Thread by @DaveKeto

1/ Thread — Does the Lipid Hypothesis account for a slow down in advanced age?

Alan Flanagan makes an interesting point at around 51:20 in our podcast for #SigmaNutritionRadio. Please listen to get full context.

sigmanutrition.com/episode321/

2/ In short (and correct me, Alan or @NutritionDanny, if I’m not representing it correctly):

Interventions with lowering LDL when at an advanced age have much less effect because of the previous cumulative burden of LDL.

As Alan put it, it’s “too little, too late.”...

3/ I’d argue it should be exactly the reverse if we follow the logic of the Lipid Hypothesis and what cumulative burden represents.

The scale should be:

Low athero = less chance of benefit in intervention
...
High athero = more chance of benefit in intervention

4/ I’m not sure why there’s be a point of exposure where you are now unlikely to see any chance of benefit when compared to likewise cohort without the intervention (again, in the context of the Lipid Hypothesis).

This suggests the “cumulative” and/or “the risk” is conditional

5/ For example:

Low athero = less chance of benefit in intervention
...
Moderate athero = more chance of benefit in intervention
...
High athero = same chance of benefit in intervention as not

⬆️This wouldn’t mechanistically represent cumulative risk.

6/ If there is a conditional logic applied, I’d be very interested in it as I’ve only read of LDL exposure as “dose dependent and log linear” as it associated to both atherosclerosis and corresponding outcome risk.