Cholesterol's relationship to Test

Mythos

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Thoughts? I noticed that a few of these didn't control for protein intake..

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Is cholesterol the forgotten anabolic?
Cholesterol is a small, fat-like molecule that supposedly clogs our arteries and kills us. But is cholesterol really the bad guy? Or maybe it’s the opposite: a lifter’s best friend?


Cholesterol & your gains: the research
Riechman et al. (2007) found that cholesterol may be good for your gains. In their study, 49 elderly individuals completed a 12-week strength training program with nutritional guidelines. Retrospective analysis of participants’ nutritional logs showed a linear dose-response relationship between dietary cholesterol intake and lean body mass increases (per DEXA). The more cholesterol they consumed, the more muscle they gained. This relationship held up when protein and fat intake were controlled for. See the figure below.

cholesterol lean body mass


Most other research on the relationship between cholesterol and muscle growth hasn’t been published yet. Below is a recap of the data we currently have.

In a similar design as the above study, Riechman & Gasier (2007) again found beneficial effects of a high cholesterol intake for muscle growth and strength development, though the effects were more modest than in their previous study and it’s unclear if protein intake was controlled for.
Riechman et al. (2008) performed another replication study and found a dose-response relationship between cholesterol intake and strength development but not lean body mass. Again, it’s unclear if protein intake was controlled for.
In yet another replication study, Iglay et al. (2009) found no relationship between cholesterol intake and muscle growth or strength development. However, they also did not find any effect of 0.9 vs. 1.2 g/kg/d of protein, which suggests their study was statistically underpowered to research this topic.
Lee et al. (2011) compared a high (~800 mg/d) and a low (< 200 mg/d) cholesterol diet in young, healthy adults. The high cholesterol group had a nearly 3 times higher myofibrillar protein synthesis rate 22 hours after intense resistance exercise than the low cholesterol group. Myofibrillar protein synthesis is a measure of muscle growth, specifically how quickly your muscles are creating new proteins, so these findings again suggest a high cholesterol diet is beneficial for muscle growth.

Research on statins also hints at a beneficial role of cholesterol for your muscles. Statins are a type of medicine used in the treatment of various cardiovascular (heart-related) problems. Statins lower your cholesterol and a common side-effect is myopathy. Statin therapy can reduce muscle strength and functionality, induce inflammation in your muscles (myositis) and even complete muscle fiber death (rhabdomyolysis).


A low cholesterol intake may also be the reason why lacto-ovo-vegetarian diets tend to result in less muscle growth than omnivorous diets in strength trainees, even with the same protein intake. Cholesterol content in plant lipids is about 100-times lower than in animals. However, many other factors, like protein quality, could also explain the lesser muscle mass of vegetarians.

All in all, the available research suggests a high-cholesterol diet is good for muscle growth and strength development.


How can cholesterol increase muscle growth?
The main-stream media demonize cholesterol based on its potential effects in your blood. If you’ve been basing your perception of cholesterol around that message, you may be surprised to find that cholesterol has several potential mechanisms of action to increase muscle growth.

Cholesterol increases membrane viscosity, which may influence membrane stability. This may have an influence on the extent to which muscle cells are damaged during exercise and the magnitude of the inflammatory response.
Cholesterol seems to play a role in the muscle repair process by controlling inflammation. Muscle damage creates inflammation, which leads to the recruitment of immune cells to assist with the recovery process.
Cholesterol is essential for lipid raft formation. Lipid rafts assemble the components for signalling pathways and enhance signalling between pathways that play an important role for muscle hypertrophy, such as the growth factors IGF-I and mTOR. Cholesterol depletion can lead to protein missorting, which reduces the signal transduction.

Simply put, cholesterol can help your muscle cells resist damage and can improve their ability to repair themselves after your workouts, which is crucial for muscle growth.

Cholesterol can also improve your gains indirectly.
Cholesterol is the precursor for anabolic hormones and is crucial for their production.

However, simply having a high serum cholesterol level or eating a ton of dietary cholesterol doesn’t necessarily lead to increased testosterone or more lean body mass gain by itself. The limiting factor of anabolic hormone production is often the transport of cholesterol into mitochondria, where its turnover takes place, not necessarily the amount of cholesterol available in the blood stream. So increased dietary cholesterol intake doesn’t lead to increases in the testosterone level in all studies.

However, we do have indirect evidence from the literature on saturated fat that a typical high cholesterol diet increases testosterone production. Saturated fat is a building block for cholesterol, which in turn is used for testosterone production.

Saturated fat cholesterol testosterone


A low saturated fat intake is associated with reduced testosterone production. For example, men going from a 40% fat diet with a high saturated fat intake to a 25% fat diet with a low saturated fat intake experienced a decrease in total and free testosterone levels; going back to their original diet caused testosterone levels to increase again (see graph below if you’re interested in the details). Several other studies have also found that diets low in saturated fat reduce circulating testosterone levels.

Fat intake testosterone

In fact, in the first study of cholesterol’s effect on lean body mass, the authors also found a significant correlation between saturated fat intake and lean body mass growth. Many diets with a high cholesterol content are also rich in saturated fat, so this is not too surprising, but it leaves open the possibility that cholesterol is actually irrelevant and it’s all about saturated fat instead. To find out, the Bayesian research team contacted Dr. Riechman, the principal investigator of the above study on cholesterol. He confirmed that they controlled for the total fat intake (and protein and energy intake) in the analysis on cholesterol, strongly suggesting cholesterol plays an independent role for muscle growth.

The cholesterol conspiracy theory
Before everyone starts eating 10 eggs a day, we feel the research is a bit suspect: only about 1 in 3 studies on the relation between cholesterol and muscle growth have been published, even though the research was conducted several years ago already. And most of the published research mentioned above was performed by the same principle investigator, Dr. Riechman, who received research grants totaling roughly $2.7 million (that we could find) from sources including the U.S. Poultry & Egg Association.


However, it’s just a fact that scientific research is expensive, so people willing to put a lot money into it, often have something to gain from it. Individuals like Bret Contreras and Menno Henselmans that pay for scientific research out of their own pocket are very rare. The scientific industry is set up so that the integrity of the researchers should prevent the sponsors’ conflict of interest from deceiving the public. And this generally works. Food industry funded nutrition research does not have significantly different outcomes than research with other funding. Plus, Dr. Riechman also received funding from the American Heart Association and the US Army. Not to mention, it’s pretty damn far fetched to pour millions of dollars and risk your career and reputation to promote – of all things you could sell – cholesterol specifically for – of all possible markets – individuals interested in muscle growth. Us meatheads are a tiny part of the population. Us meatheads interested in scientific research tinier still.


Ok, let’s take the tinfoil helmets off and assume there’s no major conspiracy theory going on. That begs the question…

But isn’t cholesterol bad for your heart?
Nope. The mainstream media portrayal of cholesterol’s health effects is about as accurate as the claim of most Olympians that they’re natural. The media will have you believe all that cholesterol you consume ends up clogging your arteries, but the reality is, for most people how much cholesterol you consume in your diet does not even influence how much cholesterol is in your blood. Cholesterol is so important for the body that it is highly regulated. If your diet does not contain much cholesterol, your intestines will increase their absorption to compensate. If that’s not enough, your body will produce its own cholesterol.


Some people, around 20%, have a genetic variation that makes them absorb or synthesize so much cholesterol that their diet does influence their blood cholesterol level. Even in these hypperresonders, however, a high cholesterol diet does not generally negatively influence their cholesterol profile. If total blood cholesterol increases at all during a high cholesterol diet, both ‘good’ HDL and ‘bad’ LDL cholesterol generally increase in the same proportion.

A review paper on the heart-related health effects of cholesterol concluded: “Epidemiological data do not support a link between dietary cholesterol and cardiovascular disease.”

A review on egg consumption concluded that “the evidence suggests that a diet including more eggs than is recommended (at least in some countries) may be used safely as part a healthy diet in both the general population and for those at high risk of cardiovascular disease, those with established coronary heart disease, and those with type 2 diabetes mellitus.”

Take-home messages
The available research indicates a high cholesterol diet may be advantageous for muscle growth and strength development by increasing muscle cell integrity and signalling for muscle growth. The beneficial cholesterol intake seems to be at least 7.2 mg dietary cholesterol per kg of lean body mass and more than 400 mg in men.
Since your body autoregulates your blood cholesterol level, a high cholesterol intake generally does not increase your serum cholesterol level. Even in hypperresonders, cholesterol intake does not generally change the ratio of ‘good’ HDL to ‘bad’ LDL cholesterol or cause heart-related problems.
Article credit to Bayesian BB
 

MrRippedZilla

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Though I agree with the idea that cholesterol isn't bad per se, saying it helps muscle growth is stretching it quite a bit :)
I'll take a look at the cited data in more detail later on in the week when I have time but I doubt I'll find them to say what Menno is claiming they say (hint: there is a massive difference between association and causation).

Also, think of the implications of this. Are you really going to sacrifice protein and/or carbs in order to bump up your cholesterol intake for gains? Physiologically speaking, that makes no sense at all to me.
 

Mythos

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The conclusion seems self contradictory..intake doesn't affect serum levels but eat more cholesterol.
I've been interested in this in the context of statin drugs because my dear old dad just got put on one again.. in the past they've caused him a lot of muscle issues, but after a mild stroke he can't take any chances being off of them anymore. Best advice I could give him was to double up the EPA/DHA. It's sad.
 

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Finally got around to looking at this in depth. We're going to take it 1 study at a time and see if there is any legitimacy to Menno's claim that cholesterol can help us make gains:


Study 1 -
https://www.ncbi.nlm.nih.gov/pubmed/17921432
This is the Riechman (2007) paper that shows a purely associative finding that cannot be used to suggest that more cholesterol = more gains because association isn't causation.

It involved a bunch of old dudes on a shit load of medication that included HRT (7 individuals), antiosteoporotics (4), thyroid medications (5) antihypertensives (9), antidepressants (3), prostatemedications (3) and gastric reflux medications (7).
Self reported dietary intake, which is notoriously inaccurate.
The statin use being associated with gains, which the last time I checked is the data as a whole disagrees with (I don't see a bunch of old, swole, statin users either).

So yes, when you have so many variables involved, using statistical wizardry to try and isolate specific relationships isn't going to hold much weight.


Study 2 - http://journals.lww.com/acsm-msse/F...ct_of_Dietary_Cholesterol_on_Muscle.1949.aspx
They found that 3 eggs leads to more gains than 1 egg.
Eggs contain a lot of stuff and, again, trying to isolate the cholesterol component via statistical wizardry means nothing when something as simple as protein intake isn't controlled.

I'm sensing a trend here, Menno has an economics background so the obsession with statistics isn't that surprising.


Study 3 -
This time its eggs vs egg whites and, again, protein intake wasn't controlled.
The fact that both groups gained muscle while losing fat also suggests poor dietary compliance. A side effect of relying on self-reported dietary intake I'm afraid.


Study 4 - https://link.springer.com/article/10.1007/s12603-009-0016-y
Menno says no relationship was found between cholesterol or protein intake and muscle gains due to the study being statistically underpowered - well, not really.
The high protein group gained more lean mass but you can only notice so much of a difference when protein intake is only increased by 6g (82-88g) from habitual intake. So this paper was really more of a low protein vs high cholesterol comparison with neither variable being isolated = associative findings = meaningless for us.


Study 5 - http://www.fasebj.org/content/25/1_Supplement/lb563.short
So 10 days of high vs low cholesterol followed by 1, acute, postworkout measurement of MPS = both the authors & Menno suggesting that cholesterol is beneficial for muscle growth. **** off.
Acute measurements mean jackshit and the fact that you cannot consume cholesterol in isolation of all other nutrients (protein included) means you're relying, AGAIN, on statistical wizardry to save your ass and it just doesn't.
I don't care how awesome your statistical analysis may be, if the study isn't designed to show causation then it means nothing as far as real world applicability is concerned.


Study 6 - http://www.tandfonline.com/doi/abs/10.1517/14740338.2011.540568?journalCode=ieds20
This is hilarious.
So remember study 1 that showed an association between statin use and gains? Well, as I said earlier, Menno is now showing us data that suggests its in fact the opposite - statin use leads to muscular weakness.
The hilarity is that he is willing to show you data contradicting the statin association but NOT the cholesterol association found in the same study that he was willing to take as a sign of more gains. Cherry picking bullshit at its finest.


At this point, I stopped looking through each data point because Menno's conclusion based on all of this was:
"All in all, the available research suggests a high-cholesterol diet is good for muscle growth and strength development".
I think I've made it clear that the research suggests nothing of the kind.

Summary

My original post holds true. There is nothing within the literature cited in this article to suggest that you all of a sudden need to start obsessing about your cholesterol intake for gains. Nothing at all.
Don't avoid cholesterol but don't prioritize it over the really important stuff (protein, carbs, etc) either :)
 
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