I did a strict vegan diet that included no added oil or nuts or other higher fat plants for 8 months. I lost nearly 20 pounds, going from the high end of normal bmi to the low end. My purpose was to bring down my cholesterol to get my doctors off my back regarding statins. My total cholesterol went down to about 200 and my ldl went down to 116 in four months. The negative consequences were that my menstruation stopped and all of my tissues, skin, eyes, etc. became very dry. I went on vacation about 8 months in and added back in olive oil, nuts, avocado to make things easier and my menstruation returned. After adding in the healthy plant fats, my cholesterol only increased two points and my ldl went down further to 106.
Maybe you should skip the olive oil and replace with flax, chia, and hemp seeds to get your ALA. ALA is an essential fatty acid and there doesn't seem to be much in your diet (even if the nuts are walnuts). Do you get any EPA or DHA? No wonder that you had health problems.
I'm on this exact same diet. I was 198 lbs at the beginning of the diet and now hover around 172 lbs. I've lost over 25 lbs in 3 months. I've tried low carb diets, keto carnivore combined with OMAD and nothing seemed to work significantly. This one works really well. The drawback is going out to restaurants is pretty well impossible.
My hunch is that reintroducing nuts and high fat plants like avocados or what ever , started to give you essential nutrients required . Just leaving out pure oils is all that's required , while still eating the odd olive or sunflower seas would be ideal
To me the big conclusion is that cholesterol did not go UP on a high olive oil diet. With all respect to Drs Esselton, Furhman, etc I'll continue to put OO on my vegetables.
The sad fact is you have so called health experts, doctors and the like that continually either encourage you or discourage you regarding foodstuffs, EVO being one of them, every one has a different point of view it's gets to the point that one doesn't know who to trust. Also everyone is different some can consume large amounts of EVO with no ill effects whereas others cannot, bottom line we the public are pig in the middle, never knowing who to believe for the better.🤔
"To me the big conclusion is that cholesterol did not go UP on a high olive oil diet. " Since the participants (most likely) switched from a way worse diet to the study diet this is the expected result, regardless of the OO. If, on the other hand, the participants switched from a plant-based diet without oil to a plant-based diet with OO I'd expect some changes for the worse.
Chris what insight did you get? Could you elaborate on what you took from this video/ trial? How you would use the information you got into your life?? Thanks and love plant chompers
I wonder the same thing. We know that weight loss already generally lowers cholesterol, so ... I would think the best way to narrow down to the effect of low oil vs more oil on cholesterol would be to not have people lose weight during the study.
True, I agree with that point. It could likely be that one group is eating a lower-calorie diet than the other. But I would say practically speaking, if you take it into population level. People don't realize how calory dens are the oils. They just used four tablespoons, which bumped up the calories so high. So, telling people that a low-oil diet is good for cholesterol and weight loss might translate into a positive thing because people won't start to overuse the oils that add so many unintentional calories.
I have a doctor whose credentials are rare - he was a Nutritionist first. I told him about this channel, and how it is my go to source for Nutrition, he wrote it down. My former doctor put me on blood pressure medication, which almost killed me, and told me I was wired for diabetes, and cardiovascular disease. I bought a Vitamix blender, and changed my diet. That was 14 years ago, I’m almost 65, and my recent blood work shows everything is great, my blood pressure is 117 over 72. Live Gill, so refreshing, and rare to find someone that looks at the research deeply, and doesn’t try to sell anything, or have any biases.
It feels so refreshing to listen to scientific facts/hypotheses being presented with the support of primary literature. So many pseudo-scientific channels out there claim that "a great deal of evidence supports the idea that [insert of favorite subject here]" without actually showing you the evidence. Gil does not expect you to trust him blindly. He actually shows the publications where he find his information, and lets your draw your own conclusions. This channel is about as scientific as it gets, and I love it for that. Don't change anything. Congratulations, and thank-you for the great work!
I don't have much faith in nutrition wash-out trials like this, because I think one week isn't enough time to really get back to baseline. Also, I don't think 4 weeks is really long enough to see the real, long-term effects of dietary patterns.
Many studies have found significant improvements in LDL cholesterol in little as 2 weeks. Obviously you can’t make long term predictions based on short term studies but LDL cholesterol changes quickly with diet changes, both good and bad.
The implication that the washout period effectively brought the subjects back to baseline was apparently based on the assessment of a lack of "statistical significance" between baseline and post-washout measures, which is a flawed/outmoded application of statistical methods.
In my opinion, me non-professional, I think the study was flawed as both groups should have maintained an equivalent caloric intake. Additionally, the washout period was too short. - Thanks for the review.
I completely agree, the calories were significantly lower for the low oil group. The weight loss in and of itself probably led to the majority of the lowering of LDL.
@@nikjovicic Force feeding? What are you talking about? There are many many studies done where the caloric intake is managed so it is equaled out between test groups. I think you may be new to clinical trial and how they are designed and carried out.
I know it's only my experience and it's not statistically significant, but I want to share with you all. I am wfpb since 5 years, I did one year of basically no oil where I only used one teaspoon in salads and my total cholesterol went to 126 with LDL value at 63. Then I added back some olive oil (and it's good quality oil, I am Italian and I buy it from a friend of mine that have a little oil mill), I cook with it (like 1 teaspoon and a half when I sautee veggies) and use it row on rice, lentils, salads etc. Now my total cholesterol is 148 and LDL is 73. So in my opinion oil does raise cholesterol (both LDL and HDL), but if you have s super healthy diet and maybe you are fairly active (i run 3 days a week and 1 day I do strength training) I don't think this is a problem. I don't know anyone that have values as good as mine, 148 total cholesterol would be a dream for most people.
Great video and great question. Olive oil does not raise cholesterol levels. In fact, it can help lower "bad" LDL cholesterol and increase "good" HDL cholesterol when consumed as part of a healthy diet. The monounsaturated fats in olive oil, particularly in extra virgin olive oil, have beneficial effects on heart health and lipid profiles.
@@Lambda_Ovine If the "noise" (additional calories) is too large, any adjustments to isolate the EVOO effect would be ineffective. C = B * log_2(1 + S / N) In this context, S stands for the EVOO effect (signal) and N for the calorie difference (noise). If N is much larger than S, then S / N becomes very small, making C (the ability to detect the EVOO effect) approach zero.
@@JohannaMueller57 That's a different question. Why ldl dropped more in low oil group can be explained by lower calories. Why the two periods were different is the mystery, which Gil covers possible reasons which likely stem from the design of the crossover study (downsides, too short washout period, etc).
Olive oil definitely increases my LDL cholesterol. When I added two tablespoons of EVOO to my WFPB diet to increase my calories when returning to the gym my LDL jumped from 90 to almost 120 mg/dL. There were no substitutes. I kept the amount of nuts and seeds the same. And I doubt going from being sedentary to exercising in the gym is what raise my cholesterol. I did this twice approximately five years apart with the same outcome. The problem with the trial is that they changed from a standard American diet, so of course, they saw a drop in LDL-C. I only changed two variables: 1) adding EVOO to add calories, 2) adding exercise.
64 yr. old female here with high cholesterol since first tested in my early forties. I tried a very low fat diet consisting of egg whites only and oatmeal, salad for lunch with 1 tbsp of olive oil and tilapia and vegetables for dinner. I also ate about 10 walnuts a day. When the Dr. called with my results my cholesterol had gone up 100 points! It was so shocking. I have been told I was a hyper absorber not an over producer per Boston Heart. I think it was the refined olive oil that my body just sucked up. Went back to normal diet with whole eggs and meat with veges and fruit and it went back down. I dont eat any refined fats like oils and butter or even nut butters anymore.
This is a great study and video, as always. However, something to keep in mind, just because EVOO doesn't impact LDL, that doesn't mean it doesn't impact other things. Obviously, the additional calories can impact weight, as Dr. Carvalho mentioned, which obviously has a slew of health consequences if excessive. Just because X helps with Y, doesn't mean X is net positive for health. I see people making this mistake a lot, so I thought I would mention that here.
I was told that a switch to plant based diet takes you microbiome (gut) about 4 weeks to adapt, the timeframe of this study is much too short in my opinion
Having been a lab scientist all my life, I love a good study. What this does point out to me is that it continues to be really hard to control for all variables without locking people up in a room for several weeks or months and totally controlling everything they eat and drink for that time period. Of course, that type of study is more difficult to recruit volunteers for and is also more expensive. Teasing out the effect of EVOO itself is going to be difficult.
Happy to hear the headlines do not match the actual findings of the study. I'll stick with a moderate amount of olive oil. My cholesterol numbers are in range (used to run high before I overhauled my diet) and my weight is stable.
Pls consider this. There are tons of brands that tout “premium, even cold pressed” olive oil. How about where the olives came from or how much time before they’re processed after they’ve been picked, and many mix these oils with other polyunsaturated seed oils, selling them in cheap transparent plastic bottles .
Just curious…did they look at other lipid parameters like TGs and HDL? APO-B versus LDL comparison was brilliant, but I wonder if the same trend was seen with the TGs (?) and if HDL was increased by this intervention? I realize the real clinical role of HDL as “cardioprotective” is controversial, but I wonder how its values would have fared in this trial. Thank you! Great analysis!
I wanna see more trials looking at oil vs no oil. The vast majority of oil studies look at oil vs another oil so we need more of this. I wanna see more with calories kept constant though and more other metrics of health as well. We personally eat very low oil in our house but we keep our calories in a good range and on the higher end since we are fairly active. Looking forward to more research on this topic.
Nice breakdown of the study. Just from my personal experience I feel like olive oil helps with memory and cognition but it's worst for athletic performance, especially if you use too much you can really feel sluggish after a meal, but I usually eat very low fat so that's why I can really tell the difference
With that calorie difference, I very much doubt the low oil group did anything other than starve people into lower LDL. You can talk about compensation all you want, but that's very hard to do.
I am convinced that olive oil can raise cholesterol levels. I cut back my use of it by about 75-80% and my cholesterol level dropped significantly. There was a 6 month period between the two blood tests for lipid panel.
Thanks for bringing this study to us. It will be interesting to see the results if they redo the study with a larger group and maybe some other improvements.
I would have said "It would have been more interesting if they published results from their final study rather than the preliminary study that should have been the basis for any serious funding."
Could there be a difference between groups in regards of how much their LDL respond to dietary changes? It's a risk with small groups. That could possibly contribute to the differences in the effects of the diets between the two periods.
Do we know if total saturated fat intake was kept the same between groups? The study says there was "slightly greater intake of saturated fat during the high EVOO period" - but how much greater?
The caloric difference alone makes it difficult to say that olive oil is bad for you. If the calories were even, there would be much more to say, either way. Ideally, the subjects would be at maintenance calories. I think this also explains some of the 2nd period. Both groups were probably in caloric deficits, which we know improve many biomarkers. I know personally My maintenance calories are around 2500-2700, so both interventions would put me in a severe caloric deficit. I can't take much, if anything, from this study.
My cholesterol was in the 215 range and I decided to go plant based. I eliminated most all meat (little smoked salmon) and dairy. My cholesterol dropped to 150 in about 4 months and has remained there for five years on a similar plant based diet.
My perspective is that the primary benefit that EVOO confers is the polyphenols, which probably has diminishing returns each tablespoon you take. Much bigger benefit to your body going from 0 to 1 tablespoons than from 3 to 4. So optimal intake is probably 1-2 tablespoons a day. After that it's probably healthier to get your fat calories from other sources. Note: do your research and try to find an olive oil with at least 300-400 mg polyphenols, or else it's a wasted effort. Almost all of the olive oils you can buy in your local grocery store have close to 0 polyphenols. It's better to shop online for EVOO, in my experience.
What about the effects on HDL. Did that increase? Because an increase in HDL and even a slight lowering of LDL would be quite significant. Also triglycerides, what happened to those. Also the type of extra virgin olive oil? As the quality really matters. Cheap extra virgin olive oils mostly are not good…buy good quality Greek/Spanish oils. The difference is mind blowing
well, if more evidence and future studies support this, I for sure won't stop cooking with oil (not 4 tbsp daily tho, that's a lot), I already gave up a bunch of stuff I used to love, giving up cooking with oil would make my food so insipid as to make it not worth it keeping my diet
It’s important to note that the study didn’t provide clear conclusions because it was not statistically significant. This means that no definitive results were found regarding the impact of EVOO compared to a calorie deficit. The only takeaway is that the effect of EVOO might be smaller than the effect of reducing calories. Future studies with better designs are needed to explore this further.
Dumb question? Given the groups had high risk of developing atherosclerosis, it is likely their regular diets were far removed from vegetarian status. Therefore, an abrupt shift to the vegetarian diet would have caused substantial changes in gut microfibre composition. Perhaps microflora-associated metabolic changes contributed to rapid responses in the 1st 4 weeks. However, with only a week of their regular diet (some may have eaten partially healthy if they saw weight improvements?), in the washout, gut microflira composition would have less time to revert. As such, in the second phase, gut microflora composition change was less extensive, and therefore had less effect on starting LDL-C reduction (etc).
In fact, the implication that the washout period effectively brought the subjects back to baseline in terms of the study measures themselves was apparently based on the assessment of a lack of "statistical significance" between baseline and post-washout measures, which is a flawed/outmoded application of statistical methods.
What cooking fat do you recommend that won't increase sdLDL or ApoB levels, since evidently EVOO is too unstable to be used as a high heat cooking fat. My ApoB is 134.
Looks like the washout should have been 4 weeks instead of 1. With regards to fat, I wonder if it is the addition of added oil that is an issue rather than the fat naturally contained in plant foods. Fructose in the context of whole fruits isn't a problem, but add concentrated fructose to foods and drinks then it seems to be. I'm wondering if it is the same issue with added oils.
Couldn't the big drop for the first group just be from the low calories and they lost more weight over the 4 weeks, and nothing to do with the olive oil? Strange they didn't make both groups eat the same number of calories...
If you rely on an average to estimate the calorie effect, residual uncertainty always remains, especially with a small sample size. According to information theory, if this uncertainty (noise) is larger than the actual EVOO effect (signal), it becomes impossible to accurately measure the EVOO effect.
In theory, this is the basis for the use of power calculations in the design of randomized trials. (In practice, classical power calculations are based on an arbitrary determination of how much "signal" would be clinically significant, so the use of non-binary measures of association (e.g., confidence intervals) that specify a range of possible effect ("signal") sizes is generally preferred to measures of "statistical significance" by modern epidemiologists and other specialists in biomedical study design and analysis. There is also the option of meta-analysis to contend with inadequate sample sizes.)
Thanks for the video. I think there are too many variables. What about oil combined with other fats, is it worse or better? It's just too hard even in a crossover diet of such a short duration to develop any significant findings. Interesting but certainly not especially conclusive, I still don't know if it's better or worse. Esselstyn, Ornish and Bernard have been banning oil for years but maybe they're wrong too. The thing is they've had a lot more time to study it with a larger audience, I tend to lean their way personally and dismiss this study for the most part.
100%. Weight loss is king. Doesn't matter what you eat. If you stick to whatever diet and lose weight your metabolic markers improve. Calories matter. Just a massive oversight.
Nice video with promising data, but I would redpectfully suggest that this could easily have been 9-10' long with just a little attention to brevity of communication.
Super interesting. Many thanks for sharing Dr Carvalho. I just started monkeying around with a 3 day sardine fast using EVO to bump up calories. I am doing it to reset my metabolism and average out my calories to a weekly maintenance and prevent a calorie surplus. I wonder if the omega3 content of the sardines intake may mitigate the potential ldl increase from the EVO. No way to know as I don’t plan to implement this beyond 3 days. Also, I don’t have acess to assess blood levels pre and post to see how the ld/apo B level would be effected
Variety is the spice of life and enjoying life is a must. If you have variety, you use moderate amounts of all kinds of different food. Olive oil is fine, just don't overdo it. Food can be tedious if we analyse it to death. Or it can be enjoyable, if we eat food that tastes great and is high quality. Exercise can be a chore, unless you find exercise that you love. Even fasting can be rewarding because if you don't eat between meals, your appetite is acute at meals and the food tastes better. Eating more vegetables isn't boring if you consider how many vegetables are out there, and all the combinations that are possible for vegetable dishes. High quality food can be expensive, unless we eat less of it and chose the right kinds that are delicious, and good for you.
Substituting EVOO which has 14% saturated fat for an equal amount of butter with almost 70% saturated fat will reduce LDL. Adding an additional 1/4 cup of olive oil per day will increase saturated fat intake. Combine that with a hefty increase in energy intake as well and it's not surprising that LDL rose. I'm going to keep using olive oil in reasonable amounts unless a much better study finds some reason not to.
they ask different questions. isocaloric experiments probe calorie-independent mechanisms. ad libitum experiments are more reflective of real life but exact cause is less clear. statistical adjustments like the one they applied can lower uncertainty but never eliminate entirely
I'm sure I've missed people talking about this but I do see a lot of mention of olive oil as used in the Mediterranean diet in nutrition circles as well as the benefits of vinegar. But I don't see anybody ever mentioned how common it is to have oil and vinegar dressing with a bit of pepper in it and how common that is in the Mediterranean diet. Common on salads and steaks
It would be interesting to evaluate the quality of the E.V.O.O. -being organic or not, whether it was cold pressed, the soil where the olives are grown, ( effecting its nutritional profile) its production age & expiry, whether it was mixed oils from different area, ( which is common, where low quality oils are included ) or a single olive oil source, whether it's stored in dark glass bottles to avoid degradation, & avoiding the effect of plastic storage for multiple reasons. Lots of factors will have an effect on the results, and all are impactful.
The kcal difference bertween low and high oil is ~25%, that is a huge difference. Isn't kcal intake one of the biggest factors in blood markers? How much can any differences really be attributed to the type of food then?
Is it possible the olive oil acts as a sort of bufferer, which would delay the systematic changes of the switch in diet? So if you measure for long enough, they would eventually end at the same result?
I would love a similar study on the effect of consuming cheese in the diet on blood work since there is an inverse correlation between cheese (and perhaps yogurt) consumption and heart disease. This is thought to be because of calcium binding with the fat during fermentation. I'd love your thoughts on this.
Not the case for me, being a WFPB vegan for 14 years and counting. I use homemade oil free vegetable broth, aquafaba, herbs and spices to season my oil-free cooking. The rare times I have consumed vegan take out with any oils, my stomach revolts, my skin breaks out and I have increased inflammation and pain that lasts for at least a week. It takes time though, like any lifestyle changes, to get used to cooking without oil. I love my air fryer!
Interesting thank you. I would go a step further than you. The trial population size is so very small nothing more than an indication as to whether or not it is worth doing a study with a decent sized population can be drawn from this. Hopefully more will be done in this area. Thanks for covering this.
A real professional who incorporates Unbiased analysis. A rare find on UA-cam..
Physionics is another one
Dont let dr berg fanboys read this, they might have a stroke
Main finding I got was - "not statistically significant " for everything.
Need to power up the test more, as they are planning.
I just discovered your channel and am watching all your videos I love how you explain things without being dogmatic or judgemental
Are you sure about that.
@@Terry-ho7dsLong time watcher, and I've definitely find that to be the case.
You found a gem of a channel bro! Enjoy the unbiased nutrition info!
I did a strict vegan diet that included no added oil or nuts or other higher fat plants for 8 months. I lost nearly 20 pounds, going from the high end of normal bmi to the low end. My purpose was to bring down my cholesterol to get my doctors off my back regarding statins. My total cholesterol went down to about 200 and my ldl went down to 116 in four months. The negative consequences were that my menstruation stopped and all of my tissues, skin, eyes, etc. became very dry. I went on vacation about 8 months in and added back in olive oil, nuts, avocado to make things easier and my menstruation returned. After adding in the healthy plant fats, my cholesterol only increased two points and my ldl went down further to 106.
Maybe you should skip the olive oil and replace with flax, chia, and hemp seeds to get your ALA. ALA is an essential fatty acid and there doesn't seem to be much in your diet (even if the nuts are walnuts). Do you get any EPA or DHA? No wonder that you had health problems.
That's actually the study I want to see.
So maybe we need to cycle those foods in and out?
I'm on this exact same diet. I was 198 lbs at the beginning of the diet and now hover around 172 lbs. I've lost over 25 lbs in 3 months. I've tried low carb diets, keto carnivore combined with OMAD and nothing seemed to work significantly. This one works really well. The drawback is going out to restaurants is pretty well impossible.
My hunch is that reintroducing nuts and high fat plants like avocados or what ever , started to give you essential nutrients required . Just leaving out pure oils is all that's required , while still eating the odd olive or sunflower seas would be ideal
To me the big conclusion is that cholesterol did not go UP on a high olive oil diet. With all respect to Drs Esselton, Furhman, etc I'll continue to put OO on my vegetables.
The sad fact is you have so called health experts, doctors and the like that continually either encourage you or discourage you regarding foodstuffs, EVO being one of them, every one has a different point of view it's gets to the point that one doesn't know who to trust. Also everyone is different some can consume large amounts of EVO with no ill effects whereas others cannot, bottom line we the public are pig in the middle, never knowing who to believe for the better.🤔
"To me the big conclusion is that cholesterol did not go UP on a high olive oil diet. " Since the participants (most likely) switched from a way worse diet to the study diet this is the expected result, regardless of the OO. If, on the other hand, the participants switched from a plant-based diet without oil to a plant-based diet with OO I'd expect some changes for the worse.
What an awesome analysis! 👏 So much insight in so little time.
Chris what insight did you get? Could you elaborate on what you took from this video/ trial? How you would use the information you got into your life?? Thanks and love plant chompers
Thank God your channels out there
im confused why they didnt equate calories, isnt that an important and potentially confounding variable with something like ldl?
I wonder the same thing. We know that weight loss already generally lowers cholesterol, so ... I would think the best way to narrow down to the effect of low oil vs more oil on cholesterol would be to not have people lose weight during the study.
Maybe they couldn't find anyone who was honest about their daily calorie intake.
Certainly has an impact
Impact on many blood markers if you’re doing this type of study. Having different caloric intakes isn’t controlling adequately
True, I agree with that point. It could likely be that one group is eating a lower-calorie diet than the other.
But I would say practically speaking, if you take it into population level. People don't realize how calory dens are the oils. They just used four tablespoons, which bumped up the calories so high. So, telling people that a low-oil diet is good for cholesterol and weight loss might translate into a positive thing because people won't start to overuse the oils that add so many unintentional calories.
Agreed. The only thing that makes a difference here is the big discrepancy with calories consumed. The difference seems big.
I have a doctor whose credentials are rare - he was a Nutritionist first. I told him about this channel, and how it is my go to source for Nutrition, he wrote it down. My former doctor put me on blood pressure medication, which almost killed me, and told me I was wired for diabetes, and cardiovascular disease. I bought a Vitamix blender, and changed my diet. That was 14 years ago, I’m almost 65, and my recent blood work shows everything is great, my blood pressure is 117 over 72. Live Gill, so refreshing, and rare to find someone that looks at the research deeply, and doesn’t try to sell anything, or have any biases.
It feels so refreshing to listen to scientific facts/hypotheses being presented with the support of primary literature. So many pseudo-scientific channels out there claim that "a great deal of evidence supports the idea that [insert of favorite subject here]" without actually showing you the evidence. Gil does not expect you to trust him blindly. He actually shows the publications where he find his information, and lets your draw your own conclusions. This channel is about as scientific as it gets, and I love it for that. Don't change anything. Congratulations, and thank-you for the great work!
I don't have much faith in nutrition wash-out trials like this, because I think one week isn't enough time to really get back to baseline. Also, I don't think 4 weeks is really long enough to see the real, long-term effects of dietary patterns.
yes 1 week seems to not have sufficed, the authors concluded this also
@@NutritionMadeSimple Interesting. Thanks.
Many studies have found significant improvements in LDL cholesterol in little as 2 weeks. Obviously you can’t make long term predictions based on short term studies but LDL cholesterol changes quickly with diet changes, both good and bad.
@@NutritionMadeSimple good of you to note that. So: interesting, but nothing more, no conclusions to be drawn.
The implication that the washout period effectively brought the subjects back to baseline was apparently based on the assessment of a lack of "statistical significance" between baseline and post-washout measures, which is a flawed/outmoded application of statistical methods.
The big question remaining is, What about all the other benefits of olive oil? Like its anti-inflammatory effects?
Thank you for finding a way to talk to the first author
In my opinion, me non-professional, I think the study was flawed as both groups should have maintained an equivalent caloric intake. Additionally, the washout period was too short. - Thanks for the review.
I completely agree, the calories were significantly lower for the low oil group. The weight loss in and of itself probably led to the majority of the lowering of LDL.
Exactly! The low oil group was consuming 3000 less calories per week! How is that specifically a test of the effect of oil, vs caloric restriction??
Studies like this are ok, problem is all studies are like this and you can't compare them to a study like what you speak of.
Forrce feeding them? Could You please explain how would You do that ethically?
@@nikjovicic Force feeding? What are you talking about? There are many many studies done where the caloric intake is managed so it is equaled out between test groups. I think you may be new to clinical trial and how they are designed and carried out.
I know it's only my experience and it's not statistically significant, but I want to share with you all. I am wfpb since 5 years, I did one year of basically no oil where I only used one teaspoon in salads and my total cholesterol went to 126 with LDL value at 63. Then I added back some olive oil (and it's good quality oil, I am Italian and I buy it from a friend of mine that have a little oil mill), I cook with it (like 1 teaspoon and a half when I sautee veggies) and use it row on rice, lentils, salads etc. Now my total cholesterol is 148 and LDL is 73. So in my opinion oil does raise cholesterol (both LDL and HDL), but if you have s super healthy diet and maybe you are fairly active (i run 3 days a week and 1 day I do strength training) I don't think this is a problem. I don't know anyone that have values as good as mine, 148 total cholesterol would be a dream for most people.
Thanks, you're a very good teacher.
I love every analysis you do!
So clear, beautifully explained.
🙏
I think moderation is key. Just don`t use to much an keep it happy and healthy.
Researchers who did the work should get on videos, give them some credit too. Thanks you for explaining this info to us.
Great video and great question. Olive oil does not raise cholesterol levels. In fact, it can help lower "bad" LDL cholesterol and increase "good" HDL cholesterol when consumed as part of a healthy diet. The monounsaturated fats in olive oil, particularly in extra virgin olive oil, have beneficial effects on heart health and lipid profiles.
Small sample size. The small amount of calories is (1300) probably the biggest variable. Not the change in evoo.
The diet change itself too could be the driving force regardless of evoo
Thank you for your considered expert analysis.
I've started Dr.Neil Bernard's book & will try his recommendations out...eating high good fats has not helped my liver or cholesterol health. 😮
His book has helped me a lot in many ways.
Great as always
Low oil group was very low in calories, they mainly dropped weight this might play a big role in cholesterol levels.
this factor was addressed on the video
how does that explain the difference between the two periods?
@@Lambda_Ovine If the "noise" (additional calories) is too large, any adjustments to isolate the EVOO effect would be ineffective. C = B * log_2(1 + S / N) In this context, S stands for the EVOO effect (signal) and N for the calorie difference (noise). If N is much larger than S, then S / N becomes very small, making C (the ability to detect the EVOO effect) approach zero.
I would be more interested to know how endotheial function was effected by the high intake group.
@@JohannaMueller57 That's a different question. Why ldl dropped more in low oil group can be explained by lower calories. Why the two periods were different is the mystery, which Gil covers possible reasons which likely stem from the design of the crossover study (downsides, too short washout period, etc).
as someone who is studying data analysis in research these kinda vidoes actually benifit me a lot
I recently switched from extra virgin olive oil to avocado oil . My LDL and HDL both bumped up by 1 and my triglycerides dropped by about 20
I love olive oil 🫒
Aye you and millions more of us.🤔
How much variation was there within each group? What do the scatter plots look like? Were outliers snd anomalies included? What did they look like?
Great video, really appreciate you going to the trouble of contacting the authors. Please do a video on the big study when it's published.
Olive oil definitely increases my LDL cholesterol.
When I added two tablespoons of EVOO to my WFPB diet to increase my calories when returning to the gym my LDL jumped from 90 to almost 120 mg/dL. There were no substitutes. I kept the amount of nuts and seeds the same. And I doubt going from being sedentary to exercising in the gym is what raise my cholesterol. I did this twice approximately five years apart with the same outcome.
The problem with the trial is that they changed from a standard American diet, so of course, they saw a drop in LDL-C. I only changed two variables: 1) adding EVOO to add calories, 2) adding exercise.
You say you added two tablespoons of EVOO to your diet, but is that two a day? Or a week? Thanks.
64 yr. old female here with high cholesterol since first tested in my early forties. I tried a very low fat diet consisting of egg whites only and oatmeal, salad for lunch with 1 tbsp of olive oil and tilapia and vegetables for dinner. I also ate about 10 walnuts a day. When the Dr. called with my results my cholesterol had gone up 100 points! It was so shocking. I have been told I was a hyper absorber not an over producer per Boston Heart. I think it was the refined olive oil that my body just sucked up. Went back to normal diet with whole eggs and meat with veges and fruit and it went back down. I dont eat any refined fats like oils and butter or even nut butters anymore.
This is a great study and video, as always. However, something to keep in mind, just because EVOO doesn't impact LDL, that doesn't mean it doesn't impact other things. Obviously, the additional calories can impact weight, as Dr. Carvalho mentioned, which obviously has a slew of health consequences if excessive. Just because X helps with Y, doesn't mean X is net positive for health. I see people making this mistake a lot, so I thought I would mention that here.
I was told that a switch to plant based diet takes you microbiome (gut) about 4 weeks to adapt, the timeframe of this study is much too short in my opinion
Having been a lab scientist all my life, I love a good study. What this does point out to me is that it continues to be really hard to control for all variables without locking people up in a room for several weeks or months and totally controlling everything they eat and drink for that time period. Of course, that type of study is more difficult to recruit volunteers for and is also more expensive. Teasing out the effect of EVOO itself is going to be difficult.
Happy to hear the headlines do not match the actual findings of the study. I'll stick with a moderate amount of olive oil. My cholesterol numbers are in range (used to run high before I overhauled my diet) and my weight is stable.
Is there anything left we can eat?
Ice cubes
Dr Esselstyn has entered the chat
Bryan Johnson takes back the Blueprint to the drawing table.
Pls consider this. There are tons of brands that tout “premium, even cold pressed” olive oil. How about where the olives came from or how much time before they’re processed after they’ve been picked, and many mix these oils with other polyunsaturated seed oils, selling them in cheap transparent plastic bottles .
Does this redeem Esselstyn?
Better if longer trial, larger numbers, calories equaled and much longer crossover washout period. Hope they do this
Sounds like they need to rely less on classical methods of study design, such as the "power calculations" that you learn about in Biostatistics 101...
Just curious…did they look at other lipid parameters like TGs and HDL? APO-B versus LDL comparison was brilliant, but I wonder if the same trend was seen with the TGs (?) and if HDL was increased by this intervention? I realize the real clinical role of HDL as “cardioprotective” is controversial, but I wonder how its values would have fared in this trial. Thank you! Great analysis!
I wanna see more trials looking at oil vs no oil. The vast majority of oil studies look at oil vs another oil so we need more of this.
I wanna see more with calories kept constant though and more other metrics of health as well. We personally eat very low oil in our house but we keep our calories in a good range and on the higher end since we are fairly active. Looking forward to more research on this topic.
4 tablespoons is a LOT, and this sort of examination of extremes says nothing about the usual recommendation of 1-2 tablespoons of olive oil.
Please review Bragg Liquid Aminos. Uses, advantages, negatives, etc.
Nice breakdown of the study. Just from my personal experience I feel like olive oil helps with memory and cognition but it's worst for athletic performance, especially if you use too much you can really feel sluggish after a meal, but I usually eat very low fat so that's why I can really tell the difference
With that calorie difference, I very much doubt the low oil group did anything other than starve people into lower LDL. You can talk about compensation all you want, but that's very hard to do.
I am convinced that olive oil can raise cholesterol levels. I cut back my use of it by about 75-80% and my cholesterol level dropped significantly. There was a 6 month period between the two blood tests for lipid panel.
My cholesterol dropped using extra virgin olive oil
Thanks for bringing this study to us. It will be interesting to see the results if they redo the study with a larger group and maybe some other improvements.
I would have said "It would have been more interesting if they published results from their final study rather than the preliminary study that should have been the basis for any serious funding."
Could there be a difference between groups in regards of how much their LDL respond to dietary changes? It's a risk with small groups. That could possibly contribute to the differences in the effects of the diets between the two periods.
Do we know if total saturated fat intake was kept the same between groups?
The study says there was "slightly greater intake of saturated fat during the high EVOO period" - but how much greater?
The caloric difference alone makes it difficult to say that olive oil is bad for you. If the calories were even, there would be much more to say, either way. Ideally, the subjects would be at maintenance calories. I think this also explains some of the 2nd period.
Both groups were probably in caloric deficits, which we know improve many biomarkers. I know personally My maintenance calories are around 2500-2700, so both interventions would put me in a severe caloric deficit.
I can't take much, if anything, from this study.
My cholesterol was in the 215 range and I decided to go plant based. I eliminated most all meat (little smoked salmon) and dairy. My cholesterol dropped to 150 in about 4 months and has remained there for five years on a similar plant based diet.
did you lose weight?
My perspective is that the primary benefit that EVOO confers is the polyphenols, which probably has diminishing returns each tablespoon you take. Much bigger benefit to your body going from 0 to 1 tablespoons than from 3 to 4.
So optimal intake is probably 1-2 tablespoons a day. After that it's probably healthier to get your fat calories from other sources.
Note: do your research and try to find an olive oil with at least 300-400 mg polyphenols, or else it's a wasted effort. Almost all of the olive oils you can buy in your local grocery store have close to 0 polyphenols. It's better to shop online for EVOO, in my experience.
What about the effects on HDL. Did that increase? Because an increase in HDL and even a slight lowering of LDL would be quite significant. Also triglycerides, what happened to those. Also the type of extra virgin olive oil? As the quality really matters. Cheap extra virgin olive oils mostly are not good…buy good quality Greek/Spanish oils. The difference is mind blowing
well, if more evidence and future studies support this, I for sure won't stop cooking with oil (not 4 tbsp daily tho, that's a lot), I already gave up a bunch of stuff I used to love, giving up cooking with oil would make my food so insipid as to make it not worth it keeping my diet
It’s important to note that the study didn’t provide clear conclusions because it was not statistically significant. This means that no definitive results were found regarding the impact of EVOO compared to a calorie deficit. The only takeaway is that the effect of EVOO might be smaller than the effect of reducing calories. Future studies with better designs are needed to explore this further.
Another excellent video. Thank you!
Dumb question?
Given the groups had high risk of developing atherosclerosis, it is likely their regular diets were far removed from vegetarian status. Therefore, an abrupt shift to the vegetarian diet would have caused substantial changes in gut microfibre composition. Perhaps microflora-associated metabolic changes contributed to rapid responses in the 1st 4 weeks.
However, with only a week of their regular diet (some may have eaten partially healthy if they saw weight improvements?), in the washout, gut microflira composition would have less time to revert. As such, in the second phase, gut microflora composition change was less extensive, and therefore had less effect on starting LDL-C reduction (etc).
Interesting supposition.
Which part was the dumb question?
In fact, the implication that the washout period effectively brought the subjects back to baseline in terms of the study measures themselves was apparently based on the assessment of a lack of "statistical significance" between baseline and post-washout measures, which is a flawed/outmoded application of statistical methods.
Would be nice too see the intake of protein and carbs as well. And both groups having same caloric intake would give more insights.
What cooking fat do you recommend that won't increase sdLDL or ApoB levels, since evidently EVOO is too unstable to be used as a high heat cooking fat. My ApoB is 134.
The concept of convexity applies to this experiment?
I don't think comparing % of macronutrients is useful if calories are not equated.
Aside from lipids, which may be wash, what are the other benefits of EVOO, or whole olives?
Does daily use of olive oil lower the risk of a heart attack?
Looks like the washout should have been 4 weeks instead of 1. With regards to fat, I wonder if it is the addition of added oil that is an issue rather than the fat naturally contained in plant foods. Fructose in the context of whole fruits isn't a problem, but add concentrated fructose to foods and drinks then it seems to be. I'm wondering if it is the same issue with added oils.
Couldn't the big drop for the first group just be from the low calories and they lost more weight over the 4 weeks, and nothing to do with the olive oil?
Strange they didn't make both groups eat the same number of calories...
Thanks Dr!
Thank you, it was interesting
Yeah, but as you always say; the question is what will you replace the olive oil with? From what will the difference in calories come from?
If you rely on an average to estimate the calorie effect, residual uncertainty always remains, especially with a small sample size. According to information theory, if this uncertainty (noise) is larger than the actual EVOO effect (signal), it becomes impossible to accurately measure the EVOO effect.
In theory, this is the basis for the use of power calculations in the design of randomized trials. (In practice, classical power calculations are based on an arbitrary determination of how much "signal" would be clinically significant, so the use of non-binary measures of association (e.g., confidence intervals) that specify a range of possible effect ("signal") sizes is generally preferred to measures of "statistical significance" by modern epidemiologists and other specialists in biomedical study design and analysis. There is also the option of meta-analysis to contend with inadequate sample sizes.)
Thanks for the video.
I think there are too many variables. What about oil combined with other fats, is it worse or better? It's just too hard even in a crossover diet of such a short duration to develop any significant findings. Interesting but certainly not especially conclusive, I still don't know if it's better or worse. Esselstyn, Ornish and Bernard have been banning oil for years but maybe they're wrong too. The thing is they've had a lot more time to study it with a larger audience, I tend to lean their way personally and dismiss this study for the most part.
The "Twinkie Diet" worked at 1800 Cal. Missed opportunity due to poor design & 1300 Cal
100%. Weight loss is king. Doesn't matter what you eat. If you stick to whatever diet and lose weight your metabolic markers improve. Calories matter. Just a massive oversight.
Nice video with promising data, but I would redpectfully suggest that this could easily have been 9-10' long with just a little attention to brevity of communication.
Thanks very much!
Did they have a look at HDL levels?
The crossover results are interesting but I’d like to see benefits of using oil or not using oil in a longer study. Not switching back and forth.
Super interesting. Many thanks for sharing Dr Carvalho. I just started monkeying around with a 3 day sardine fast using EVO to bump up calories. I am doing it to reset my metabolism and average out my calories to a weekly maintenance and prevent a calorie surplus. I wonder if the omega3 content of the sardines intake may mitigate the potential ldl increase from the EVO. No way to know as I don’t plan to implement this beyond 3 days. Also, I don’t have acess to assess blood levels pre and post to see how the ld/apo B level would be effected
Variety is the spice of life and enjoying life is a must. If you have variety, you use moderate amounts of all kinds of different food. Olive oil is fine, just don't overdo it. Food can be tedious if we analyse it to death. Or it can be enjoyable, if we eat food that tastes great and is high quality. Exercise can be a chore, unless you find exercise that you love. Even fasting can be rewarding because if you don't eat between meals, your appetite is acute at meals and the food tastes better. Eating more vegetables isn't boring if you consider how many vegetables are out there, and all the combinations that are possible for vegetable dishes. High quality food can be expensive, unless we eat less of it and chose the right kinds that are delicious, and good for you.
Were calories corrected for? The glucose effect seems to be related to calories as well
The issue with this study is the caloric discrepancy between groups and short duration.
Substituting EVOO which has 14% saturated fat for an equal amount of butter with almost 70% saturated fat will reduce LDL. Adding an additional 1/4 cup of olive oil per day will increase saturated fat intake. Combine that with a hefty increase in energy intake as well and it's not surprising that LDL rose. I'm going to keep using olive oil in reasonable amounts unless a much better study finds some reason not to.
Very interested in this topic. Especially in relation to lipoprotein a
I can't understand why they did not make total calories equal between the 2 groups. Was there some rationale behind this strategy?
they ask different questions. isocaloric experiments probe calorie-independent mechanisms. ad libitum experiments are more reflective of real life but exact cause is less clear. statistical adjustments like the one they applied can lower uncertainty but never eliminate entirely
Maybe a second look at the compositon of the quality of individual oils
Wonder if water weight might be a factor.
Thank goodness! For a minute I thought you were going to conclude that olive oil raises cholesterol! Phew!
As a side note, at the 13:58 mark, you said “the reality” just like Christopher Walken would. 😊
I'm sure I've missed people talking about this but I do see a lot of mention of olive oil as used in the Mediterranean diet in nutrition circles as well as the benefits of vinegar. But I don't see anybody ever mentioned how common it is to have oil and vinegar dressing with a bit of pepper in it and how common that is in the Mediterranean diet. Common on salads and steaks
It would be interesting to evaluate the quality of the E.V.O.O. -being organic or not, whether it was cold pressed, the soil where the olives are grown, ( effecting its nutritional profile) its production age & expiry, whether it was mixed oils from different area, ( which is common, where low quality oils are included ) or a single olive oil source, whether it's stored in dark glass bottles to avoid degradation, & avoiding the effect of plastic storage for multiple reasons. Lots of factors will have an effect on the results, and all are impactful.
This lesser drop from baseline on high olive oil is due to the high calorie from oil itself ?
The kcal difference bertween low and high oil is ~25%, that is a huge difference. Isn't kcal intake one of the biggest factors in blood markers? How much can any differences really be attributed to the type of food then?
Is it possible the olive oil acts as a sort of bufferer, which would delay the systematic changes of the switch in diet? So if you measure for long enough, they would eventually end at the same result?
So olive oil is mildly virtuous wrt CVD. It is a vaso constrictor though.
What about flaxseed oil ?
I would love a similar study on the effect of consuming cheese in the diet on blood work since there is an inverse correlation between cheese (and perhaps yogurt) consumption and heart disease. This is thought to be because of calcium binding with the fat during fermentation. I'd love your thoughts on this.
No or very low oil on strict vegan is very difficult to maintain! My anecdotal 2 cents!😊
Not the case for me, being a WFPB vegan for 14 years and counting. I use homemade oil free vegetable broth, aquafaba, herbs and spices to season my oil-free cooking. The rare times I have consumed vegan take out with any oils, my stomach revolts, my skin breaks out and I have increased inflammation and pain that lasts for at least a week. It takes time though, like any lifestyle changes, to get used to cooking without oil. I love my air fryer!
It still appears like olive oil might raise LDL vs. no the low oil diet, doesn't it?
Always worried when I watch your videos, as they often shatter my beliefs what is a healthy diet 😢.
I purchased Sam’s extra virgin for years. My lipids were sketchy. 1 yr ago I switched to only canola. My lipids changed dramatically for the best.
I would say the only take away is that you have to be mindful that incorporating olive oil into your diet may lead to increased overall calorie intake
Interesting thank you. I would go a step further than you. The trial population size is so very small nothing more than an indication as to whether or not it is worth doing a study with a decent sized population can be drawn from this.
Hopefully more will be done in this area.
Thanks for covering this.