The Science of Eggs & Heart Health (Should You Eat It?) | The Proof Podcast EP #328

Summary

This script debunks myths surrounding eggs and cholesterol, highlighting individual genetic differences in cholesterol absorption. It explains the role of liver-produced cholesterol and the impact of diet, emphasizing the importance of understanding one's genetic predisposition to cholesterol hyper-absorption. The video offers practical advice on testing for phytosterol levels to tailor dietary choices and discusses the implications for heart health, suggesting alternatives for those who should reduce cholesterol intake.

Takeaways

• 🥚 Eggs contain a significant amount of cholesterol, with about 200 mg per egg, which can affect blood cholesterol levels differently depending on the individual.
• 🧬 Approximately 30% of the population are considered cholesterol hyper absorbers, meaning they absorb more cholesterol from their diet, potentially leading to higher blood cholesterol levels.
• 🧪 To determine if you're a hyper absorber of dietary cholesterol, consider testing your phytosterol levels, particularly beta-sitosterol and campesterol, which can be done at various labs worldwide.
• 🔍 If identified as a hyper absorber with high apoB, lowering cholesterol-rich foods in your diet can make a significant difference, especially for those at low risk of cardiovascular disease.
• 🍳 For those at moderate to high risk of cardiovascular disease, dietary changes alone may not suffice, and discussing lipid-lowering medications like ezetimibe with your physician is important, as it is particularly effective for hyper absorbers.
• 🚫 If you are a cholesterol hyper absorber, avoid supplementing with phytosterol supplements, as these compounds could circulate at dangerous levels in your bloodstream, potentially damaging your arteries and accelerating plaque buildup.
• 🌱 For non-hyper absorbers, focusing on lowering saturated fat in the diet in exchange for mono and polyunsaturated fats is key, especially if apoB levels are high.
• 🥗 Eggs and shellfish, which are rich in cholesterol but relatively low in saturated fat, probably aren't dramatically affecting apoB levels for about 70% of the population, but they still have some effect.
• 🧠 The script mentions the importance of choline found in eggs for brain health and suggests that an upcoming video will address this topic, indicating the need for a balanced approach to diet and nutrition.
• 🔗 The role of genetics in cholesterol absorption and the individual response to dietary cholesterol is emphasized, highlighting the importance of personalized nutrition based on genetic makeup.
• 📉 The video script busts the myth that dietary cholesterol directly correlates with blood cholesterol levels, explaining the complex interplay of liver production, peripheral cell production, and dietary absorption.

Q & A

What is the main topic of the video script discussing?

The main topic of the video script is the impact of eggs on blood cholesterol levels and how individual genetic differences can affect this relationship.

Why might the cholesterol content of a single egg have different effects on different individuals' blood cholesterol?

The cholesterol content of a single egg might have different effects on different individuals' blood cholesterol due to their genetic makeup, specifically how efficiently their bodies absorb and excrete cholesterol.

What are lipoproteins and why are they important in the context of cholesterol?

Lipoproteins are proteins that carry cholesterol and fats through the bloodstream. They are important because they transport cholesterol produced by the liver and peripheral cells, as well as cholesterol from the diet, throughout the body.

What is the primary role of LDL, or low-density lipoprotein, according to the script?

The primary role of LDL is to carry triglycerides or fats to cells for energy production and to carry cholesterol back from cells to the liver.

How does the body absorb cholesterol from the diet?

The body absorbs cholesterol from the diet through transporters in the small intestine, which act like doorways controlling the absorption of cholesterol and phytosterols.

What are the two types of transporters in the small intestine that control cholesterol absorption?

The two types of transporters are NPC1L1 transporters, which act as entrance doors, and G5/G8 transporters, which act as exit doors.

Why might someone be considered a 'cholesterol hyper absorber'?

Someone might be considered a 'cholesterol hyper absorber' if their transporters are very efficient at letting cholesterol into the intestinal cells but not as effective at pushing it back into the gut for excretion, due to their genetics.

How can one determine if they are a cholesterol hyper absorber?

One can determine if they are a cholesterol hyper absorber by testing their blood levels of phytosterols, such as campesterol and beta-sitosterol.

What is the significance of phytosterol testing in understanding an individual's cholesterol absorption?

Phytosterol testing is significant because it provides a proxy for dietary cholesterol absorption. If blood levels of phytosterols are high, it indicates that an individual is a hyper absorber of cholesterol.

What dietary changes can a cholesterol hyper absorber make to potentially lower their blood cholesterol levels?

A cholesterol hyper absorber can reduce their intake of cholesterol-rich foods like eggs, shellfish, dairy, and meats, and increase their intake of cholesterol-free plant-based foods such as tofu, tempeh, chickpeas, beans, and lentils.

How does the medication Zetia (ezetimibe) work in relation to cholesterol absorption, and why might it be particularly effective for hyper absorbers?

Zetia blocks cholesterol absorption from both food and bile, making it particularly effective at lowering cholesterol for hyper absorbers by essentially offsetting the function of genes that are working against them.

What are some potential dietary swaps that could benefit individuals looking to lower their cholesterol levels?

Potential dietary swaps include replacing fatty meats with salmon and plant-based proteins like tofu and lentils, and choosing olive oil over butter to increase intake of unsaturated fats.

Why might someone with healthy blood cholesterol levels still consider reducing their egg intake?

Even with healthy blood cholesterol levels, reducing egg intake can be beneficial for those following a high-fiber, plant-based diet, such as a Mediterranean or pescatarian diet, to maintain a balanced nutritional profile.

What is the potential risk of supplementing with phytosterols for a cholesterol hyper absorber?

For a cholesterol hyper absorber, supplementing with phytosterols could lead to dangerous levels circulating in the bloodstream, potentially damaging arteries and accelerating plaque buildup.