Comment by heymijo | Hacker News Reader

Comment by heymijo | Hacker News Reader

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Dietary cholesterol has little impact on blood cholesterol.

Yes, it's confusing as the names are the same.

Yes, high blood cholesterol can lead to heart disease.

But here's the thing, the body synthesizes its own cholesterol. Mainly in the liver. Dietary cholesterol doesn't have much if anything to do with this process.

Statins work by reducing the liver's production of cholesterol leading to lower blood cholesterol levels and decreasing the risk of heart disease.

Now, a change in diet can "do the trick" and lead to lower blood cholesterol levels but for different reasons than the amount of cholesterol in the food.

The big caveat to all of this is for some people who are genetic outliers and people with diabetes.

Here are a few sources you can check out:

Dietary Cholesterol, Serum Lipids, and Heart Disease: Are Eggs Working for or Against You? https://www.ncbi.nlm.nih.gov/pubmed/29596318

Cholesterol Overview https://www.hsph.harvard.edu/nutritionsource/what-should-you...

Cholesterol in Food https://health.clevelandclinic.org/why-you-should-no-longer-...

It has little impact on fasting cholesterol, but absolutely raises your blood cholesterol after eating it. So e.g. you eat one egg, you get a spike in blood cholesterol. Wait 8 hours, it's gone. So it would seem that if your baseline fasting blood cholesterol is "healthy", eating one meal a day that leads to a spike in blood cholesterol should not be an issue. The problem is if you eat an egg for breakfast, then bacon on toast for brunch, then a steak for lunch, then an afternoon snack and then a burger for dinner. In that scenario your body can't clear out the dietary cholesterol you've ingested and you absolutely have a persistent raise in blood cholesterol.

Of course then there's still the question of if cholesterol is a cause of, or an indication of increased danger of cardiovascular disease. This guy [1] summarises several studies and it comes out as a shrug. At least we know that statins do help people to not have a second heart attack. The science on this is progressing slowly partly because you need to run 10-year long trials on thousands of people to get good data.

[1] https://www.youtube.com/watch?v=0RKrFQ-cKZc

That's good context that I did not know. Thanks.

If you open the first study you are citing, it’s says in the original PDF:

Conflicts of Interest: M.L.F. and C.N.B. have received prior funding from the Egg Nutrition Center. The funding sponsors had no role in the interpretation of data or the writing of the manuscript.

https://examine.com/nutrition/will-eating-eggs-increase-my-c...

That's true. In this case, a broader search will show you that in spite of the potential conflict, the research seems solid.

if dietary cholesterol is not the primary culprit, which is it ? systemic imbalance in how cholesterol and lipids are transported back and forth in your body ? vascular health ?

Meaning a low cholesterol diet person could still suffer from plaque due to accumulation ? while someone with more cholesterol intake may be ok because her/his body would not accumulate plaque ?

More about blood sugar signaling than lipid content.

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