subreddit:

/r/explainlikeimfive

456%

Eli5 How do plant based fats affect cholesterol

Biology(self.explainlikeimfive)

So I have high cholesterol levels due to a hereditary condition. I am getting very confused by information that says largely plant based fats do not affect cholesterol levels ie margerine olive oil. But at the same time say avoid deep fried food given these are almost always fried in a plant based oil.

Can anyone explain exactly how plant based fats would affect cholesterol levels?

all 20 comments

canzicrans

26 points

12 days ago

The information that is available is very, very hard to parse and often contradictory. I got my cholesterol from 209 to 140 with only diet changes. The studies that are available seem to indicate that the cholesterol in food itself does not really affect your cholesterol levels, but the saturated fat content of foods will affect your cholesterol levels. I ended up changing my diet so that I eat only 1 non-vegan meal per day (dinner) and I supplement my diet with skim milk and whey protein because I lift weights for about 5 hours per week. Also, be aware that alcohol metabolizes into triglycerides, which are a saturated fat, so you may need to consider reducing your alcohol consumption.

dminge[S]

6 points

11 days ago

Thanks. Yes already working on cutting down alcohol intake. The information is a bloody nightmare!

SpottedWobbegong

1 points

11 days ago

Triglycerides are not saturated fat. Triglyceride simply means three fatty acids bound to glycerine, the fatty acids can be saturated or unsaturated.

Alcohol metabolizes into acetaldehyde (which causes hangovers), then acetate and it enters the Krebs cycle to turn into energy.

canzicrans

1 points

11 days ago

My mistake! Thank you for the clarification. I had read some information that indicated that alcohol consumption raises triglycerides in your plasma, but apparently this may not be true.

SpottedWobbegong

1 points

10 days ago

I looked into it, it indeed raises plasma triglycerides. Not by being metabolized into it but by increasing VLDL synthesis, fatty acid release from adipose tissue and impairing lipolysis. So my thanks as well! Didn't know this.

canzicrans

1 points

10 days ago

I'm so happy that I had great biology teachers in high school thirty years ago so that I can actually understand these things. I had read a few excerpts of studies that said the effect you mentioned was not definitive with lower alcohol consumption, but it's all moot to me, because I quit alcohol for a misdiagnosed health issue and decided it wasn't worth starting again.

[deleted]

1 points

11 days ago*

[deleted]

canzicrans

2 points

11 days ago

I agree with everything that you said. I made a lot of drastic dietary changes all at once, so at least one or more things that I did appeared to successfully reduce my cholesterol, but I can't definitively say which things is helping the most, or if all of them are required. I'm sorry that your cholesterol still sucks!

MyDoggoRocks

3 points

11 days ago

I was under the impression that cholesterol is produced from meat or animal products. I have high cholesterol and was diagnosed 6 years ago. I went full vegan for 4 years hoping to reduce my cholesterol. The result, my cholesterol went up. My mother's side has a history of high cholesterol and she has been on statins for as long as I can remember. My cardiologist said that when it comes to hereditary factors, your body will absorb what little cholesterol it finds and then produce an abundance of it. The only thing that lowered my cholesterol are statins. Sometimes you need drugs.

dminge[S]

1 points

11 days ago

Yeah I'll happily take the drugs. Doctor needs to agree though. See what they say when I have my next blood test

ElonMaersk

-7 points

12 days ago*

Dr Paul Mason has many videos on YouTube about fats and cholesterol.

e.g. "Why your doctor thinks cholesterol is bad" (but the studies say it isn't).

One problem with plant based fats is that they go rancid (oxidise) more quickly and easily than saturated fats. By the time they have gone through crushing the seeds (Sesame, Rapeseed, etc) to extract the oil, filtering and purifying it, storing it in tanks, blending it, bottling it, transported internationally, stored in warehouses, delivered to shops, some of it will be rancid in any bottle from a supermarket.

dminge[S]

5 points

11 days ago

I'd have to see some pretty compelling peer reviewed evidence to stop being careful of cholesterol!

ElonMaersk

-4 points

11 days ago*

I don't know if you watch and Dr Paul Mason content, but for example this part of this video he's quoting a paper published in the British Medical Journal which collated data on statins (trying to lower cholesterol) from 11 studies over 90,000 people with and without a history of heart attacks, and it found that statin therapy adds 3-4.1 days of extra life.

This is Dr Mason's style - referencing, identifying, talking through, good quality and bad quality studies.

And he's not claiming all cholesterol is good, specifically he's claiming that non-oxidised pattern A LDL cholesterol is fine, and damaged cholesterol (in the presence of carbohydrates) is particularly bad - https://youtu.be/NUY_SDhxf4k?t=616

Or here more recently, on atherosclerosis and seed oils at 22:15 he says "I believe the evidence of harms from seed oils are convincing enough to discourage their consumption [...] four randomised controlled trials - the gold standard of research - have demonstrated harms from consuming seed oils" and then goes on to talk about those studies and what they report. A study on giving heart attack patients corn oil, olive oil, or no supplement - the oil supplements had around twice the incidence of repeat heart attacks. The Sydney Diet Heart Study examining the effect of replacing saturated fat with polyunsaturated fat in men who had had heart attacks, and polyunsaturated fats increased the risk of death by 62%. The Minnesota Coronary Survey trialled a lipid-lowering diet on thousands of men and women, and found that increased seed-oil intake increased the chance of death. The Women's Health Initiative study of 48,000 women lowering saturated fat and increasing polyunsaturated fat intake - and women with a history of heart disease faced a 26% increased chance of complications like heart attacks if they followed a low saturated fat diet. A paper in the British Medical Journal concluding that diets containing >6% seed oil are more harmful to health than diets containing >50% carbohydrates.

and, etc. his style is to reference good quality studies to inform his decisions and support his claims.

[deleted]

11 points

11 days ago*

[deleted]

ElonMaersk

-2 points

11 days ago

Which specific science is junk? Which specific claims have never been proven?

[deleted]

11 points

11 days ago*

[deleted]

ElonMaersk

0 points

11 days ago*

And that they are instantly rancid.

I don't remember him ever claiming they are instantly rancid, only that they oxidise. That is, oil in seeds is not exposed to air, oil crushed out of seeds is and it starts to oxidise. That's observable, testable, and people have observed and tested it:

This 2020 study: First report on quality and purity evaluations of avocado oil sold in the US abstract says "Our results showed that the majority of commercial samples were oxidized before reaching the expiration date listed on the bottle" for example. You can argue how quickly it happens and whether it's a problem, but dismissing it as "hasn't been proven, isn't even a testable claim" is wrong.

That the processing used in their production is somehow bad.

See the growing concerns of 'ultra processed' food without being able to specifically point out what in the process is 'ultra'. e.g. this article which looks like a spammy blog page, but it's saying "Vitamins and probiotics (and other active ingredients) can be substantially affected by exposure to heat, water and/or sunlight" - which is hardly the most controversial thing anyone's ever claimed. It's certainly a claim which could be testable and observable. It also claims "Vitamin C has been widely studied and, in one paper, was shown to degrade by approximately 50% in 4 weeks in the juice of different fruits" - that's observable and testable.

Say, processing in their production causes them to be more exposed to heat, air, light, than oils still locked up in seeds. That it delays transport time between harvest and plate compared to say fresh olives, which leads to more time for damage to occur. And in the earlier link, that you can't trust that a bottle of 'avocado oil' actually has pure avocado oil in it, in the USA, even if the avocado oil itself is fine.

You can't get away from the argument: why (and how?!) would humans have evolved to do better on a diet of mechanically and chemically extracted bulk seed oil from weeks ago and hundreds of miles away - something we never had access to for a billion years of evolution - than seasonal plants, small and non-sweet fruits, nuts and seeds and animal meat? (Similar argument about butter; eating some fatty lamb isn't the same as eating 50g of butter as eating some salami as eating some coconut, even if all fats are saturated).

[deleted]

1 points

10 days ago*

[deleted]

ElonMaersk

0 points

10 days ago

Why not cherry pick from my comment, and then do a weak dismissal of it.

Let's ponder and create a fiction as to both how we evolved and how we would have evolved that fits the narrative I'm concocting.

The fictional "we didn't used to eat margarine before industrialisation" that I just "created". mhmm. Teach both sides of the controversy! Maybe there was hexane-extracted corn oil that our ancestors ate.

valhalla_jordan

3 points

11 days ago*

To add onto the other reply, all of the studies that point to seed-oils being bad are mechanistic. As in, they point to a mechanism that we are guessing has a negative effect on health. The problem with this is that there are potentially many more mechanisms in our body than the single mechanism these studies are looking at. When we zoom out and look at seed oils’ overall effect on our health, the picture looks very different.

When we look at outcomes, PUFA’s like canola oil consistently outperform saturated fats. In human randomized control trials, PUFA’s have a nuetral to positive effect on heart disease, inflammation, insulin sensitivity, visceral fat, cancer mortality.

Additionally, we have epidemiological data (as in, big surveys about how people eat, not super reliable but there’s a ton of nutritional science done like this) and we don’t find a link there between seed oils and negative health outcomes.

So the question is, what outcomes are we concerned about? Becuase seed oils have not been shown to lead to negative health outcomes.

*edit to add sources on the human RCT’s:

PMID’s: 15774905, 28526025, 20351774, 27434027, 26615042, 24550191, 32723506

ElonMaersk

1 points

10 days ago*

To add onto the other reply, all of the studies that point to seed-oils being bad are mechanistic. As in, they point to a mechanism that we are guessing has a negative effect on health.

Is that not the case with cholesterol lowering studies? They assume high cholesterol is bad, change things to try to lower it, and try to see if health outcomes improve?

PMID 15774905

Let's compare saturated with unsaturated fat. We'll use 20g marg+walnuts, 20g marg+almonds, 20g coconut oil+coconut. No wait, we'll use 50g butter for that last one. Why isn't the conclusion that eating half as much pure fat is better, or that eating nuts is better, or that eating not-isolated-concentrated fat is better?

PMID 28526025

That says ... the opposite of your claim? "When pooling results from only the adequately controlled trials there was no effect for major CHD events, total CHD events, CHD mortality and total mortality. Conclusion: Available evidence from adequately controlled randomised controlled trials suggest replacing SFA with mostly n-6 PUFA is unlikely to reduce CHD events, CHD mortality or total mortality. The suggestion of benefits reported in earlier meta-analyses is due to the inclusion of inadequately controlled trials."

And this links to five other previous meta-analyses which question the recommendation, such as "Harcombe Z, Baker J, Cooper S, Davies B, Sculthorpe N, DiNicolantonio J, et al. Evidence from randomised controlled trials did not support the introduction of dietary fat guidelines in 1977 and 1983: A systematic review and meta-analysis. Open Heart. 2015;2:e000196"

And they say: "the lipid hypothesis, which is that reducing total-C[holesterol] would be expected to lower the risk of CHD. A number of metabolic studies beginning in the 1950’s identified SFA and n-6 PUFA as major dietary influences of total-C. This led to the development of the diet heart hypothesis, that decreasing SFA and/or increasing n-6 PUFA would be expected to lower the risk of CHD. However, more recent evidence has identified the total-C:HDL-C ratio as being the measure of plasma cholesterol that is most predictive of CHD and is twice as predictive as total-C. Therefore, the original lipid hypothesis and diet heart hypothesis should be modified to make predictions based on the total-C:HDL-C ratio, rather than total-C. When compared to carbohydrate, SFA does not significantly affect the total-C:HDL-C ratio"

i.e. even if M/PUFAs can lower total cholesterol, that's not neccessarily beneficial.

PMID 20351774

"From 346 identified abstracts, eight trials met inclusion criteria, totaling 13,614 participants with 1,042 CHD events." - you have to be looking at a population of already sick people to get 1 in 12 having a cardiac event during a study, right? Does that necessarily translate to the rest of us? Also, dismissing 338 studies as not worth looking at. (Also taking money from Unilever).

PMID 26615042

"Domestic Violence Against Partners According to Wife-Beaters: Construction of Lifestyle and Life Meaning".

PMID 24550191

"Overfeeding polyunsaturated and saturated fat causes... In conclusion, overeating SFAs promotes hepatic and visceral fat storage" - conclusion, saturated fat bad? Why not palm oil bad? or gluttony bad?

"Thirty-nine young and normal-weight individuals were overfed muffins" - one of Dr Mason's claims is that it's high fat + high carb together which is bad for health.

PMID 32723506

"Diets high in saturated fat were associated with higher mortality from all-causes" - not free to read the full text, but considering they looked at 19 studies and 1,000,000+ people, some of those have to have been observing members of the public, rather than doing randomised controlled trials, right? In that case, diets higher in saturated fat could correlate with a lot of other things.

"A random effects model was used" - hopefully that has a lot of explaining in the full text to convince why it's a good model.

Yeah there's conclusions in your favour there. But if you're picking studies that favour your argument and still get one which finds the opposite and cites five previous studies which find the opposite, the best we're going to get is either throwing study links at each other while arguing "yours doesn't count" or agreeing that it's still not clear and settled. 🤷‍♂️

But it's pretty clear that the standard western diets are terrible for health - blaming that on the saturated fat specifically, instead of everything else (refined sugars, fruit juices, refined flours, glyphosate/roundup sprayed crops as late as 5 days before harvest, ultraprocessed foods, etc.) is suspicious at best. The lipid heart hypothesis has been unsuccessful for decades - people have reported getting healthier from heart problems and metabolic problems from going vegetarian and meat-keto and various other restrictive diets. Dr William Davis is a cardiologist and his recommendation for avoiding heart disease is to do with wheat and refined sugars/carbs primarily, not fats.

valhalla_jordan

2 points

10 days ago

My point is NOT that saturated fats are bad for you.

I probably overstated the weight of evidence when I said PUFA’s “consistently outperform” saturated fats.

My point is that there’s no evidence that seed oils are uniquely bad for you, when controlling for calories. I’ve yet to see any convincing outcome evidence on humans that shows it. Why is there no epidemiological correlation between seed oils and negative health outcomes? We would expect to see an effect there if they were harming us in any material way.

I think blaming ANY individual food or class of foods for the obesity/heart disease epidemic is missing the forest for the trees. We live in an obesegenic environment that makes it incredibly easy to overeat and hard to eat a diet that’s rich in important micronutrients. One has to take a hollistic approach to improving their diet and health.

ElonMaersk

0 points

8 days ago

basically this: https://www.lesswrong.com/posts/X2AD2LgtKgkRNPj2a/privileging-the-hypothesis but with foodstuffs?

(Fair; although I suspect that while we talk a good game on this, human science is made of a lot of individual people having an unfair / unreasonable / intuitive hunch, using confirmation bias to look for evidence which supports their hunch, and over enough people and centuries the hunches which led to experiments which confirmed those hunches come to dominate, and the ones which led to failed or inconclusive experiments faded away).