1/ Whether in agreement or not, @DBelardoMD's statement does represent the existing position of mainstream medicine, particularly lipidology. (Tho she's adding a bit more "color" to it, ofc :) )
My retweets like these are to further generate cross exposure to other voices...
2/ ... Think of it as working toward breaking down some of the echo-chamber-ism.
If you follow me, you're going to get this on a regular basis because I feel hearing every side is important (I have many friends who are LDL skeptics who definitely don't agree with me on this!)
4/ And again, while I'm "cautiously optimistic" with regard to higher cholesterol as we assume is due to fat-adaptation in a metabolically healthy context (see #LipidEnergyModel), that shouldn't be taken as certainty it is safe. Hence the need for the study.
5/ Per @DBelardoMD's concern, if having high ApoB = high CVD even where one has no other risk factors, then LMHRs are developing (and really, have been developing) atherosclerosis quite rapidly. The sooner we confirm/disconfirm this at a population level, the better
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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.
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.
... And obligatory disclosure -- @siobhan_huggins and I are trying to see if we can get this offered through OwnYourLabs.com, but my comment above is not a pitch for OYL specifically, there are many ways to get a @BostonHeartDX lab done, in many cases thru your doctor...
... For anyone reading this who has a doctor who uses @BostonHeartDX, you can consider asking if you can get it ordered (and if they cover it). That's likely to be the best option.
(Also obligatory this-isn't-medical-advice, just an assay I hypothesize has enormous value)
1/ I want to tackle this question head on because it needs to be discussed -- particularly in why the #LMHRstudy is needed.
I now know a number of #LMHRs with long term data that looks very encouraging. Does that prove it's a safe profile? No. This is small, selected sample..
2/ Would a handful of #LMHRs with deleterious outcomes prove it's a dangerous profile? No -- for the same reason.
We don't which are the outliers.
As the known population of these now number in the thousands, a statistician would ask, "what the odds you *wouldn't* see both?"
3/ Those supporting this profile could point to the many showcasing excellent results. Those opposed could point to the few demonstrating the opposite.
Each feeling their examples represent the central mean and others' the outliers.
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”
vs
“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...”
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... 😐)
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