Presentation Polls
—————————-

1/ Your current LDL cholesterol is:

(All units are mg/dL)
2/ Your current HDL cholesterol is:
3/ Your current triglyceride (TG) level is:
4/ Do you have a combination of LDL above 130, an HDL above 50, and triglycerides below 100 (the “low carb lipid triad”)?
5/ Do you have a more pronounced version of this triad with LDL above 200, an HDL above 80, and triglycerides below 70 (typical of LMHRs)?
6/ Our coming #LMHRstudy will be capturing high-resolution CCTA scans to detect plaque volume progression in this context to help determine risk.

How important is this study to you personally?
7/ LMHRs have LDL cholesterol (and ApoB) in the highest 3% of the general population.

Assuming a stratification of the population into thirds — highest, middle, and lowest risk thirds, which of these would you predict we’ll see with LMHRs at a population level?
Bonus-8/
LMHRs have LDL cholesterol (and ApoB) in the highest 3% of the general population.

Assuming a stratification of the population into progression of plaque by highest, middle, and lowest 1/3rds, which of these would you predict we’ll see with LMHRs at a population level?
Heads up -- I added question 8 above as a more specific version to question 7 with regard to our study per @DrNadolsky's excellent suggestion.

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More from @DaveKeto

15 Apr
I saw this paper linked by @BioLayne (hat tip!) in a twitter discussion and had to stop and read most of it. Basically SFA vs PUFA infused muffin RCT. There's quite a lot of interesting data within. And it's publicly available, btw (no firewall)...

ncbi.nlm.nih.gov/pmc/articles/P…
... The lipid profile changes for the SFA group are unsurprising to me, ofc. But I was surprised they went with ALT as the proxy for "liver fat accumulation". Relative change 53%, but I didn't find the absolute values listed for ALT between groups? Maybe in the supplement...?
... They had a subgroup of 10 (5 of each) where the did PET-MRIs (need more of this in studies) to detect "change in hepatic palmitate uptake" -- which tends to be a stronger proxy for liver fat accumulation, but it showed no association.
Read 4 tweets
9 Apr
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!)
3/ And while we're at it -- here's a list of people I've had excellent, cordial conversations with who are likewise concerned about high LDL whether LMHR or not:
@DrNadolsky
@ethanjweiss
@lansberg
@Lpa_Doc
@NutritionMadeS3

Listen to them as well -- I do...
Read 5 tweets
8 Apr
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.

Obvious example: Hibernation

#LDL #Cholesterol goes up... does #Atherosclerosis?

pubmed.ncbi.nlm.nih.gov/22686205/
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.
Read 5 tweets
6 Apr
Yes -- a million times, yes.

OxPL-ApoB -- it's the assay I was excited about YEARS before it was available to us -- and particularly OxPL-ApoB/ApoB ratio.

I'd love if a *lot* more low carb hyper-responders (and especially LMHRs) would get this assay.
... 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)
Read 4 tweets
30 Mar
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.
Read 4 tweets
30 Mar
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...”

I couldn’t possibly agree with this more!
Read 12 tweets

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