Vegans and Cholesterol

Note: I am not a doctor or nutritionist, just someone who does a lot of research. You should do your own.

All cholesterol in food comes from animals — and by all accounts, way too much of it. Put differently, if you’re vegan like I am, then you get precisely none in your diet, your body has to manufacture it all.

There’s ton of pages out there explaining about “good” and “bad” cholesterol, for example this one:

LDL and HDL Cholesterol: "Bad" and "Good" Cholesterol

Plus many not so great sources, but they point out that excess in our diet is really bad for us. That’s been known for a long time. Not so much what happens with vegans, where the intake is zero. So first, some numbers. When you get your blood tests for physicals, there are many things doctors look at, but headline numbers include blood pressure and your cholesterol numbers (also called a lipid panel). As usual, there are recommend values for these. Measurements are in milligrams per deciliter (mg/dl). According to one set I found:

• LDL — No higher than 100 mg/dl
• HDL — Greater than 60mg/dl
• Total — less than 200 mg/dl

There are a couple of problems here for me — one is that the HDL is in practice, a proportion of the LDL level, so a sum is really only a rough guide. The second is that, I believe (with only circumstantial evidence, I freely admit) that these levels are somewhat high. If they weren’t, then we might have excess people being diagnosed with high cholesterol — put differently, the typical Western diet is somewhat unhealthly and is high in cholesterol and these values have been normalized to that. By comparison, consider blood pressure levels:

High blood pressure redefined for first time in 14 years: 130 is the new high

In 2017, the new “high” value became 130/80 from 140/90.

So what were my cholesterol readings? (From June 2019). LDL = 72 and HDL = 34. I should point out that every single other value on my test was within expected range (yes, even B12, which many non-vegans have deficiencies in). And as an aside, I do have high bloody pressure due to a congenital condition for which I take medication.

In any case, these values are very low compared to most of the population. So, should I worry? Well, first let’s review the role of cholesterol. Getting a good answer is actually kind of tricky, but here’s what I found:

“It plays an important part in the functioning of every cell wall throughout the body so needs to be transported around the body. It is the material that the body uses to make other vital substances, including certain hormones.”

Which seems to have been cut and pasted a lot, since I found the same words on a number of sites. Not entirely satisfactory, but we’ll go with it — it’s needed for normal body function. Also, if you dig deeper, you’ll discover that your body makes it as required.

So, first of all — can a vegan diet lower high cholesterol? The overwhelming assertions are yes, and there’s plenty of empirical evidence for this. And finally some actual research:

Cardiovascular Disease Markers in Vegans

“Vegans have lower total cholesterol, LDL cholesterol, and triglycerides, while having about the same HDL cholesterol as
lacto-ovo and non-veg.”

So who else has low cholesterol?

How about this:

The puzzling relationship between cholesterol and psychopathology

Oops. There is a correlation between low cholesterol and psychopathy. That is not to say that vegans = low cholesterol = psychopaths, because of course, correlation does not equal causation. And we can probably assume that such measurements were not done in vegans (for the simple matter that they have been historically a very small part of the population), but I have to mention this for completeness.

Also, I should mention this:

https://www.sciencedaily.com/releases/2019/04/190410163018.htm

That is, LDL levels below 70 in women are more at risk of stroke — at least, within the confines of the study — if you read the summary, this study has some limitations.

So Where Are We?

Precisely nowhere. There seems to be no studies done on this topic — that is, the effects of “too low” cholesterol in vegans. Like much else vegan, we don’t really have a lot of long term studies — veganism is by and large a late 20th century invention — and the widespread interest and science really only started in the 1970s (The China Study for example).

Finally, my doctor suggested one more entirely plausible explanation — I’m genetically inclined to have low cholesterol — what I don’t have is my pre-vegan blood tests, to try and confirm or deny that.

Conclusion

I’m not worried about my low readings. Of course, research is ongoing, and we can expect much, much more nutrition research about veganism in the next decade.

Addendum

This came up just yesterday in the news, if you want to know more about this topic:

Low HDL cholesterol 'stable marker' of high triglycerides