Thursday, May 4, 2017

High-cholesterol diet, eating eggs do not increase risk of heart attack, not even in persons genetically predisposed, study finds

As reported at Science Daily, a 2016 study (full text) done in Finland "shows that a relatively high intake of dietary cholesterol, or eating one egg every day, are not associated with an elevated risk of incident coronary heart disease. Furthermore, no association was found among those with the APOE4 phenotype, which affects cholesterol metabolism and is common among the Finnish population. In the majority of population, dietary cholesterol affects serum cholesterol levels only a little, and few studies have linked the intake of dietary cholesterol to an elevated risk of cardiovascular diseases. Globally, many nutrition recommendations no longer set limitations to the intake of dietary cholesterol."

As reported on Science Daily:

"The study found that a high intake of dietary cholesterol was not
associated with the risk of incident coronary heart disease -- not in
the entire study population nor in those with the APOE4 phenotype.
Moreover, the consumption of eggs, which are a significant source of
dietary cholesterol, was not associated with the risk of incident
coronary heart disease. The study did not establish a link between
dietary cholesterol or eating eggs with thickening of the common carotid
artery walls, either.

"The findings suggest that a high-cholesterol diet or frequent
consumption of eggs do not increase the risk of cardiovascular diseases
even in persons who are genetically predisposed to a greater effect of
dietary cholesterol on serum cholesterol levels. In the highest control
group, the study participants had an average daily dietary cholesterol
intake of 520 mg and they consumed an average of one egg per day, which
means that the findings cannot be generalised beyond these levels."

Table 3 of the study reports no increased risk of heart disease with egg intakes up to 36 g/d (about one large per day) nor for cholesterol intakes up to 522 mg per day, regardless of ApoE type.

The study population, ethnic Finns, are descendants of ancestors who survived the last Ice Age in Europe by hunting wild animals.  Their ancestral diet was high in animal fat and protein and contained little plant matter.  That diet selected against the survival of anyone who would have been harmed by animal fat or protein or required daily doses of plant foods to survive, thrive or reproduce.

In about 110 A.D., the Roman historian Tacitus reported on the food habits of the German people the Romans sought to conquer:

“Their food is of a simple kind, consisting of wild-fruit, fresh game, and curdled milk.”[1]
This describes a low carbohydrate, animal-based diet.  Germans did not live by agriculture in 110 A.D., and they lived south of the Finns.  We know that the Finns also ate an animal based diet. 

What is more likely toxic to Europeans, meat and fat that enabled the European stock to survive in Europe through the last Ice Age and formed the basis of the European diet up until about 500-1000 years ago, or various plant foods, particularly refined carbohydrates that were never even available to Europeans until quite recently?

It seems that the hypothesis that heart disease is caused by eating cholesterol and other animal products is dying a long, slow but sure death, skewered by evolutionary theory and evidence to the contrary. 


1.  Tacitus, Germania and Agricola (Ostara Publications, 2016), p.9. 


François Létourneau said...

May I ask what you think of the work of Plant Positive now that you have reverted back to a paleo approach? I know you are well familiar with is work.

FXScouse said...

I am sorry Don but I have to disagree with you on this one.

First, this is an observational study and observational studies are notoriously subject to confounding factors. For example, the Finns have an intake of dietary omega 3 plant fat, which is generally regarded as a protective factor, that is 80% higher than the Western European average.

Also, other observational studies have usually shown a clear dose relationship between dietary cholesterol and LDL cholesterol. As the US National Academies of Science observe, there is a i linear trend between dietary cholesterol intake and LDL cholesterol concentration.

Secondly, observational studies are generally regarded as weaker forms of evidence than experimental studies. And meta analyses of experimental and observational studies have concluded eg that "Serum cholesterol concentration is clearly increased by added dietary cholesterol but the magnitude of predicted change is modulated by baseline dietary cholesterol. The greatest response is expected little, if any, measurable change would be expected once baseline dietary cholesterol was > 400-500 mg/d."

That this Finnish study found no association between increased cholesterol intake and LDL cholesterol levels and CAD, is perhaps not surprising therefore since both the second and third tertiles of dietary cholesterol intake in that study approached or exceeded the 400 mg per day threshold. It is also perhaps not surprising that many of such modern dietary cholesterol studies, often funded by the egg, dairy and meat industries, other food industries or the Atkins organisation, or people associated with those bodies, fail to account adequately for this factor even though baseline dietary cholesterol consumption in Western countries is usually high. If I were a cynic, I might suggest that such studies are deliberately designed to take advantage of this fact by observing subjects whose baseline dietary cholesterol is already high and therefore less likely to be affected by added dietary cholesterol. They seldom if ever examine the effect of added dietary cholesterol on people whose baseline dietary cholesterol level is low by Western standards.

I also find your evolutionary theory argument unconvincing. First it assumes that ancestral Western Europeans had high levels of dietary cholesterol consumption. I am not sure that there is good evidence for this and in any case a dietary factor that increases mortality in older age is unlikely to be a powerful Darwinian selection factor since its effects would presumably only be felt after individuals had reproduced and brought up the next generation. In fact there is a counter theory that white skinned Europeans evolved as a response to a diet high in cereals rather than a diet high in cholesterol from animal foods.

Don Matesz said...


Unfortunately before I posted this article, in editing I removed a portion that was important, and neglected to repaste it in, but I left in the Note at the end from Tacitus. I juet restored it to what I intended.

As noted, Tacitus reported that the Germanic people were eating a low carbohydrate, animal-based diet in 110 A.D.

The idea that white skin came from eating cereals is incredible. White skin came from living in the snowy, forested and low light environment of ancient Europe. Again, Tacitus wrote of the Germanic people in 110 A.D.:

"For my own part, I agree with those who think that the tribes of Germany are free from all taint of intermarriages with foreign nations, and that they appear as a distinct, unmixed race, like none but themselves. Hence, too, the same physical peculiarities throughout so vast a population. All have fierce blue eyes, red hair, huge frames, fit only for a sudden exertion. They are less able to bear laborious work. Heat and thirst they cannot in the least endure; to cold and hunger their climate and their soil inure them."

Aside from the obvious error that people can't build "huge frames" if they are actually suffering from hunger, this passage indicates that the Germans were Caucasian, yet they were not living on cereals. Tacitus mentions that what grain was grown was used to make beer and liquor, or feed animals, not eaten directly by the people, at that time.

Now imagine living in an environment that has snow cover 6-10 months of the year. If you have dark skin, you stand out like a sore thumb. You are an easy target for predators. Prey can see you coming a mile away. If you have white skin, you blend in. Its harder for a predator to find you against the background.

Arctic animals have white and/or gray fur – think polar bears, arctic fox, arctic wolf e.g.

White skinned humans are arctic born humans. White skin hunters would be more successful than dark skinned because the prey can't see you coming; and white skin also protects a human from other arctic predators. The idea that this came from eating cereals is weak. Any reasonable theory has to also account for the natural selection of white coloration among non-humans as well. Did polar bears get white fur by eating cereals? LOL.

Arctic animals also have blue eyes. Blue eyes reflect the blue light that is reflected off snow, thus are not easily "blinded by the light" that is reflected off snow, and they also allow in more light in dim environments than dark brown eyes. This has obvious survival advantages. Dark eyes are an adaptation to bright light (tropics), as they are more resistant to damaging effects of sunlight (like dark skin), and light eyes to predominantly dim environments (forests, long winters, etc.).

Don Matesz said...

Finally, the idea that eating a diet high in animal foods and cholesterol kills you in old age has yet to be supported by evidence. In fact this research indicates just the opposite. Despite having high cholesterol diets, above the threshold you may consider toxic, they are not dying from heart disease.

Then there is the fact that the body naturally produces about 1500 mg of cholesterol daily, and this increases under the influence of insulin, which the body releases in response to consumption of carbohydrate, not fat. High blood sugar raises cholesterol:

"The study population was classified into subgroups according to glucose tolerance as follows: normoglycemia, impaired fasting glucose, impaired glucose tolerance, and type 2 diabetes. LDL cholesterol did not differ between the groups. Cholesterol synthesis markers were lowest and absorption markers highest in normoglycemia." Translation, when you have high blood sugar your body produces more cholesterol.

And, high normal fasting plasma glucose, which I sustained over 5 years of a low fat vegan diet (and it even may have risen a bit), is a stronger predictor of cardiovascular disease than total cholesterol: "Elevated CVD risk is strongly and independently associated with glucose levels within the normoglycemic range." and "The importance of each risk factor for CVD was ranked independently by the Wald score: for FPG levels the score was 15.3, after age (171), gender (39) and smoking (17.9) similar to hypertension (15.2) and more significant than BMI (3.6), family history (10.6), cholesterol (12.4), and TG (7.2)."

As for your commercial insinuation, if you walk into a grocery store, what percentage of the "foods" therein are high fat, low carbohydrate, versus low fat, high carbohydrate?

I estimate ~90% of what is sold in a typical grocery is high in carbohydrate, and most of that is low in fat. Imagine that people accepted that carbohydrates were the real culprits. How many industries would suffer if people started turning away from carbohydrate rich foods? Compare that to how many food industries would be affected by condemning fat. A look at a grocery store quickly confirms that the money is in selling low fat, high carbohydrate foods. Cheap to produce, with a high profit margin. Those industries can't allow carbohydrate to be vilified.

Then consider how the pharmaceutical industry benefits from the idea that cholesterol is the culprit. Researchers (funded by the drug producers) are suggesting that everyone take statins daily:

Statins deliver the drug industry about $30 billion annually. The cholesterol theory is of benefit to the drug industry and the carbohydrate-rich food industry as a whole, which as I said, is clearly the most profitable.

Don Matesz said...

One more thing: As mentioned above, high blood sugar stimulates cholesterol synthesis:

"The study population was classified into subgroups according to glucose tolerance as follows: normoglycemia, impaired fasting glucose, impaired glucose tolerance, and type 2 diabetes. LDL cholesterol did not differ between the groups. Cholesterol synthesis markers were lowest and absorption markers highest in normoglycemia."

And normal blood sugar results in more cholesterol absorption, but dietary cholesterol actually suppresses cholesterol synthesis: "In all subjects the cholesterol synthesis rate as measured by deuterium incorporation was significantly lower (P<.05) after the transition from low- to medium- and low- to high-cholesterol diets."

Don Matesz said...


I just find it hard to reconcile the idea that humans are best adapted to a whole foods plant based diet with the very large amount of historical, anthropological, and archaeological data that indicates that humans are by nature carnivorous. I tried my best to argue for the idea that humans were molded by evolution to thrive on a whole foods plant based diet in Powered by Plants, and I tried in my personal life to prove it by eating such a diet for more than five years. But evidence has refuted most of the key arguments I made in Powered by Plants, and my own personal experience did not readily confirm what I wanted to believe or argued for either. Since I am seeking healing of my own chronic inflammatory skin conditions and a whole foods plant based diet did not in 5+ years improve the condition at all, and the condition has in fact worsened on the WFPBD, I find it necessary to re-evaluate the evidence and try a different approach myself. Perhaps I will never find a solution, but I think that I will and I won't stop trying any time soon. The evidence in favor of an anti-inflamatory effect of ketosis

which is consistent with the idea that human metabolism (or at lest European human metaoblism) evolved on an animal-based, high fat diet,

and some anecdotal evidence that confirms the anti-inflammatory effect of a ketogenic animal based diet

gives me enough reason to try what I have never tried before because I believed that "the authorities" knew for certain that humans "need" carbohydrate and are in fact primarily plant-eating animals.