Published March 20, 2025
Are you getting enough fiber in your diet? If you are like most of us, you probably get way too little. This is tragic, because people who consume a low-fiber diet have an about thirty-five percent higher risk of dying from a heart attack or a stroke than people who eat a high-fiber diet. That’s right! The stuff that promotes digestion and helps you “stay regular” might also dramatically reduce your risk of atherosclerotic cardiovascular disease (ASCVD).
In this blog post, I will share what the different types of fiber are, and if, how, and through which mechanisms each type of fiber affects ASCVD risk, with a particular focus on two major cardiovascular disease risk factors, LDL-cholesterol and insulin resistance. I’ll also share practical tips that you can implement in your own diet to very meaningfully lower your risk of having a heart attack or stroke.
What Are The Different Types of Fiber?
Let’s start with what dietary fiber is. Dietary fiber is a type of carbohydrate that the body cannot digest. Most people think of fiber as something that promotes regular bowel movements. But fiber does much more than just keep us regular!
We categorize dietary fiber into insoluble and soluble fiber. All plants contain both insoluble and soluble fiber in varying proportions. Insoluble fiber is the structural material of plants that gives them shape. It includes cellulose, lignin, and hemicellulose. This type of fiber is found in the bran of whole grain, which is the outer layer of the grain. It’s also found in the skin, stalks, and membrane of fruits and vegetables. Insoluble fiber adds bulk to the stool and prevents constipation by promoting regular bowel movements.
Soluble fiber, as the name suggests, dissolves in water, forming a gel-like substance. It’s found in oats, beans, lentils, fruits, and vegetables. Common soluble fibers that you may have heard about are beta-glucan, pectin, psyllium, and inulin.
The Impact of Dietary Fiber on LDL-Cholesterol
Let’s start by looking at a systematic review and meta-analysis of 24 randomized controlled trials (RCTs), published in the American Journal of Clinical Nutrition, which evaluated the effect of whole grain consumption on LDL-cholesterol and other blood lipids in a total of 2,275 healthy adults, some of whom had elevated cholesterol levels. The whole grain dose ranged from 28 g per day to 213 g per day across studies, obviously a very broad range, and the duration of the studies ranged from 2 weeks to 16 weeks.
What the authors found was that, OVERALL, whole grain consumption led to a drop in LDL-cholesterol compared with a control diet. We’re talking, on average 3.5 mg/dL – a 2% reduction. Now, this was statistically significant and potentially clinically relevant, but certainly not enough to motivate anyone to change their diet meaningfully.
However, this meta-analysis about the impact of whole grains on LDL-cholesterol still provides valuable insights. Because when the 11 RCTs that used oats were taken out of the analysis, the LDL-cholesterol-lowering effect of whole grains disappeared. As it turned out, the only grain that had LDL-cholesterol-lowering effects was oats, whereas no other type of whole grain had any impact.
Why would that be? Well … we know that oats are somewhat unique among the commonly consumed grains by being high in a type of SOLUBLE and viscous fiber, whereas other whole grains such as wheat and rye contain mostly IN-soluble fiber.
So, the first thing I’d like you to take away is that soluble fiber has an LDL-cholesterol-lowering effect, whereas insoluble fiber has no effect.
But the story doesn’t end there. Because we can get soluble fiber from many other foods as well, not just from oats, and the overall dose of soluble fiber we consume matters a lot for LDL-cholesterol reduction.
Soluble Fiber Reduces LDL-Cholesterol in a Dose-Dependent Manner
Let’s look at another systematic review and meta-analysis. This one summarized 181 randomized controlled trials that investigated the impact of soluble fiber on LDL-cholesterol. It considered data from 14,505 adults, which included healthy participants as well as people with elevated cholesterol, type 2 diabetes, or obesity. The authors estimated that each 5 g of additional soluble fiber per day would result in an average reduction in total and LDL-cholesterol by about 6 mg/dL.
And here is why that’s good news: Just five more grams of soluble fiber per day – a cup of cooked black beans, or a bowl of baby carrots with half an avocado – can meaningfully lower your LDL-cholesterol over time. And an additional ten grams per day even more so!
Small changes, implemented regularly, can amount to a significant effect.
The Effect of Viscous vs. Non-Viscous Soluble Fiber
To make things even more interesting, research has shown that the more viscous a soluble fiber is, the more effective it is at lowering LDL-cholesterol. What does that mean? “Viscous fiber”, refers to soluble fiber that forms a thick, viscous gel in our gut. Foods rich in viscous fiber include oats and barley, psyllium husks, chia seeds, avocado, beans, Brussels sprouts and blackberries, just to name a few. It is the viscosity or the “thickness” of the gel it forms that plays a critical role in reducing LDL-cholesterol.
In a systematic review & meta-analysis of 89 randomized controlled trials, published in 2023, the authors compared the effect of viscous fiber to non-viscous fiber on LDL-cholesterol in a combined 4,755 adults. The median dose of viscous fiber was 7 g per day and the duration ranged from 3 to 52 weeks. On average, viscous fiber lowered LDL-cholesterol by 10 mg/dL MORE than non-viscous fiber.
But here’s the real question: WHY does a fiber’s thickness matter so much for lowering LDL-cholesterol? Let’s explore what happens inside the gut.
How Does Viscous Fiber Reduce LDL-Cholesterol?
Our liver synthesizes cholesterol, which is packaged into very-low-density lipoprotein (VLDL) particles for transport through the bloodstream, where the VLDL particles “shed” triglycerides and then eventually become low-density-lipoprotein, or LDL, particles. These LDL particles deliver cholesterol to cells in various tissues, but they can also be trapped in the artery wall, where they can contribute to atherosclerosis. That is why higher LDL-cholesterol concentrations are associated with a higher risk of atherosclerotic cardiovascular disease.
But the liver also uses cholesterol as a raw material to create bile acids, which are a key part of bile. Bile is collected in the gall bladder, and secreted into the small intestine when we eat a fatty meal to help with fat digestion. After the bile acids have done their “job”, most are reabsorbed in the small intestine and returned via the portal vein to the liver where they can be converted back into cholesterol. This process is known as “enterohepatic circulation”.
This is where the viscous fiber comes in. When we consume viscous soluble fibers, these interrupt that cycle by trapping bile acids and cholesterol in the intestine and blocking its reabsorption. Similarly, viscous fibers can trap dietary cholesterol from a meal we just ate. The trapped bile acids and cholesterol then travel further down the small and large intestine and eventually are excreted in our feces. This means less bile acids and cholesterol are returned to the liver, and less dietary cholesterol is absorbed, and this reduces the amount of cholesterol in the liver. This ultimately lowers our blood LDL-cholesterol levels.
The thick gel formed by viscous fiber lowers LDL-cholesterol by literally interrupting the enterohepatic circulation. And I hope you can now appreciate why the thickness of the gel is so important. The thicker the gel, the more effectively it can trap the bile acids and cholesterol and prevent them from being reabsorbed and being re-converted to cholesterol.
But that might not be the whole story. Emerging evidence suggests that fiber could also lower LDL-cholesterol levels through a completely different pathway.
The Gut Microbiome Connection
There is emerging evidence that soluble fiber lowers LDL-cholesterol by influencing cholesterol absorption through a mechanism that involves our gut microbiome.
Most soluble fiber is fermentable by the bacteria in our gut, some more than others, while insoluble fiber is usually poorly fermentable. So when we consume soluble fiber, our gut bacteria ferment it and convert it into short-chain fatty acids. One of these short-chain fatty acids called propionic acid is thought to suppress the expression of a major cholesterol transporter in the small intestine. Scientists always come up with great names for stuff in our bodies, so this cholesterol transporter they called Niemann-Pick C1-like 1, or NPC1L1.
NPC1L1 is an interesting molecule because it is also the target for the lipid-lowering medication ezetimibe, also known by the brand name Zetia. So, by being converted to propionate, soluble fiber reduces NPC1L1 activity, lowering cholesterol absorption from both food and from the bile.
In a small double-blind, placebo-controlled RCT published in 2021, 62 adults with elevated LDL-cholesterol were given either 500 mg of propionic acid supplement or a placebo. After 8 weeks, the group that received the propionic acid supplement saw a reduction in LDL-cholesterol by 16 mg/dL and a reduction in total cholesterol by 20 mg/dL.
There are potentially other LDL-lowering mechanisms through the gut microbiome. For example, fiber might feed certain gut bacteria, like lactic acid bacteria that increase the breakdown of bile acid and interrupt the enterohepatic circulation. But we will not get further into this mechanism in this blog post.
So we have talked about the impact and mechanism of soluble viscous fiber, and you might be thinking: Does this mean we should just focus on soluble and particularly viscous fiber and ignore insoluble fiber? Not quite. Because while insoluble fiber might not lower LDL-cholesterol concentrations, it plays a role in something just as critical for cardiovascular health.
Effect of Insoluble Fiber on Insulin Sensitivity
As you probably know, in addition to elevated LDL-cholesterol, there are other risk factors for ASCVD, such as excess body fat mass or type 2 diabetes. I have shared in a prior blog post that diets rich in fiber tend to be more satiating per calorie, which helps us eat fewer calories and prevent or even reverse weight gain. And because carrying excess body fat is a key risk factor for insulin resistance and type 2 diabetes, a fiber-rich diet lowers our risk of becoming insulin resistant and developing type 2 diabetes partly because it helps us prevent weight gain. However, some types of fiber actively improve insulin sensitivity in a way that is independent of body weight changes. And this is where insoluble fiber comes into play. Let’s take a closer look.
In a randomized cross-over controlled-feeding trial published in the American Journal of Clinical Nutrition, 11 overweight or obese adults free of diabetes, with normal fasting blood sugar but elevated fasting insulin (suggesting insulin resistance), were fed either a whole grain diet containing about 20 g of insoluble fiber per day for 6 weeks, or a refined grain diet providing about 11 g of insoluble fiber per day. After 6 weeks, the participants went through a 6-9 week washout period and then switched to the other diet.
Both the whole grain and refined diet were adjusted in calories to keep the participants’ weight stable. And except for the difference between whole grain vs. refined grain, they were identical and matched for macronutrient composition, types of fatty acids, and also the amount of soluble fiber.
After six weeks, participants on the wholegrain diet showed a higher insulin sensitivity as measured by the gold-standard hyperinsulinemic-euglycemic clamp, or clamp for short. And that difference was quite meaningful. Really important to note here is that their body weight had not changed. In other words, the increase in insulin sensitivity could not be due to weight loss but rather, due to the insoluble fiber content which, by design, was the only difference between the two study diets.
Let’s look at another study. This randomized cross-over controlled feeding trial assessed insulin sensitivity again using the gold-standard clamp technique in 17 overweight or obese women free of diabetes after 3 days of consuming either a low-fiber white bread or a white bread that was enriched specifically with insoluble fiber. The fiber amount was about 30 g of insoluble fiber in the treatment group vs. no insoluble fiber in the control group. So the intervention period in this study was much shorter, but the difference in insoluble fiber intake was much more pronounced. The rest of the diet was identical in macronutrient composition and energy-adjusted to ensure participants maintained their weight. After a wash-out period, participants switched over to the other diet, so everyone completed both diets. After participants consumed the insoluble fiber-enriched bread for just 3 days, insulin sensitivity again had increased significantly.
What these studies show is that insoluble fiber improves insulin sensitivity, in a manner that is independent of weight change. So this is in addition to any positive effect fiber may have on insulin sensitivity by helping us avoid weight gain. And that is something to pay attention to because this seems to translate to a lower risk of type 2 diabetes in people consuming more insoluble fiber.
For example, a recent large prospective cohort study in China followed 16,272 participants without diabetes. During a median duration of 9 years, 1,101 people developed diabetes. The authors found that those who had the highest intake of insoluble fiber from a variety of sources had the lowest risk of developing diabetes. And notably, consuming a greater variety of different types of insoluble fiber was also associated with a lower risk of developing type 2 diabetes. This is quite consistent with other cohort studies showing that the risk of developing type 2 diabetes is 15-30% lower in people consuming high-fiber diets compared to those consuming low-fiber diets.
The big takeaway here is that when it comes to understanding the impact of fiber on cardiovascular disease risk, we have to keep the big picture in mind and recognize that both soluble and insoluble fiber are important. All types of fiber make our meals more satiating per calorie, thereby lowering our calorie intake and body weight, which in and of itself is associated with a lower risk of ASCVD. Soluble fiber specifically lowers LDL-cholesterol concentrations, which also lowers the risk of ASCVD. And insoluble fiber improves insulin sensitivity, thereby lowering the risk of type 2 diabetes, which again lowers the risk of ASCVD.
I dive deeper into insulin resistance in this blog post, and discuss how to reverse it in another blog post.
I’d like to also remind you that most whole plant foods contain both soluble and insoluble fiber. Rather than focus on one or the other specific type of fiber, focus on your total fiber intake by including plenty of whole vegetables, fruits, legumes, and whole grains in your diet. That way, you automatically get a variety of types of soluble and insoluble fibers.
So, when it comes to fiber intake, what kind of ASCVD risk reduction are we talking about here? Let’s take a look …
The Impact of Dietary Fiber on Cardiovascular Disease Risk
We have data from a massive systematic review & meta-analysis, published a few years ago in the Lancet, which analyzed data from 185 observational studies and 58 randomized controlled trials. It found that those with the highest total fiber intake, compared to those with the lowest fiber intake, experienced a 31% lower risk of dying from coronary heart disease, a 24% lower risk of having a heart attack, and 22% lower incidence of stroke. They also observed a 15% lower risk of all-cause mortality in those with the highest compared to those with the lowest fiber intake.
Higher fiber intake was also associated with a lower risk of developing type 2 diabetes, by 16% in those with the highest compared to the lowest fiber intake. Again, type 2 diabetes and also the determinants of glucose intolerance, particularly insulin resistance, are in and of themselves major risk factors for cardiovascular disease.
The greatest reduction in disease risk was seen with 25–29g of total fiber per day, which is about twice as much as the average person in the United States, for example, is consuming. That is only because in most populations, few people consume more than that amount. At the same time, the study suggested that even higher intakes could offer additional protection against heart disease, type 2 diabetes, and some cancers. There simply were not enough people consuming more than 30 or even 40 g of fiber per day to make a conclusive statement. It does seem likey, however, that more fiber equals better health!
Practical Tips to Maximize Dietary Fiber Intake
Now that we’ve covered the science behind how fiber reduces LDL-cholesterol, improves insulin sensitivity, and lowers ASCVD risk, let’s talk about practical ways to incorporate more fiber into your daily diet. The Academy of Nutrition and Dietetics recommends 14 g of total fiber for every 1000 kcal of food consumed. For an adult woman, that’s about 25 g per day in dietary fiber, and for a man, it’s about 38 g per day. There are no specific guidelines for soluble fiber, but based on the evidence, 10 – 15 g per day would be a good target. By the way, the actual total fiber intake in the US population is only about 15 g per day – far below what is recommended, so there is a lot of room for improvement!
What could the fiber intake look like for an entire day? I will use myself as an example and share what I might eat on a typical day. I guess I need about 2400 kcal per day to maintain my weight, plus maybe a little extra depending on my activity level, so I should shoot for about 38 g of total fiber per day. Now, I don’t usually log my food intake, and have never actively kept track of my fiber intake. I simply prioritize a variety of fruits, berries, and vegetables, in large quantities as the basis of most meals, and I often also eat other fiber-rich foods such as legumes, whole grains, or nuts throughout the day.
I’ll often start the day with Greek yogurt with pecans and blueberries for breakfast (see image below). Blueberries, or all berries, really, are a great source of fiber. You can see I also add two teaspoons of psyllium husk to my yogurt, which thickens the yogurt a bit. It all comes out to about 590 kilocalories, about 12 g of total fiber, and of that, 3.5 g is soluble fiber. This breakfast keeps me full for a while.
Then for lunch, I love having a big mixed salad like the one shown in the figure below, with various greens and different kinds of vegetables and fruits. I love to add things like celery, fennel, and maybe a pear, and all of these are really high in fiber. Plus tuna and goat cheese for protein, and roasted sunflower seeds for crunch. A salad like this packs a big punch as far as fiber. And it’s very easy to make different variations of this: smoked salmon or some grilled chicken instead of the tuna. Some nuts instead of the sunflower seeds. An apple instead of the pear. And some days I’ll have goat cheese, other days, feta or some shaved parmesan cheese. You can see, including a homemade vinaigrette dressing, this version comes out to about 788 kilocalories with over 23 g of total fiber and 6 g of soluble fiber. This lunch alone gets me more than halfway to my goal fiber intake.
On days when I am busy, an alternative lunch might be a big bowl of chili or lentil soup with vegetables cooked the day before, maybe with a slice of gluten-free wholegrain bread which would also get me to about 15 g of total fiber.
For dinner, I might have a mixed meal like the one shown below: half a steamed cauliflower, a side salad, boiled potatoes, and a nice Bratwurst. Yes, OK, I am German, and I like some sausage sometimes. Bratwurst is actually not all that great nutritionally, as it’s pretty fatty and energy dense, and a piece of unprocessed meat would be better in a lot of ways. But I wanted to include this here, to demonstrate that you don’t need to be perfect all the time if you generally make good choices. And in a meal like this, I simply eat a huge portion of the salad and the cauliflower, rather than mostly sausage and a tiny portion of vegetables. The biggest issue with a meal like this is that most people would eat two or three sausages, then a big pile of potatoes or even fried potatoes, and they’d forget about the vegetables and the salad, or just have tiny side dishes of one or the other. Try to think about the meat and potatoes as the side dishes, and focus heavily on the whole plant foods. This is a pretty hearty meal, comes out to 813 kilocalories with a total of almost 12 g of total fiber and 3.1 g of soluble fiber.
On other days, I might have brown rice or quinoa instead of potatoes, maybe with another piece of meat or fish or something with eggs or legumes and – again – a large pile of salad or vegetables. I think you can see the meal pattern: I usually either have a salad or a lot of cooked vegetables with my lunch and dinner.
As far as my snacks, I might have some carrots, an apple, and an orange, and that adds another 10 g of total fiber or so to my day.
Where does this leave me at the end of the day? Withthree3 meals and my snacks, I come in at 2,340 kcal with a total of about 58 g of total fiber and of that, and almost 16 g of soluble fiber.
That may sound high, but what this illustrates is that fiber intake is as much about eating fiber-rich foods at all meals as it is about avoiding foods that have been stripped of their natural fiber content, like a lot of ultra-processed foods, refined grains, and added sugars. I barely ever eat those. So my main tips are, first, always include a large serving of a salad, vegetables, or other fiber-rich plant foods such as legumes, fruit, or berries. And second, look where you can make easy food swaps to minimize foods that are totally devoid of fiber. Brown rice instead of white rice. Whole grain bread with nut butter instead of white bread and butter. Whole fruit instead of fruit juice. You get the idea.
By the way, if you’re new to increasing fiber, it’s important to start slow and gradually increase your fiber intake to give your gut time to adjust. Increasing fiber intake too quickly, particularly from legumes, can temporarily cause bloating, gas, or digestive discomfort. By giving your gut and its inhabitants time to adjust, you can enjoy the benefits of fiber while minimizing any unwanted side effects.
What about Fiber Supplements?
Depending on your current diet, lifestyle, and food preferences, you might be wondering: can’t I just take a fiber supplement and call it a day? You saw that I sprinkled some psyllium husk onto my yogurt as well; that’s kind of a fiber supplement. My view is that fiber supplements can certainly help, but they should ideally not replace whole foods. While fiber supplements often just contain one or two specific types of fiber, whole plant foods provide a variety of different soluble and insoluble fibers, and there is almost certainly a benefit to consuming a variety of different types of fiber. Further, these same plant foods that contain the most fiber also are very micronutrient-dense, meaning they provide essential vitamins, minerals, and trace elements. Similarly, fiber-rich plant foods tend to be very rich in secondary plant compounds, such as polyphenols, compounds that are not essential to us, but that have health benefits, for example, by acting as antioxidants. Fiber-rich plant foods also have a low energy density, and eating a lot of them makes it difficult to overeat calories. Including whole, fiber-rich plant foods in a meal is also known to lower the blood glucose response to that meal. In other words, try to eat a variety of unprocessed or minimally processed whole plant foods every day, ideally with every meal.
That said, if you struggle to get enough fiber from food alone, adding a supplement can be a helpful boost. Again, remember to start with a small dose and increase gradually.
Summary & Conclusions
In summary, we have strong scientific evidence that soluble, especially viscous fiber reduces LDL-cholesterol concentrations in fasting blood, while insoluble fiber improves insulin sensitivity and reduces the risk of type 2 diabetes. We also have good evidence that these effects translate to a lower risk for cardiovascular diseases in people eating the most fiber.
My recommendation is to aim for about 38 g of total fiber per day if you are an adult male, and 25 g of total fiber if you are an adult female. There are no consistent guidelines for intake of soluble fiber specifically, but the evidence points towards aiming for 10 – 15 g in soluble fiber per day. Try to consume the majority of fiber from whole, unprocessed plant foods like vegetables, fruit, berries, legumes, whole grain, and also nuts and seeds in moderation. Fiber supplements are also a good option, but prioritize getting your fiber from whole plant foods due to their numerous other health benefits.
Thank you for reading!
Let me also thank Yoshiko Roth-Hidalgo for her very capable help with this blog post and the associated YouTube video. Yoshiko is currently pursuing a graduate degree in clinical nutrition, and she is completing an internship with me. She led much of the research and production of this content, so thank you, Yoshiko.
Lastly, a huge thank you to the Patrons of this website and the YouTube channel. As you may know, it is my goal to produce evidence-based videos and the associated blog posts in a way that is independent of financial conflicts of interest. We, therefore, do not engage in any sponsorships, affiliate marketing, or any other relationship with the food, supplement, or pharmaceutical industries. If you value our unbiased approach to making high-quality content freely available, please consider becoming a patron of the channel here at Patreon.com.
Take care!
References
- Hollænder et al. Whole-grain and blood lipid changes in apparently healthy adults: a systematic review and meta-analysis of randomized controlled studies. Am J Clin Nutr. 2015; 102: 556-72.
- Ghavami et al. Soluble Fiber Supplementation and Serum Lipid Profile: A Systematic Review and Dose-Response Meta-Analysis of Randomized Controlled Trials. Adv Nutr. 2023; 14: 465-474.
- Jovanovski et al. Are all fibres created equal with respect to lipid lowering? Comparing the effect of viscous dietary fibre to non-viscous fibre from cereal sources: a systematic review and meta-analysis of randomised controlled trials. Br J Nutr. 2023; 129: 1180-1192.
- Haghikia et al. Propionate attenuates atherosclerosis by immune-dependent regulation of intestinal cholesterol metabolism. Eur Heart J. 2022; 43: 518-533.
- Pereira et al. Effect of whole grains on insulin sensitivity in overweight hyperinsulinemic adults. Am J Clin Nutr. 2002; 75: 848-55.
- Weickert et al. Cereal fiber improves whole-body insulin sensitivity in overweight and obese women. Diabetes Care. 2006; 29: 775-80.
- Yang et al. Variety and Quantity of Dietary-Insoluble Fiber Intake From Different Sources and Risk of New-Onset Diabetes. J Clin Endocrinol Metab. 2022; 108: 175-183.
- Weickert and Pfeiffer. Impact of dietary fiber consumption on insulin resistance and the prevention of type 2 diabetes. Journal of Nutrition 2018; 148: 7-12.
- Reynolds et al. Carbohydrate quality and human health: a series of systematic reviews and meta-analyses. Lancet. 2019; 393: 434-445.
- Dahl and Stewart. Position of the Academy of Nutrition and Dietetics: Health Implications of Dietary Fiber. J Acad Nutr Diet. 2015; 115: 1861-70.
11 Responses
Excellent article. Thank you.
If fiber absorbs cholesterol that would be recycled to make bile (bile acids?), then something else needs to provide that resource. I assume it would come from a dietary source? So if we have a diet with a lot of fiber, do we need to eat anything special to make sure we maintain good bile production?
No, the body can produce cholesterol if it needs to, but if there is less cholesterol in the liver, it will also increase the removal of LDL-particles from the blood. And that’s why LDL-cholesterol levels drop.
Excellent article. All goes back to eating a variety of whole foods regularly. Since the start of this low carb, whole food journey I am on, there have been changes to many things with my body, mostly good. Only negative is I am struggling to maintain solid bowel movements with all the healthy fats(avocado, etc) that I have introduced into my diet. Lately I have been lethargic and somewhat jittery during the day. Could too much fat cause this ? I also drink lemon water every day(just once). Other than low carb and whole foods, this is the main dietary changes I have made. Any suggestions?
Could it be that you are on the brink of entering ketosis? That can often cause any number of issues, often summarized as keto-flu where many people have a headache or fatigue. Either keeping carb intake low and moving through this phase, or increasing carbs enough to stay out of ketosis, may help.
Now how about that Bratwurst? What’s is your thinking on saturated fats in diet and LDL levels? You do mention the Bratwurst is fatty but then highlight the “processed” nature There seems to have been a bit of back and forth on how bad saturated fats really are. But maybe arises the same distorted perspective on the role of LDL in cardiovascular health that you have addressed in your lipids video? Is keeping saturated fats in diet at a minimum still the thing to do? Thanks!
Hi Axel,
I good question, and one I feel – in hindsight – I should have addressed briefly in the video. I have a video coming soon about saturated fatty acids (and other strategies to lower apo B-containing lipoproteins, such as LDL).
In short, what matters here is the overall fatty acid composition. So of course, eating processed fatty meats, or fatty cuts of red meat daily would not be ideal. However, as much as I like saussage, I have bratwurst or fatty cuts of red meat probably no more than once a week. Also worth mentioning that I see it as more important to cut out isolated/concentrated sources of saturated fatty acids, such as butter, cream, ice cream, coconut oil, palm oil etc., because (a) their impact on the blood lipid profile is more substantial than that of saturated fat consumed in whole foods (particularly compared to full-fat dairy), and (b) these isolated fats are not nutritionally valuable in any other way, as they are basically empty calories and make everything very energy dense, whereas fatty foods such as meat and dairy products and even bratwurst are a lot less energy dense and usually have pretty good nutrition value related to their protein and micronutrient content. So that’s what I personally do: I rarely, if ever, eat butter, lard, tallow, coconut oil, palm oil, or cream, and ice cream only rarely. I prioritize whole foods rich in unsaturated fatty acids, and have nuts and seeds, olives, avocado etc. regularly, along with mostly using olive oil and avocado oil. And that allows me to also enjoy cheese and an occasional fatty cut of meat or a processed meat such as bratwurst or liverwurst. Could I lower my LDL-cholesterol more if I cut out all red meat, processed meat, and cheese? Yes, probably, but not by all that much, and it would have other ‘costs’ as these foods are protein-rich, micronutrient dense, and add a variety to my otherwise heavy plant-based diet that I appreciate. If all I could have for my main meal was piles of plants, I would almost certainly go looking for rewarding foods such as cookies or sweets after each meal …, and that may well be worse.
Cheers
Mario
Thanks. That argument about concentrated/isolated saturated fat sources probably needs some refining. . Don’t know about you, but a slice of butter by itself, doesn’t sound that appealing to me. But Butter on fresh german bread, delicious! Isn’t it still just keeping your calorie sources balanced while keeping those from saturated fats low? Or is there something special about how those isolated sources are processed?
Thanks axel
I’ll talk about this a lot more in a future video. In short, 50g of dairy fat as butter clearly raises LDL-cholesterol compared to 50g of dairy fat in the form of full-fat cheese. And consistent with this, butter is much more strongly associated with ASCVD than full-fat cheese. Plus, and in addition to this, butter is an energy-dense food low in essential nutrients, so in contrast to cheese it doesn’t contribute anything of value to our diet other than calories, of which most people get enough anyways.
What about fibre and calcium absorption for us with osteoporosis?
Hi Ella,
There are a lot of different factors that affect calcium absorption, and to some degree it does make some sense to consider them. To me, the most important are (a) not to be vitamin D deficient, and (b) to not over consume foods rich in oxalic acid, which bind calcium in the gut and dramatically lower it’s bioavailability. Fiber acts somewhat similarly, but not nearly as strong, and fiber has numerous benefits (whereas oxalic acid, in excess, carries additional health risks), so I generally would not recommend that people reduce their fiber intake to increase calcium absorption.
Note, however, that this is not medical or medical nutrition advice for you personally. If you want to understand how this applies to your specific situation, please talk to a doctor or – better – registered dietitian.
Cheers
Mario