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


60 points | by supperburg 25 days ago


  • carbocation 25 days 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.

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    • fspeech 25 days 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 25 days 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 =

      • supperburg 25 days ago
        I disagree. These drugs do a lot more than change cholesterol.
      • wombatmobile 25 days 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

        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 25 days ago
          this comment needs more upvotes!
        • chiefgeek 25 days 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.

          • hirundo 25 days ago
            Much the same, one year carnivore as of last week. Physically I'm greatly improved. Mentally I'm happier and less fragile, and I've been particularly productive at work.

            But my cholesterol has risen and my doctor wants me on statins. Brain fog is a common side effect of those. I declined. I don't believe my higher cholesterol is dangerous in a carnivore context, but even if it were, I would tend to choose a clear mind and a sudden death over a fogged mind and longer life.

            I also have extended strict vegan experience, and stopped partly due to brain fog.

            • mancerayder 25 days ago
              Do you have exercise habits ?

              I notice in this thread there is little mention of this giant portion of the heart-health puzzle, and talk of nutrition only.

              I've been doing weight training for years (because I don't enjoy endurance exercise) and it's kept my numbers in strong shape. I eat a vast amount of animal products (although heavily biased towards fish and eggs instead of red meat), and could not imagine for a second a vegetarian and especially vegan diet.

              I think a vegan diet requires supplementation (B12, and god knows what else), for one thing, and most vegans aren't doing it for health reasons but for moral ones.

              But I still think the biggest health killer is a lifestyle with insufficient movement in the day to day. Many people don't even walk anywhere, and their ever-increasing sizes show it.

              • LinuxBender 25 days ago
                Most doctors are also quite a bit behind on the science around cholesterol. Most of them still just measure HDL and LDL and consider LDL to be "bad". There is some hope however. Some doctors are starting to do lipid panels on the LDL to get a spectrum analysis of small dense particles to large buoyant particles. There is light at the end of the tunnel, at least for the doctors that are not being coerced into pushing statins.
                • chiefgeek 25 days ago
                  I told my doctor I would not take them. No way. I haven’t felt this good in years.
                • PragmaticPulp 25 days ago
                  > As someone who began eating carnivore eighteen months ago

                  18 months is around 2% of your total expected lifespan. Cardiac issues take decades to build up. It’s far too early to draw conclusions about the diet after less than 2 years, especially when you spent twice as long on a vegan diet immediately before the carnivore diet.

                  • chiefgeek 25 days ago
                    Could be. I know that if I had remained vegan, I probably wouldn’t be here now. I felt terrible. There were multiple things going on with my health - both physical and emotional - and vegan was helping exactly zero of them. And I was doing it on the advice of multiple physicians, two of them “integrative/functional medicine. I’ll take the conclusions I’ve drawn so far, thank you.
                    • mentos 25 days ago
                      I did a carnivore diet for 3 months this year it really opened my eyes to how different you can feel running on a diet without carbs/sugar. Took me about 3 weeks to transition and definitely had withdrawal symptoms with deep cravings for bread but managed to break through and found a completely new horizon on the other side. Biggest improvement was to my cognition, I could keep a bunch of nested thought bubbles up and open in my mind for much longer. My mood improved to the point where I felt almost a spiritual calm during the day and made me wonder if maybe I've been pushing through life with a low grade depression. My joints stopped cracking and some nerve pain I had from long covid completely subsided. Unfortunately I had to stop the diet because I was losing too much weight (I'm normally 5'11 155lbs but started to fall under 148lbs) and could not eat enough to remain stable.

                      Since May I've gone off the diet and been indulging in carbs/sugar at every turn to try to get back up and above my normal weight (I'm at 165lbs now) and it has been like dropping a neutrino bomb on my cognition. I would describe my new mental state as being in a stupor. Writing this recap I'm struggling with word recall and remembering all the events of my diet and just generally feel lethargic/slow. Once I get to 170lbs I'm hoping to give the diet another go this fall and maybe be able to go for a bit longer and give me time to experiment with other calorie sources like sweet potatoes/white rice/berries.

                      Anyways, leaving this comment here for myself as a note to reflect back on and some anecdote for anyone interested in trying the diet. I'd recommend it if you're curious.

                      • adventured 25 days ago
                        I'd strongly advocate for white rice as an inclusion for carbs. I consider it to be almost magic. When I hit my early 30s, I wanted to find a consistent diet for the rest of my life that would give me the weight I prefer along with the broader mental/health/enjoyment outcome I was looking for, that balance. I didn't want to have ongoing weight-diet conflicts, I was looking for easy consistency to maintain as I got older (I don't want to have to think much about it, I don't want to have to manage it or fight with it; I want it to just work, day in day out, for my lifestyle). When I first began testing out various diets and measuring, I assumed brown rice would be necessary/ideal to get the results I wanted. That turned out to be false, white rice worked remarkably well. Which was great, because I dislike brown rice unless I bury it in seasoning, whereas I enjoy white rice plain.

                        Another thing you might consider along with white rice is (ab)using one day per week as a carb stuffing day to artificially float your weight a bit, if that's a concern. I've found that injection of carbs didn't cause carb-induced brain fogging through the rest of the week, and I use it to occasionally eat unhealthy things that shouldn't be consumed frequently. I eat a low calorie, low sugar diet that I'm quite happy with, so that optional carb-heavy day is a nice flex point in an otherwise rigid dietary approach.

                        • mentos 25 days ago
                          Ah great to hear, thank you for your story. I share the same sentiment of wanting something easy and dependable sounds like white rice may be that.

                          Yea I think if I can't control my weight the second time around, I'll consider doing a carb day on Fridays so that I have the weekend to recover. Thanks for that suggestion!

                    • lambdaba 25 days ago
                      There are many anecdotes of people reversing arterial plaque calcification with an all-meat diet. Hypertension, type 2 diabetes, etc., all reversed. If those hypothesies were true that shouldn't happen ever.
                      • sgtnoodle 25 days ago
                        My cholesterol was at its lowest the year I ate low carb and did high intensity workouts, and I lost 40 pounds. I was eating bacon and 2-3 eggs every morning.
                      • supperburg 25 days ago
                        Cardiac symptoms take decades but CAC increase doesn’t take decades.
                      • supperburg 25 days ago
                        A lot of people get CAC zero and that’s great. But we need someone who’s been carnivore for 1 or 2 years to get an angiogram to settle the heart disease debate once and for all. Because CAC still leaves the possibility of non-inflamed congestion. Paul Saladino announced he was going to get one a while ago but fell silent on it. I even DMed him about it but he never responded. I really wish someone would do an angiogram.
                        • chiefgeek 25 days ago
                          I’ll look into the angiogram. Very interesting. I wonder why Saladino hasn’t steeped up?
                          • chiefgeek 25 days ago
                            I did the heart scan after a year of carnivore AND I was still eating sugar (bad addiction, kicked six months ago). It’s now been 18+ months. I will do another in six months.
                          • xyzzy21 25 days 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!

                            • trombonechamp 25 days 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.

                              • tsimionescu 25 days ago
                                > 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.

                                That is not how science works. A scientific experiment has to have enough statistical power for the claim you are trying to make. If it doesn't, then you don't make the claim.

                                As you say, it's extremely hard to make good (I would say even decent) nutritional studies. The vast majority of nutritional studies are not even close. Why then do dieticians pretend to be medical doctors and give advice based on these studies? Why do they give advice to entire nations based on scientific-sounding gobbledygook?

                                When you don't know something, the scientific thing to do is to say you don't know. Physicists don't claim they know how gravity works at the quantum level just because they have some models that sorta kinda work sometimes. A linear model of a non-linear phenomenon is not in any way better than no model - it's obviously worse.

                              • HPsquared 25 days ago
                                More generally, it sounds like a problem of too much extrapolation.
                                • zeusk 25 days ago
                                  what's DoE?
                              • wibagusto 25 days ago
                                “Fat is bad push” has nothing to do with veganism. In fact the opposite: fat is essential. As a vegan I eat tubs and tubs of olives, avocados, cashews, almonds, peanuts, hazelnuts you name it—all loaded in fat.

                                The “fat is bad” push is a product of the sugar industry and using nutrition labels to sell products to consumers based on fear. And it was an easy sell because people were getting fatter (due to sugar intake and nutrition-devoid white bread).

                                Which brings me to gluten free: If you think you have gluten intolerance but you don’t swell up when eating whole wheat bread (e.g. no celiac disease), you’re probably eating some crappy off-the-shelf loaf with all kinds of additives.

                                Gluten free is just as stupid as Keto diets. The only real diet is in balance. It’s real fruits, vegetables, legumes, and other plants. Meat contains MINIMAL nutritional value compared to the plant world.

                                • chiefgeek 25 days ago
                                  “ Meat contains MINIMAL nutritional value compared to the plant world.” This is categorically untrue. Meat has more bioavailable vitamins than any food.
                                  • wibagusto 25 days ago
                                    You’ll have to give a source on that because just looking up nutritional value of Kale (one vegetable) I think that’s a tough sell.

                                    In fact kale juice alone is proof milk is not necessary.

                                    • lambdaba 25 days ago
                                      Absorption is what's important. It should go without saying flesh is easier to break down than cellulose (add to that that various plant compounds inhibit absorption and impose a toxic burden, e.g. oxalates, phytates, etc.)
                                      • chiefgeek 25 days ago

                                        There are links to various studies in the article.

                                        • Aengeuad 25 days ago
                                          When looking at nutrient rich vegetables serving size has to be considered, it's going to be difficult to eat 100g nuts or of parsley in a meal for instance. This is less of an issue with things like potatoes or bulky leafy greens like kale but is still something to keep in mind. Another thing to consider is overlap between what types of nutrients you're getting, it's sensible to say that diets should be balanced but when you're talking about fruit/vegetables it's a necessity as they're often not good for broad nutrients or mineral content.

                                          In terms of nutritional value let's start with 100g of cooked kale, you're getting vitamin a/c/k and some manganese but not much else. Broccoli has vitamin a/c/k/folate. Bell peppers vitamin a/c/k/b6. Potatoes vitamin c/b6, potassium/manganese. Tomatoes vitamin a/c. Avocados have vitamin c/e/k/b6/folate/pantothenic acid and some potassium. Olives have iron and copper.

                                          At this point a pattern is emerging, significant amounts of vitamins a/c/k, some folate, some b vitamins if you're lucky, and mineral wise it's mostly manganese and potassium. Spinach and mushrooms are much more interesting, with spinach having vitamins a/e/k/riboflavin/b6/folate, calcium/iron/magnesium/potassium/manganese. White mushrooms have vitamin riboflavin/niacin/pantothenic acid, iron/potassium/copper/selenium.

                                          It should be noted that these are all 100g servings (cooked where appropriate) which might not be ideal. So while kale is indeed incredibly rich in vitamins a and k (1021% of your daily value in just 100g of kale!) it's really, really not useful to you if you're already eating even just reasonable amounts of vegetables, as leafy greens especially usually contain lots of vitamins a/c/k. Something that is lacking in most of these is minerals in any significant quantity, nuts in general do a lot better with a 100g serving of most types of nuts providing 15-85%~ of your DV in minerals, but it shouldn't need to be explained that eating 500 kcal of nuts to get close to your DV in minerals isn't ideal.

                                          When compared to meat or animal products liver would be the gold standard, with 100g of beef liver containing significant amounts of vitamin a and all of the b vitamins as well as folate, along with large quantities of iron/phosphorus/zinc/copper/selenium along with some manganese and potassium. With just 100g of liver and 100g of kale you're going to get roughly >85% of your DV vitamin and mineral needs with the exception of vitamins d/e and magnesium/potassium. Other cuts of meat (beef/chicken/pork) or animal products aren't quite as good but you'll still be getting decent amounts of b vitamins (sans folate) and iron/phosphorus/zinc/selenium and calcium from cheese specifically. With fish/seafood it depends on the type but sardines are a particularly good example providing lots of vitamin d/niacin/b12 and reasonable amounts of calcium/iron/phosphorus/potassium/copper/manganese/selnium.

                                          This comment is all over the place so to try to conclude and put it more succinctly, the common deficiencies that vegetarians face (vitamins d/b12, calcium, iron, zinc, omega-3) shouldn't be dismissed so easily especially when trying to make the point that meat contains 'minimal' nutritional value. Even nutrients that are commonly used to fortify foods (calcium, iron, thiamine, niacin, folate, vitamin d, iodine) are all readily found in meat/animal products with the exception of folate (it's abundant in liver but common in vegetables).

                                          • wibagusto 25 days ago
                                            For the “deficiencies”: nutritional yeast for b12, sunlight for d3, hemp seeds for omega 3 oils. All abundant all easy to obtain.

                                            Calcium, iron, and zinc easily obtained in collard greens, kale, spinach, brown rice, whole wheat, etc.

                                            Point being: there should be no deficiencies (including cholesterol) when eating balanced plant foods.

                                      • ArchD 25 days ago
                                        I've got nothing against Carnivore, but you confused Keto with Carnivore. You can eat lots of plants on Keto.
                                        • wibagusto 24 days ago
                                          I suppose I mean specific diets like Keto or Gluten-Free are extreme diet concepts and easily unbalanced.
                                      • brandonmenc 25 days ago
                                        > As someone who began eating carnivore eighteen months ago after three plus years as a vegan

                                        From one faddish extreme to another.

                                        Anecdotally, I feel best when I eat a varied diet where ~20% of my calories come from healthy i.e. unsaturated fats and ~60% of the calories come from whole grain carbs.

                                        Serious question though: did you feel great in the early phases of your vegan diet? If so, maybe you're getting a rush from the positive feedback of adhering to a set of strict rules.

                                        > We were sold a bill of goods with the whole “fat is bad” push.

                                        Honestly, the messaging for over a decade now is that carbs are bad. No one is like, thumbing their nose at "pop nutrition" by saying this.

                                        We are definitely going to find out that this also was a horrible overcompensation.

                                        • chiefgeek 25 days ago
                                          I'm glad that works for you. It doesn't work for me. I went from worse than SAD (Standard American Diet) slowly into gluten free, then sort of vegetarian, then vegan. I had two different functional medicine docs prescribe a very strict elimination diet. Nothing alleviated my symptoms - fibromyalgia, brain fog, constant fatigue that required a nap daily, sore joints and a messed up lower GI. I did not feel great on the early phases of the vegan diet. I really never felt good at all while eating vegan. I also have an oxalate intolerance which means most vegan foods are not good (whereby "not good" means they make it feel as though I'm peeing razor blades).

                                          I didn't feel great initially on the Carnivore diet. In fact it took months and months to get my system cleaned out. I had diarrhea for most of the first year. I quit sugar six months ago, which as also been a huge help. I realize it may not be for everybody however right now it is for me. My doctor told me, "Whatever you're doing, keep doing it." I can go hours without eating if I have to. I never get "hangry". I eat when I'm hungry, as much as I want until I'm full.

                                          The current zeitgeist that says we all have to eat plants for optimal health is plain wrong. I'm 52 years old. I've done a lot of experimenting. Fat is not the enemy. Carbs are the enemy. Also, just about any diet that relies on drastically restricting your caloric input is bound to fail.

                                          > Honestly, the messaging for over a decade now is that carbs are bad

                                          Maybe, but for YEARS it was "fat is bad". And it isn't. It is incredibly satiating. And that messaging came from Big Ag, who completely buried the very valid research of an English scientist, John Yudkin.


                                          • fredophile 25 days ago
                                            In your posts you said you've been eating carnivore for 18 months but you also say you cut out sugar 6 months ago. My understanding of the carnivore diet is that it doesn't contain sugar, except possibly from sources like milk if you're allowing it in your definition of carnivore. Can you elaborate on where the sugar in your carnivore diet was coming from?
                                            • chiefgeek 25 days ago
                                              I was not full carnivore until 6 months ago. I have a serious addiction to sugar. I was on and off of it for the first year. I kicked it for good six months ago. I’m the sugar was coming from chocolate bars, mostly.
                                        • wolfi1 25 days ago
                                          fun fact: the food intake does not change cholesterol levels, the body itself produces it
                                          • heavenlyblue 25 days ago
                                            What were you trying to achieve with a gluten-free diet btw?
                                            • chiefgeek 25 days ago
                                              It felt as though I had some sensitivity to gluten. I get a stuffed up nose within minutes after eating it. Overall, I was battling a high level of inflammation (homocysteine was 26; 10 is high normal, I believe) and was looking to cut out possible contributors. It worked.
                                            • agumonkey 25 days ago
                                              how much physical exercise do you get btw ?


                                            • xdrone 25 days 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.


                                              • rgrieselhuber 25 days 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 25 days ago
                                                  I'm interested if you could share more details of what you've seen.
                                                • atdrummond 25 days 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:

                                                  They’ve also confirmed the heart sparing benefits of “good” cholesterol, HDL:

                                                  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: for a thoughtful review of current Japanese lipid suggestions and the literature on longevity and vascular disorder.)

                                                  • carbocation 25 days 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 =

                                                    • supperburg 25 days 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 25 days 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.

                                                        • supperburg 25 days ago
                                                          There are numerous examples of people with elevated LDL for years who have zero CAC or no cardiac symptoms. It’s easier to disprove something I admit.

                                                          I am still in the process of becoming learned. Eventually I will finish biochemistry, read all the relevant studies and truly get to the bottom of it in a way that is convincing. So even if I am wrong and spreading wrong information I will have a positive contribution in the long term. But I am being intellectually honest always.

                                                          • carbocation 25 days ago
                                                            The fact that LDL cholesterol is not the only risk factor for heart disease is very well established - just as well established as the fact that LDL cholesterol is a causal risk factor for heart disease. Unfortunately human diseases almost never have a bijective relationship with a risk factor.
                                                  • bfrog 25 days 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
                                                    • ArchD 25 days 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:

                                                      • RockyMcNuts 25 days 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.



                                                        • ArchD 24 days 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.

                                                          • RockyMcNuts 22 days ago
                                                            the 2 links cover a bit of ground, if those are the only 2 cherry-picked criticisms it would seem to validate the rest?
                                                            • ArchD 21 days ago
                                                              A full criticism would take a book. There are such books and presentations you can find easily and the papers I linked to are a start.

                                                              I was just giving examples to show that there are flaws. The appearance of scientific rigor and trustworthiness disintegrates as you find more and more flawed studies or unsubstantiated arguments from the orthodoxy.

                                                      • m_herrlich 25 days 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.
                                                        • cmarschner 25 days 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.”
                                                          • cmarschner 25 days ago
                                                            • chmod600 25 days ago
                                                              What are the implications for a vegan diet?
                                                              • supperburg 25 days 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 25 days 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.

                                                                • goldenkey 25 days 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 25 days 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).

                                                                    • Buttons840 25 days ago
                                                                      There's a guy out there, I haven't been able to find him again, but he measured his cholesterol daily and carefully controlled his diet. The results were incontrovertible, when he ate things like eggs and meat, his cholesterol went down, these were the objective results.

                                                                      Either this guy is lying, or that's how it works for some people. But beware, this guy claims it's not the same for everyone, so don't assume that your body responds the same way his does. Ask your doctor or make your own observations.

                                                                      Unfortunately good and detailed cholesterol tests are expensive.

                                                                      I wanted to be a fly on the wall when this guy showed his doctor that his advice to avoid eggs resulted in higher cholesterol, clear as day.

                                                                      • rebuilder 25 days 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.
                                                                        • xyzzy21 25 days 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.

                                                                          • ozim 25 days 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.

                                                                            • ianai 25 days ago
                                                                              Is there a reputable source for this? Like for an outsider to grasp what the literature knows about affecting cholesterol.
                                                                        • xutopia 25 days ago
                                                                          B12 deficiency.
                                                                        • goldenkey 25 days 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 25 days 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 25 days ago
                                                                              Whoops, I remembered wrong. Isn't there some neurotransmitter that is made from cholesterol?
                                                                          • fsckboy 25 days 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.