9 ms·

The implications of low cholesterol in depression and suicide (2015)

60 points by supperburg 5y ago

cmarschner 5y ago
2015
goldenkey 5y ago
Well, cholesterol is used to make everything in your body from Vitamin D (Cholecalciferol) to testosterone and estrogen. So it shouldn't be surprising. Low hormones = depression
- cat_food 5y ago
  Epinephrine is synthesized from tyrosine. It isn’t even similar in structure. Cholesterol is necessary to make many steroids in your body, many of which are important hormones. No need to overstate the importance of a vital biomolecule.
  - goldenkey 5y ago
    Whoops, I remembered wrong. Isn't there some neurotransmitter that is made from cholesterol?
chmod600 5y ago
What are the implications for a vegan diet?
- goldenkey 5y ago
  If the body produces enough you ought to be fine. But that depends almost entirely on genetics. Some people have high cholesterol without consuming a drop of it.
  - ianai 5y ago
    One of the selling points or main assumptions of the keto diet is that dietary cholesterol doesn’t contribute to circulating cholesterol. Not saying I defend that argument, but it can’t be both safe to eat endless amounts of cholesterol because it never affects your cholesterol levels and the lack thereof causing low cholesterol (probably/these are chaotic, nonlinear systems we’re taking about.) Having said that, correlation is not causation. Maybe people with depression have a correlation with other things that also correlate with factors that lower cholesterol (ie poverty and poor food choices).
    - xyzzy21 5y ago
      Most cholesterol in the body IS synthesized de novo. This is biochem 101. Cholesterol is essential for the brain. But it's also essential for muscle function.
      - ianai 5y ago
        Is there a reputable source for this? Like for an outsider to grasp what the literature knows about affecting cholesterol.
      - ozim 5y ago
        Well that got me thinking about my blood test results. I have higher than norm cholesterol but I also have higher than normal muscle mass. Will get into reading about it, because I was stressing about my cholesterol result. When in reality it might be just like BMI which does not really work well for people with bigger muscle mass than average.
    - rebuilder 5y ago
      IIRC in the USA, the food guidelines were recently updated to no longer recommend keeping intake of eggs and shrimp low. The reasoning was that those are pretty much the only foods high in colesterol but low in saturated fats, and had been lumped in with the “raises blood cholesterol” group of other animal products that are high in saturated fats. This change being the US gov’t agency in question essentially saying that it now seems it’s the saturated fats that are a problem, not dietary cholesterol, the two just mostly come in the same package.
- supperburg 5y ago
  A lot of people do fine on a vegan diet, many improve because they eat less sugar. But a lot of people are hurting themselves with fat free or vegan diets but it’s totally overlooked. Anyone who says vegan might be unhealthy is ignored and called insane.
  - brandonmenc 5y ago
    Study after study has shown that all-cause mortality drops the more plant-based a diet is, up to and including vegan. Ditto for drops in cardiovascular disease. > hurting themselves with fat free Yes, if you drop below the minimum fat intake level required to sustain life, you will have health problems. No one disputes that. But a diet that low in fat is very difficult to maintain.
- xutopia 5y ago
  B12 deficiency.
cmarschner 5y ago
Tldr: “ There is a growing amount of research looking at the use of essential fatty acids, particularly omega-3's in psychiatry, but we often overlook cholesterol. Low levels of cholesterol and essential fatty acids are intimately linked to depression. Understanding the consequences of deficiencies in essential fats and cholesterol is important for the effective treatment of depression. Whether it is drug induced, genetic, or a result of dietary patterns, low cholesterol impairs optimal brain function and often prevents successful recovery from chronic depression.”
rgrieselhuber 5y ago
I’ve watched the low cholesterol cult destroy the health of many people around me and anyone who questioned it was always crazy or ignorant.
- gedy 5y ago
  I'm interested if you could share more details of what you've seen.
chiefgeek 5y ago
As someone who began eating carnivore eighteen months ago after three plus years as a vegan (and a strict, gluten-free one at that) I can attest to the truth of this piece. My cholesterol has risen, however, the ratio is fine and a heart scan showed ZERO calcium. I feel great, lifelong depression has lifted, my brain is much more clear and I’m as thin and muscular as ever. It truly is remarkable. We were sold a bill of goods with the whole “fat is bad” push. It’s bullsh*t.
- xyzzy21 5y ago
  The fat bad and cholesterol bad is also based on "linear thinking" - the problem is metabolic systems are decidedly nonlinear and have feedback loops which is 100% incompatible with linear system modeling. One of the major reasons I hold the medical and bio community is such low esteem - they don't know what they don't know yet act as if they do. Most can't manage a DoE correctly. But imagining systems? Nope!
  - HPsquared 5y ago
    More generally, it sounds like a problem of too much extrapolation.
  - zeusk 5y ago
    what's DoE?
    - zweifuss 5y ago
      https://en.wikipedia.org/wiki/Design_of_experiments https://en.wikipedia.org/wiki/Design_of_experiments
  - trombonechamp 5y ago
    > One of the major reasons I hold the medical and bio community is such low esteem - they don't know what they don't know yet act as if they do. On one hand, this is due to poor science journalism. The media loves nutritional research because telling people what they are doing wrong generates clicks. It is very easy to sensationalize. "A small correlation between celery and colon cancer in a specific population from a specific region" (or whatever) in a scientific paper becomes "Celery slowly killing you, Harvard researchers prove". One the other hand, this is how science works. We do experiments, get the results of those experiments, and try to make the best use of the data we have. Usually, the truth is much more complicated, but there are always bigger and more complicated experiments which need to be done to understand this more complicated truth. This happens all the time in all fields of science, but isn't as visible to the broader public because most research isn't all that relevant or interesting to non-scientists. It is REALLY hard to design good (ethical) experiments in nutrition. The scientific consensus now is very different than what it will be in 10 years, because we will have more data and higher quality data. This will allow researchers to continue to incorporate more complexities and nonlinear effects. So you're right in that "linear thinking" is not ideal, but a linear model is better than no model.
carbocation 5y ago
The (2015) label is very important, because people have had concerns like this, and consequently have directly studied things like: Do statins (cholesterol lowering drugs) increase suicidality and depression? No (in fact, the signal was for benefit)[1]. In a causal genetic analysis, does a decrease in cholesterol cause an increase in depression? No (in fact, the only significant finding from the study was that an increase in triglycerides is causal for increased depression risk)[2]. Does driving cholesterol to extremely low levels with powerful new medications called PCSK9 inhibitors cause change in neurocognition? No, and while there were no significant differences between the PCSK9i group and the placebo group, the PCSK9i group had numerically superior results, so there is really no signal for harm[3]. The concerns raised in the article don't really stand the test of time. I think this is probably because they were cherry-picked to begin with. 1 = https://www.thelancet.com/pdfs/journals/lanpsy/PIIS2215-0366(20)30311-4.pdf https://www.thelancet.com/pdfs/journals/lanpsy/PIIS2215-0366... 2 = https://www.cambridge.org/core/journals/psychological-medicine/article/abs/causal-relationships-between-blood-lipids-and-depression-phenotypes-a-mendelian-randomisation-analysis/692E465119A9CA9257243940134D3D5F https://www.cambridge.org/core/journals/psychological-medici... 3 = https://www.nejm.org/doi/full/10.1056/nejmoa1701131 https://www.nejm.org/doi/full/10.1056/nejmoa1701131
- fspeech 5y ago
  While trials can determine that on average there is no adverse effect it does not necessarily imply that no individual would experience any negative effect. It is possible that the negative effects experienced by some are cancelled out by positive effects experienced by others. If the effect is reversible, one can prove causality by giving an individual both placebo and the drug, in sequence, without the subject knowing which is which.
  - carbocation 5y ago
    Yes, a crossover trial design would be one way to address that. For example, various side effects have long been attributed to statins. This was tested in a trial published very recently in a placebo controlled crossover design, which found that the effect attributed to statins has probably been overestimated[1]. (They found no significant difference between placebo and statin; but, by eye, I would be willing to agree with a skeptic that it looks like there is probably a difference that is just too modest to identify at statistical significance at this sample size.) I should add that the original article being discussed is making claims that would not require any crossover trial to identify. If lowering cholesterol doesn't cause numerically higher suicide or depression, then the author's point is invalidated. 1 = https://www.jacc.org/doi/10.1016/j.jacc.2021.07.022 https://www.jacc.org/doi/10.1016/j.jacc.2021.07.022
atdrummond 5y ago
Japan has given us some very interesting lipid studies the past few decades. One continued the analysis of the famous seven countries study, and it found that chronic heart disease rates appear at the least uncorrelated to lipid rates, if not in fact possibly lowered by increased cholesterol: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6086557/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6086557/ They’ve also confirmed the heart sparing benefits of “good” cholesterol, HDL: https://www.ahajournals.org/doi/full/10.1161/01.STR.0000060869.34009.38 https://www.ahajournals.org/doi/full/10.1161/01.STR.00000608... On top of this, there are numerous studies showing that high total cholesterol (not just HDL) in women is linked to longevity and that perhaps that age and CHD advice on total/LDL cholesterol was only ever relevant for men. (See: https://www.karger.com/Article/Fulltext/342765 https://www.karger.com/Article/Fulltext/342765 for a thoughtful review of current Japanese lipid suggestions and the literature on longevity and vascular disorder.)
- carbocation 5y ago
  As has been noted by other authors who have specifically addressed the first article that you cite, Japan's decline in heart disease despite rising cholesterol appears to be due to Japan's reductions in smoking and blood pressure[1]. RCTs have demonstrated, over and over, that reducing LDL cholesterol reduces cardiovascular disease. 1 = https://www.sciencedirect.com/science/article/pii/S0167527318341482 https://www.sciencedirect.com/science/article/pii/S016752731...
  - supperburg 5y ago
    No, there are RCT that show taking a drug which has the effect of lowering LDL, among many other effects, reduces heart disease. There is no proof that it’s LDL and not something else. And it’s not a coincidence that drugs that help heart disease have intersections with diabetic pathology.
    - carbocation 5y ago
      Between randomized trials and Mendelian randomization studies, all of the causal tools demonstrate that LDL is a causal biomarker. (There are other elements in the causal pathway, but very clearly LDL is one of them.) You are welcome to postulate a different explanation and test that novel mechanism, which is the process of science.
m_herrlich 5y ago
Interesting read but they lost me in the last paragraph before the conclusion where they recommend a specific brand and dose of cholesterol supplement.
wombatmobile 5y ago
This article looks like it might be a scientific paper, but look closer and it contains a promo for New Beginning's Sonic Cholesterol supplement which is a product from a company called New Beginnings Nutritionals https://www.nbnus.net/shopcontent.asp?type=About-Us https://www.nbnus.net/shopcontent.asp?type=About-Us which is a scheme for taking money from the parents of autistic patients. > New Beginnings Nutritionals was co-founded with Lori Knowles-Jimenez under the guidance and direction of Dr. William Shaw, PhD. Dr. Shaw is the Director of The Great Plains Laboratory, which specializes in the biochemical testing of metabolic disorders for diseases such as autism, PDD, hyperactivity, inborn errors of metabolism, and adult disorders such as depression and chronic fatigue. He is a PhD. biochemist that is world renowned as a researcher and speaker in the field of autism and related disorders. Dr. Shaw has been actively involved with both the Defeat Autism Now (DAN!) and Cure Autism Now (CAN) groups and is a board member of the National Academy for Child Development. He is the author of the books: "Biological Treatments for Autism and PDD" and "Autism: Beyond the Basics" that has helped thousands of parents seeking answers for their children on the autistic spectrum.
- fsckboy 5y ago
  this comment needs more upvotes!
ArchD 5y ago
The mainstream theory about dietary fat, cholesterol & CVD that started in the 1960s is mainly based on epidemiological studies, not randomized controlled trials. Additionally cholesterol is used for many bodily functions, including maintaining cell membranes. Cholesterol is so important that the brain produces its own. Yet, some doctors are very enthusiastic about pushing statin to people who have high LDL-C but are not sick. Because of studies like tho following, I decided to not believe in the mainstream cholesterol narrative: https://bmjopen.bmj.com/content/6/6/e010401 https://bmjopen.bmj.com/content/6/6/e010401 https://www.tandfonline.com/doi/full/10.1080/17512433.2018.1519391 https://www.tandfonline.com/doi/full/10.1080/17512433.2018.1...
- RockyMcNuts 5y ago
  The evidence that cholesterol is implicated in heart disease is quite strong. For one thing, people with genetic predisposition to very high cholesterol get heart disease early and die, and are now successfully treated with cholesterol-lowering drugs. For another, people who are at risk and take statins have fewer heart attacks (strong evidence), and live longer (limited evidence). It's likely true that we don't fully understand the dynamics, other factors may be implicated, stress, hormones, microstructure of coronary arteries. But I would caution against 'deciding not to believe' things about which there is a great deal of empirical work and a medical consensus. Small dense LDL and triglycerides may be better biomarkers for CVD than the typical calculated LDL-C. Calcium scans starting in middle age may be a good idea for people with CVD in the family or higher than normal cholesterol. Then if arteries are getting blocked you can consider dietary intervention, drugs, bypass before a heart attack. - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4525717/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4525717/ - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8174280/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8174280/
  - ArchD 5y ago
    The claims in the 4S study paper referenced by the first paper is not generalizable to the general populration. The studied patients were as follows: - 75% smokers or ex-smokers - already had AP or MI episodes - 51% at least 60 yo - 57% were on beta-blockers. (How do you know that the statins are not mainly protecting against some unknown side effects of beta-blockers.) These patients are not healthy people. The observations do not constitute evidence that cholesterol itself is a risk factor. These days, a lot of doctors are pushing statins to people without any risk factor like age or high-blood pressure, simply because of high LDL-C. As for the second paper about sdLDL, the mainstream dogma is laser-focused on LDL-C, not sdLDL.
xdrone 5y ago
This article is suspect to me. Only 3 references, none of which are actually studying depression and diet. If this was true, wouldn't we see depression in communities with lower cholesterol, Communities like the Seventh Day Adventists, many of which are vegetarian or vegan? Personal opinion, articles of this quality are to keep the public confused on diet and maintain the status quo. The food industry is a giant money machine. It can't survive if you're eating boring old unprocessed plants for the majority of your diet. Here's a more reputable meta study on the subject of diet and depression. It's long so skip to the conclusion if you want the unsurprising results. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7084175/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7084175/
bfrog 5y ago
I think I’ve read more that sugar and processed foods correlate with obesity and depression more than cholesterol? Explains maybe some of the folks here posting turn around when going carnivore, not likely to eat a lot of sugars or processed foods. There’s lots of ways to be a vegan, not all of them are healthy
fsckboy 5y ago
bear in mind, for most people there is no link between dietary cholesterol and blood cholesterol. Your digestion/body does not take food cholesterol and absorb it directly into your blood. So for example, cholesterol could be bad for you in your blood (heart disease), but still good or neutral for you in your food.
- fsckboy 5y ago
  https://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/fats-and-cholesterol/cholesterol/ https://www.hsph.harvard.edu/nutritionsource/what-should-you... "The biggest influence on blood cholesterol level is the mix of fats and carbohydrates in your diet—not the amount of cholesterol you eat from food." https://www.healthline.com/nutrition/dietary-cholesterol-does-not-matter https://www.healthline.com/nutrition/dietary-cholesterol-doe... "However, dietary cholesterol has little to no effect on blood cholesterol levels in most people." https://www.medicalnewstoday.com/articles/does-dietary-cholesterol-affect-blood-cholesterol https://www.medicalnewstoday.com/articles/does-dietary-chole... "A scientific advisory from the AHA indicates there is no proven link between the risk of cardiovascular disease (CVD) and dietary cholesterol.."

60 points by supperburg 5y ago

2015

Well, cholesterol is used to make everything in your body from Vitamin D (Cholecalciferol) to testosterone and estrogen. So it shouldn't be surprising. Low hormones = depression

cat_food 5y ago
Epinephrine is synthesized from tyrosine. It isn’t even similar in structure. Cholesterol is necessary to make many steroids in your body, many of which are important hormones. No need to overstate the importance of a vital biomolecule.
- goldenkey 5y ago
  Whoops, I remembered wrong. Isn't there some neurotransmitter that is made from cholesterol?

chmod600 5y ago

What are the implications for a vegan diet?

goldenkey 5y ago
If the body produces enough you ought to be fine. But that depends almost entirely on genetics. Some people have high cholesterol without consuming a drop of it.
- ianai 5y ago
  One of the selling points or main assumptions of the keto diet is that dietary cholesterol doesn’t contribute to circulating cholesterol. Not saying I defend that argument, but it can’t be both safe to eat endless amounts of cholesterol because it never affects your cholesterol levels and the lack thereof causing low cholesterol (probably/these are chaotic, nonlinear systems we’re taking about.) Having said that, correlation is not causation. Maybe people with depression have a correlation with other things that also correlate with factors that lower cholesterol (ie poverty and poor food choices).
  - xyzzy21 5y ago
    Most cholesterol in the body IS synthesized de novo. This is biochem 101. Cholesterol is essential for the brain. But it's also essential for muscle function.
    - ianai 5y ago
      Is there a reputable source for this? Like for an outsider to grasp what the literature knows about affecting cholesterol.
    - ozim 5y ago
      Well that got me thinking about my blood test results. I have higher than norm cholesterol but I also have higher than normal muscle mass. Will get into reading about it, because I was stressing about my cholesterol result. When in reality it might be just like BMI which does not really work well for people with bigger muscle mass than average.
  - rebuilder 5y ago
    IIRC in the USA, the food guidelines were recently updated to no longer recommend keeping intake of eggs and shrimp low. The reasoning was that those are pretty much the only foods high in colesterol but low in saturated fats, and had been lumped in with the “raises blood cholesterol” group of other animal products that are high in saturated fats. This change being the US gov’t agency in question essentially saying that it now seems it’s the saturated fats that are a problem, not dietary cholesterol, the two just mostly come in the same package.
supperburg 5y ago
A lot of people do fine on a vegan diet, many improve because they eat less sugar. But a lot of people are hurting themselves with fat free or vegan diets but it’s totally overlooked. Anyone who says vegan might be unhealthy is ignored and called insane.
- brandonmenc 5y ago
  Study after study has shown that all-cause mortality drops the more plant-based a diet is, up to and including vegan. Ditto for drops in cardiovascular disease. > hurting themselves with fat free Yes, if you drop below the minimum fat intake level required to sustain life, you will have health problems. No one disputes that. But a diet that low in fat is very difficult to maintain.
xutopia 5y ago
B12 deficiency.

cmarschner 5y ago

Tldr: “ There is a growing amount of research looking at the use of essential fatty acids, particularly omega-3's in psychiatry, but we often overlook cholesterol. Low levels of cholesterol and essential fatty acids are intimately linked to depression. Understanding the consequences of deficiencies in essential fats and cholesterol is important for the effective treatment of depression. Whether it is drug induced, genetic, or a result of dietary patterns, low cholesterol impairs optimal brain function and often prevents successful recovery from chronic depression.”

rgrieselhuber 5y ago

I’ve watched the low cholesterol cult destroy the health of many people around me and anyone who questioned it was always crazy or ignorant.

gedy 5y ago
I'm interested if you could share more details of what you've seen.

chiefgeek 5y ago

As someone who began eating carnivore eighteen months ago after three plus years as a vegan (and a strict, gluten-free one at that) I can attest to the truth of this piece. My cholesterol has risen, however, the ratio is fine and a heart scan showed ZERO calcium. I feel great, lifelong depression has lifted, my brain is much more clear and I’m as thin and muscular as ever. It truly is remarkable. We were sold a bill of goods with the whole “fat is bad” push. It’s bullsh*t.

xyzzy21 5y ago
The fat bad and cholesterol bad is also based on "linear thinking" - the problem is metabolic systems are decidedly nonlinear and have feedback loops which is 100% incompatible with linear system modeling. One of the major reasons I hold the medical and bio community is such low esteem - they don't know what they don't know yet act as if they do. Most can't manage a DoE correctly. But imagining systems? Nope!
- HPsquared 5y ago
  More generally, it sounds like a problem of too much extrapolation.
- zeusk 5y ago
  what's DoE?
  - zweifuss 5y ago
    https://en.wikipedia.org/wiki/Design_of_experiments https://en.wikipedia.org/wiki/Design_of_experiments
- trombonechamp 5y ago
  > One of the major reasons I hold the medical and bio community is such low esteem - they don't know what they don't know yet act as if they do. On one hand, this is due to poor science journalism. The media loves nutritional research because telling people what they are doing wrong generates clicks. It is very easy to sensationalize. "A small correlation between celery and colon cancer in a specific population from a specific region" (or whatever) in a scientific paper becomes "Celery slowly killing you, Harvard researchers prove". One the other hand, this is how science works. We do experiments, get the results of those experiments, and try to make the best use of the data we have. Usually, the truth is much more complicated, but there are always bigger and more complicated experiments which need to be done to understand this more complicated truth. This happens all the time in all fields of science, but isn't as visible to the broader public because most research isn't all that relevant or interesting to non-scientists. It is REALLY hard to design good (ethical) experiments in nutrition. The scientific consensus now is very different than what it will be in 10 years, because we will have more data and higher quality data. This will allow researchers to continue to incorporate more complexities and nonlinear effects. So you're right in that "linear thinking" is not ideal, but a linear model is better than no model.

carbocation 5y ago

The (2015) label is very important, because people have had concerns like this, and consequently have directly studied things like: Do statins (cholesterol lowering drugs) increase suicidality and depression? No (in fact, the signal was for benefit)[1]. In a causal genetic analysis, does a decrease in cholesterol cause an increase in depression? No (in fact, the only significant finding from the study was that an increase in triglycerides is causal for increased depression risk)[2]. Does driving cholesterol to extremely low levels with powerful new medications called PCSK9 inhibitors cause change in neurocognition? No, and while there were no significant differences between the PCSK9i group and the placebo group, the PCSK9i group had numerically superior results, so there is really no signal for harm[3]. The concerns raised in the article don't really stand the test of time. I think this is probably because they were cherry-picked to begin with. 1 = https://www.thelancet.com/pdfs/journals/lanpsy/PIIS2215-0366(20)30311-4.pdf https://www.thelancet.com/pdfs/journals/lanpsy/PIIS2215-0366... 2 = https://www.cambridge.org/core/journals/psychological-medicine/article/abs/causal-relationships-between-blood-lipids-and-depression-phenotypes-a-mendelian-randomisation-analysis/692E465119A9CA9257243940134D3D5F https://www.cambridge.org/core/journals/psychological-medici... 3 = https://www.nejm.org/doi/full/10.1056/nejmoa1701131 https://www.nejm.org/doi/full/10.1056/nejmoa1701131

fspeech 5y ago
While trials can determine that on average there is no adverse effect it does not necessarily imply that no individual would experience any negative effect. It is possible that the negative effects experienced by some are cancelled out by positive effects experienced by others. If the effect is reversible, one can prove causality by giving an individual both placebo and the drug, in sequence, without the subject knowing which is which.
- carbocation 5y ago
  Yes, a crossover trial design would be one way to address that. For example, various side effects have long been attributed to statins. This was tested in a trial published very recently in a placebo controlled crossover design, which found that the effect attributed to statins has probably been overestimated[1]. (They found no significant difference between placebo and statin; but, by eye, I would be willing to agree with a skeptic that it looks like there is probably a difference that is just too modest to identify at statistical significance at this sample size.) I should add that the original article being discussed is making claims that would not require any crossover trial to identify. If lowering cholesterol doesn't cause numerically higher suicide or depression, then the author's point is invalidated. 1 = https://www.jacc.org/doi/10.1016/j.jacc.2021.07.022 https://www.jacc.org/doi/10.1016/j.jacc.2021.07.022

atdrummond 5y ago

Japan has given us some very interesting lipid studies the past few decades. One continued the analysis of the famous seven countries study, and it found that chronic heart disease rates appear at the least uncorrelated to lipid rates, if not in fact possibly lowered by increased cholesterol: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6086557/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6086557/ They’ve also confirmed the heart sparing benefits of “good” cholesterol, HDL: https://www.ahajournals.org/doi/full/10.1161/01.STR.0000060869.34009.38 https://www.ahajournals.org/doi/full/10.1161/01.STR.00000608... On top of this, there are numerous studies showing that high total cholesterol (not just HDL) in women is linked to longevity and that perhaps that age and CHD advice on total/LDL cholesterol was only ever relevant for men. (See: https://www.karger.com/Article/Fulltext/342765 https://www.karger.com/Article/Fulltext/342765 for a thoughtful review of current Japanese lipid suggestions and the literature on longevity and vascular disorder.)

carbocation 5y ago
As has been noted by other authors who have specifically addressed the first article that you cite, Japan's decline in heart disease despite rising cholesterol appears to be due to Japan's reductions in smoking and blood pressure[1]. RCTs have demonstrated, over and over, that reducing LDL cholesterol reduces cardiovascular disease. 1 = https://www.sciencedirect.com/science/article/pii/S0167527318341482 https://www.sciencedirect.com/science/article/pii/S016752731...
- supperburg 5y ago
  No, there are RCT that show taking a drug which has the effect of lowering LDL, among many other effects, reduces heart disease. There is no proof that it’s LDL and not something else. And it’s not a coincidence that drugs that help heart disease have intersections with diabetic pathology.
  - carbocation 5y ago
    Between randomized trials and Mendelian randomization studies, all of the causal tools demonstrate that LDL is a causal biomarker. (There are other elements in the causal pathway, but very clearly LDL is one of them.) You are welcome to postulate a different explanation and test that novel mechanism, which is the process of science.

m_herrlich 5y ago

Interesting read but they lost me in the last paragraph before the conclusion where they recommend a specific brand and dose of cholesterol supplement.

wombatmobile 5y ago

This article looks like it might be a scientific paper, but look closer and it contains a promo for New Beginning's Sonic Cholesterol supplement which is a product from a company called New Beginnings Nutritionals https://www.nbnus.net/shopcontent.asp?type=About-Us https://www.nbnus.net/shopcontent.asp?type=About-Us which is a scheme for taking money from the parents of autistic patients. > New Beginnings Nutritionals was co-founded with Lori Knowles-Jimenez under the guidance and direction of Dr. William Shaw, PhD. Dr. Shaw is the Director of The Great Plains Laboratory, which specializes in the biochemical testing of metabolic disorders for diseases such as autism, PDD, hyperactivity, inborn errors of metabolism, and adult disorders such as depression and chronic fatigue. He is a PhD. biochemist that is world renowned as a researcher and speaker in the field of autism and related disorders. Dr. Shaw has been actively involved with both the Defeat Autism Now (DAN!) and Cure Autism Now (CAN) groups and is a board member of the National Academy for Child Development. He is the author of the books: "Biological Treatments for Autism and PDD" and "Autism: Beyond the Basics" that has helped thousands of parents seeking answers for their children on the autistic spectrum.

fsckboy 5y ago
this comment needs more upvotes!

ArchD 5y ago

The mainstream theory about dietary fat, cholesterol & CVD that started in the 1960s is mainly based on epidemiological studies, not randomized controlled trials. Additionally cholesterol is used for many bodily functions, including maintaining cell membranes. Cholesterol is so important that the brain produces its own. Yet, some doctors are very enthusiastic about pushing statin to people who have high LDL-C but are not sick. Because of studies like tho following, I decided to not believe in the mainstream cholesterol narrative: https://bmjopen.bmj.com/content/6/6/e010401 https://bmjopen.bmj.com/content/6/6/e010401 https://www.tandfonline.com/doi/full/10.1080/17512433.2018.1519391 https://www.tandfonline.com/doi/full/10.1080/17512433.2018.1...

RockyMcNuts 5y ago
The evidence that cholesterol is implicated in heart disease is quite strong. For one thing, people with genetic predisposition to very high cholesterol get heart disease early and die, and are now successfully treated with cholesterol-lowering drugs. For another, people who are at risk and take statins have fewer heart attacks (strong evidence), and live longer (limited evidence). It's likely true that we don't fully understand the dynamics, other factors may be implicated, stress, hormones, microstructure of coronary arteries. But I would caution against 'deciding not to believe' things about which there is a great deal of empirical work and a medical consensus. Small dense LDL and triglycerides may be better biomarkers for CVD than the typical calculated LDL-C. Calcium scans starting in middle age may be a good idea for people with CVD in the family or higher than normal cholesterol. Then if arteries are getting blocked you can consider dietary intervention, drugs, bypass before a heart attack. - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4525717/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4525717/ - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8174280/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8174280/
- ArchD 5y ago
  The claims in the 4S study paper referenced by the first paper is not generalizable to the general populration. The studied patients were as follows: - 75% smokers or ex-smokers - already had AP or MI episodes - 51% at least 60 yo - 57% were on beta-blockers. (How do you know that the statins are not mainly protecting against some unknown side effects of beta-blockers.) These patients are not healthy people. The observations do not constitute evidence that cholesterol itself is a risk factor. These days, a lot of doctors are pushing statins to people without any risk factor like age or high-blood pressure, simply because of high LDL-C. As for the second paper about sdLDL, the mainstream dogma is laser-focused on LDL-C, not sdLDL.

xdrone 5y ago

This article is suspect to me. Only 3 references, none of which are actually studying depression and diet. If this was true, wouldn't we see depression in communities with lower cholesterol, Communities like the Seventh Day Adventists, many of which are vegetarian or vegan? Personal opinion, articles of this quality are to keep the public confused on diet and maintain the status quo. The food industry is a giant money machine. It can't survive if you're eating boring old unprocessed plants for the majority of your diet. Here's a more reputable meta study on the subject of diet and depression. It's long so skip to the conclusion if you want the unsurprising results. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7084175/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7084175/

bfrog 5y ago

I think I’ve read more that sugar and processed foods correlate with obesity and depression more than cholesterol? Explains maybe some of the folks here posting turn around when going carnivore, not likely to eat a lot of sugars or processed foods. There’s lots of ways to be a vegan, not all of them are healthy

fsckboy 5y ago

bear in mind, for most people there is no link between dietary cholesterol and blood cholesterol. Your digestion/body does not take food cholesterol and absorb it directly into your blood. So for example, cholesterol could be bad for you in your blood (heart disease), but still good or neutral for you in your food.

fsckboy 5y ago
https://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/fats-and-cholesterol/cholesterol/ https://www.hsph.harvard.edu/nutritionsource/what-should-you... "The biggest influence on blood cholesterol level is the mix of fats and carbohydrates in your diet—not the amount of cholesterol you eat from food." https://www.healthline.com/nutrition/dietary-cholesterol-does-not-matter https://www.healthline.com/nutrition/dietary-cholesterol-doe... "However, dietary cholesterol has little to no effect on blood cholesterol levels in most people." https://www.medicalnewstoday.com/articles/does-dietary-cholesterol-affect-blood-cholesterol https://www.medicalnewstoday.com/articles/does-dietary-chole... "A scientific advisory from the AHA indicates there is no proven link between the risk of cardiovascular disease (CVD) and dietary cholesterol.."