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...
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
->Of course, neither this or statements like these are controversial by conventional med standards
4/ 2:33 @RealDoctorMike asks if studies regarding saturated fat and its association with LDL and CVD outcome could be biased by those "living a very unhealthy lifestyle with that" @DBelardoMD points to metabolic ward studies on this showing increases in LDL with SFA...
5/ 3:22 "...One of the things that we have the most robust research in cardiology history is the predictability of LDL cholesterol being causative in atherosclerosis..."
Again, not controversial by today's standards -- but important for coming context...
Again, not controversial by today's standards -- but important for coming context...
6/ 4:13 @RealDoctorMike: I see a difference in that if someone can have an LDL of 90 vs if they raise their LDL by introducing, let's say, one egg a day or chicken... and it now goes up to 110. Have we seen the difference between a 90 and a 110 [in] primary prevention?
7/ @RealDoctorMike: "...Or is it solely if they go extreme and introduce a lot of saturated fats, go full #keto that you start seeing the 190s, 200s figures."
@DBelardoMD: (First explains diff between primary and secondary prevention)
@DBelardoMD: (First explains diff between primary and secondary prevention)
8/ @DBelardoMD "For LDL targets in primary prevention, the more and more data that's coming out, we really want your lifetime exposure of LDL to be as low as possible..."
9/ @DBelardoMD "So, I would say, yes you want... someone without heart disease and without other risk factors, keep your LDL below 100. And if it's, the difference between a 100 or 110 or 90, it's not quite significant."...
10/ Again, none of this advice is unexpected for a cardiologist (vegan or not).
The reason this became super topical for many is @RealDoctorMike was effectively discussing #Keto #HyperResponder (perhaps even thinking of #LMHRs...?), particularly near the launch of #LMHRstudy
The reason this became super topical for many is @RealDoctorMike was effectively discussing #Keto #HyperResponder (perhaps even thinking of #LMHRs...?), particularly near the launch of #LMHRstudy
11/ Which is why a lot of this is moot given how close we are to looking specifically at this population and their progression of atherosclerosis with high resolution CCTA. 90 to 110 is certainly very different than "190s and 200s" LDL from the conventional perspective of risk.
12/ I'd definitely extend an invitation to @RealDoctorMike to review our research for the #LMHRstudy as it is released.
It will certainly be charting very new ground given the very high level of #LDL #Cholesterol in an otherwise healthy, non-FH population.
It will certainly be charting very new ground given the very high level of #LDL #Cholesterol in an otherwise healthy, non-FH population.
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