Discover and read the best of Twitter Threads about #cholesterol

Most recents (24)

Mag ik jullie er nog eens aan herinneren wat vitamine D met mij heeft gedaan. Weg gewrichtspijnen door ontstekingen (dat weet ik omdat ik etoricoxib slikte). @MinVWS en @ministerVWS. Vitamine D is goed voor je. Het is kanker remmend en zorgt er blijkbaar ook voor dat…

ontstekingen in gewrichten verdwijnen. We krijgen al weinig natuurlijke vitamine D binnen op het noordelijk halfrond. Want vit. D krijg je van zonlicht op je blote, niet ingesmeerde huid. En wat doet @MinVWS daartegen? Niets sterker nog ze zorgen ervoor dat we zo min…

mogelijk vit D aanmaken of binnen krijgen. Hun laatste offensief:…

Andere middelen die ze hanteren (mijn visie, hoeft net persé waar te zijn):
1 maak de mensen wijs dat zonlicht kankerverwekkend is. Laat ze zich insmeren met factor 50 zodat ze…

Read 16 tweets
📊Polls ahead of #KetoSaltLake

Poll (1/4)
Lean Mass Hyper-responders (#LMHRs) are defined by:

+⬆️#LDL #Cholesterol at 190mg (5.17mm) or higher,
+⬆️#HDL-C 80 (2.07) or higher &
+⬇️#Triglycerides of 70 (0.79) or lower

In your opinion, cardio risk level of this profile is likely
Poll (2/4)
Many demonstrating the #LMHR phenotype (but not all) consume a diet...

High in animal protein
High in red meat
High in saturated fat

In your opinion, if we were to further stratify the #LMHR population to those with the above diet, their cardio risk level would be...
Poll (3/4)

When did you first hear of the Lean Mass Hyper-responder profile?
Read 5 tweets
1) Welcome to @cardiomet_CE's new series on #lipid management! This is a 10-#tweetorial program, all #accredited, that will cover it all. Our first expert author is Paul Thompson MD @PaulDThompsonMD, esteemed #cardiologist from @hartfordhosp @UConn Med & now @MGHHeartHealth ! Image
2) This #tweetorial, accredited for #CME/CE and intended for #physicians #physicianassociates #nurses #nursepractitioners #pharmacists is supported by an educational grant from Esperion Therapeutics. See faculty disclosures at
3) @PaulDThompsonMD took on education re mechanisms & use of ezetimibe & bempedoic acid. He proposes a case: 45 ♂️ w/history of inferior wall #MI treated with primary angioplasty.
Read 57 tweets
This one aimed to assess whether inflammation mediates the Black-White incident diabetes disparity.
- In this prospective cohort study of Black and White adults, Black adults had higher CRP and higher rates of incident diabetes than White adults.
- Inflammation as measured by CRP was found to be a risk factor for diabetes regardless of race.
Read 7 tweets
This one tried to investigate the incidence and characteristics of metabolic-associated fatty liver disease (MAFLD) in individuals living in Liaoning Province, China.
- In all subjects, BMI, systolic and diastolic blood pressure, fasting blood sugar, TG, TC, LDL-C, HDL-C, liver enzymes (ALT, AST, GGT, alkaline phosphatase), blood urea nitrogen, serum creatinine, serum uric acid, haematocrit, mean corpuscular volume and urine protein...
...were associated with MAFLD.
Read 7 tweets
This one tried to evaluate changes in the lipid panel data in type 2 diabetes patients with comorbid obesity and chronic pancreatitis taking into account the C/A polymorphism of the insulin receptor substrate 1 (IRS1) gene (rs2943640).
- The results suggest an association between IRS1 gene polymorphism (rs2943640) and lipid profile abnormalities in patients with T2DM and T2DM+obesity.
- Within the C/C genotype of the IRS1 gene in type 2 diabetic patients with comorbid obesity and chronic pancreatitis, lower HDL-C levels and higher levels of TG, non-HDL-C and remnant cholesterol in relation to type 2 diabetic patients with comorbid obesity were found.
Read 6 tweets
This one found greater adiposity measures to be associated with CVD risk factors even after adjustments for covariates and physical fitness in Swedish 9-year-old children.
- Body composition and physical fitness were strongly associated.
- Fat mass and fat mass index were strongly and positively associated with CVD risk factors also after adjustments for covariates including physical fitness.
Read 9 tweets
1/ #Study #MegaThread

A new study dropped with a trove of data I've long waited for around #CCTA/#CAC scans and #LDL #Cholesterol

✅ >23k studied (!)
✅ Largest sample of CCTA w/ ≥190 #LDL to date (!)
✅ Very uniform study population

Let's unpack...…
2/ First, be sure to check out this short thread from the lead author, @MaBMortensen.

2 quick notes:
a) While there'll be lots of data appreciated by LDL skepticism, @MaBMortensen maintains LDL-C is still "an important causal RF"
b) Usual epi caveats, etc
3/ Okay, so if you've followed me a while, you know just how incredibly thankful I am of studies that seek to avoid common risks of selection bias (Even if entirely unintended).

This study had the distinct advantage of categorically scooping its population directly...
Read 18 tweets
1/ #ReminderThread -

One thing that still surprises me is when I'm tweeting or retweeting opinion, articles, etc that are generally pro #LDL #Cholesterol-lowering or LDL-as-problematic (such as recently) I get some pushback...
2/ If you've followed me a long time, you should know this is something I'm proactive about doing -- in fact, I'm more active at doing it now than ever.

If you've only heard the ⬆️LDL isn't-so-bad case, please hear out the mainstream case on how ⬆️LDL *is* bad...
3/ If you somehow hadn't already heard, I literally spearheaded a crowdfunding campaign for an IRB-approved study with longitudinal CCTAs to track plaque development

Why? Because we don't know what the risk levels are for this context. If we did, there'd be no need for the study
Read 11 tweets
1/ If you want to hear a great discussion on the #LMHRstudy from my colleague,@DrNadolsky (who is most definitely pro-#LDL #Cholesterol lowering), I highly recommend this podcast that just dropped via @Plant_proof.

I'll add just a few quick thoughts...
2/ Firstly, this may be the most I've heard myself talked about in a podcast I wasn't in (😂 weird, but understandable given the context).

But while certainly critical in many respects, I felt both @DrNadolsky and @Plant_proof provided a lot of good context...
3/ @DrNadolsky bring up my oft-repeated phrase, "cautiously optimistic" [in the context of higher LDL/ApoB as a seemingly resulting from metabolic fat-adaption]

Worth repeating that mine is a hypothesis and should be treated as such, hence the "cautious" part of the phrase...
Read 8 tweets
1/ This is especially important timing.

As many of you know, we're conducting a study on #LMHRs (link later in thread) who not only have extremely high #LDL #Cholesterol, but many (likely most) have diets quite contrary to this advice by the @American_Heart.

Let's unpack...
2/ First, and most importantly, we do not know what the outcome of this prospective study is. So while I'll be outlining commonalities we observe with #LMHRs, this isn't an explicit endorsement of the diet nor any altered lipid levels as a result.

With that said...
3/ We have a lot of data between our standing survey, submissions to, and CC and LMHR Facebook groups (7.7k and 7.5k members, respectively).

Diets are often:
1) Low to no fruits & veg
2) Low to no grains
3) High animal protein
4) Low in plant oils
Read 6 tweets
1/ Okay, finally getting around to this experiment video by @ScepticalDoctor

Naturally, this has many things I'm interested in -->
- N=1
- #Lipids (esp #Cholesterol)
- and not least of all, Anna and I have many respectful, kind debates (more of that plz, #NutritionTwitter)
2/ "But this experiment is mainly for entertainment purposes. Self experiments like this are irrelevant from a scientific perspective."

Unsurprisingly, I do disagree on this wording. I think it's fair to say self-experiments have "limited" relevance (depending on design)...
3/ ... But a well designed N=1 can provide quite a lot of scientific value, even if primarily hypothesis-generating.
Read 15 tweets
1/ Very cool experiment and thread by @ScepticalDoctor who did a more #PlantBasedKeto and saw low #LDL #Cholesterol given high MUFA/PUFA relative to sat fat, along with high fiber (which supports my prior thread)

If looking to keep LDL low, this might be worth considering...
2/ As per my various tweets before this one on the topic, and not to beat a dead horse, I feel it is too often "low carb vs plant based" is often assumed the latter *must* be high carb -- thus, "low carb, animal-based vs high carb, plant-based"

... This is a false dichotomy...
3/ There are definitely some of us who are, as I like to say, "cautiously optimistic" with regard to higher LDL as appears to be resulting from metabolic fat adaptation in the context of higher sat fat, lower MUFA/PUFA and low to no fiber. But this risk degree is uncertain...
Read 6 tweets
1/ Still one of my favorite studies in relation to the #LipidEnergyModel. One might wonder what happens to animals who become fat adapted due to fasting for a long period.

Obvious example: Hibernation

#LDL #Cholesterol goes up... does #Atherosclerosis?
2/ They were comparing bears in captivity and the wild. And in both, lipid levels during hibernation are "considerably higher than what is normally found in humans"
3/ In spite of the high lipid levels alongside other risk factors, they found no signs of atherosclerosis in brown bears.
Read 5 tweets
2/ I love that Alan Flanagan kicked off with distinction question re bio markers.

“System Biomarkers in the causal pathway. Systemic biomarkers that can report on the overall picture”
“Biomarkers of disease progression”
3/ “... It seems to be in the wider conversation a lot of these are often conflated to a degree. Or there is misplaced emphasis placed on a particular marker...”

I couldn’t possibly agree with this more!
Read 12 tweets
1/ For a very layperson-friendly video on conventional view of #LDL / #HDL #Cholesterol, and #ApoB, I highly recommend this one from @NutritionMadeS3

It's very visual and IMO fairly true to the more specific position of mainstream lipidology...
2/ Love his opening: "why is this topic so confusing? well, for starters scientists are horrible at coming up with names...there's LDL...and LDL cholesterol and they're different things....but a lot of people call them both LDL....and then there's HDL, VLDL..." (trails off)
3/ He's 100% right. It's why it's so hard to convert this for the lay audience. Lipidology could use a terminology upgrade.

For example, how did "Chylomicrons" manage to get a special exception to the "-DL" acronym party? (Only fellow lipophiles will get that joke... 😐)
Read 7 tweets
1/ Okay, I've been getting lots of pings regarding @DBelardoMD appearing on @RealDoctorMike, particularly given discussion earlier in the video with regard to LDL-C and CVD.

I'll do a reaction thread for now, but I'd like to keep it respectful, ofc...
2/ *First, whether ur a @DBelardoMD fan or not, I have to emphasize I respect anyone willing to move against the grain of their community for where they feel the evidence takes them. While unrelated to lipids, she's endured a lot of unpleasantness for a principled re CVD reversal
3/ 2:08 @DBelardoMD: "Nowadays you want to get your LDL cholesterol as low as possible for cardiovascular risk prevention. So, primary prevention versus also secondary prevention."

->Of course, neither this or statements like these are controversial by conventional med standards
Read 12 tweets
1/ Great new thread by the incomparable, @Lpa_Doc -- covering a number of my favorite topics.

Read his thread and return for my added thoughts...
2/ Vilhjalmur Stefansson is a well discussed explorer among the #LowCarb and (of course) #Carnivore communities.

But even more interestingly, he may have been the first #LeanMassHyperResponder of record*

(* Kinda -- as Sam notes, we didn't advanced lipid panels then)
Read 6 tweets
1/ Long running thought exp'nt:

If a drug did many of the same things with one's lipid profile as a #LowCarb diet, particularly decreasing triglycerides while increasing #LDL #Cholesterol:

1) Would it reduce ASCVD risk?
2) And if so, would it be more acceptable than #LowCarb?
2/ If you haven't heard, SGLT2 Inhibitors have recently emerged and have been gaining a lot of popularity. Data thus far shows they typically:

1) Decrease TG levels
2) Increase #LDL #Cholesterol levels
... yet...
3) Reduce risk for cardiovascular disease
3/ Naturally, that has the attention for those of us interested in how triglyceride trafficking and turnover could be relevant to #LDL increasing for what may turn out to be non-pathogenic reasons (kinda my focus ;) )

But wait -- it get's better...
Read 7 tweets
"we observed significant associations with insulin secretion. Notably, C-peptide based indices were positively, but insulin-based ones were negatively associated with LDL cholesterol. This was due to an association of LDL cholesterol with insulin clearance."
Low-density lipoprotein cholesterol is associated with insulin secretion (open access)…

#nutrition #diet #MetabolicSyndrome #cholesterol #BloodSugar
- "We detected a significant, positive association between fasting LDL concentrations and C-peptide based estimates for insulin secretion...
Read 9 tweets
1/ 😁Thread -- About Me -- 5 year update😁

It's been a busy 24 hours since @joerogan's podcast dropped where @CarnivoreMD discussed our work (mega thx, Paul!). There's been a surge of new followers, so I figured it was high time to do an update for those just tuning in...
2/ I'm a senior software engineer and systems architect having developed a variety of platforms over my career.

Five years ago next month I saw my cholesterol levels skyrocket on a ketogenic diet and was extremely interested as to the mechanisms behind it...
3/ I began learning everything I could about Lipidology and the system that moves #cholesterol around in our body. To my surprise, it has many structural things in common with a network (a very advanced one, mind you), but soon I was manipulating my own lipid levels easily.
Read 20 tweets
1/ Thread -- Let's Get the Data

Many medical professionals (like my good friend and colleague, @DrNadolsky) feel strongly that #LowCarb-ers may be acting very recklessly by allowing their #LDL #Cholesterol to be much higher than the guidelines allow.…
2/ And this may well be the case.

Certainly if "diet induced" high LDL is the equivalent to genetically high LDL, such as those with #FamilialHypercholesterolemia (FH), then there should be likewise rapidly progressing #atherosclerosis.
3/ "The sine qua non of FH is severe elevation of total and LDL cholesterol levels."…

Often heterozygous FH is considered where LDL is 190 to 500 mg/dL, with homozygous being above 500.
Read 14 tweets
‘Although proportionately scarce, exercise may paradoxically trigger sudden cardiac arrest in individuals with #cardiovascular disease (CVD), particularly those who were previously sedentary or have advanced CVD.’
‘In parallel with the drive to promote #exercise in all individuals, physicians will be confronted with an increasing number of enquiries from individuals with established risk factors for coronary artery disease or established CVD about participation in exercise‘
‘Such consultations need to strike a balance between the multiple benefits of #exercise, the small risk of sudden death, and the patient’s goals for cardiorespiratory fitness & ongoing participation in relatively strenuous exercise following a #cardiovascular diagnosis.’
Read 30 tweets
Scientists have shown for the first time how two proteins provide a tunnel for so-called "bad #cholesterol" to enter our body's cells.

Published in prestigious journal @CellPressNews, the findings have implications for a range of diseases.…
“We were able to look at the NPC1 and NPC2 proteins and see exactly the role they play in transporting low-density lipoprotein (LDL) #cholesterol into the cell.”

- Prof Rob Yang of @UNSW Science's School of Biotechnology and Biomolecular Sciences (BABS).
“If you imagine NPC2 bringing the cholesterol to the gate at the edge of the lysosome membrane, the NPC1 protein provides a tunnel for this #cholesterol into the cell itself."
Read 7 tweets

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