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May 19, 2010


Olive oil, canola oil, butter, no oil ...

Ornish, Atkins, Esselstyn ...

Why can't all the experts agree on anything?

Jim Purdy


I'm sorry to hear about your cholesterol numbers. That must have felt like a setback for you after all your efforts you kindly post. But, just think, it might have been much worse if you weren't as strict as you already are.

But, as usual, something adverse also brings something good and you now have that invitation from Dr.Esselstyn.

What I found very surprising in you article was the fact you weren't "allowed" to have a cholesterol test for 2.5 years!

For all the criticism of our (wonderful) NHS both here in the UK and recently from some in the US, this is not a problem we face here. I'm not saying one system is better than another, nor that ours does not have its problems. But, maybe the prevention message is a little stronger here.

Keep up the good work!

Steven at Positive Massage Therapy

As a pure speculation, I would blame the eating out more than what you have at home.

One unproven opinion I hold is that eating out is nutritional Russian roulette. No matter what the server says, assume what you order has high quantities of everything you want to avoid. Even knowing what's in the food, there's a psychological disconnect between that knowledge and the finished dish on your plate that is avoided when you prepare your own food.

My diet has large amounts of nuts, seeds, and olive oil, and yet my cholesterol is in the 120's. Of course, as you mention, everyone is different.

Positive Massage Therapy

Ken Leebow

Yes, eating out is one of the worst. Even when you get vegetables, they are loaded with butter, salt, and other assorted mystery toppings.

Please give Dr. Esselsytn my regards. He was the first doctor who I have ever heard discuss getting total cholesterol down to 150. My doc certainly did not. My doc told me it was mostly related to genes. Oops, got mine from 202 to 155 in less than six months.

Thank you Dr. Esselstyn! And good luck to you...Debby.

Ken Leebow


It seems that European cultures feel that there must be some form of fat in everything. I have struggled with that and my solution is eat Asian food -- noodles in broth is good. So is pasta in Tomato sauce which you can buy with very little fat added -- though not zero.
Try Japanese Soba (Buckwheat noodles) cooked in broth and served in dipping sauce. Or Udon cooked the same. It is possible to make a vegan broth, though that is not the most common kind.
The best source for this that I have seen is:
It has a couple of truly delicious fat-free recipes. I find those very hard to find. And these are easy to make.

Gael in Vermont

I, too, was feeling quite cocky going into my lipid profile last month. Yes, indeed, my total cholesterol numbers came down but my LDL went up! And I am eating a full force vegan-plant-based-gluten free diet. Who thought about the fat in nuts and avocados and the good-for-you olive oil on a diet like this? I agree with Jim above when he says "why can't the experts all agree?" Of course, they can't. I just listened to a podcast from the author of Bone Vitality talking about how wonderful dried fruits are for my bones! What's a girl to do? I have seen the benefits of a plant-based doubt about it, but I need to adjust my own thinking about fats-oils. So, last week, I gave up on my beloved avocados and handfuls of walnuts and almond butter and Earth Balance and olive oil (except for a bit in my salad dressing). Yikes, what's next? I'm going to try this throughout the summer and get re-tested and see what happens. It's a tough road to travel, but in the end, everyday, I feel SO much better than I ever have in my life. I can't go back now. Good luck Deb. Can't wait until your 5 hour consult.


I have been reading your blog for several months and have learned a lot about health and nutrition, but I think you're going overboard on the cholesterol and I think the medical profession has led us to be cholesterol phobic. Personally, I would rather live fewer years and eat foods that I enjoy such as cheese, pasta and bread. We rarely eat out and I cook everything from scratch. We eat a lot of vegetables,but I cannot imagine cooking them without olive oil and garlic. From the research I've done, I learned that half of those who have heart attacks DO NOT have high cholesterol. My father-in-law died of a massive heart attack. He was on statin medication for years. He had a complete check-up and was given a clean bill of health by his cardiologist two weeks earlier. There's still a lot we don't know about heart disease.

Kiki Ohio

I would not lose heart as this information about your total cholesterol profile is showing you where you need to go. I gave up using oil to saute foods and now only use H2O or veggie broth and my taste buds adjusted just fine. However, the comment about restaurant food is right on: always assume that you are getting loads more fat than you realize. I have minimized eating out and have gotten to the point that I eat before going out so that I can nibble around the plate without eating more than is good for me. This might be "weird" to some, but in my business I must eat out with others several times a week and this would wreck my waistline and cholesterol levels in short order. I do not care for nuts so that is not a problem for me. I know a *lot* of people think nuts are "healthy" but they pack an unbelievable caloric wallop and can drive up my cholesterol in short order as well. I think overall it is just consistency: figuring out where there are gaps in your eating plan and plugging the holes! :-)


The last time I had my cholesterol checked, about a year and a half ago at age 51, my total was 124 (starred as just below the reference range of 125-200). I attribute this result largely to my diet. However, I find that it is extremely difficult to eat as I think I should when socializing. Hence, eating healthily pushes me toward being somewhat of a hermit. I read convincing research reports indicating it is much healthier not to live like a hermit, so I feel like I'm in somewhat of a Catch-22 situation. I sometimes use the strategy Kiki mentions above, eating healthier food ahead of time so that I can just nibble at social occasions. Also, at times I bring healthier foods to non-restaurant social occasions. Last year I took expensive organic apples when we went to my mother-in-law's home for several days beginning on Christmas Eve. That night she gave most of them away along with some leftovers to a departing guest who had no concern about organic food or healthy eating!! I try to be diplomatic and low profile about my eating preferences, but I think I looked horrified as the apples I had paid a premium price for and counted on as healthy snacks during our visit went out the door! I also find, as Kiki mentions, that my taste buds adjust if I stick to my diet. However, even a nibble of some foods that I'd rather avoid sets off cravings for them. And we often have such foods around the house due to my husband's preferences. Fortunately, those have started to shift since his doctor talked to him recently about his cholesterol numbers!

I'll be very interested in any upcoming tips on maintaining a healthy diet while socializing!


My last five cholesterol screenings (from 3 different sources) always include a "Risk Ratio", determined by dividing total cholesterol level by HDL level. The desirable number is <4, borderline 4.0-4.9, and High Risk 5.0+.
So even though my total cholesterol was 239 in one test, my HDL was a nice high 114, so my risk ratio was 2.0. My most recent test was 204/80=2.5.
Using risk ratios, your numbers look fine. 209/77=2.7


i love your blog...
as a longtime vegan - and as someone who prepares fresh food daily - delicious 'no-oil added' food, without sacrificing taste, is not that big of a deal. An fast and easy alternative for dressing salads is to use some ripe avocado pieces(either smashed or pureed), water, and dijon mustard (all according to taste and preference). throw in some raw sunflower seeds (also can be smashed to better integrate), optional herbs and seasonings(ie dill, ground pepper, etc) and your salad will be fully 'dressed'!
good luck....claire


If you've gone completely plant based and removed most fats from you diet, you have likely increased your intake of carbohydrates (and perhaps protein to a lesser extent) to maintain the same caloric intake and satiety. And it is the excess carbohydrates, along with the glycemic load they present your body, which can raise triglycerides. Moral of the story: when removing an entire macronutrient class from your diet, you have to pay attention to what you are replacing it with. If you remove all fats from your diet and end up replacing a lot of those fat calories with carbs, that may not necessarily be a good thing, even if they are whole grains as eating too many of them will still present your body with a high glycemic load.

Kiki Ohio

I have to disagree with Charlie regarding carbohydrates driving up triglyceride levels. While *refined* carbohydrates will definitely drive up triglyceride levels, complex carbs such as those found in brown rice and vegetables are not absorbed as quickly and affect triglyceride levels far differently. I know that John McDougall encourages some patients with severe heart disease to limit their fruit intake to 2 pieces or less per day to avoid spiking triglyceride levels but I do not see any evidence in the research literature to show empirically that complex carbs drive up triglyceride levels.

The only caveat to this I can think of is for people who have been diagnosed with Metabolic Syndrome X. Individuals who have become, or are becoming, insulin resistant respond to glucose differently and can experience spikes in both glucose and triglyceride levels with even complex carbs. However, I believe that research by Neal Barnard clearly shows that reducing fat intake can effectively heal insulin resistance allowing the cells to move dietary sugar appropriately. Research out of Italy on morbidly obese patients who had gastric bypass surgery was the impetus for this finding. These patients, who were insulin resistant, became well within weeks of gastric bypass surgery. And this was *not* due to weight loss as they had only lost 20-30 pounds by that time (meaning that many of them still had 100+ pounds to lose). However, due to the way gastric bypass shunts dietary fat, the patients could not absorb the fat they ate and their cells began to "de-gunk" and allow sugar in and out of the cells to enter the bloodstream as necessary.

In addition, refraining from adding oil to food does *not* mean that a person has removed all fat from their diet thereby constituting "removing an entire macronutrient class from your diet". Quite the contrary. Raw oats are 16% fat without the butter that many people add to them after cooking. All fruits and vegetables contain trace amounts of fat in them. It is virtually impossible to remove all fat from your diet. However, removing *added* fat from your diet is a different proposition all together and one that increases heart health on every level.

Kiki Ohio

I agree with Lora that avoiding "just a taste" or "just a bite" of rich foods helps keep my taste buds and cravings for those foods in check. Caldwell Esselstyne cites a study on this that showed that the less that people ate of high fat foods, the less they wanted them. However, this took about 15 weeks to occur. Esselstyne urges his patients to eat clean with no slip-ups for 3 months. That three month period is the time it takes to reset the taste buds and it is well worth it in my experience.

I lived abroad for several years in East Asia and found that children there *loved* vegetables and whole soy foods. East Asians, at that time, ate fruit as their dessert and it was rare to serve cakes, pastries, or sweets after a meal. Fruit cleanses the palate, is satiating, and delicious (not to mention healthy). It was an adjustment at the time (I ate sweets several times a day) but one that I am grateful to have acquired.

The truth is that our taste buds are 100 % trainable. That is why children in East Asia love vegetables while U.S. kids want potato chips, french fries, and sugary soft drinks. We train ourselves (or our parents do) to eat and therefore enjoy certain types of foods. That means that we can re-train our taste buds and reap the benefits from it.


Cooking without oil tips:


Very enlightening post! I've noticed a lot of people here have pointed out that East Asian diets are very healthy and low in cholesterol. I can attest to this- I lived in Tokyo for four months and quickly lost almost 15 pounds almost effortlessly because of the local diet and the amount of activity in my daily life- going up and down stairs all day, walking everywhere, jumping from subway to subway, that type of thing. I had a good time in Asia and I'd love to return.

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