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1/ I wrote a big long tweet thread to address @JTMarlin77's point below. But I realized it has a central flaw, one that I'll keep getting mired in unless "next level" this conversation. So let me come at it a different way...
2/ My position on LDL is nuanced.
I try to make a good faith effort to represent this, even on Twitter. I regularly caveat, qualify, and openly express uncertainty where it should be noted. I don't know that I'm perfect on this, but I do my best.
I try to make a good faith effort to represent this, even on Twitter. I regularly caveat, qualify, and openly express uncertainty where it should be noted. I don't know that I'm perfect on this, but I do my best.
3/ Many people will still seek to interpret my nuanced position as non-nuanced. And that's the problem with talking about this subject. If I attempt to unpack the nuance, it will stretch to 80 tweets. And those same people who simplified in the first place, probably won't read it
4/ In @CarnivoreMD's podcast along with my recent presentations, I pointed to the NHANES data that shows higher LDL correlating with greater longevity. But in both mediums I emphasized this is observational data.
5/ Epidemiological data isn't good about proving causations, but it is good at knocking down claims of causation, particularly where trends go opposite expectations. That's meaningful data where you are interested in the impact of LDL with mortality.
6/ So with all this said, do I feel *certain* higher levels of LDL will result in greater longevity? No.
Again, my position is nuanced. I don't just want to see LDL, I want to see the triad of ⬆️LDL, ⬆️HDL, and ⬇️TG as applied to metabolism and risk.
Again, my position is nuanced. I don't just want to see LDL, I want to see the triad of ⬆️LDL, ⬆️HDL, and ⬇️TG as applied to metabolism and risk.
7/ Which is why my short, uncertain, yet-gets-the-point-across-phrase is that I'm "cautiously optimistic" where I see populations with this triad (⬆️LDL+⬆️HDL+⬇️TG)
This opinion is evidenced-based, it's not idle speculation. Everything I've found on this triad has shown low risk
This opinion is evidenced-based, it's not idle speculation. Everything I've found on this triad has shown low risk
8/ To recap:
- I'm not certain high LDL isn't higher risk for mortality
- However, I do find it is correlated with longevity in NHANES and many other studies
- My position is nuanced, but some will make it not so
- I'm "cautiously optimistic" re the triad (⬆️LDL+⬆️HDL+⬇️TG)
- I'm not certain high LDL isn't higher risk for mortality
- However, I do find it is correlated with longevity in NHANES and many other studies
- My position is nuanced, but some will make it not so
- I'm "cautiously optimistic" re the triad (⬆️LDL+⬆️HDL+⬇️TG)
