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Dave Feldman Profile picture
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19 Jun, 7 tweets, 4 min read
1/ This would be a good opportunity to clear the air on a few things...

Per @DrNadolsky's tweet, we don't know everything we want to know about #atherosclerosis. Almost everyone would agree it is multifactorial, and most of Med would ascribe the central risk driver to LDL/ApoB..
2/ If you see your LDL rise on a #keto/#lchf diet and you're uncomfortable with this, here's a thread I made for that 👇

3/ In the mean time, @DrNadolsky, @DrRagnar and I are literally in the final stages of IRB (knock on wood) to get clinical data via CitizenScienceFoundation.org <obligatory plug>

Clinical data is almost always more valuable than anecdotal data (assuming good design, reputable team)..
4/ I don't think someone dying early of CVD is proof positive it was their diet any more than their living longer is a likewise categorical endorsement.

Rather -- I'm looking for population data, as we all should be.
5/ I have many cases to draw on for longer term #LMHRs who have reporting positive longitudinal bloodwork and vascular imaging of various kinds (CTA, CAC, CIMT).

Why not post these? Because they're anecdotal.

We might do a case series, but I'll stress that point there as well.
6/ Let's not look for good or bad examples and assume they are the central tendency. They can be outliers -- which is why we want to do studies on the population to capture a distribution.

Anyway, I'm thankful to have such a great team helping us move this process forward...
7/ ... It will be interesting to look back on all these conversations (and expectations of outcome) once the study has been completed in a couple years.

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More from @DaveKeto

Dave Feldman Profile picture
21 Jun
1/ #Thread - Hypothesis on why leanness + low carb likely to lead to high cholesterol

I originally retweeted this with a simple "yep" given how it this relates to the #LipidEnergyModel.

Many have asked me to expand, so this thread will be my simple, layperson-friendly breakdown
2/ Let's have some fun and use a relatable analogy...

Imagine you had exactly two kinds of stores in the neighborhood: bakeries and butcher shops.

You normally get groceries from both, but recently the bakeries were closed down, so now you just get meat only for meals...
3/ Now that the bakeries are down, there's more demand on the butcher shops, so they are having more inventory sent to them.

But then, the neighborhood increased while the number of butcher shops actually decreased, and this required an even higher rate of shipments to restock.
Read 11 tweets
Dave Feldman Profile picture
16 Jun
1/ This tweet below from @DBelardoMD brought a lot of interesting conversation.

I wasn't going to weigh in, but given I'm pretty vocal on this topic already, here are some respectful additions...
2/ First, I agree glucose going up and down -- in and of itself -- is not inherently a mechanism of concern.

The key questions of interest are by how much and for how long -- and from this, can we determine if there is a dysregulation?
3/ I was listening earlier in a Clubhouse chat to @Dr__Guess discuss her recent study and how "all over the map" glucose levels were for these T2D patients -- which is unsurprising given the nature of the disease.

Read 11 tweets
Dave Feldman Profile picture
13 Jun
1/ #ListeningThread — actually didn’t know this, but @BioLayne has a podcast. I actually found it in reverse as I’ve been hunting down all things Hypertrophy - and they have a recent podcast with @YngvaiMalmsteve on the topic so I’ll give it a listen… open.spotify.com/episode/2tgWUE…
2/ @BioLayne “… if you torture the data enough, you can get it to show what you would like it to show.”

This is actually a variation I was one of my favorite quotes of all time.👇
3/ it’s also very prescient in its timing. I was actually just talking with @NutritionMadeS3 yesterday, and why I tend to be more interested in studies that work off open or shared data sets given the level of transparency in the statistical instruments being used…
Read 6 tweets
Dave Feldman Profile picture
12 Jun
1/ Great question -- and an important one.

The majority of things I'd "take back" have more to do with my having a simplified version of certain concepts that I now much more about (and would present as such)

But I'll be hit up on those things that are more overtly incorrect...
2/ Probably the biggest is my originally saying "Low Density Lipoprotein's primary purpose" is to deliver fat for energy. I had meant it at the time as the class opposite HDL (thus, all ApoB). Sure, a few slides later I differentiate with VLDL, IDL, and LDL...
3/ But the more appropriate way to have stated the same thing would have been: "The primary purpose of ApoB-containing lipoproteins overall is to deliver fat-based energy."

However, I don't think I'd like this statement as much either given how ApoB impacts immune other mechs...
Read 7 tweets
Dave Feldman Profile picture
7 Jun
1/ Interesting thread via @ck_eternity_

I'll add some thoughts in my own thread to follow, but consider reading his entirely first.

As always, this is in the spirit of discourse. Love keeping it respectful and productive on such challenging topic. :)
2/ Before getting started, note the coming #LMHRstudy will effectively be tackling much of these common considerations quite directly as we study #LMHRs who have considerably high #LDL from being fat-adapted with otherwise #CVD healthy metrics (See CitizenScienceFoundation.org)
3/ While not commonly known, another major carrier protein for chol is Albumin. It's typically considered in light of transporting NEFAs, but its binding sites can (and are) applied to many other lipids, including cholesterol.
ncbi.nlm.nih.gov/pmc/articles/P…
Read 13 tweets
Dave Feldman Profile picture
6 Jun
1/ #Keto > #LowCarb

It’s a ironic, my bloodwork looks fine when I’m either keto (less than 25 net carbs) or low carb (25-100 net carbs).

I have a lot more choices when I am low-carb and the food experience is generally more pleasurable with more treats and greater variety…
2/ But in all that time outside of when I’m eating, I just typically feel better. More balanced, better focus, and on top of all of that, I find I simply think about food a lot less. While it’s fun to anticipate a good meal, it can also be an unhelpful distraction.
3/ It’s annoying to have to identify food that is satisfying, but not *too* satisfying. Food I can enjoy but won’t actively overeat. That’s pretty much everything super low carb that isn’t highly refined (I could definitely drink way too much heavy whipping cream “fat shakes”)
Read 4 tweets

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