[1] https://en.wikipedia.org/wiki/Bile_acid_sequestrant
[2] https://www.bbc.com/future/article/20200108-the-medications-...
However many clinicians do take a “let’s sort out the problem as quickly as possible with medication, and if you want to try lifestyle and back off (or even stop entirely) the meds and see how your cholesterol is afterwards, we can do that.”
This seems like a good balance to me.
In reality lifestyle modifications are more conservative than using a medication so lifestyle modification would be first line from an ethical perspective.
In reality though it does seem like statins are used first line by many clinicians. But ethically speaking conservative interventions like lifestyle modification in terms of changing diet and exercise should be used prior to medicating a young otherwise healthy person.
In other groups such as when someone has had a recent heart attack of course the thought process is different. Such people should be immediately placed on a statin.
Lifestyle is more effective and has less side effects.
Lifestyle is the first line of treatment, with meds being a later line of action.
There's no financial incentive for the healthcare industry to promote a healthy lifestyle.
For one, there could be some financial incentives mixed in in that health insurance companies would want their people to be healthier so they don't pay out as much, but it's not that simple for them either - the health industry as a whole profits more if there is more treatment ergo more health problems. If health care was cheap or less needed the insurers themselves would make less.
More importantly, there can be other than financial incentives mixed in for doctors and public health organizations to encourage health. Doctors for example take an oath and I think often genuinely want their people to be healthy. Public health organizations may be more murky but there's definitely a financial and otherwise incentive for the government itself minus those corrupted by the health industry, to want people to have less health problems.
You can't force them to have healthy lifestyles.
It's been used pretty much every day for 7+ years since I purchased it.
Every night I put 130g steel cut oats in, 400-420g of water, set it to cook for 45 mins and be ready for when I wake up in the morning. I'll then add 25g protein powder, sometimes a few berries or sprinkle with seeds/nuts. A nutritional power house.
I find steel cut oats more filling, a lot more substantial with ground oats more goopey. Steel cut oats are normally a hassle to cook but it's set and forget with the rice cooker. From what i've read I also believe the fact they sit soaking over night in water also is breaks down the starches which helps nutrient absorption.
Does wonders for digestion and satiety. Everything runs like clockwork with them. If I don't have them for a few days, things get irregular and a noticeable difference in satiety for the rest of the day where i end up snacking as feel hungry after meals.
Put your oats, portion of milk, some berries, cinnamon and honey in a container and leave it in the fridge overnight.
Do it now.
Come thank me tomorrow morning once you've tried it.
I like the fact that they are more concentrated in terms of calories/nutrients per 100g than cooked oats and also provide steadier energy. I often pair them with a protein drink (pea protein + rice protein), a drizzle of avocado/olive oil, and berries. Takes just a few minutes to prepare.
Come thank me, once you've tried it. If cold stuff is your thing at all, which could be compensated with some nice green tea, or coffee, ofc.
I might be wrong, but I do think non-instant oats is more nutritious.
But to answer your question, it's a combo of laziness and taking care of future me. Nothing beats opening the fridge in the morning, groggy AF, and finding delish breakfast ready to go, and it's dirt easy to prepare with no pots to clean afterwards.
The overnight oats (rolled or steel cut) will cook much faster after they've soaked up liquid. If you're adding ingredients such as egg (two per 1/3 cup s.c. oats) this takes care of the raw elements as well.
Hell, go full insanity mode and make your overnight oats with cream!
https://mccanns.com/product/mccanns-traditional-steel-cut-ir...
I'm using an instant pot. Maybe it develops more pressure? But 3 minutes high, rest for 10 minutes, vent, is just a bit on the al dente side. Cooked through, but slightly chewy.
Sometimes I sauté the dry oats in a pat of butter for a few minutes before adding the water and cooking. It gives them a nice nutty flavor.
> Sometimes I sauté the dry oats in a pat of butter for a few minutes before adding the water and cooking. It gives them a nice nutty flavor.
Sounds great. It's the nuttiness from the skins I like about them compared to rolled.
You've got almonds and chia, so your fats should already be covered.
also found in mushrooms, rye, some fruits, pectin, etc.
oat fiber is fine but you'd probably see similar benefits from psyllium husks or other fiber sources.
Do you need a knife and fork?
While peanut butter does contain some useful nutrients, there are much better choices out there in case someone would like to further improve/optimize their nutrition. Many topics in nutrition can be quite debatable but IMHO most other nuts outperform peanuts (which aren't even nuts) in many ways. Furthermore I'd say peanuts aren't that useful as a protein source in this situation given that protein powder is already being added.
I recently discovered the world of nut butters, and usually choose them over whole nuts due to easier digestibility and nutrient availability. Unless I'm eating macadamia nuts which already feel quite easy on the gut.
My cholesterol has been in range for years despite eating almost exclusively saturated fat since I'm in the keto camp. Just watched an interesting episode by Peter Attia and Layne Norton on seed oils which might shift my view on PUFAs a bit.
Thoughts?
Many many studies over many decades, reviewed and controlled for other factors have showed that consumption of saturated fat increases heart health issues leading to death in the majority of the population. Finland and Norway have reduced the number of CVD at the population level by educating and pushing for a reduction in sat fat. You are probably one of the few exception.
This, and the infamous seed oils are subject on which Attia has controversial opinions - he is not an expert on nutrition, nor an epidemiologist, but neither am I, so my advice would be to broaden your sources of information.
Having said this, is the thing about PUFA the results of the studies from Walter Willet? I've just watch Chris MacAskill (Viva Longevity on YouTube) talking about it, it seems that PUFA (fatty fish, walnuts, sunflower seed oil) has the most positive effect on triglycerides across the whole population, and beyond reducing saturated fat and increasing fiber intake.
I can eat McDonalds and still get perfect blood results. (I dont do that anymore). I have a friend who does not like any vegetables and fruits, he is fine. But also friends who just look at a bag of sweets and grow fat. Allergies and stomach health can be very specific.
Of course you do control a lot. But at the same time, it seems very individual. Maybe a chance for personal AI nutrition practice?
Any particular reason for changing your dinner and not BF or lunch?
I blend the oats and the flax seeds first, then add the rest, blend again for 10 secs, boom - easy. You may want to adjust peanut butter quantity depending on whether you’re trying to lose, maintain or gain weight. 2 tbsp is me trying to maintain weight as I easily lose weight.
I wish I didn't need the maple syrup. Adjust to taste I guess. Doc says my cholesterol levels are immaculate.
Saturated fats _are_ essential for humans but you should be getting enough of them from non-animal sources.
YMMV
My understanding is that the very few studies that showed positive impact of "adding" saturated fat turned out to be a replacement issue. They replaced junk (candy, refined carbs) with sat fat. Replacing with MUFA and PUFA showed a much greater effect.
https://www.ahajournals.org/doi/pdf/10.1161/CIR.000000000000...
The experiment halved energy intake at minimum and still provided 30+ grams of fibre then kept doing it until the gut emptied, which I reckon most people would expect to nuke and replace the gut microbiome, but did oatmeal have any specific advantage?
Their hypothesis for the mechanism is "gut bacteria" but these people in the study all had a trifecta of "high" body weight (overweight? obese? not specified in this article), high blood pressure, and hyperlipidemia.
So we've got some unhealthy people, we cut their calories to less than half, we jack their fiber way up (most likely - we don't know their baseline diet but with those biomarkers we can make some educated guesses), we restrict the timing of when they eat and remove all junk food.
So is this oatmeal specifically? Fiber? Calorie deficit? Meal timing effects? Removal of processed food for two days?
The idea that you can "shock" your body to better biomarkers like this and have it last over a month is extremely cool, but I wonder how they can be certain that this is some oatmeal thing versus a general "eat way less and limit yourself to a food that is high in fiber" thing.
The low protein here is a problem when in a calorie deficit, for example, because if you don't have enough protein you're likely to lose weight as muscle mass rather than fat. If you could do the same technique with legumes your protein would be way better.
It's an intervention for people with metabolic syndrome, characterized specifically by those traits. Quoting the first sentence of the paper:
"Metabolic syndrome (MetS), characterized by the co-occurrence of central obesity, dyslipidemia, elevated blood pressure (BP), and dysglycemia, ..."
I did a similar unscientific experiment in the past where I did a juice fast for two weeks and had bloodwork done before and after (similar bodytype, unhealthy, overweight, high blood sugars, high cholesterol etc). Basically the doctor was shocked how all my numbers became the same as someone really healthy during the fast. So I think the lack of junk and calorie restriction is doing more than the fiber.
> Oats offer an interesting and promising approach for treating MetS due to their unique composition characterized by a high fiber content, especially β-glucan, essential minerals and vitamins, and various bioactive substances, including phenols which exert antioxidant and anti-inflammatory effects that may improve metabolic function. Furthermore, oats are an accessible and sustainable food item.
I eat Bob's Red Mill steel cut oats for breakfast every day; 1/2c dry is about 88g. That's a pretty decent meal. 3.5x that is probably most of what you eat that day.
6 weeks of 'oatmeal for breakfast every day' was less effective than 2 days of 'stuff yourself with oatmeal'.
I'd guess the easiest way to get it down would be to just blend the oats into water without cooking so you have something that you can just drink like water.
The oatmeal put them on a crash diet of 1000 calories a day. And filled them so they didn’t reach for non reported snacks.
88g dry may get much heavier after adding 3/4 cups water
The original paper describes two protocols, short-term and long-term (2-day and 6-week respectively) of 100g dry oats and 80g dry oats prepared for each meal. That's a generous but not outrageous serving size, and the former comes out to 300g oats per day over three meals.
Indeed they suggest that the difference may be due to changes in gut microbiome caused by oatmeal.
The trial was funded by the German Federal Ministry of Education and Research (BMBF), the German Diabetes Association (DDG), the German Research Foundation (DFG), the German Cereal Processing, Milling and Starch Industries’ Association (VGMS), and RASO Naturprodukte."
I'd be quite suspicious of this study for this reason alone.
"They also lost two kilos in weight on average and their blood pressure fell slightly."
Two kilos in two days?
Edit: Oatmeal is great. I have some most mornings, either as porridge or letting it soak for a bit in "viscous mesophilic fermented milk", as Wikipedia suggests it can be called in english. Lots of starch but it takes a while for it to sugar the blood, and some fiber and protein.
(For purposes of weight loss, normies are also advised to weigh themselves weekly instead of daily, because it's easier than explaining to them what a low-pass filer is.)
1. When someone consumes fat, bile is released into the gut.
2. Oatmeal (and other soluble fibers like psyllium husk) capture this bile and it is excreted in stool.
3. In order to create the bile, the liver needs LDL. Because the LDL it used to create the bile was lost when it was captured, it exposes more LDL receptors and pulls LDL out of the bloodstream, thereby lowering LDL levels.
It seems to me that in order to maximize the effectiveness of this LDL-lowering approach, one must not simply consume psyllium or oatmeal, but rather consume them in conjunction with fat. Not saturated fat, obviously, which raises LDL, but perhaps unsaturated or polyunsaturated fats. My expectation is that this would trigger the bile secretion required in order to actually sequester it.
Some proteins seem to have a similar effect - but I haven't tried to narrow that down, and don't know the food science behind it.
Also, (and I learnt this much too late in my life), cook the pasta until a few minutes before it's done, and _finish cooking in the sauce_. This is what makes the sauce adhere. Keep a cup of the starchy pasta water to add in case it needs to be loosened a bit.
Bile is used to process food in the gut. It does not go back into our system. Bile is still produced by liver even in long fasts.
Oatmeals is a kind of elimination diet, much like carnivore diet or rice diet. The later one also lowered cholesterol.
What oatmeal diet really does is it completely eliminates essential fatty acids in food. These fatty acids are critical in VLDL production and, thusly, oatmeal diet reduces LDL levels through less production of VLDL.
I don't think that's correct: https://en.wikipedia.org/wiki/Enterohepatic_circulation
I also think you're mischaracterizing HDL as a VLDL. If you search for Apolipoprotein A here: https://www.ncbi.nlm.nih.gov/books/NBK305896/ you'll see that HDL is constructed from it, while VLDL and LDL are part of the Apolipoprotein B lineage.
I’m genuinely curious. I have a vested interest in this.
Current recommendations are to get 15+ grams of fiber per 1000 Calories, but we know from, e.g., hunter-gatherer populations that humans can eat far more than that.
Building a diet around whole food sources that are high in fiber and protein is basically all you need for a healthy diet, constrained by however many calories you need to support a healthy weight.
Fruits, veggies, legumes, whole grains, nuts, seeds, etc. should make up the majority of your diet.
What? Absolutely not. Not even close. Provide a source if you really believe this.
Also the paper says that the "Oats only" people were allowed to eat other fruits and vegetables with their meals.
I realized this when tracking micronutrients with an app (tracking every gram I put into my body), and realized my 600 calorie steel-cut-oats breakfast was often outdone by soybeans I'd eat later in the day. The soybeans had more fiber.
And I think they're easier to eat. It's pretty boring, but I microwave a bowl of frozen soybeans and then just eat them plain. They're clean, you could eat them with your fingers without causing a mess (I use a spoon though), and their cleanliness means I'm comfortable having a bowl next to me at the computer or wherever; if they spill I would just pick them up with my fingers and that's it.
If you are eating any kind of snack cracker or refined wheat product, I would suggest replacing with oats and then reporting back on results after one week.
I think the beneficial effects are strong enough to completely offset the impact of things like occasional bowl of ice cream and package of nerds gummy clusters. This is what gets me to power through. If there wasn't some kind of strong upside no one would be eating this stuff willingly.
- oatmeal + blueberries: moderate glucose spike
- oatmeal + blueberries + chia seeds: moderate glucose spike
- oatmeal + blueberries + ground flax seed: moderate glucose spike
- oatmeal + blueberries + protein powder: moderate glucose spike
- oatmeal + blueberries + protein powder + chia seeds: very minimal spike
In my case, it seems like carbs, proteins, and fats are all necessary to prevent a spike.
I don't like oatmeal (porridge), but whole oats in muesli are pretty good.
Also, using ice cream as the benchmark is misleading, as people might view it as a junk food and think that its glycemic index is higher than they otherwise would, but actually its glycemic index is low/moderate, depending on the type.
Are you kidding? I love the stuff. I used to eat it daily as a kid and had gotten out of the habit, but when I had high cholesterol and my doctor told me to eat a lot of it, it was like being prescribed a treat.
Try assuming that the target audience for this research is clinicians and nutritionists working with general population patients - particularly patients who really need cholesterol-reducing interventions. The medical system has limited resources; patients have limited attention spans and compliance curves. The patient may be in your ER or hospital after a medical incident, or in your clinic after a bad test result. If the hospital kitchen, a family member, or the patient himself can get through two days of this relatively easy oatmeal diet, the research say that his short-term and intermediate-term numbers should (X fingers) improve by [details]. If, two real-world days later, both a follow-up cholesterol test and (hopefully) the patient's daily symptoms and perception of his health are greatly improved - that's a clear win, both for him and for the medical system. And (hopefully) the patient's perception of the medical system - because high cholesterol is a chronic health problem, and you need him to readily seek care, show up for appointments, and comply with prescribed treatments.
https://en.wikipedia.org/wiki/Porridge
Oatmeal is a more specific term than porridge, because porridge isn’t necessarily made from oats (eg, rice in Asia).
Though in the UK, when someone says “porridge” they almost always mean oat porridge or oatmeal.
Already the Mycenaean Greeks, 3500 years ago, used a cognate word with the same meaning: "meleuro-".
"Flour", which comes from "flower", originally meant the finest grade of meal, which was considered the best.
Nowadays the usage of these words is not always consistent with their original meanings.
It's not often I find myself quoting Gwar, but this reminds me of "Bone meal! Better than no meal at all!"
A porridge made of rice in the UK is not a thing as far as I am aware (I'm not in hipster London though), I suspect it would be what we call Rice Pudding?
No, for that we've adopted the name "rice pudding"
Breakfast: overnight oats with milk (half and half) and a bit of yoghurt and a banana mashed in.
Lunch: Oatcakes with tahini/hummus and a salad??
Dinner: Skirlie with spinach and a couple of poached eggs on top. Along with some roast carrots/courgette/aubergine.
The eggs would be outside the OA diet I suppose. I think I might try this.
It's unbelievably easy, genuinely tasty, and was the result of me trying to make a concerted effort at trying to lower my cholesterol.
If somebody wants to start a company. I would suggest a steel-cut oats (rice) cooker, that has an overnight timer that will have the oats prepared when I wake up. With one compartment for oats, one for water, and a refrigerated compartment for frozen berries (even just insulated with ice cubes). I'd pay good money for that.
I don't even cook it, simply soaking it with water overnight in a refrigerator does the job. Preparation takes 2-3 minutes (except for the overnight soak). Not boiling it also saves all the vitamins.
I much prefer steel cut oats to rolled and/or instant.
1/4 cp is good for breakfast for one person.
It's much more interesting if you mix in a small amount of other grains. I like to add a large pinch each of farro, barley and buckwheat. Very important: also add a pinch of salt.
Add plenty of water and cook on low while you take your morning shower and get dressed. (20-30 mins)
https://www.nature.com/articles/s41467-026-68303-9
I was curious what the implementation looked like:
> In the short-term intervention study, participants assigned to the oat group (OG) consumed three oat meals daily for two days instead of their habitual Western diet. Each oat meal comprised 100 × g of rolled oat flakes (Demeterhof Schwab GmbH & Co. KG, Windsbach, Germany) boiled in water. To ascertain potential long-term effects, the two-day intervention period was followed by a six-week follow-up period during which the participants returned to their habitual diet without oats. Subjects assigned to the control group (CG) consumed three standardized control meals without oats on each intervention day, which were macronutrient-adapted to the OG, instead of their habitual Western diet.
> In the six-week intervention study, participants in the oat group (OG6w) replaced one habitual meal per day with an oatmeal comprising 80 × g of rolled oat flakes (Demeterhof Schwab GmbH & Co. KG), while maintaining their habitual Western diet. Participants in the corresponding control group (CG6w) maintained their habitual Western diet and remained abstinent from oats during the six-week study period according to the inclusion criteria.
This is pretty remarkable:
> Since cholesterol levels tended to remain below baseline during the six-week, oat-free follow-up period, persistent effects on lipid metabolism might be assumed (Fig. 3d). This assumption is further supported by the high compliance observed during the follow-up period, as all participants abstained from oat consumption and returned to their habitual Western diet, with no significant differences compared to their pre-study dietary patterns (Supplementary Data 2). Thus, our results indicate clearly that a high-dose oat diet improves lipid metabolism by decreasing serum TC and LDL-C levels, even after two days, which is consistent with the known cholesterol-lowering effect of oats. In addition, beneficial effects on anthropometrics and glucose metabolism were observed within each diet group (Supplementary Data 2), which we attribute to the diet-related calorie restriction.
I gotta say though, 100 grams of oats (three times a day) is a lot. That's over a cup (dry). A typical serving is less than half that (40 grams dry).
I've had something similar in Iceland, good call.
Another option might be curd / quark (differs a lot per country).
i should try steel-cut someday...
It's not necessarily equivalent but I think that losing fat can dump cholesterol into the body, and gaining body fat can sequester it.
And I don't eat rabbit food. I still have pasta and pizza and other stuff.
And I do like oatmeal but don't eat it too often.
Eating a low sugar breakfast does feel pretty healthy.
I use rolled oats and cook with just salt and water which avoids the risk of the milk burning if you are inattentive, then add milk or yoghurt (and raw brown sugar) to my bowl.
Don't get me wrong, to each their own, if you like it that's great, but way too liquidly oatmeal plus oil just sounds really disgusting compared to just normal oatmeal + normal amounts of water.
I tried to get into rolled or cut but the prep time was hard to keep up with.
As a single guy, I just cook the oats in the bowl that I intend to serve them in and, since it's basically water just water in the base of the instant pot, there's not much cleaning required. The oats cook without manual intervention during the cooking process.
It takes a bit of time, but in theory you could set up your instant pot on a delay timer and wake up to freshly-cooked steel-cut oats.
That can be achieved within many other diets too. I wish they were more specific in saying what's special about oats, if anything.
I also get upset when I see a ton of junk options at the grocery store. They are talking about plain cut oats and whole fresh fruit, but based on the way shelves are stocked I imagine a majority of people get the kind with all the added sugar. You might as well be eating honey smacks at that point. Yogurt has the same problem at the store.
Effects on but biome are real too, and apparently beneficial, and may factor in, but it isn't the only (or necessarily the primary) mechanism for reducing serum cholesterol.
I don't see how. Adding sugar doesn't remove the fiber.
Oats are for horses. Mankind basically co-evolved with Barley.
I would consider a normal bowl of oatmeal for breakfast to be about half a cup, so this is quite a bit more.
The study is not suggesting this is a long-term diet. They're saying "eat oats for all your food for two days, and your cholesterol lowers by ~10% and then stays low for ~6 weeks due to changes in your gut biome".
They're not saying eat 300g for breakfast and then eat as normal. They're not saying do this every day.
They're saying 2 days, this is what you eat, spread out to replace all your meals across those 2 days, then go back to normal.
its more effective than daily oatmeal consumption (80g per day)
Oats only! (with some fruit and veg garnish ok)
ymmv- Tested on people with high cholesterol only
meta: expect to see "cholesterol cleanse diet" in your ai generated ads?
Oatmeal and milk, nothing more. No fruit no nuts no sugar no honey no sprinkles of whatever. Perfect.
My go-to is oatmeal with milk and pepper, but some days I want some aged cheddar, or smoked cheddar (mmmm!). Frozen wild blueberries/wineberries for a winter treat. Tumeric, ginger, cinnamon and honey if I'm getting sick. A fried egg and hot sauce if it's a lazy sunday.
What a lot of people don't realise is that the creamy texture comes from the oats rather than the milk.
It is a shame that most people's associations with oatmeal is either "bland" or "I've added in so much sugar that I may as well ignore the benefits of oats entirely".
But it's your bowl of oatmeal, do what you want with it. Otherwise, what was that whole punk thing for, really?