White Meat & Cholesterol

In light of recommendations for heart healthy eating from national professional organizations encouraging Americans to limit their intake of meat, the beef industry commissioned and co-wrote a review of randomized controlled trials comparing the effects of beef versus chicken and fish on cholesterol levels published over the last 60 years. They found that the impact of beef consumption on the cholesterol profile of humans is similar to that of fish and/or poultry—meaning that switching from red meat to white meat likely wouldn’t make any difference. And that’s really no surprise, given how fat we’ve genetically manipulated chickens to be these days, up to ten times more fat than they had a century ago.

There are a number of cuts of beef that have less cholesterol-raising saturated fat than chicken, so it’s not so surprising that white meat was found to be no better than red, but the beef industry researchers conclusion was that “therefore you can eat beef as part of a balanced diet to manage your cholesterol.”

Think of the Coke versus Pepsi analogy. Coke has less sugar than Pepsi: 15 spoonfuls of sugar per bottle instead of 16. If studies on blood sugar found no difference between drinking Coke versus Pepsi, one would hardly conclude that “Pepsi may be considered when recommending diets for the management of blood sugars,” you’d say they’re both equally as bad, so we shouldn’t ideally consume either.

The study did also compare beef to plant proteins. As I started reading it, though, I was surprised that they found no benefit of switching to a plant protein diet either. What were they eating?

For breakfast, the plant group got a kidney bean and tomato casserole and a salad, instead of a burger. And for dinner, instead of another burger, the plant protein group just got some boring vegetables. So why was the cholesterol of the plant group as bad as the animal group? Well, it turned out they had the plant protein group eating three tablespoons of beef tallow every day—three tablespoons of straight beef fat!

Not really an accurate gauge for a plant based diet, to say the least. In conclusion, just swapping plant protein from animal protein may have advantages, but if you really want to maximize the power of diet to lower cholesterol, move entirely toward plants. The standard dietary advice to cut down on fatty meat, dairy, and eggs may lower cholesterol 5-10%, but flexitarian or vegetarian diets may drop levels 10 to 15%, vegan diets 15 to 25%. Healthier vegan diets can cut up to 35%, as seen in a study out of Canada, showing a whopping 61 point drop in LDL cholesterol within a matter of weeks.

                         — Nutritional Facts, Michael Greger M.D. FACLM, February 28, 2017

Benefits of Oatmeal for Lowering Disease Risk

If oatmeal is so powerful that it can clear up some of the ravages of chemotherapy just applied to the skin, what might it do if we actually ate it? Oats are reported to possess varied drug-like activities like lowering blood cholesterol and blood sugar, boosting our immune system, anti-cancer, antioxidant, and anti-atherosclerosis activities, in addition to being a topical anti-inflammatory, and reportedly may also be useful in controlling childhood asthma and body weight.

Whole-grain intake in general is associated with lower risk of type 2 diabetes, cardiovascular disease, and weight gain. All of the cohort studies on type 2 diabetes and heart disease show whole grain intake is associated with lower risk.

Researchers have observed the same for obesity—consistently less weight gain for those who consumed a few servings of whole grains every day. All the forward-looking population studies demonstrate that a higher intake of whole grains is associated with lower body mass index and body weight gain. However, these results do not clarify whether whole grain consumption is simply a marker of a healthier lifestyle or a factor favoring lower body weight.

For example, high whole grain consumers—those who eat whole wheat, brown rice, and oatmeal for breakfast—tend to be more physically active, smoke less, and consume more fruit, vegetables, and dietary fiber than those who reach for Froot Loops. Statistically, one can control these factors, effectively comparing nonsmokers to nonsmokers with similar exercise and diet as most of the studies did, and they still found whole grains to be protective through  a variety of mechanisms.

For example, in terms of helping with weight control, the soluble fiber of oatmeal forms a gel in the stomach, delaying stomach emptying, making one feel full for a longer period. It seems plausible that whole grain intake does indeed offer direct benefits, but only results of randomized controlled intervention studies can provide direct evidence of cause and effect. To know that, we need an interventional trial, where you give half the people oatmeal, and the other half fake placebo oatmeal that looks and tastes like oatmeal, to see if it actually works. And that’s what we finally got—a double-blinded randomized trial of overweight and obese men and women. Almost 90% of the real oatmeal-treated subjects reduced body weight, compared to no weight loss in the control group. They saw a slimmer waist on average, a substantial drop in cholesterol, and an improvement in liver function.

Nonalcoholic fatty liver disease, meaning a fatty liver caused by excess food rather than excess drink, is now the most common cause of liver disease in the United States, and can lead in rare cases to cirrhosis of the liver, cancer of the liver, and death. Theoretically, whole grains could help prevent and treat fatty liver disease, but this has been the first time it had been put to the test. A follow-up study in 2014 confirmed these findings of the protective role of whole grains.
—Michael Greger M.D. FACLM;  February 9th, 2017