1/ This new MR study by @mendel_random, @mvholmes, et al makes use of UK Biobank data and determines #ApoB increases risk of #AllCauseMortality, and even #T2Diabetes

This is actually relevant timing as we are rapidly approaching the #LMHRstudy. sciencedirect.com/science/articl…
2/ If you didn't already know, "Lean Mass Hyper-responders" (#LMHRs) would be considered hypercholesterolemic, with this resulting from being very low carb (typically #keto), and are often lean and/or athletic.

(You can read more on this phenotype at CholesterolCode.com/lmhr)
3/ Setting aside why this population exhibits this (see #LipidEnergyModel for more), the most important question is whether they are at risk.

This MR study builds on the existing conventional expectation that they are, and no less in a dose-dependent manner...
4/ #LMHRs don't just have high #LDL cholesterol and particle account, they likewise have very high #ApoB.

However, their #HDL-C/-P levels are high and #triglycerides low (which is relevant to the model). But if #ApoB is the central driver of risk, this will have little impact.
5/ This is why the coming study should provide uniquely powerful data as we've never had a population with the variable of interest being so high (in this case, #LDL/#ApoB), yet all other major #CVD risk markers low to test the specificity of this important molecule and risk.
6/ Naturally, I have to fit in obligatory plug => If you care -- as we do -- about studying this important phenotype and what it can help uniquely tell us about risk with high #ApoB, come visit and show your support 👇


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More from @DaveKeto

18 May
1/ #ListeningThread for @PeterAttiaMD's new podcast with @DrSarahHallberg

Full disclosure, I have tremendous respect for Sarah and all the incredible mountains she has moved in nutrition and health, not to mention just being an incredible human being.

2/ Oh boy -- just 1 minute in and Peter is asking Sarah about dietary fat vs observed composition in vivo! I have a feeling I'm really going to like this episode...
3/ Sarah: "Fatty acids play a critical role, study after study, in cardiovascular risk." -- Love this line...

(Though I'd add a few caveats with regard to lipid profile, but more on that another time)
Read 17 tweets
17 May
1/ Big Update Thread for OwnYourLabs

If you didn't already know, @siobhan_huggins and I launched OwnYourLabs.com last year as a means of ordering private blood work directly. (Feel free to visit the site and for our short intro video)

We have some cool news to share...
2/ In the last few months we've been growing... *a lot*

When we started this originally, it was to help others not only get the labs, but to help encourage them to contribute their anonymized data to help #CitizenScience by given a special discount for opting in (at checkout)...
3/ A few months ago we overhauled the site to include all the features we've been wanting all along (advanced searching/sorting, single page lists, multi-add, bundles, etc)

But even better, checkout is now more streamlined for the anonymous data submission (for those opting in).
Read 7 tweets
24 Apr
1/ Reminder: "Lean Mass Hyper-responder" is literally defined as a combination of LDL ≥ 200, HDL ≥ 80, and Triglycerides ≤ 70.

In other words -- by definition -- #LMHRs are not hypertriglyceridemic (high triglycerides). They are the opposite. (See CholesterolCode.com/lmhr)
2/ For example, in the first of this case series a woman is identified as hypertriglyceridemic (triglycerides of 1109). This is if 15 fold higher than the TG max cap of #LMHR.

3/ Moreover, we actually addressed this particular case of hypertriglyceridemia in our Letter to the Editor of this very case series. In fact, it's how we set up the question on what to consider when triglycerides are low instead

Read 4 tweets
17 Apr
1/ It’s ironic, I came across an email I wrote almost 3 years ago when I was first pushing for a “Study on atherosclerosis in LMHRs”. For that first 1.5 years I tried to raise interest and money from inside the system. Some of these details I’ll go into with the book eventually..
2/ Not at all calling anyone out — just noting that it took me a while to realize it was likely a dead end.

For almost all of them, the answer to this question was already known: High LDL LMHR = high atherosclerosis

(And FWIW, it’s possible they’re right— we’ll soon see...)
3/ Then I had the crazy idea to start a charity and announce at #LowCarbHouston in Oct 2019 that we’re going to just try to straight up raise the money to do this study through crowdfunding.

And you know what?

The community stepped up.
Read 4 tweets
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)...

... 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
14 Apr
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:
Read 9 tweets

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