack of critical thinking and scientific skills. I guess we shouldn't attempt to lose weight either: https://www.ncbi.nlm.nih.gov/pubmed/10539776. Fasting, which has all kinds of scientific evidence for its life extending properties, jacks up your LDL.

    Just like everything else in the human body and frankly everything else in life; there's a bigger picture. Correlation does not prove causation. That's a fundamental principle. Yes, crossing the street increases your risk of being hit by a car. But, you need to not just be crossing the street, you need to be in front of a moving vehicle, the driver has to not be paying attention most likely and going fast enough to not avoid you – so many things have to happen to be struck by a car. Merely using the mathematical statistics to prove that yes, you can avoid dying from a car accident by 100% if you never cross the street completely fails to observe the root cause.

    Moreover, it's going to force a lot of people to avoid crossing the street when you can actually eliminate your risk just by looking both ways before you cross because the real risk is being hit by a vehicle – not crossing the road. And the downstream impact is that life gets more complicated, more difficult and potentially more hazardous as instead of crossing the street you decide it is safer to swing from the light posts. At least you won't be hit by a car, but never mind the fact that you can plummet to your death at any time.

    Tweaking things in this manner without knowing the root cause is dangerous and it is not science. Statins, for example, have almost the same lowering effect on LDL but create the rather unwanted downside of dying from an increased risk of Cancer. Most people will much rather die from heart disease. Cancer sucks.

    While it is true that you can substantially reduce your risk of dying from a heart attack by eliminating your LDL cholesterol, just like avoiding being hit by a car by not crossing the street, the bigger picture is that LDL does something vital in the body and you are surely trading something off. LDL is filling a hole that is being dug in the first place, and probably by inflammation.

    People with diabetes (and high sugar intakes) generate amazingly poor LDL profiles. I suspect, as most rationally minded thinkers, that it is elevation of glucose in the bloodstream that is generating damage and that damage is being filled by LDL. It is a known quantity – excess carbohydrates lead to advanced aging and advanced glycation end products.

    If we know that excess carbohydrate consumption leads to fatty liver and ultimately cirrhosis, which we do because that's how we fatten farm animals to begin with, then what are we left with? Just two macro-nutrient groups. Where do you expect us to get our calories from?

  56. Don't eat plant based full time, so have been eating shit fast food among other things, still have total cholesterol of 149, HDL 42 ldl 74, triglycerides 104, acl 5.3, not as simple as dietary cholesterol. If I ate better sources of food overall it'd be even lower.

  57. 2:33 Aw yeah, so this is the study that Joel Kahn brought up to Joe Rogan; I didn't know he was a part of it before.

  58. Dr Greger, could you answer this article quoting studies and facts to support the idea that Cholesterol plays no role in heart attack?
    https://reason.com/archives/2018/09/22/new-research-confirms-we-got-cholesterol?fbclid=IwAR1UXa5Sb2Zct6QqP6X7Npf30YkBRuJI0TT-Mg3OYAYDuFXilU5ls1V1xpk

  59. Everyone talks about cholesterol, but no one talks about inflamed epithelial cells lining your arteries, these cells send signals to the liver to produce more cholesterol to protect the epithelial cells. So when you eat smart you don’t get signaling therefore reduced cholesterol. Cholesterol joins with under carboxcialated osteocalcin to form plaque. Go get a heart calcium score scan, and get on vitamin K2-Mk7(Rotterdam Study).

  60. So correlation of LDL to heart disease is the causation of heart disease? I believe the role of LDL is to be the emergency responders for inflammation and damage. The more LDL in the body, the more inflammation exists. This makes sense why there is a correlation due the LDL sparkling the arteries after damage has occurred. So perhaps the increase of LDL is often due to the inflammation and that is the root cause and the LDL is just doing its job. Wouldn’t we want to a) allow the LDL to continue to repair and also B) focus on finding ways to boost vascular strength and avoiding the damage? What are the dynamic effects of us not allowing the body the repair forces to come out? I am not sure that is the answer.

  61. Couldn't the genetic mutation that caused low cholesterol also cause lower inflammation? in that case, it would support the idea that inflammation is the root cause. i wish greger had addressed this.

  62. We still don't understand the relationship between CVD and cholesterol. You may be convinced either way but the debate continues. Eat healthy just in case.

  63. I want to see the total number of those people that actually got heart disease. Reduction of "risk" is complete horseshit. The actual difference can be less than 1% for all we know.

  64. An unhealthy diet causes an increase in cholesterol because the body is responding to inflammation due to the unhealthy diet. The liver makes most of the cholesterol our body needs for many things such as repair, hormones, etc.. If you eat more foods that contain cholesterol the body will produce less and vice versa. SO, is cholesterol the main problem or is inflammation? In my 30 years experience in the health and fitness industry I'd have to say – INFLAMMATION. Eat a healthy diet and you'll see a decrease in inflammation and when the inflammation decreases then your body will make less cholesterol. Inflammation is the cause of CVD or ANY disease for that matter. Most physicians just tend to blame cholesterol not realizing that inflammation is the primary cause!

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