Comment by EZ-E

Patient compliance is notoriously fickle, especially when it comes to changing one's lifestyle (diet).

Because medication is more effective. Side effects from statins are relatively uncommon and generally mild, so it wouldn’t be ethical to use lifestyle as a first-line treatment in place of, say, a combination of low dose statin and pcsk9 inhibitors.

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.

My guess is something like, because there aren't patents on food.

There's no financial incentive for the healthcare industry to promote a healthy lifestyle.

One of my most used appliances is a Tiger rice cooker with Porridge and timer function.

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.

> I'll have to try to add olive oil as well

You've got almonds and chia, so your fats should already be covered.

Oat fiber. I've been taking 30g of oat fiber everyday for the past 3 years. Slugging it down in 8oz of warm water and 10g of nooch. Not only are my cholesterol levels fantastic after starting that regime, but very regular as well.

Add some walnuts. See my other comment for reasoning.

> one cup of oatmeal + one cup of water

Do you need a knife and fork?

Peanut butter is cheap and delicious. A lot of people hyper-optimising nutrition (I was one of them) tend to forget much more obvious stuff like fiber, amino-acid profiles, absorption of specific vitamins like D, etc.

Peanuts are an order of magnitude cheaper. Sometimes, if you buy a packet of "mixed nuts", you find the first three ingredients are three different types of peanut.

Being pedantic the only nuts we generally eat that are actually nuts are hazelnuts. The rest are seeds, drupes, or as in the case of peanuts legumes.

Peanut butter is much cheaper as nut butters are usually very expensive (at least here), but I agree, substituting peanut butter with tahini drastically improved my stomach/digestive issues.

I added it for weight maintenance/gain (I'm close to underweight)

30 % of the population have genetic makeup such that they can smoke all their life and not increase their risk of lung cancer by much, yet it's deadly for the other 70% of the population.

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.

Not related to your question, but the lead levels in psyllium husks are too high for me to consume them daily.

People are just different. I always wonder how we should think about eating and health on a personal level.

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?

Breakfast I don’t eat. Lunch I typically eat outside, dinner after work I’m lazy to cook so replacing by a shake was perfect! 15 min all in for preparation, consumption, cleaning.

• half of 1 cup rolled oats • 1 banana • 1 scoop soy or pea protein powder • 2 tablespoon flax seeds (make sure to buy whole and grind them, in my case I don't need to grind them separately the blender chops them while doing the shake) • 2 tablespoon peanut butter (100% peanut no added oil) • 1 tablespoon extra virgin olive oil • unsweetened oat or soy milk • I add some water if it's too thick

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.

Not op but for breakfast I do 1/4 cup steel cut oats, 1 cup water, 1 tbsp olive oil, 1 tbsp maple syrup, 1/4 tsp cinnamon, pinch of salt. Add a spoon of flax meal at the end. I sometimes add walnuts.

I wish I didn't need the maple syrup. Adjust to taste I guess. Doc says my cholesterol levels are immaculate.

They’re also somewhat less flexible in terms of a yummy breakfast, more likely to be GMOs, and a heavily sprayed crop.

I don’t, they’re rolled oats and blended they are easy to drink as long as there is enough liquid

The science around what fats are good or bad is so confusing I don't think we can say much about them with certainly, except that trans fats are probably bad. I lean towards "eat whole foods", but those can include anything from beef and coconut which are full of saturated fats, to fish and nuts which are full of polyunsaturated fats.

I think that depends on the individual, or maybe on the dose. Years ago I read a bunch of books arguing for saturated fat, started eating a lot of it, and my cholesterol and triglycerides got horrifically bad. Even those books, which claimed high cholesterol is no big deal, were like "but if it goes over X then you need to fix that," and I was over X. I had high particle numbers too, which the books agreed was pretty bad. I went back to my normal diet and that took me back to my normal bloodwork.

Citation Needed.

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.

there are always layfolks who think they're smarter than the medical professionals

https://www.ahajournals.org/doi/pdf/10.1161/CIR.000000000000...