Saturated fat: villain and bogeyman in development of cardiovascular disease? | Hacker News Reader

Saturated fat: villain and bogeyman in development of cardiovascular disease?

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48 pointsdeegles101 comments

I buy into the counter theory that high fructose corn syrup is killing us all and that arteriosclerosis is one of its manifestations. I think some people are even trying to blame it for osteoporosis. Something to do with blood pH and bones dumping calcium to buffer it.

Bullshit or not, my life does seem to be better without cheap soda in it. I drink fancy soda as a treat, instead of being on a hedonic treadmill of several a day. Every time I quit soda in my 20’s and early 30’s I lost 10 lbs. Eventually it stuck.

The advent of Kombucha changed that landscape quite a bit. Now I have a beverage that’s < 100 calories and I can’t chug.

You forget one thing: outside of US, people don't put HFCS into everything like there's no tomorrow. We use sugar proper across the pond, and while it's a poison, it's not to the extent fructose is.

There are at least 56 different names for sugar on food labels in the USA

Table sugar is also high fructose. Sugar is also called sucrose, it is 50% fructose and 50% glucose.

High fructose corn syrup is "available at various fructose levels. HFCS 42, used in beverages, processed foods, cereals and baked goods, comprises 42 % fructose and 53 % glucose. HFCS 90 comprises 90 % fructose and 10 % glucose... HFCS 55, which is used in soft drinks."

-https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5983097/#:~:tex....

I think sucrose tastes better but it seems to be processed in the body the same way as corn syrup.

Btw, fruit juice or honey are also high in fructose. Most likely they are all equally bad. All stored in the liver and all build insulin resistance.

Sucrose is mostly not processed like fructose. Fructose is processed in the liver, sucrose mostly by the regular digestion tract, with a little bit in the liver. You should do more reading, it's pretty fascinating.

No this is just lore, there is a great deal of pseudo science around this. They are slightly different chemically so it's not impossible but there is no evidence to that effect.

Note also that Sucrose is 50% fructose, so saying sucrose isn't processed like fructose is very unlikely.

There is lots of speculation even in the mainstream, but our best understanding now is that they are similar.

This is a fallacy, HFCS is no worse than cane sugar. What is more important is the amount stuffed into food. HFCS has been demonized when it's sugar&hfcs that should be demonized. Human bodies can handle small amounts of sugar pretty well but when you increase that 10-100x like modern America diets then you get issues.

There is one thing worst than fructose: fat + fructose.

There was a study where some kids with fatty liver replaced most fructose with glucose and the liver fat was severely decreased.

Fructose + fat seems to be the most destructive thing in practice.

You're talking about pie. Pie is poison. Apple pie, cherry pie, peach pie. Home-made by grandma with her own wrinkly hands. Poison.

That's a hard pill to swallow.

These pies are a new invention.

Humanity has never eaten so much carbs + fats at the same time as we do now.

The fact that your dear grandma makes it does not make it less poisonus.

Even our grandparents eat totaly different foods nowadays then people 200 years ago do, so even though grandma is old compared to us, she is still a very young compared to human evolution and our dietary changes.

maybe not the combination but fat is very essential in early human diets so it stands to reason we are pretty fucking good at processing them (barring the frankenfoods produced by hydrogenated fats). We never encountered the quantities of sugar that we encounter now in foods now however. They took out the fat and put in sugar to keep it taste in man-made concoctions like "low fat ___________"

Wasn't grandma using cane sugar?

Ya but the fruit is full of fructose.

Nobody was fat when grannie was a little bit younger and ate her own pies, litteraly nobody.

That was all the smoking and lack of micro plastics

When you read US novels about 1920s and 1930s, there are actually fat characters in them.

The meaning of ”fat” is also very different from the contemporary.

Historically and for most people, pies were baked as a way to stretch foodstuffs. "Sugars" were added to make meat and other ingredients that turn sooner more palatable. Lots of baking before refrigeration was done with an eye toward food preservation.

Sugar as a fungible and fiber-free isolated ingredient made dessert baking more economical and of course we love sugar naturally so demand skyrocketed. The Caribbean slave trade and the decades of indentured servitude that followed was really pushed by new high demand for sugars. Pies got sweeter and more decadent. People aren't today baking turtle or rabbit into their pies with a few dried apples for flavor. They're wrapping syrupy fruit in fat and flour -- or in some cases just making pies with sugar fluff alone.

Grandma herself is generations removed from the original rationale for pie and we're even more so. You're right, pie is a blight today despite being oh-so-nostalgic. You don't need to seek out something so obviously sickly sweet as grandma's cherry pie to find issue though. Pasta sauce, bread and even processed meat contain far more sugar than at any time in history. Fruits and vegetables are even sweeter due to our crop selection and our meat contains more fat per gram of protein because of our farming methodology.

Just by eating an ordinary American lunch today, we probably take in in something more nutritionally similar to our former generation's special weekly indulgence than their evening meal; literal pie is just the cherry on top.

It’s time to put this tired myth to bed. The truth is that HFCS and table sugar are virtually identical, and the health effects of consuming either are the same.

https://www.healthline.com/nutrition/high-fructose-corn-syru...

If fructose is much more toxic than glucose then NO, they are NOT identical since it would depend on the ratio between fructose to glucose.

It would dependt on the concentration of fructose vs glucose in HFCS, so in theory HFCS might be diffren.

>> The 2 most important HFCS products of commerce contain 42% fructose (HFCS-42) and 55% fructose (HFCS-55). The remaining carbohydrates in HFCS are free glucose and minor amounts of bound glucose, predominantly maltose (di-glucose) and maltotriose (tri-glucose). Mention of HFCS with higher fructose content (ie, HFCS-80 or HFCS-90) is occasionally seen in the literature, but these products are highly specialized and are manufactured infrequently and in insignificant amounts.

https://academic.oup.com/ajcn/article/88/6/1716S/4617107

Eg a potato and an apple might have the same amount of carbs, but since an apple has more fructose it's more toxic (assuming we only measure toxicty based on the glucose:fructose ratio).

It matters how quickly it is absorbed and the actual -amount- as usual. Apple has far less "energy" per volume than a potato. You can't just look at ratios obviously. all that glucose gets broken down into sucrose and fructose and that's the point. Being toxic is a function of both "chemical" and amount. a potato will have a much higher amount of fructose per unit that an apple after it all gets broken down, an apple also has fiber that will slow down the absorption of the glucose/fructose.The ratio of fructose/sucrose in standard issue is such that it should be slightly worse than cane sugar, but not that much worse.

What are you even talking about?

You mixed many words + potato has practicaly 0 fructose compared to an apple.

When a potato is eaten, the amylase in the saliva mixes with the potato starch and starts breaking it down into sugars, some wil be glucose acording to [1].

You can test this yourself by eating a plain cracker. A plain cracker doesn't contain any sugar, but if you keep chewing it you will notice a sweet taste in the mouth. This is from the sugars released by amylase.

There is no mention of fructose on the amylase wikipedia page. So maybe you are right.

[1] - https://en.wikipedia.org/wiki/Amylase

I buy into both parent statements - table sugar and hfcs are basically the same AND hcfs is in absolutely everything and is bad for us

The point is that if HFCS was replaced with table sugar it would be 90% as bad and essentially the same in the grand scheme of things. This is why I cook 80% (approx) of my own food. I do eat out occassionally I suppose but most of my food comes from raw ingredients where I control what goes in. It's also far cheaper.

Your article took a surface look at the issue. Here is a study showing they are not identical.

Effects of high-fructose diets on central appetite signaling and cognitive function https://pubmed.ncbi.nlm.nih.gov/25988134/

Added sugar and saturated fats are both bad.

Do you have evidence for this theory?

Researchers link high LDL cholesterol to things like saturated fat and dietary cholesterol. Arteriosclerosis has been linked to LDL cholesterol, too. Dietitians, doctors, and health programs have done diet altering programs with people to lower the intake of these and see LDL cholesterol drop.

Numerous papers are linked here and can be found in search.

Do you have evidence for your view? Papers on it?

Update: Note, I'm not suggesting high fructose is good. We digest fructose differently when it's by itself compared to when it's part of the fruit/fiber it comes from. Eating fructose in fruit with all the parts is healthy.

Dietary cholesterol has little relationship to blood lipid levels.

https://doi.org/10.3390/nu13061935

The paper itself is interesting. By in large the study consisted of people who already had high cholesterol (to the level their doctor would likely recommend putting them on a statin) and eat above the recommended level (from the american heart association) of saturated fat and a fair amount of dietary cholesterol.

They don't appear to say how they deal controlling for other factors that raise ones cholesterol.

Reading through the paper I find it hard to see signal among so much noise. And, it looks like the data shows the more people increased dietary cholesterol the more their cholesterol levels increased.

It makes me wonder how they draw their conclusions. Reading the paper and looking at their data doesn't give me confidence in their conclusions.

No papers to link. Anecdata of n=1.

My cholesterol levels were always very high. Even with statins. They helped but less than doctors wanted and they kept increasing even when increasing statin dose to the max. I craved lots of sugary stuff too. Cut out fat, didn't eat any eggs except what's hidden in the sugar stuff etc.

Then one year I decided to do Keto. Levels were still elevated but multiple points lower than before. Actual <20g carbs Keto. Quite a bit on the carnivorous side too.

I'm back to a 'normal' diet but this time I am not cutting out fats. In fact I'm eating lots of healthy fats (that were previously and maybe still are marked as "bad") such as eggs and butter and cream. I also eat carbs again, though I try for less sugary stuff. Cholesterol levels are slightly up again.

My conclusion: Carbs (overall) are the bad guy.

My doctor told me (again I have no papers to link) that the most up-to-date science nowadays seems to suggest that carbs, especially refined carbs, cause inflammation and calcium deposits in arteries which the body tries to "repair" (overlay) with cholesterol (that's its job). Problem is if it keeps doing that up to the point where it blocks. But cholesterol isn't the bad guy basically. It's just doing its job and if you don't eat the cholesterol, the body makes it by itself so that it has it available to do its job.

Totally. I've moved my addiction from soda to La croix, and noticed a big difference.

I think jumping to conclusions based on this paper is not a good idea:

  * The authors are not experts in this field. They seem to be experts in business management [0], other science fields [1], and the culinary arts [2] but not cardiovascular disease or anything related to it.

  * Experts in this field have done extensive reviews, and there is a strong link between saturated fat & CVD, especially if you take into account replacing SFA with PUFA.

  * All the world's health bodies agree — from Wikipedia: "Recommendations to reduce, limit or replace dietary intake of trans fats and saturated fats, in favor of unsaturated fats, are made by the World Health Organization, American Heart Association, Health Canada, the US Department of Health and Human Services, the UK National Health Service, the UK Scientific Advisory Committee on Nutrition, the Australian Department of Health and Aging, the Singapore Ministry of Health, the Indian Ministry of Health and Family Welfare, the New Zealand Ministry of Health, and Hong Kong's Department of Health." [3]

  * In my observation, many people strongly dispute the link between SFA & CVD usually subscribe to fringe health beliefs like all-meat diets, etc. Note: I do think limiting sugar/HFCS is a good idea as well.

[0] Reimara Valk: https://www.aud.edu/aud-school/school-of-business-administra...

[1] James Hamill: https://scholar.google.com/scholar?q=author:%22Hammill%20Jam...

[2] Jonas Grip: https://ch.linkedin.com/in/jonas-karl-grip-89875a12

[3] https://en.wikipedia.org/wiki/Saturated_fat

>I think jumping to conclusions based on this paper is not a good idea

Something that I think most people on HN need to realize is that we are not experts on biology or medical science, so we shouldn't be reading these papers and coming up with conclusions on how to live our lives. Until the organizations that you list in your 3rd bullet point start changing their recommendations, we'd all be well served to follow their advice.

The tech community is saturated with hubris and inflated egos.

It's always funny when you read HN comments chastising people for not staying in their lane and getting things wrong about tech and then reading the comments on articles like this. Obviously the overlap on people in the respective comment sections I'm talking about isn't 1:1, but it's a pretty good illustration of people not sticking to the standards that we hold others to.

I'm undoubtedly guilty of the same thing sometimes as well.

Something that I think most people on HN need to realize is that we are free to choose on our own, given the information presented, and that doesn't require one to be expert on biology or medical science.

You are of course free to do so, but that's not likely how you're going to get the best results.

I disagree. Professional has knowledge but lacks context. You lack knowledge but know all of the context. You can improve knowledge but professional can't improve knowing everything relevant about you. You are in far better position to handle your health then anybody else.

Sure. But what is known about atherosclerosis is that plaques are not _on_ the arterial wall, but _inside_ the arterial wall. For plagues to form, fats have to be pulled into the arterial wall. How does this happen? Inflammation as designed opens up the arterial wall as a way to allow immune cells passage. Atherosclerosis happens when you have a bunch of fat in your arteries and you open them up to go inside. That's why cheeseburgers and pizza are the perfect heart disease vectors (Western diet). The bread parts cause inflammation via innate immunity (saccharomyces receptors) and the saturated fat parts (cheese and meat) flow in.

https://pubmed.ncbi.nlm.nih.gov/18163971/

"Fats" don't flow in, lipoproteins do at high blood pressure parts.

It has nothing to do with saturated fats being pushed in.

It's more likely that foods high in saturated fats cause inflammation of the blood vessels.

But there is no difference between saturated and unsaturated fats since they are all transported in lipoproteins once they are in the blood.

The issue is inflamation, not the actual lipoprotein cargo (fat, cholesterol,..) that gets pushed in.

The real question is what causes the blood vessels to get damaged.

saturated fats are associated with increasing LDL cholesterol. Here's another paper on it... https://pubmed.ncbi.nlm.nih.gov/9101427/

From the paper... "Thus, an important mechanism by which reductions in dietary saturated fatty acids decrease LDL-cholesterol in humans..."

unsaturated (e.g., polyunsaturated) fats do not have the same association.

There are now many studies and papers linking saturated fat to increased LDL cholesterol. This is why groups, like the American Heart Association, recommend low intake of saturated fats (20 grams per day or less).

It’s not at all clear that LDL is actually bad. Some studies show that LDL is inversely correlated with all cause mortality. That is, the lower your LDL, the sooner you die.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8586008/#:~:tex....

There are also fascinating studies showing a strong link between aggression and violence and low LDL in all animals with vertebrae.

Did you look at the study, the details, the limitations, how info was collected, and so forth? I just did a quick read. The data set they're working with is incomplete and poor. It also deals with LDL levels while only looking at baseline and takes no account in for people on drugs to alter it.

So much detail is missing, poor, or uncontrolled for that it's only good to show you published, have something on your resume, and use to justify more research could be useful in the space.

I don't disagree. It's actually my belief that most nutritional and health science is likely bunk. Partially, it is for the same reasons there is a lot of bad science, which you touch on. But it also has it worse than other fields - look how bad a lot of CS papers are, where you're dealing with a domain that is, relatively speaking, one in which you can generate immediate, obvious, and empirically demonstrable results. Now, imagine a field dealing with the most intricate and complex system known to man, where actual clear, concrete results may take decades to manifest, there are zillions of confounding factors, the code is insane spaghetti, truly controlled experiments are practically impossible, and every individual is slightly different and may operate differently. It's really a field where can have very little practical faith that it will ever be much good, but we can hope.

That's why I prefer for myself to hold to heuristics. We have good life expectancy and diet data going back a long time. We can see, for example, various periods and places where, excluding childhood mortality, people lived as long or longer than they do now - remarkable and slightly horrifying, considering the advances in medical science in the past 50-70 years. This included peoples with diets high in saturated fats. The best practical advise you can give anyone, I believe, is simply to eat traditional foods your ancestors have eaten for hundreds of years, and to therefore avoid anything prepared, sticking to fruits, vegetables, grains, dairy, and meats. And if at all possible, try to get the food you buy grown in a closer-to-traditional matter; ruminants should eat grass, not soy and corn, for example; oats, if possible, should not have been treated with Roundup. And naturally, whatever your diet, do not let yourself get overweight and try to maintain a high level of productive physical activity (of course, unproductive is better than none at all!)

Thanks for providing some scientific literacy to my argument. The western diet is designed around eating fatty foods wrapped around some innately-inflammatory bread product. If I was trying to give myself arterial plaque I would eat something that causes inflammation (yeast) and at the same time eat lots of fat. It boggles my mind how researches have failed to synthesize that yeast is the cause of so much disease.

While I can accept on the face that saturated fatty acids doesn’t have an effect on cardiovascular disease, their conclusions are near useless without access to the full paper and their methods of analysis.

It’s not hard to observe the American diet being high in SFA and Americans leading CVD morbidity.

It’s also not hard to find diets high in SFA like keto and paleo and their practitioners being relatively healthy.

I suspect it is the combination of high amounts of SFA and sugar that are driving the high rates of CVD.

> It’s also not hard to find diets high in SFA like keto and paleo and their practitioners being relatively healthy.

Keto actually looks like it might be bad for long term use based on some studies. For someone who finds that it helps them lose weight, it will still be beneficial as long as they they continue to lose weight, but it probably isn't great as a long-term lifestyle change when not losing weight.

Since most people who go on a keto diet cheat about as much as anyone on any diet (i.e. a lot), the real effect is not so much remaining in a ketogenic metablolic state for years at a time as it is cutting out some number of doughnuts, and while the original idea is extreme, the product is a result just about anybody could get behind.

It's kind of like how most religions have some insane stuff in their holy texts, but regular nice people turn it in to a positive reminder to be kind by filtering it with their human inexactness.

I find keto diet is much more satiating than low fat or "zone" type diets. I lost 80lbs this way and kept it off by doing a moderate version of it 1 meal a day of "zone" type mix and other two keto style. Obviously I eat whatever I want some days, but 90% of the time I'm good about it. My goal was always to be satiated and not to be in ketosis however. I have kept the weight for ~7 years now.

If keto was bad then the Inuit (Eskimos) as a people would not exist.

This debunks that long term low-carb is unhealthy.

Historically, Inuit life expectancy was shorter than other populations [1]. Are we looking at what people have done or do today? Should we look at the diet of the people who live the longest and have the best health as long as possible? I'm for looking at the diets that produce the best health the longest and best vitality as we age. The Inuit people on an animal diet are not a good example of this.

[1] https://www150.statcan.gc.ca/n1/pub/82-003-x/2008001/article...

The problem with these studies is that: 1) They mix in infant mortality rates. 2) Many of these "native peoples" are poorer and have less access to healthcare compared to others.

So in general it's very hard to get good data on life expectancy on these fringe groups.

You're right about infant mortality rates.

Then there's a question of how much access to health care should be needed? I was recently reading about a study that found when western diets entered a region health care costs go up. I was reading about it in Barons which is a financial publication. I imagine they are looking for investment opportunities. But, the observation is interesting. I'd link it if I could find it.

If you look at the US causes of death, a high percent of them are related to lifestyle. Like so many heart disease issues being linked to smoking or arterial blockages (and they've studied the causes of those). If a group doesn't have those lifestyle components they they have better health and longevity.

Some other indigenous North American tribes also subsisted almost entirely on meat (mainly bison), and seem to have been fairly healthy. This site is pushing a particular diet so take their conclusions with some skepticism, but their underlying data seems to be mostly accurate.

https://thepaleodiet.com/north-american-plains-indians-tall-...

>If keto was bad then the Inuit (Eskimos) as a people would not exist.

What you're saying might be true if keto being bad meant near immediate death. It does not.

The idea that the Inuit had low cardiovascular disease on a high meat, high fat diet looks to be unfounded, and based on unreliable mortality data [2]. Several Inuit bodies mummified in ice from centuries years ago have been autopsied and found to have evidence of atherosclerosis

[1] This paper has images of atherosclerosis in the coronary arteries of a 45 year old Inuit woman who died 500 years ago - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC325106/pdf/thij...

[2] https://www.atherosclerosis-journal.com/article/S0021-9150(0...

I'm no expert, by far.

But American diet being high in SFA and Americans being CVD leader, could also be due to results _of_ the diet but not the SFa itself. What I mean is, I think America still has the highest level of obesity. And obesity could cause CVD. So SFA in isolation can be fine, but combined with low physical activity and generally being overweight can cause the risk.

Again, no expert, just sharing my 5 second thoughts.

EDIT: Typos

> I think America still has the highest level of obesity

Don't worry, most of the world is catching up fast

IMO it's mainly an exposure problem. Excessive exposure to food volume. Excessive exposure to low-fiber foods (fast food = food without fiber). Excessive exposure to fructose. Excessive exposure to pesticides. I personally highly distrust seed and vegetable oils but I don't have any hard evidence to back up my concerns.

All things considered these eventually add up to leptin resistance one way or another. The downstream consequences (obesity, constant hunger, never feeling full, CVD) stem from leptin resistance.

No its not that simple. Many cultures ie all South European ones have very different attitude to food. Savouring and ritual around it, discussion and not fast chop chop and back to treadmill. Quality of ingredients and overall taste experience. Organic whenever possible. Olive oil, cold pressed. Salads. ANd so on and on.

You are saying the same thing I did with different words

Agreed here. I'm from EU but moved to CA, and the attitude is different. When I visit family in the USA it feels even worse. The quality of food is usually quite bad here. And people eating out fast food just for lunch, or even going to {Fast food chain} in the morning for breakfast just seems crazy to me.

The variety of food is pretty good, I find a lot of different cuisines here. But actual quality food is much harder to find. (Quantity over quality I guess).

What is cardiovascular disease? If we dig into that we find things like atherosclerosis and other types of diseases. Something like atherosclerosis happens, in large part due to LDL cholesterol [1]. There are many studies and papers on it. Scientists know a fair amount about what's going on here.

Saturated Fat is a leading cause of high LDL cholesterol [2]. Dietary cholesterol plays a role in elevated cholesterol but to a lesser extent. A way to think about it is that animals (including humans) produce the LDL cholesterol they need. Cows, pigs, and other animals do too. When you eat them you eat extra LDL cholesterol that ends up in your system.

I just grabbed a couple quick links on the topic. There are many podcasts with cardiologists on this, books by dietitians, and papers by researchers.

On a personal note, I had high cholesterol and cut out dietary cholesterol and saturated fats (to the level recommended by the american heart association [3]). In a few months my LDL cholesterol dropped about 70 points. I know it's anecdotal but it worked for me and several others I know.

[1] https://pubmed.ncbi.nlm.nih.gov/33966809/

[2] https://www.mayoclinic.org/diseases-conditions/high-blood-ch...

[3] https://www.heart.org/en/healthy-living/healthy-eating/eat-s...

Aren't there certain cultures with high saturated fat intake but very low occurrence of heart disease? E.g. Inuits

The data on their life expectancy shows it was far lower than average. What caused this? Was it heart disease? Infant mortality? Something else? Did they live long enough on average to get heart disease? The inuits eat more of a western diet now so getting data on their traditional diet must be difficult.

In any case, we don't have enough data to justify them as a data point supporting high saturated fat diets.

What data are you looking at?

Consider also the Minnesota Coronary Experiment which violates this connection: https://www.scientificamerican.com/article/records-found-in-...

Also the French: https://en.wikipedia.org/wiki/French_paradox

Eating cholesterol has very little impact on the cholesterol levels in your body.

https://peterattiamd.com/the-straight-dope-on-cholesterol-pa...

Yeah this is my understanding as well. Dietary cholesterol only weakly correlates with blood cholesterol

Cholesterol is not as well understood as is believed.

No comments on saturated fat vs liver disease (ie fatty liver) though. The common wisdom, I believe, is that you want to avoid sat-fat if you have fatty liver disease. That may not be a killer like cvd, but it is a big deal too.

A lot of people in here pointing to fructose though as a primary driver of problems, not saturated fat. Unlike glucose which can be used almost everywhere in the body, excess fructose has to be processed in the liver. In a caloric excess (which can be further exasperated by consumption of additional saturated fat), it's going to be converted to fat in the liver. More on that topic: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4838515/

Thanks for the article, looks like that one is from 2016. I'll share another article I found with a quick search -- "Saturated fat is more metabolically harmful for the human liver than unsaturated fat or simple sugars" : https://pubmed.ncbi.nlm.nih.gov/29844096/

Now I'm not so sure which is the "primary driver". There are quite a few competing thoughts but maybe the point is you should lower both. That's probably one reason many docs (including mine in the past) recommend cutting both.

> Now I'm not so sure which is the "primary driver". There are quite a few competing thoughts but maybe the point is you should lower both.

On that I don't think we disagree.

However, saturated fat on its own isn't super palatable. There was a community I discovered a few years ago deliberately trying to up their saturated fat intake (specifically steric acid) and on it's own it's about as pleasurable as chewing on a candlestick (steric acid is used as a stiffener in paraffin candles).

One thing I remember seeing too is that inflammation increases damage caused by de novo lipogenesis. I am wondering if consumption of stable saturated fats vs. consumption of unstable (and commonly rancid polyunsaturated fats) exasperates things.

The way I think about it - the higher your fat content in your diet the likely the higher amount of fat (cholesterol) circulating in your blood veins. It might not be a big deal if your body doesn't attach that fat the walls of your arteries however if you have inflammation in your arteries the fat will attach to the arteries and over time that causes a whole host of problems. My unqualified suspicion is that if you manage inflammation you likely won't arterial walls lined with cholesterol (which is trying to repair the damage to your arterial walls from inflammation).

However I also suspect that as you get older your vein structures change and theres probably a time in your 30s-50s where you biology changes and you start adsorbing more cholesterol (from fat) onto your arteries that cause CVD.

Fat doesn't "attach" to the artery walls.

Atherosclerosis is found ONLY in largest arteries where the blood pressure is highest and where the blood vessel splits into 2 because there the fluid (blood) flow gets distorted and slight vortexes are created.

Those vortexes then cause the blood pressure to be exerted perpendiculary to the blood vessel wall at artery junctions.

It's the high blood pressure + vortices + damaged blood vessel lining that PUSHES particles into the blood vessel walls.

There is no atherosclerosis in veins (because those carry blood back to the heart at lower pressure).

If fats would "attach" to the blood vessels you'd expect atherosclerosis even in veins, but you never get it there.

Also: atherosclerotic plaque is only 0.5% cholesterol and 0.5% fat. The other 99% is "scar tissue" and other stuff.

It's time to put this silly "fat attaches to blood vessel walls" thing to rest, it's 2022.

You might wish to check out Bart Kay's youtube channel, he explains it nicely there.

What causes the scar tissue?

Smoking? Irregular exercise?

Macrophages/white blood cells who wish to save you from those stuck particles.

The real question is what causes the blood vessel walls to get damaged (since the scar tissue is the healing response of the body, but if the damage keeps on piling it grows too much instead of being gradually reduced over time).

The problem is that there are millions of causes of inflamation etc...

In general the best answer is "modern diet" full of sugars + fat at the same time.

Carbs in high doses are poisonus, there is a reason the the lives of diabetics end in limb amputation, blindness and severe pain due to nerve damage due to sugar destroying them from the inside out...

Ok so what you are saying is that the particles are pushed into the arterial walls which builds plaque. At some point some of that plaque breaks off and causes a blockage --> heart attack / TIA / Stroke.

Agree biggest concern is what is causing damage to the arterial walls. To be fair --> fat + cholesterol attach to the wall in order to repair the arterial wall so, fat does attach to the wall.

I'm guessing the scar tissue cell matter attaches to the cholesterol+fat which is trying to repair the wall.

The carnivore books I've read have long lists of citations, it's not an unscientific set of positions they've taken.

Their choice of bogeyman is seed oils, which has seen a significant increase in consumption over the 20th century compared to most other things (meat has been mostly flat, and has declined over the last 30 years).

Got a source?

This one could not be interpreted as mostly-flat / declining meat consumption...

https://ourworldindata.org/grapher/per-capita-meat-consumpti...

https://youtu.be/ULBj3Ne45wE at 19:13

That is a non-sourced .png from a clearly biased Youtuber. You're going to believe that over OurWorldInData's source, United Nations Food and Agricultural Organization (FAO)?

I think that establishes you're being misled on this aspect. Now, what other aspects of "carnivore" diet are you being misled on?

Extra ironic that you claim carnivore research is so well-cited, while your first and only example isn't and is contradicted by known facts.

So what causes heart disease? Trans-fats, carbohydrates, sugar, lack of fiber? ... I guess it has been evident to me for a while that saturated fat doesn't cause heart disease, but it's not apparent what does.

I would imagine that being sedentary and/or obese is a significant risk factor, although it is surprisingly difficult to quickly locate estimates of relative effect size. Official sites like the CDC's mostly reiterate the popular weak-effect nonsense about cholesterol etc. without any numeric scale comparisons.

Vegetable oils: https://www.youtube.com/watch?v=hzQAHITIUhg

yes, https://www.youtube.com/watch?v=rQmqVVmMB3k

It seems like we really don't actually know.

Sugar and trans-fats are the only things everyone can agree is bad, and it's not even totally clear whether sugar is actually that bad for people who aren't overweight and aren't sedentary (although most people are overweight and sedentary now anyway so it may not matter).

(Even fiber, for example, might not be that important in itself so much as it is simply a proxy for vegetable consumption considering that fiber supplementation does nothing.)

I think it's just added sugar and sugar found in processed food that is bad. Dark red fruits with high sugar content is good.

LDL. Which is awkward because it's an important molecule in the body, yet if it hits the arterial walls in such a way, the body has this crazy pathological response to it.

I thought it went LDL repairs your cell walls so when your walls suffer from damage through inflammation LDL goes to patch it up.

Oxidized LDL (oxLDL)

Survey paper of interest (have not read, for future reference): https://www.frontiersin.org/articles/10.3389/fphar.2020.6137...

I think not enough has been said for the neurobiology of food. A lot of modern foods (high processed) have been engineered to maximize food rewards using a mixture of salt, fat, carbohydrates, and proteins / amino acids / MSG. These foods tend to be highly calorie dense and extremely rewarding / addictive while at the same time producing low satiety (so you don't feel full and want to keep eating).

Doritos is the classic example of this.

There was an interesting study on rabbits done (can't find it now):

First they gave one batch of rabits only saturated fat -> the developed atherosclerosis.

Then they gave the other batch unsaturated fats -> no atherosclerosis.

Now you might think, "ok, saturated fat bad."

But wait!

Then they removed ALL fat from the 3rd batch of rabbits and you'd expected no atherosclerosis: but NO! Even at no fat the rabits developed atherosclerosis.

Sugar and fat are the culprits. As in, fatty processed foods everyone eats.

Saturated fat alone is not the issue. Heck, your brain is made out of it. Sugar IS the issue. And sugar is a molecule. Fruit and HFCS are the same thing.

Keto is the way to lose weight. Low carb/high fat is the way to move forward.

Worth noting that because your body is made of something that doesn't mean that it is good or bad for your diet.

Extraordinary claims require extraordinary evidence.

Doesn't the preponderance of evidence show that saturated fats aren't horrible but still- when people replaced them with unsaturated fats their heart disease risk dropped?

With this kind of uncertainty, is it any wonder that many people don't trust medical science when we are told to behave in a certain way, or when we are told to take a certain medical treatment?

How many years have we been told that saturated fat is the nutritional devil? This is a great example of why censorship of "misinformation" is not justified- who is to say what constitutes misinformation?

Atkins was saying this 40-50 years ago and continued until his death.

- disclaimer: I am no health expert -

Still, personally, the North Korelia Project [1] and the public debates/podcasts with its author(s) convinces me of the link

[1] https://pubmed.ncbi.nlm.nih.gov/30083543/

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