Dave Feldman Profile picture
Jun 18, 2020 9 tweets 3 min read Read on X
1/ Random Thursday Thoughts Thread...

- I consider myself an optimist, but I’ve been a little less so lately. For example, as much as there are things to be concerned about right now, I’m looking toward all the economic fallout ahead and... it wont likely be rosy.
2/ - There’s at least a dozen times I’ve wanted to complain openly about how the pandemic really disrupted my plans for #TheCCDoc, the CSF study and several key experiments.

But that’s so tiny compared to many of the friends I personally know whose businesses have gone under.
3/ - On a lighter note, My friend Bill was in from out of town and wanted to play some poker with me at the casinos who now allow for five handed games.

Everyone is required to wear masks, and the dealer provides mandatory hand sanitizer every time someone returns to the table.
4/ - Maybe it’s just my imagination, but for as much as Twitter has a reputation for getting Intensively argumentative — this moment in time feels about 3X more so than any other. Even many of the people I consider to be even keel are showing a lot more edge lately.
5/ - I’m still very interested in what lipid levels are pre-infection versus post COVID-19 outcome severity.

OK, I guess that wasn’t a random thought – more of a central one.

But imagine a world where I could just go get that data – right now.
6/ - This last Sunday my wife and I built a Lego “Hulk Buster” as a fun bonding activity. I figured it take an hour to two hours... nope! That was an all day affair. But I will say it was quite a lot of fun and a welcome distraction. Image
7/ - Speaking of comic book movies, while I am a true blue #Marvel fan, I’ll concede I’m excited about this #Snydercut actually happening. If you don’t know what it is, follow the hashtag.
8/ - In the evenings I have occasionally watched some episodes of Alone. It’s a show that puts 10 contestants out by themselves in the wilderness to survive as long as they can stand it. It’s surprisingly more entertaining than I’d have guessed...
9/ ... The show has occasional “Med Checks” where they visit for a moment and take vitals. They then have discretion to pull a contestant, such as if they get too underweight (rightly so)

Of course, I secretly want to see what their comparative blood work is entry vs exit

• • •

Missing some Tweet in this thread? You can try to force a refresh
 

Keep Current with Dave Feldman

Dave Feldman Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @realDaveFeldman

May 8
🧵 #KetoCTAUpdate thread

I have lots to share today on our recent Keto-CTA paper (#LMHRstudy).

Let's unpack:
⏳ Background & study overview
🤼 #MiHeart match analysis
📊 Initial findings
⚠️ Controversy & missteps
💡 New discoveries
📀 #OpenData release
✅ Next steps
2/ ⏳A brief background, study overview

(For those just tuning in...)

This research started 10 years ago with my work on #lowcarb/#keto, identifying "Lean Mass Hyper-Responders" (#LMHR) with this lipid triad:

+⏫#LDL #cholesterol ≥200 mg/dL
+⬆️#HDL #cholesterol ≥ 80 mg/dL
+⬇️#triglycerides ≤70 mg/dL

(See the original article here: cholesterolcode.com/are-you-a-lean…)

After trying (and failing) to get conventional researchers interested, I started the Citizen Science Foundation (@realCSF) – a 501(c)(3) Public Research Charity.

💰We crowdfunded a study budget for #LMHR and near-#LMHR individuals with this triad. It took a lot of work, but the community stepped up to make this happen.

📝 We recruited 100 participants who traveled to Lundquist Institute to undergo a high-resolution heart scan called a CT angiogram (#CTA).

A year later (visit 2), they returned for a second #CTA, allowing Lundquist to compare the scans and track plaque progression.

When Lundquist shared the aggregate data of the first set of scans after they were completed, I was excited, but we needed more data to make comparisons.Image
3/ 🤼#MiHeart Match Analysis
-- Semi-Quantitative --

Component #1:
🔬The semi-quantitative match with Miami Heart showed nearly identical plaque levels with our Keto-CTA cohort
---

Following the initial baseline scans, Lundquist was then able to conduct a matched analysis with participants from another study, known as Miami Heart (#MiHeart). Eighty of our participants were matched with individuals from this other study based on age, sex, ethnicity, and shared low CVD risk factors.

They were compared with a semi-quantitative analysis. Semi-quantitative readings involve a cardiologist visually evaluating and scoring plaque buildup at key locations in the coronary arteries.

So what were the results?

In short, our participants, with an average LDL cholesterol of 272 mg/dL over 4.7 years, showed no statistically significant difference in plaque levels compared to the Miami Heart cohort (average LDL cholesterol: 123 mg/dL).

You can read our published paper for this analysis here: jacc.org/doi/10.1016/j.…Image
Read 11 tweets
Apr 14
🧵 My thoughts on the Baseline Piece of the Puzzle
-- That everyone keeps missing... 1/10

A week ago today the longitudinal paper for our KETO-CTA study dropped (jacc.org/doi/10.1016/j.…) and there's been a lot of positive feedback, but also critiques worth discussing. I'd like to zero in on the topic of NCPV and PAV change.

First and foremost, I’m looking to be respectful of lead author Dr. Adrian Soto-Mota (@AdrianSotoMota) and Principal Investigator Dr. Matthew Budoff (@BudoffMd) regarding the complexity and relevance the heterogeneity of the cohort with regard to our findings. The coming paper expanding on this for both classification and clinical use is already under submission for review.

However, waiting for the publication of the new paper seems very untenable given how long these things take and interest in discussing the overall change in NCPV and PAV for the KETO-CTA study.

This can be challenging on my end as I want to represent this study effectively. And that’s difficult right now when I not as versed to delve deeper into both the heterogeneity relevance statistics like Dr. Soto-Mota or the issues with looking to changes in NCPV or PAV at low baseline levels like Dr. Budoff.

However, here’s what I can speak to…

I can speak to my own personal challenges in looking to the change of NCPV and PAV overall and why this hasn’t made sense to me. Not from a standpoint of discouragement, such as — this makes the study look bad. No, I mean it actually doesn’t fit any model I’m aware of save present plaque being predictive of future plaque change.

Let me unpack what I’m talking about…

Our baseline scans from the study showed this was a low risk population. Again, if looking at this from a population level.

But then, we were able to do a match analysis with Miami Heart. Matching up age, sex, ethnicity and risk factors quite tightly, but with our cohort having an average LDL-C of 272 mg/dL, and the matched Miami Heart cohort having average LDL-C of 123 mg/dL. And what did we find? They were nearly identical. In fact, for the semi-quantitative data ours was trending slightly better. jacc.org/doi/10.1016/j.…Image
2/10 - Moreover, while unpublished, I was cleared to present a preliminary quantitative match analysis with Miami Heart last year at a conference. These would make use of Cleerly scan data for both our cohort and Miami Heart. So it had both overall plaque volume and non calcified plaque volume (NCPV).Image
3/10 - But even better, there was a subgroup analysis that excluded those taking cholesterol lowering medication on Miami Heart to match again with ours... Image
Read 10 tweets
May 21, 2023
1/🧵 If Plaque #ApoB-48 > #ApoB-100

Quite a rabbit hole so far...

First, let me say that data on this has been a bit limited. But *IF* we do ultimately confirm there are more ApoB-48 (B48) than ApoB-100 (B100) in ASCVD plaque, it would be a very big deal.

Let's unpack... Image
2/ First, thanks to @TuckerGoodrich for pinging me on these pubs and pressing the discussion.

But also credit to @CaloriesProper on tweeting this a couple years ago (I missed it then)

To understand why this would be so important if true, some review...
3/ B48 and B100s are the major proteins on chylomicrons (CMs) and VLDLs, respectively.

CMs mostly carry lipids from the small intestine to the bloodstream (lipids consumed), VLDL mostly carry lipids from storage; predominantly from adipose stores.

See full linages here 👇 Image
Read 10 tweets
Apr 14, 2023
1/ Chat on Triglyceride rich #LDL

#Me: Why would triglyceride rich LDL particles be more atherogenic than triglyceride poor LDL particles?

#ChatGPT: Triglyceride-rich LDL (low-density lipoprotein) particles are more atherogenic (i.e., more likely to contribute to the… twitter.com/i/web/status/1…
2/

#Me: Couldn’t it also be possible that triglyceride rich LDL are ultimately the result of metabolic dysfunction and that better explains its association with atherosclerosis?

#ChatGPT: Yes, that is also a possibility. Triglyceride-rich LDL particles are often associated… twitter.com/i/web/status/1…
3/

#Me: Is it possible that almost the entire amount of atherogenesis associated with high triglyceride rich LDL is due to dysfunctional lipid metabolism and the diseases that result in these profiles rather than the LDL particles themselves?

#ChatGPT: Yes, it is possible that… twitter.com/i/web/status/1…
Read 4 tweets
Apr 13, 2023
1/🧵 I'm definitely a fan of both @DominicDAgosti2 and @DrRagnar (obviously), so I was excited to see them chatting about #lipids, #LMHRs, and Dom's consideration of increasing carbs to lower his #ApoB

If no one minds, I'd like to add some thoughts...

2/ First -- I'm extremely excited to share @DominicDAgosti2 may be the most notable N=1 I've waited for regarding #ResistanceTraining change & #LDL/#ApoB in a #ketogenetic context

Those who've followed me for a while know exactly what I'm talking about...
3/ When chatting with Dom in SD last year for dinner, he mentioned focusing less on maintaining such a sizable muscle mass as he typically does, and I predicted he'd likely see his LDL/ApoB as considerably higher with this change if still #keto. This podcast appears to confirm...
Read 10 tweets
Mar 24, 2023
🧵Followup on #salt comment last night:

Took 3 readings of my blood pressure this morning:
113/78
106/68
98/74
Average: 106/73

Context:
- Male, 49
- Moderate exercise
- Moderate-high stress career
- Supp 6-10g of salt daily when #keto* to relieve fatigue, cramping (for >5 yrs)
2/ So everyone on #keto should be like me and take copious amounts of #salt?

Well, sorry, but the answer appears to be:
👉 Your results may vary.... a lot.

On the little-to-no salt side, check out @KetoCarnivore's recent discussion on this
3/ Also check out this short video answer in a Q&A from Steve Phinney regarding salt intake research
Read 5 tweets

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Don't want to be a Premium member but still want to support us?

Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal

Or Donate anonymously using crypto!

Ethereum

0xfe58350B80634f60Fa6Dc149a72b4DFbc17D341E copy

Bitcoin

3ATGMxNzCUFzxpMCHL5sWSt4DVtS8UqXpi copy

Thank you for your support!

Follow Us!

:(