Why you shouldn’t lower cholesterol with OREOS

study published last month showing that eating OREO cookies can lower cholesterol better than statins is getting a LOT of attention, especially on social media.

But before you ditch your Lipitor and reach for a sleeve of black and white disks, read on…

The experiment involved one  27-year-old man managing ulcerative colitis who tried two different approaches to lower his LDL cholesterol levels.

First, he ate 12 OREO cookies every day for 16 days, then after a 3-month cookie break he took 20 mg of rosuvastatin (Crestor) daily for 6 weeks instead. Surprisingly, the OREOs dropped his LDL by 71 percent, while the statin only lowered it by 32.5 percent.

So far, so amazing. But here’s more detail… 

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The catch

The man was following a strict keto diet.  His starting LDL cholesterol was in the 380 to 420 mg/dL range (!).  If you recall, one of the mechanisms that can cause high LDL is saturated fat intake impacting LDL receptor function

Keto diets are high in saturated fats and can turn off LDL receptors keeping LDL levels high.  Lesson number 1:  Some people who follow a ketogenic diet can see their LDLs rise to stratospheric levels.

The fact that adding OREOs lowered his LDL is not the point.  The point is that adding CARBS lowered his LDL.  Lesson number 2: The way our bodies respond to nutrients is complex and, for overall health, a mix of nutrients is usually preferred over favoring only one nutrient class.  Maybe, just maybe, a super high-fat diet is not such a good idea.

The fact that he did not have as big a response to Crestor is also not the point.  Another mechanism that can cause high LDL is excess LDL production in the liver related to HMGCo-A reductase activity

Statins inhibit this enzyme, but if it’s not a major driver in causing high LDL levels in a specific individual, even high doses of statins are not going to have much of an effect. 

It’s one of the reasons we order follow-up lab tests on people placed on statins.  We don’t know ahead of time if their LDL elevations are HMGCo-A reductase driven.  Lesson number 3:  Not everyone will see dramatic LDL reductions with statins.

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Why whole-food, plant-based wins

Finally, there’s more to health than an LDL effect — whether attained through medications or through food. 

The fact that LDL is lower with OREO cookies added to a restrictive keto diet doesn’t make the OREOs or the keto diet the best choice for health. 

We have boatloads of data showing that a whole-food plant-based diet not only supports better cholesterol levels but is also the dietary pattern most consistently associated with healthy longevity. 

This is why Step One Foods is grounded in the whole-food plant-based approach and why it works to lower cholesterol in most people, not just those following a keto diet. 

In the same vein, we have boatloads of data showing that consumption of highly processed carbohydrates (I’m talking to you, OREOs) contributes to insulin dysregulation as well as chronic inflammation and a higher burden of chronic disease. 

Meanwhile, there are no examples of human populations following a ketogenic diet as experiencing longer life or longer healthspans.

Lesson number 4:  You always knew this was too good to be true.

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Dr. Elizabeth Klodas MD, FACC

By Dr. Elizabeth Klodas MD, FACC

"Diet is a major driver of high cholesterol, but instead of changing the food, we prescribe medications. This never seemed logical to me.” Dr. Klodas has dedicated her career to preventive cardiology. Trained at Mayo Clinic and Johns Hopkins, she is the founder and Chief Medical Officer for Step One Foods. Dr. Klodas is a nationally sought out speaker and has an active role at the American College of Cardiology. Her clinical interests include prevention of heart disease and non-invasive cardiac imaging and she has published dozens of scientific articles throughout her career. Dr. Klodas has been featured on CNN Health for her mission to change how heart disease is treated. An independent study performed at leading medical institutions affirmed the ability of Step One Foods to deliver measurable and meaningful cholesterol-reduction benefits in the real world. The results of the trial were presented at the 2018 American Heart Association’s Scientific Sessions. Dr. Klodas has also authored a book for patients, "Slay the Giant: The Power of Prevention in Defeating Heart Disease," and served as founding Editor-in-Chief of the patient education effort of the American College of Cardiology. In addition to her practice and her duties at Step One Foods, she also serves as medical editor for webMD.