Recap: Diet changes that could reduce bad cholesterol | Dr Sarah Berry

Summary

Detailed Summary of "Recap: Diet Changes That Could Reduce Bad Cholesterol | Dr. Sarah Berry"

Podcast: ZOE Science & Nutrition
Host: Jonathan Wolf
Guest: Professor Sarah Berry
Release Date: November 12, 2024

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Introduction to the Topic

[00:01]
Jonathan Wolf opens the episode by highlighting the prevalence of high cholesterol, noting that "around half of adults have high cholesterol," and emphasizes its role in increasing the risk of heart disease. He introduces Professor Sarah Berry, a leading expert with over 30 studies in cardiometabolic health, setting the stage for an in-depth discussion on how dietary choices influence cholesterol levels.

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The Portfolio Diet: A Scientific Approach to Lowering Cholesterol

[00:43]
Dr. Sarah Berry introduces the Portfolio Diet, a scientifically-backed dietary pattern designed to reduce cholesterol. She explains that the diet involves replacing certain foods with alternatives known to lower cholesterol, focusing on four key components:

• Soy Protein
• Plant Sterols
• Tree Nuts
• Soluble Fiber

[01:14]
When asked about the effectiveness of the Portfolio Diet, Dr. Berry confirms that it can "reduce cholesterol by 30%," which is comparable to the cholesterol-lowering effects of statin medications.

Key Quote:
Dr. Berry: "It was shown to reduce cholesterol by 30%. Now, this is similar to the level of reduction that we see in cholesterol lowering from medication like statins." [01:15]

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Practicality of the Portfolio Diet vs. the Mediterranean Diet

[01:26]
Jonathan expresses amazement at the Portfolio Diet's efficacy but questions its practicality.

[01:33]
Dr. Berry acknowledges the impressive results but points out that the Portfolio Diet is "difficult to follow," making it more suitable as a scientific experiment rather than a sustainable long-term dietary strategy. She then introduces the Mediterranean Diet as a more realistic and effective alternative for reducing cholesterol.

[02:01]
Jonathan shares his insights on the Mediterranean Diet, noting its variability across different regions but agreeing that its core principles include "plenty of fruit and vegetables, whole grains, nuts, and olive oils." He mentions ongoing debates about the inclusion of fish, lean meats, and dairy products.

Key Quote:
Dr. Berry: "While it's not quite as drastic at the portfolio diet and reducing your cholesterol, it's a really sustainable diet that lets you enjoy food that would be cut out if you followed a more restrictive diet like the portfolio." [02:47]

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Understanding the Impact of Dietary Components on Cholesterol

[03:01]
Jonathan seeks clarification on which specific foods influence cholesterol levels. He emphasizes that while foods like eggs are high in cholesterol, their impact on blood cholesterol might differ from other dietary components.

[03:17]
Dr. Berry clarifies that dietary cholesterol has a minimal effect on blood cholesterol levels. Instead, saturated fats—found in red meats, ultra-processed foods like pastries, and certain dairy products such as butter—are the primary contributors to elevated blood cholesterol.

Key Quotes:
Dr. Berry: "Dietary cholesterol... has only a really small impact on our blood cholesterol levels." [03:17]
Dr. Berry: "The saturated fats... can have quite a potent effect on raising our blood cholesterol." [03:50]

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The Misconception of Low-Fat Diets

[04:04]
Jonathan raises a common misconception: that reducing fat intake will lower cholesterol. Dr. Berry strongly refutes this, explaining that healthy fats (polyunsaturated and monounsaturated fats) can actually improve blood cholesterol levels.

[04:04]
She warns against low-fat foods, which often compensate for the removed fat with refined carbohydrates or sweeteners, substances detrimental to liver health and capable of increasing triglycerides, another risk factor for cardiovascular disease.

Key Quotes:
Dr. Berry: "Instead of worrying about the amount of fat that you're consuming, you should be thinking about the types of fat." [04:04]
Dr. Berry: "If you strip out the Fat, you've got to replace it with something... often refined carbohydrates or sweeteners... which are really bad for us." [04:50]

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Actionable Dietary Changes to Lower Cholesterol

[06:10]
Jonathan asks for practical advice for listeners looking to lower their cholesterol through diet. Dr. Berry emphasizes the importance of personalized, sustainable changes that align with individual preferences to ensure long-term adherence and effectiveness.

[06:10]
She highlights that blood cholesterol levels can respond quickly to dietary adjustments, with measurable changes within 10 to 14 days. Dr. Berry suggests several strategies:

• Reduce intake of red meats and processed foods to lower saturated fat consumption.
• Increase fiber-rich foods like beans and vegetables.
• Incorporate plant-based protein sources that are known to lower cholesterol.
• Use spreads made from vegetable oils instead of butter to benefit from healthy unsaturated fats.

Key Quotes:
Dr. Berry: "Your blood cholesterol can change really quickly from dietary changes... as little as 10 days to 14 days in blood cholesterol." [06:10]
Dr. Berry: "Try and eat less red meat and less processed foods... introduce many fiber rich foods... and also plant based protein sources that we know will lower your cholesterol." [06:10]

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Clarifying the Role of Saturated Fats vs. Dietary Cholesterol

[07:38]
Jonathan recalls that high-cholesterol foods like red meat have historically been blamed for raising cholesterol levels. Dr. Berry clarifies that it's not the dietary cholesterol itself but the saturated fats in these foods that are responsible for increasing bad cholesterol levels.

[08:15]
She uses liver as an example, a food high in both cholesterol and saturated fat. Dr. Berry explains that the rise in bad cholesterol is due to the saturated fat, not the cholesterol content itself.

Key Quotes:
Dr. Berry: "It's the saturated fat... not the dietary cholesterol." [07:47]
Dr. Berry: "It's the saturated fat that's increasing the bad cholesterol in our blood." [08:15]
Dr. Berry: "Please don't follow a low fat diet, but please change to really healthy oils..." [08:15]

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Conclusion and Encouragement for Dietary Change

Dr. Berry concludes by reaffirming the significance of type of fat over the amount of fat in managing cholesterol levels. She encourages listeners to adopt healthy oil choices and underscores the potential for rapid improvements in cholesterol through thoughtful dietary modifications.

Final Note:
Jonathan wraps up the episode by inviting listeners to continue their health journey with Zoe's membership program, promoting it as a daily coach for better health.

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Notable Quotes

• Dr. Sarah Berry:

  • "It was shown to reduce cholesterol by 30%. Now, this is similar to the level of reduction that we see in cholesterol lowering from medication like statins." [01:15]
  • "Instead of worrying about the amount of fat that you're consuming, you should be thinking about the types of fat." [04:04]
  • "Please don't follow a low fat diet, but please change to really healthy oils and also be motivated in knowing that a dietary change can actually induce a change in your cholesterol in as little as two weeks." [08:15]

• Jonathan Wolf:

  • "A 30% reduction, that sounds pretty incredible." [01:26]
  • "And so there's sort of, there could have been this confusion. Right." [07:38]

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Key Takeaways

1. Portfolio Diet: Highly effective in lowering cholesterol by 30% but challenging to maintain long-term.
2. Mediterranean Diet: A more sustainable alternative that emphasizes fruits, vegetables, whole grains, nuts, and healthy oils.
3. Saturated Fats vs. Dietary Cholesterol: Saturated fats significantly impact bad cholesterol levels, whereas dietary cholesterol has minimal effect.
4. Healthy Fats are Beneficial: Incorporating polyunsaturated and monounsaturated fats can improve cholesterol profiles.
5. Quick Impact of Dietary Changes: Meaningful improvements in cholesterol can occur within two weeks with appropriate dietary adjustments.
6. Smart Dietary Swaps: Reducing red meat and processed foods, increasing fiber and plant-based proteins, and using healthy spreads can effectively lower cholesterol.

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By understanding the nuances of how different dietary components affect cholesterol levels, listeners can make informed and effective changes to support their heart health.

Transcript

[A]

Hello and welcome to Zoe Recap, where each week we find the best bits from one of our podcast episodes to help you improve your health. Today we're discussing how the food we eat can lower cholesterol. It's an important question, as high cholesterol can increase our chances of developing heart disease. Did you know that around half of adults have high cholesterol? And it gets more common as you age? So how can we break this trend? Today's guest, Professor Sarah Berry, has led more than 30 human studies on cardio metabolic health. It's safe to say she knows a thing or two about heart health and cholesterol.

[B]

So the best way to illustrate just how effective food and our diet can be at low in cholesterol comes from the portfolio studies. And these are key nutrition science experiments showing the power of food in relation to our health. And the concept of the portfolio diet isn't very straightforward. What you do is replace certain foods in your diet with other foods and ingredients that have been shown to lower cholesterol. And it's centered around four key elements. It's centered around soy protein, plant sterols, tree nuts and soluble fibre.

[A]

And did it work?

[B]

Absolutely. So it was shown to reduce cholesterol by 30%. Now, this is similar to the level of reduction that we see in cholesterol lowering from medication like statins.

[A]

So 30%, that sounds pretty incredible. So does Zoe recommend this diet to people with high cholesterol?

[B]

So it is an incredible dietary pattern to follow, but there's a catch with a portfolio diet that it's really difficult to follow. So it's therefore more of a science experiment showing us what actually is the potential of food in terms of lowering cholesterol, rather than something that's really practical, I think in the long term. Now, I think there's a more realistic dietary pattern that's also been shown to be effective in reducing cholesterol. And this is the Mediterranean diet.

[A]

So I love the concept of the Mediterranean diet, which I think was invented by a bunch of nutritional scientists living a long way away from the Mediterranean, because I've spoken to a lot of nutritional scientists now and every single one has a slightly different definition of what's in it, which is probably not surprising when you think that people living in Italy and Greece and Morocco and Israel all think they're eating a Mediterranean diet. And if you go on holiday to these places, they're eating a very different diet. However, I think everyone agrees, Sarah, that it's about eating plenty of fruit and vegetables, sort of whole grains, nuts and olive oils. And then I think people start to argue a lot more about, you know, fish and lean meat and dairy products and the exact proportions.

[B]

Yeah, that's right, Jonathan. And while it's not quite as drastic at the portfolio diet and reducing your cholesterol, it's a really sustainable diet that lets you enjoy food that would be cut out if you followed a more restrictive diet like the portfolio.

[A]

And so, Sarah, you know, to be clear, for people who are listening to this, while eating foods like eggs that are high in cholesterol won't necessarily raise your cholesterol, there really are foods that can make your cholesterol go up or down. And if so, can you explain what those foods are?

[B]

Yeah, so we know that actually dietary cholesterol, so cholesterol that's in the food that we consume actually has only a really small impact on our blood cholesterol levels. But what we do know is that saturated fat, rich foods, and particular types of saturated fat actually can have quite a potent effect on raising our blood cholesterol. And these are the kind of fats that are found in red meats, for example, lots of ultra processed foods such as pastries, and also in some dairy such as butter.

[A]

And what about carbohydrates? Because lots of people will be listening to this and saying, oh, well, so I've got high cholesterol, so I'm not going to eat any fat and therefore my cholesterol is going to go down. Which sounds really logical. Is it correct?

[B]

No. So this is a big mistake, I think, that lots of people make. And unfortunately, there's lots of really poor misinformation out there around people with high cholesterol being told to follow a low fat diet. What we do know is that if you consume healthy fats and healthy oils, you can actually improve your circulating blood cholesterol levels. So rather than worrying about the amount of fat that you're consuming, you should be thinking about the types of fat. So the types of fat that we know increased cholesterol, like I've just said, are the saturated fats. But we know that the poly and monounsaturated fats that are found in many vegetable oils, nuts and seeds, for example, can actually reduce our blood cholesterol levels. Now, the problem is if you take out the fat from foods so that you choose low fat versions of foods, it's got to be replaced with something. Because fat is actually the component in food that gives the lovely creamy mouthfeel, it carries much of the flavor. So if you strip out the Fat, you've got to replace it with something that still confers that nice mouthfeel and that great flavor to the food. Quite often refined carbohydrates or sweeteners or other kind of ingredients are added back into the food. And we know that these are really bad for us because we know that they impact your liver, which is involved in the production, like I said earlier, of cholesterol, but also they increase another type of fat that circulates in your blood, which is called triglycerides. And we know that this is really unfavorable in terms of cardiovascular disease if it's elevated as well.

[A]

Amazing. Thank you, Sarah. So I think now that we understand a bit more that what we eat can cause high cholesterol and it could actually be a carbohydrate or a fat. Can you be a bit more specific about what a listener should do to change their diet? If right now maybe their doctor has told them that they have high cholesterol or they know that it's in their family? And are there any sort of smart swaps that they could do without completely changing the way that they eat?

[B]

Absolutely. And I think it's making simple smart swaps, as you call them, Jonathan, are personalized to your body, but also your preferences that are ones that people will most likely stick to and therefore lead to sustained improvements in blood cholesterol. And actually your blood cholesterol can change really quickly from dietary changes. So we see changes in our studies as little as 10 days to 14 days in blood cholesterol. So that should really motivate people that quick changes, but sustainable changes will really have an impact. And the kind of things that you could do is to try and eat less red meat and less processed foods, because these have the types of fat that we know increase your bad cholesterol. You could introduce many fiber rich foods such as beans and vegetables, and also plant based protein sources that we know will lower your cholesterol. And spreads are also a good substitute for butter, since most spreads are made from vegetable oil. So they contain these healthy unsaturated good fats that I've talked about, the poly and monounsaturated fats. Although, Jonathan, this is quite a controversial.

[A]

Area and I remember from our previous episode that many of the foods that are high in cholesterol are also high in saturated fat. And this may have led to some of the previous misinformation suggesting that it's the cholesterol in some food, such as red meat, that explains why red meat, for example, is bad. For us.

[B]

Yeah. And with regards to cholesterol, Jonathan, saturated fats are what's increasing the bad cholesterol in our blood. Not that dietary cholesterol.

[A]

Yes. And so there's sort of, there could have been this confusion. Right. When they looked at it, because some of those foods happen to have high cholesterol as well. And so we now understand, I think this is right, Sarah, like, we understand better the mechanisms today. And therefore, you know, the high cholesterol in the egg or the meat is no longer being blamed for it. But actually the red meat still in the dock, still in trouble. We just understand that it's sort of different properties of the red meat that are causing us problems.

[B]

Absolutely. So if we think of liver, for example, liver is high in cholesterol, but also high in saturated fat. If we eat lots of liver, we'll have an increase in bad cholesterol. But it's actually not the cholesterol in the liver that's going to cause this. It's the saturated fat. There's clear evidence to show that it's the type of fat that's important and not the amount of fat that's important to consider. So please don't follow a low fat diet, but please change to really healthy oils and also be motivated in knowing that a dietary change can actually induce a change in your cholesterol in as little as two weeks.

[A]

That's it for today's recap. If you want to continue your health journey with Zoe, why not try our membership? Zoe is your daily coach to better Health for Life. Click the link in the show notes to get started today. And don't forget to follow Zoe, Science and nutrition and your favorite podcast player so you never miss an episode. See you next time.