Triglycerides; lowering them in a non-Vegan

[carnap]

Both impact the risk factors he's concerned with: dying of cardiovascular disease. It doesn't make sense to decrease triglycerides only to spike your cholesterol, and improving his cholesterol even more (even if it's OK right now) can lower his risk a little.

The question was about lowering triglycerides and the impact of saturated fat on LDL cholesterol isn't that dramatic.

Fish fat is simply more saturated than the preferable vegetable fats (like canola). 6 grams saturated out of 27 total, which is 22%.
Compare to something like Walnuts, at 4.9 grams saturated out of 52 total, which is slightly under 10%.

The amount of saturated fat in fish varies from fish to fish, some are very low. But you're also comparing apples to oranges, people aren't consuming isolated fish fat. One can easily eat a good deal of fish (and other other meats low in saturated fat) on a low-carbohydrate diet and maintain a saturated fat intake that doesn't exceed guidelines.

The point is that ANY animal fats, even coming from lean meat, will negatively influence your ratio, which is hard enough to keep low with such high consumption of vegetable fats.

You could make the same point about a variety of plant-based fats. The only thing that matters is that your total saturated fat intake doesn't exceed guidelines and you can do that even with eating a good deal of fish and specific meats.

For example a 1000 calorie meal of 12 oz of salmon, a chickpea/veggie salad made with 1 tablespoon of vegetable oil and medium sliced avocado would only have around 7~8 grams of saturated fat. Which is 3~4 grams less the guideline for 1000 calories worth of food. Macro-nutrient ratios are around 20% carb, 35% protein and 45% fat.

It's also worth remembering that most animal products contribute dietary cholesterol, which may or may not affect him more than others depending on his genetics, but which none the less should be avoided to minimize his high risk.

Dietary cholesterol isn't known to increase triglycerides and has little impact on blood cholesterol levels in most people, there is no reason to worry much about it unless you know you respond poorly to it.

That's uncommon. A few like beyond burger do, since they're made with coconut oil. He should not be eating those (although the type of fat in coconut is probably not as bad, it still contributes).

Many of them do and when they don't they are often just low-in fat which is comparable to lean meats. You have to compare apples-to-apples.

In any case, your comments seemed to be based on the premise that one should try to achieve the lowest saturated fat intake possible but there is no reason to believe that helps. You're also suggesting lean-meats are too high in protein while suggesting very high protein foods like TVP, its not consistent. But even if that was your goal, you could still eat a good deal of lean-meats. They would just be the protein component of your diet where as nuts, avocados, vegetable oils, etc would be the fat component.

There is no reason to single out meats in terms of saturated fat, many vegan products are high in saturated fat while many meats are low. What matters is that your total saturated fat intake doesn't exceed guidelines.

[brimstoneSalad]

The question was about lowering triglycerides and the impact of saturated fat on LDL cholesterol isn't that dramatic.

That's just completely untrue. While it depends on the type of saturated fat (like the lauric acid in coconut isn't as bad), it's a major contributor, and unlike genetics it's one of the only ones you can do much about.

One can easily eat a good deal of fish (and other other meats low in saturated fat) on a low-carbohydrate diet and maintain a saturated fat intake that doesn't exceed guidelines.

There are no meats that are legitimately low in saturated fat as a ratio of fat, only relative to other meats and rare saturated plant fats like coconut or palm.
There are some that are relatively low in TOTAL fat, but not enough to eat a significant amount of them.
You can on a low fat diet ( https://www.ncbi.nlm.nih.gov/pubmed/20107198 ) but that's not what he needs to do, and a low carb AND low fat diet is not the kind of diet anybody should be following unless that person needs to lose weight (as part of calorie restriction). Getting a majority of calories from protein lacking other calorie sources is a very bad idea.

But if you're losing weight you should probably be even more concerned with your cholesterol levels and lower saturated fat intake; more so than you would otherwise need to since levels may rise from the weight loss itself:
https://www.ncbi.nlm.nih.gov/pubmed/2035468

So, that is, there's NOBODY who should be following a low carb diet including any significant amount of animal products. That's only tolerable in lower fat diets.

A thousand calories of fat from even strictly plant sources will already have you very close to the max for general guidelines, and regardless, somebody at high risk like that needs to do a little better than general guidelines. Animal fat is going to push that over very easily.

If he's not going to stop drinking, he needs to do everything he can about his LDL. I already mentioned that it has diminishing returns beyond the guidelines but that doesn't mean zero returns. He can reduce his risk despite his triglycerides (which will probably remain elevated) by having a better than good LDL level.

You could make the same point about a variety of plant-based fats.

I talked about coconut and palm. Cashews are another nut he may want to avoid. There are only a few plant fats that are worse than animal fat, for the most part he can eat a variety of plant fats, and the difference between them is not as significant as the difference between plant fats and animal fats.

For example a 1000 calorie meal of 12 oz of salmon, a chickpea/veggie salad made with 1 tablespoon of vegetable oil and medium sliced avocado would only have around 7~8 grams of saturated fat. Which is 3~4 grams less the guideline for 1000 calories worth of food. Macro-nutrient ratios are around 20% carb, 35% protein and 45% fat.

Only because it's lower in fat than it should be. Too many carbs, too much protein. The majority of calories should come from fat.

Very low carb/ketogenic recs are something like:

Generally, the macronutrient ratio varies within the following ranges: 60-75% of calories from fat (or even more), 15-30% of calories from protein, and. 5-10% of calories from carbs.

And again, to reduce risk he should aim for doing better than guidelines since he's high risk. There are diminishing returns but it's still significant when you're that high risk.

Dietary cholesterol isn't known to increase triglycerides

Didn't say they did, but they both contribute to the same risk. There's no reason to consume dietary cholesterol if he wants to reduce his risk.

and has little impact on blood cholesterol levels in most people,

As I said, but we don't know his genetics so it's safer to avoid them, also they do have an effect: it's just non-linear since absorption is decreased with amount.
NO dietary cholesterol at all is significantly better than a little bit, but a lot of dietary cholesterol isn't much worse than a little bit for most people.
So if you're already eating SOME cholesterol it probably doesn't matter how much you eat, but it's still better to eat none at all.

That's more reason to choose vegan (or vegan plus egg whites) over limited meat consumption.

there is no reason to worry much about it unless you know you respond poorly to it.

Quite the opposite: worry about it until you know you don't respond to it. It's not like a one in a million thing.

Also, even if you're a typical responder that doesn't mean you don't absorb it, just that you don't absorb it linearly and your body reduces absorption based on amount. It's still better to eat none at all. There's also some reason to be concerned that dietary cholesterol may be worse than endogenous production.

Guidelines on dietary cholesterol have been played down because most people are simply not going to eat none of it at all, so at that point it doesn't matter how much they eat and worrying about cholesterol could push them away from healthier meat options like shrimp which are otherwise lower in saturated fat. Doesn't mean dietary cholesterol isn't relevant to somebody at high risk who IS willing to follow a strict diet. If he is so willing.

You're giving bad advice and risking people's lives if you're telling people not to worry about consuming cholesterol.
I'm honest about egg whites despite that I'd rather people not eat them. Seems like you can't overcome your pro-meat biases to admit most animal products are a problem for somebody at high risk like this.

Many of them do and when they don't they are often just low-in fat which is comparable to lean meats. You have to compare apples-to-apples.

Most of them aren't that low in fat, but are made with canola oil. Saturated fat ratio is much better than lean meats.
Fat isn't the problem, it's saturated fat. I explained that already.

In any case, your comments seemed to be based on the premise that one should try to achieve the lowest saturated fat intake possible but there is no reason to believe that helps.

There's very good reason to believe that lowering cholesterol helps. You're just a cholesterol skeptic.

You're also suggesting lean-meats are too high in protein while suggesting very high protein foods like TVP, its not consistent.

TVP is probably too high in carbohydrates. He should not eat huge amounts of mock meats. Majority of calories should come from fats. But choosing mock meats over lean meats is a better choice since they contain less saturated fat.

There is no reason to single out meats in terms of saturated fat, many vegan products are high in saturated fat

I said that he should not eat those.

while many meats are low.

No they aren't. Egg whites are, though. That could conceivably be the protein component.

What matters is that your total saturated fat intake doesn't exceed guidelines.

1. That's almost impossible on a low carb diet including ANY amount of animal fat, because plant fat alone will put him about at the guideline, or just a little below if he's very careful.
2. He needs to do better than that if he wants to reduce his risk as much as possible given his other habits. If he IS very careful as above, and does better than the guidelines, there's no reason to screw that up with a piece of meat when he could have a lower risk by eating some mock meat instead.

[carnap]

That's just completely untrue. While it depends on the type of saturated fat (like the lauric acid in coconut isn't as bad), it's a major contributor, and unlike genetics it's one of the only ones you can do much about.

Firstly what I said is accurate, the research on saturated fat doesn't show dramatic shifts in LDL cholesterol levels when saturated fat increases. You see modest or no change depending on the type of saturated fat. Lauric acid increases LDL cholesterol and is also found in various animal fats, there is currently no reason to believe that coconut fat isn't "as bad" as other foods high in saturated fat. In fact, coconut fat may be the worst since it has the highest concentration of saturated fat (e.g., 90% saturated fat vs 55% in butter). Lastly saturated fat is one of many dietary and lifestyle factors that impact your cholesterol levels.

https://www.hsph.harvard.edu/nutritions ... ease-risk/

There are no meats that are legitimately low in saturated fat as a ratio of fat, only relative to other meats and rare saturated plant fats like coconut or palm.

The ratio is irrelevant, what matters is the total amount of saturated fat per serving. There are many lean meats that have almost no saturated fat per serving. And even if you look at a fatty fish like salmon, you'd have to eat almost your entire diet in salmon for you to exceed the guideline for saturated fat. A diet that combines meats that are low in saturated fat with fatty plant foods can easily be low in carbohydrates while not exceeding saturated fat guidelines.

For example a diet of 500 calories of salmon, 500 calories of almonds/peanuts, 500 calories of avocado, 300 calories from chickpeas and 200 calories of mixed veggies (with a bit of oil) would be approximately 15 grams of saturated fat which is well below guidelines. The diet is 25% meat with marco ratio of around 55% fat, 25% protein and 20% carb.

Very low carb/ketogenic recs are something like:

I'm not only discussing "very low carb" diets, diets are concerned low-carb when carbohydrates get below 30~40%.

Quite the opposite: worry about it until you know you don't respond to it. It's not like a one in a million thing.

Its by no means the norm and as a result there is no reason to believe you respond poorly unless you have good evidence to believe so.

You're giving bad advice and risking people's lives if you're telling people not to worry about consuming cholesterol.
I'm honest about egg whites despite that I'd rather people not eat them. Seems like you can't overcome your pro-meat biases to admit most animal products are a problem for somebody at high risk like this.

Firstly I find this comment ironic because you're trying very hard here to demonize animal based foods with little more than your opinion, you've made a variety of bold claims without citing a single credible resource. Also what you're attempting to do here little more than a fallacy. Further, as a vegan, you're the only one here that has an ideological commitment that would subject them to strong bias. Honestly, I find it amusing that vegans so often talk about people having bias when its vegans that you'd expect to have the strongest biases. While everyone is subject to bias, the average person doesn't have an ideological commitment to eating meat or their diet as a whole.

Secondly I've never made the statement that nobody should worry about dietary cholesterol, rather I've said that unless you have reason to believe you respond poorly to dietary cholesterol than there is little reason to try to limit dietary cholesterol. It has only a small impact on total cholesterol levels and there is little reason to suspect it causes issues beyond that.

There's very good reason to believe that lowering cholesterol helps. You're just a cholesterol skeptic.

You're not responding to what I said, to say it again, there is no reason to believe people need to try to limit saturated fat as much as possible. Maintaining low cholesterol levels are important but reducing saturate fat intake has diminishing returns which is the basis of the current guidelines, there is little evidence of benefit when you drop saturated fat lower than guidelines.

I have no idea what you mean by "cholesterol skeptic". What I've said on cholesterol here is well supported by the research and echoed by major health groups.

TVP is probably too high in carbohydrates. He should not eat huge amounts of mock meats. Majority of calories should come from fats. But choosing mock meats over lean meats is a better choice since they contain less saturated fat.

This isn't true, they typically have more saturated fat. There is also no reason to believe that (highly processed) mock meats are a healthy choice, we have no studies that have evaluated their long-term impacts on health.

No they aren't. Egg whites are, though. That could conceivably be the protein component.

They are, let's look at some examples. A serving of tilapia has around half a gram of saturated fat. A serving of skinless chicken breast has around 1 gram of saturated fat. A serving of lobster has almost no saturated fat at all (around .2 grams). There are many examples of meat that have 1 gram or less of saturated fat per serving. Any of these can be a "protein component" in a diet low in saturated fat.

2. He needs to do better than that if he wants to reduce his risk as much as possible given his other habits. If he IS very careful as above, and does better than the guidelines....

The reasoning in much of your comments seems to be that if X has some negative consequences than its best to limit X as much as possible, but that is really the basis of all sorts of pseudo-science. Nobody knows what diet is going to be optimal for a given person, at the moment all one can do is follow science-based guidelines. The guidelines represent what we know based on the current evidence, doing "better than the guidelines" has no known benefit. You're arguing against the guidelines in an effort to promote vegan style diets and instead making a number of recommendations that have no support in current research.

[brimstoneSalad]

That's just completely untrue. While it depends on the type of saturated fat (like the lauric acid in coconut isn't as bad), it's a major contributor, and unlike genetics it's one of the only ones you can do much about.

Firstly what I said is accurate, the research on saturated fat doesn't show dramatic shifts in LDL cholesterol levels when saturated fat increases.

You're just being deceptive.
It takes a dramatic reduction in saturated fat to see dramatic shifts in LDL. That's just not the norm in terms of interventions.
Most importantly, it's one of the only lifestyle factors that are really under our control. Genetics may play a larger proportional role, but you don't get to choose or change your genes.

there is currently no reason to believe that coconut fat isn't "as bad" as other foods high in saturated fat. In fact, coconut fat may be the worst since it has the highest concentration of saturated fat (e.g., 90% saturated fat vs 55% in butter).

Gram for gram of fat, coconut is better than butter despite its higher saturation, but the point is that the dominant type of saturated fat in coconut isn't as bad as the dominant types in animal products. Gram per gram of saturation, Lauric acid is less bad (which dominates in many mockmeats).
Like I said,m coconut is still good to avoid, including the FEW mock meats which are rich in it.

Lastly saturated fat is one of many dietary and lifestyle factors that impact your cholesterol levels.

If you think there are more things he can do that have a positive impact, then why don't you recommend them?

If he's obese or leads a sedentary lifestyle, those would be things to address too.
Obviously he need to stop drinking and smoking to lower his overall risk, but he's not keen on that.

A diet that combines meats that are low in saturated fat with fatty plant foods can easily be low in carbohydrates while not exceeding saturated fat guidelines.

For somebody at very high risk for other reasons (like the heavy drinking) aiming to do better than guidelines is a smart decision.
If he wants average risk from diet, he's going to still come in considerably above average risk due to other lifestyle factors.

I'm not only discussing "very low carb" diets, diets are concerned low-carb when carbohydrates get below 30~40%.

Again, he can't afford going half-assed with this if he really wants to lower his risk despite the heavy drinking.
Obviously it's up to him to decide.

Its by no means the norm and as a result there is no reason to believe you respond poorly unless you have good evidence to believe so.

Looking at average response can mask individual variation. In several clinical trials, the majority of subjects given a cholesterol challenge exhibited little or no increase in total circulating cholesterol, apparently due to the additional influence of decreased endogenous cholesterol synthesis.8,10 Plasma cholesterol did increase in approximately 25-30% of subjects, dubbed hyper-responders or noncompensators. Individual variation in plasma or serum cholesterol responsiveness to dietary cholesterol appears independent of, and thus can't be predicted based on, baseline circulating cholesterol level.8,10

https://www.acc.org/latest-in-cardiolog ... holesterol

Russian roulette is only a 17% chance. I guess you love that game.
There's every reason to NOT pull that trigger if in doubt, since there's no reason TO eat cholesterol. Your body makes all you need.

The only factors in its favor would be personal taste/convenience, but @PsYcHo suggested his friend would probably be pretty flexible on this front if it meant lowering his risk so he can keep drinking.

Further, as a vegan, you're the only one here that has an ideological commitment that would subject them to strong bias.

I'm not a vegan for health reasons, but for ethical ones. I have no ideological commitment to believing animal products are unhealthy.

You eat meat. Intrinsically, that means you have a bias to defend the ethics of what you're doing. A lose-lose proposition would make them ever more questionable.

Honestly, I find it amusing that vegans so often talk about people having bias when its vegans that you'd expect to have the strongest biases.

You'd expect it, because you're biased and you can't admit it; you view yourself as being impartial and ultra-rational. You're bullshitting yourself. I've met few people as biased in favor of meat as you are, from your fear mongering diatribes against veganism as dangerous despite professional consensus (which you write off like an anti-science conspiracy theorist) to your perverse aesthetic obsession with the beauty you see in grazing and animal husbandry like some half-mad bucolic painter fresh from the 19th century.

While everyone is subject to bias, the average person doesn't have an ideological commitment to eating meat or their diet as a whole.

The average person has some bias, which favors ignorance, but anti-vegan apologists like you take the cake.

there is no reason to believe people need to try to limit saturated fat as much as possible.

People, in general, at otherwise healthy weight and no other extenuating lifestyle factors that put them at high risk.

I said trying to address this without cutting down on drinking would be like trying to bail out a boat under a waterfall. But he's not willing to stop drinking, ergo if he wants to be serious about reducing his risk he can't afford half-assing everything else by just meeting recommendations. That might be more or less fine if he'd meet alcohol recommendations too, but he won't.

Maintaining low cholesterol levels are important but reducing saturate fat intake has diminishing returns which is the basis of the current guidelines,

Diminishing returns, not no returns. Again, it's up him if he wants to half ass things with the guidelines.

there is little evidence of benefit when you drop saturated fat lower than guidelines.

Because virtually nobody does that, but mechanistically there's plenty of evidence based on the way plaques form and the cause of cadiovascular events.
I've said the returns are diminishing. He really ought to stop drinking.

This isn't true, they typically have more saturated fat.

I addressed that.

There is also no reason to believe that (highly processed) mock meats are a healthy choice, we have no studies that have evaluated their long-term impacts on health.

Again with the fear mongering because there aren't enough studies.
You need to cut this out. You can make mechanistic arguments if you want (complain about the sodium content? The lower levels of micronutrients?) but this isn't an argument.

He could go with less processed options if he wants to, he wouldn't even need to eat them at all if he can be satiated without (hard to do, I don't think most people are satiated on a low protein diet and that could cause over-eating), since vegetables and nuts/seeds can probably provide enough protein within carb limits. That would be more tricky, though.

They are, let's look at some examples. A serving of tilapia has around half a gram of saturated fat. A serving of skinless chicken breast has around 1 gram of saturated fat.

A half a gram, a gram, etc. that he doesn't need ON TOP OF the other inevitable saturated fat he's consuming from a fat dominated macronutrient ratio. There's no reason for it when there are superior alternatives. And then there's the unnecessary dietary cholesterol on top of that.

For somebody not at otherwise high risk that might not be a big deal, but this guy doesn't want to stop his most risky behavior, which is drinking in excess. He needs all the help he can get elsewhere.

A serving of lobster has almost no saturated fat at all (around .2 grams).

I'm more familiar with shrimp, but for a hyporesponder that might not be an issue. The trick is knowing he's a hyporesponder. Also, as I said, there's some reason to be concerned that dietary cholesterol may be worse than endogenous production.

The reasoning in much of your comments seems to be that if X has some negative consequences than its best to limit X as much as possible, but that is really the basis of all sorts of pseudo-science.

It's not that it has "some" negative component; it has a known negative component that's causally linked to a risk he's facing.
I noted that returns are diminishing there, and even used the analogy of trying to bail out a boat under a waterfall.

Nobody knows what diet is going to be optimal for a given person, at the moment all one can do is follow science-based guidelines.

The guidelines are for the general public, and also take into account probable adherence; people are going to ignore advice that seems too strict or difficult to follow.
This is a special case. If @PsYcHo just wanted to know the guidelines, that would be easy but it also wouldn't answer his specific question.

The only real caveat to lowering his cholesterol more (under 150) could be IF his blood pressure is high too there are some correlations he may want to be aware of. While there's no mechanistic causal link, there is a correlation with hemorrhagic stroke in high alcohol consumers. Probably just an indication of alcohol damage, though.

Reduced cardiovascular risk from lower cholesterol is so substantial it more than makes up for anything else.

His friend really needs to cut down on drinking. Like I said, that's the waterfall.

[carnap]

You're just being deceptive.
It takes a dramatic reduction in saturated fat to see dramatic shifts in LDL. That's just not the norm in terms of interventions.
Most importantly, it's one of the only lifestyle factors that are really under our control. Genetics may play a larger proportional role, but you don't get to choose or change your genes.

There is nothing deceptive about my claims. How saturated fat impacts one's cholesterol is actually genetically variable but you typically don't see dramatic shifts in cholesterol when people greatly reduce saturated fat consumption. And your claim about saturated fat being "one of the only lifestyle factors under our control" isn't accurate. There are number lifestyle factors that impact your cholesterol levels, for example, your level of physical activity, your weight, your refined carbohydrate intake, your fiber intake and so on.

Gram for gram of fat, coconut is better than butter despite its higher saturation, but the point is that the dominant type of saturated fat in coconut isn't as bad as the dominant types in animal products.

There is no reason to believe this is the case and animal based saturated fats all differ in composition. Also as I noted, "gram for gram" coconut fat has a much higher fraction of saturated fat than animal fat which may actually make it worse.

If you think there are more things he can do that have a positive impact, then why don't you recommend them?

I did, given the primarily issues here is with triglycerides I'd recommend that they avoid simple sugars and refined carbohydrates. I disagree with the idea that a keto style would be good for this person, the composition of high-fat diet with simple sugars (from the alcohol) is likely to promote fatty liver and other metabolic problems. If I was talking to the person I'd suggest a diet of mostly legumes, lean meats, vegetables, some fatty dairy products and good deal of fatty plant foods like nuts and avocado and to greatly limit sugary foods (including sugary dairy, fruits, etc).

But really this is all speculation, this is a unique individual with a special lifestyle issue.

For somebody at very high risk for other reasons (like the heavy drinking) aiming to do better than guidelines is a smart decision.
If he wants average risk from diet, he's going to still come in considerably above average risk due to other lifestyle factors.

There is no reason to believe this and trying to do "better than the guidelines" can be counter-productive because it leans to more restrictive dietary choices. Dietary recommendations should be based on solid evidence and not speculation.

Russian roulette is only a 17% chance. I guess you love that game.
There's every reason to NOT pull that trigger if in doubt, since there's no reason TO eat cholesterol. Your body makes all you need.

The response seen in people that respond poorly varies, only a small fraction respond very poorly. But this is nothing like a game of Russian roulette since we have cheap and reliable ways of testing cholesterol. People should make decisions based on their cholesterol figures and not assume they are genetically prone to this and that. If someone has high cholesterol despite eating healthy, being active, etc then it would be worth while thinking about your dietary cholesterol intake but otherwise there is no reason to focus on it.

Also you can look at your family history as well. Actually my mother's family is moderately impacted by this issue but I don't seem to have the genes for it. But I'm not entirely sure since I wasn't raised eating a lot of high cholesterol foods and still rarely eat them out of habit.

I'm not a vegan for health reasons, but for ethical ones. I have no ideological commitment to believing animal products are unhealthy.

Vegans have an ideological commitment to veganism which obviously entails a lot of dietary claims. Secondly being an "ethical vegan" creates psychological incentives to demonize animal products.

You eat meat. Intrinsically, that means you have a bias to defend the ethics of what you're doing. A lose-lose proposition would make them ever more questionable.

We aren't discussing ethics and eating meat isn't rooted in a particular ideology, its just a feature of western dietary culture. But as I said, everyone has biases and my point is about the fallacious and hypocritical nature of your comment. Vegans are, if anything, going to be more prone to bias since they are the ones that have strong ideological and social commitments to veganism.

You'd expect it, because you're biased and you can't admit it; you view yourself as being impartial and ultra-rational. You're bullshitting yourself. I've met few people as biased in favor of meat as you are, from your fear mongering diatribes against veganism as dangerous despite professional consensus (which you write off like an anti-science conspiracy theorist) to your perverse aesthetic obsession with the beauty you see in grazing and animal husbandry like some half-mad bucolic painter fresh from the 19th century.

You'd expect it because that is what the psychological research shows, when people become anchored in a belief it creates the tendency for strong bias. The rest of your comments are just your usual attempts to insult. I've never presented myself as being "impartial and ultra-rational", on the contrary, I noted that everyone has biases. Secondly I've never claimed that vegan diets are "dangerous" rather I've claimed there isn't sufficient evidence to evaluate them. I'm not even sure what you're talking about with the last comment but I reckon its because I've presented pasturing animals as ecological sound.

Because virtually nobody does that, but mechanistically there's plenty of evidence based on the way plaques form and the cause of cadiovascular events.

If virtually nobody does it....then we'd have no evidence as I suggested. And there is no mechanistic evidence that indicates reducing saturate fat below guidelines is helpful.

One mechanistic piece of information you seem to be ignoring here is that the body synthesizes saturated fat on its own and various dietary factors promote or inhibit saturate fatty acid synthesis. When you look at blood levels of saturated fat you actually see stronger correlations with simple carbohydrate consumption then with saturated fat intake. The reason for this may be that firstly the simple carbs promote high synthesize of saturated fats but also that the body limits their use for energy which allows them to build up in the blood.

Again with the fear mongering because there aren't enough studies.
You need to cut this out. You can make mechanistic arguments if you want (complain about the sodium content? The lower levels of micronutrients?) but this isn't an argument.

Sorry but I'm not going to stop insisting that empirical claims be evidence-based. Your implying that mock meats are healthy or at least healthier than meats but there is no evidence that this is the case, how in the world is it fear-mongering to demand evidence? I didn't discuss sodium content, etc because ultimately what matters is studies that compare various types of meat consumption to the consumption of mock meats and we don't have those types of studies.

From the perspective of health it makes no sense to promote mock meats over the consumption of fish and lean poultry which are known to be healthful and you don't find any health organization making this recommendation. You are once again going well beyond what any health organization would claim in what seems to be an effort to promote plant-based products over animal based ones.

A half a gram, a gram, etc. that he doesn't need ON TOP OF the other inevitable saturated fat he's consuming from a fat dominated macronutrient ratio. There's no reason for it when there are superior alternatives. And then there's the unnecessary dietary cholesterol on top of that.

What is and isn't "necessary" has nothing to do with my comment, the point is that he can easily keep his saturated intake below guidelines while eating a good deal of meat. But your comments again are all premised on the idea that going below guidelines will be beneficially and there is little reason to believe that is the case. Its just speculation and dietary recommendations should not be rooted in speculation but instead strong evidence, every restrict you add to a diet makes it more difficult to follow which will lower adherence. This is why encouraging a non-vegan to eat mostly vegan foods makes no sense, there is no health basis for such a shift and it makes the diet much more difficult to follow.

[brimstoneSalad]

More deception and strawmanning.

And your claim about saturated fat being "one of the only lifestyle factors under our control" isn't accurate. There are number lifestyle factors that impact your cholesterol levels, for example, your level of physical activity, your weight, your refined carbohydrate intake, your fiber intake and so on.

I mentioned weight. @PsYcHo is he over weight?

We already addressed refine carbohydrate intake, and he should seek to avoid simple carbs with a low carbohydrate diet.
A mostly vegan low carb diet will also help increase his fiber consumption; mock meats in general are a lot higher in it than animal meat, but of course vegetables will be the main drivers there.

Psychical activity is something to consider, but many people do not have the time or ability to increase it very much, and there are diminishing returns there too. Saturated fat is the easiest to avoid.

There is no reason to believe this is the case and animal based saturated fats all differ in composition. Also as I noted, "gram for gram" coconut fat has a much higher fraction of saturated fat than animal fat which may actually make it worse.

It's not worse, it's better; there are studies that have been done with fat comparisons between butter and coconut oil.
One more recent one showed virgin coconut oil to be particularly better, comparable to olive oil, but it's not clear if that extends to the refined oils and those are often what's used in the few RARE mock meats that use it because it has less coconut flavor.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5855206/

Like I said, it should still be avoided, but there are credible reasons to believe plant saturated fats like from coconut are not as bad, gram for gram of saturation.

I disagree with the idea that a keto style would be good for this person, the composition of high-fat diet with simple sugars (from the alcohol) is likely to promote fatty liver and other metabolic problems.

The alcohol will contribute to fatty liver with or without dietary fat, but of fats it's only transfat and saturated fats that are thought to be major contributors to fatty liver disease:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3732059/

Recent findings suggest that short term hypercaloric feeding leads to increased intrahepatic triglyceride (IHTG), while short term hypocaloric feeding leads to decreased IHTG despite little change in total body weight, suggesting that ongoing excess caloric delivery directly contributes to the development of NAFLD. Weight loss with either low fat or low carbohydrate diets can improve IHTG, however specific macronutrients: fructose, trans-fatty acids, and saturated fat may contribute to increased IHTG independent of total calorie intake. N-3 polyunsaturated fatty acids and mono-unsaturated fatty acids may play a protective role in NAFLD. The mechanisms behind these effects are not fully understood.

All the more reason he needs to restrict saturated fat intake as much as possible.
Obviously, he should also avoid trans-fats, but I assumed that went without saying.

On a low carb diet, he will already be restricting fructose.

As far as we currently know, polyunsaturated and monounsaturated fats (which my recommendation is to make up the majority of his food nutrients) seem to be protective.

Every gram of saturated fat matters. He needs to eat as little as possible for multiple reasons.

I would also note here that I forgot about his history with cancer, which is yet ANOTHER reason to favor plant over animal proteins.
@PsYcHo I don't know if his cancer was tested or if it's methionine depdendent or not, but many cancers are so restricting methionine could be a good idea to reduce his chances of a relapse. Methionine is primarily found in animal products. There are only a few plant products rich in it (like sesame seeds), so a plant-based diet will help if that's the case (if not, it's safer to assume it).

If I was talking to the person I'd suggest a diet of mostly legumes, lean meats, vegetables, some fatty dairy products and good deal of fatty plant foods like nuts and avocado and to greatly limit sugary foods (including sugary dairy, fruits, etc).

Fatty dairy products too? That's a terrible recommendation.
Like I said, cholesterol skeptic. Most mainstream sources specifically recommend fat free or low fat dairy. It's a very poor choice for fat macros.

He needs poly and monounsaturated fats, and to limit saturated fat as much as possible both to reduce risk of heart disease (which is high enough from his triglycerides) and to reduce the risk of liver failure.

But really this is all speculation, this is a unique individual with a special lifestyle issue.

Everything is speculation on some level, you demand unreasonable and impossible levels of proof to everything you don't like, but continually default to recommending meat despite the evidence against it.

Everything I'm saying is evidence based, it just doesn't meet your unreasonably high/impossible standards.

There is no reason to believe this and trying to do "better than the guidelines" can be counter-productive because it leans to more restrictive dietary choices.

@PsYcHo suggested his friend might be willing to follow a pretty strict diet to minimize his risk and keep drinking.
Avoiding death can be a pretty powerful motivator. Obviously if he can not follow this 100%, getting as close as he can will still lower risks more than doing nothing.

If someone has high cholesterol despite eating healthy, being active, etc then it would be worth while thinking about your dietary cholesterol intake but otherwise there is no reason to focus on it.

"High cholesterol" is bad, but even the normal ranges involve higher than necessary risk.
There's no reason NOT to focus on lowering your cholesterol even more if you're at otherwise high risk.

https://www.thelancet.com/pdfs/journals ... 2290-0.pdf

There was a monotonic relationship between achieved LDL cholesterol and major cardiovascular outcomes down to LDL-cholesterol concentrations of less than 0·2 mmol/L. Conversely, there were no safety concerns with very low LDL-cholesterol concentrations over a median of 2·2 years. These data support further LDL-cholesterol lowering in patients with cardiovascular disease to well below current recommendations.

Current recommendations may have acceptable levels of risk for the general public, but PsYcHo is asking about something else: his friend is already at elevated risk due to his habits.
Again, if he just wanted standard recommendations he wouldn't have needed to ask. That would pretty much start and stop at "STOP DRINKING". He said his friend wouldn't go for that, so yes, this is a subject that goes beyond mainstream recommendations.

There's plenty of reason to continue to lower LDL, and limiting dietary cholesterol is very likely to be part of that for a significant percentage of the population. There's no good reason to consume it beyond taste/convenience, and PsYcHo indicated that his friend might be flexible if it meant potentially living longer and continuing to drink without dying from it.

I'm not a vegan for health reasons, but for ethical ones. I have no ideological commitment to believing animal products are unhealthy.

Vegans have an ideological commitment to veganism which obviously entails a lot of dietary claims.

Veganism entails no dietary claims.

https://www.vegansociety.com/go-vegan/d ... n-veganism

"A philosophy and way of living which seeks to exclude—as far as is possible and practicable—all forms of exploitation of, and cruelty to, animals for food, clothing or any other purpose; and by extension, promotes the development and use of animal-free alternatives for the benefit of humans, animals and the environment. In dietary terms it denotes the practice of dispensing with all products derived wholly or partly from animals."
Source (Vegan Society)

This is a warning: Do not twist the definition of vegan to suit your agenda. See the forum rules. That's not cool.

Animal cruelty and environmental destruction are plenty reasons enough to be vegan without ANY compulsion from a health direction.

Secondly being an "ethical vegan" creates psychological incentives to demonize animal products.

Being an anti-vegan carnist creates a lot more incentive to exonerate them.
It is not my habit to advocate veganism from a health perspective, because most people eat junk food and do things that they know are unhealthy, and there are plenty of unhealthy vegan foods (like processed sugars). Most vegans don't completely avoid junk foods, and I don't think a health obsessed diet is an attractive one for advocacy (look how delicious Mic. The Vegan's fat free sugar free salt free recipes aren't).

It is only rare cases where people are at inordinately high risk where a very strict health-focused diet is advisable, and that diet just so happens to be mostly vegan. That kind of advocacy is effective for maybe 1% or less of the population. I don't think it's that productive to spend time on.

We aren't discussing ethics and eating meat isn't rooted in a particular ideology, its just a feature of western dietary culture.

Some people just happen to eat it, but it is rooted in ideology: carnism. One you express regularly.

Veganism isn't a commitment to believing animal products are unhealthy, it's an ethical commitment with respect to animal treatment, etc.
Don't misuse the definition again to make that argument.

Secondly I've never claimed that vegan diets are "dangerous" rather I've claimed there isn't sufficient evidence to evaluate them.

You consistently fear monger against veganism, waxing conspiratorial against professionals, by demanding an unreasonable and impossible level of evidence we'd never need for other decisions.
You've proved your dishonesty on this point in your double standards.

If virtually nobody does it....then we'd have no evidence as I suggested.

We have limited epidemiological evidence, at least from diet (we do from cholesterol lowering medication).

And there is no mechanistic evidence that indicates reducing saturate fat below guidelines is helpful.

Mechanistic evidence is how cholesterol is made in the body.

There are intervention trials, like the Ornish diet, which while not controlled properly for exercise have impressive results (obviously this is a low fat diet which I'm not recommending here). Studies have also looked at lower than 10% recommendations for saturated fat without very low fat and seen some results (although the reductions are more modest, like 7% of calories instead of 10%) and that's part of many mainstream recommendations for people with elevated LDL now (less than 7% of calories from saturated fat), the trouble with these more extreme diets is adherence which isn't great when people are surrounded with temptation.

We also know vegans on low saturated fat diets (usually low fat diets) can end up with very low cholesterol levels; there's no reason to believe that's not caused by diet when it happens fairly regularly, and their cholesterol levels go back up upon consuming foods like coconut oil.

Low saturated fat diets cause lower cholesterol, lower cholesterol causes lower risk of cardiovascular events.
Denial of that is a critical part of cholesterol skepticism.

Again, this is probably not something most people worry about if they're otherwise at moderate risk levels and good weight etc. but this guy isn't; his risk is greatly increased due to his habits.

When you look at blood levels of saturated fat you actually see stronger correlations with simple carbohydrate consumption then with saturated fat intake.

@cornivore was just looking into the data on sugar recently in another thread.
Yes, if your body doesn't burn it off quickly through activity, you will produce fat to store it.
This isn't relevant to the present context where a low carbohydrate vegan diet is being recommended.

Sorry but I'm not going to stop insisting that empirical claims be evidence-based.

More deception. That's not what I'm saying and you know it.
Everything I'm talking about is evidence based, you just demand impossible standards of evidence.

Your implying that mock meats are healthy or at least healthier than meats but there is no evidence that this is the case,

Again, I'm talking about saturated fat. I said he should not consume the few mock meats that are rich in it (products which I almost never see).

I didn't discuss sodium content, etc because ultimately what matters is studies that compare various types of meat consumption to the consumption of mock meats and we don't have those types of studies.

This is all I hear:

"I didn't discuss how many kilograms pianos are, because ultimately what matters is studies that compare dropping pianos on people vs. dropping guillotines on them which is the only thing we have controlled evidence of lethality for. So you can't say dropping pianos on people is harmful until you have a study on that!"

This is your go-to anti-science position: skepticism so radical that it rejects all evidence, no matter how strong or obvious, if it's not the EXACT thing being compared.

You are once again going well beyond what any health organization would claim in what seems to be an effort to promote plant-based products over animal based ones.

Health organizations make practical recommendations for the general public that they think will be accessible and readily adopted.
The only strong recommendations PsYcHo's friend would find is the stop drinking, and if he can't do that then switching a few meals for chicken or fish isn't much risk reduction and probably won't save his life.

If you're in an extreme situation, it doesn't make sense to stop at the general recommendations and leave it at that when we certainly DO know more.

every restrict you add to a diet makes it more difficult to follow which will lower adherence.

That's true, which is why public health recommendations are so modest. That by no means means all you can possibly do (or all there's evidence for) is limited to what generally unmotivated or less strong willed people can bother to do. If PsYcHo's friend is WILLING to follow a stricter approach, he can do more than that and he can lower his risks beyond the modest recommendations his doctor will likely provide and despite his ignoring the most important recommendations about reducing alcohol consumption.

[PsYcHo]

I mentioned weight. @PsYcHo is he over weight?

Nope. Skinny as a rail.

PsYcHo is staying out of debate between BrimstoneSalad and Carnap

[brimstoneSalad]

I mentioned weight. @PsYcHo is he over weight?

Nope. Skinny as a rail.

In that case, his options are pretty limited.

Is he a couch potato? (I know skinny ones are a little more rare, but it does happen)
If so, exercise might help a little, but the main way he's going to lower his risk all-around is avoiding saturated fat and carbohydrates as much as possible, so eco-atkins style diet as I explained earlier in the thread.

Please let me know if you or he have any questions about Carnap's claims, I think I addressed them all and with links to studies.
Radical skepticism of mechanistic evidence and refusing to do anything beyond mainstream recommendations would really limit your friend's ability to lower his risk given the drinking he doesn't want to give up. It could help a lot, it might not do very much, but all we know says it shouldn't hurt and it's the best shot he has short of doing the most sensible thing and going easy on the alcohol.