1/ Great thread by @nicknorwitz

Yes, we started talking about this paper as I stumbled in it while looking up citations for a project we’re doing (more on that later)

Per my recent talks/threads, I think successful LPL activity (emphasis on “successful”) is key with triad/LMHRs
2/ But I had no idea there could actually be such a direct pathway to Acetate/Acetoacetate (AcAc) and LPL expression- being crucial for accessing fat stores. While this paper is a mouse model, it’s results are quite impressive when looking to knockout of GRP43 (GRP4-/-) vs normal
3/ and while Nick’s thread importantly mentions the fact these knockout mice *gained* weight on the ketogenic diet — I think a likewise incredible finding is that they also demonstrated far more difficulty in losing weight when eating nothing at all (fasting)
4/ But also note what happen with energy expenditure by comparison over that same period of fasting — the GRP43-/- mice drop lower than controls. Reduced weight loss coupled with reduced expenditure.
5/ Needless to say, I think we consider this a potentially powerful piece to the puzzle, particularly with regard to direct ketone signaling and fatty acid release and overall homeostasis in both fasting and a ketogenic diet.

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More from @DaveKeto

6 Jul
1/ #ListeningThread

Two fantastic intellectuals, @robbwolf and @lipoprotein, chatting about lipids, cardiovascular disease, and #LMHRs

Good podcast for my evening walk — might add some thoughts here…
2/ Wow, in the intro Rob mentions Bill having discussed LMHRs with me (and yes, we’ve had many great chats on the topic). Where he agrees, and where he disagrees. To be sure, I have a bit of an advanced preview on what that will likely be. ;) but I’m excited to hear it in the ep.
3/ 28:30 Bill: I think Dave Feldman has probably helped more than any one person in giving disability and how radically our bodies can change [lipid levels] in just days… So yeah, you can actually influence these results quite a bit in a 3 to 5 day period of time…
Read 28 tweets
2 Jul
1/ I'd like to put a lot of misconceptions to bed on this topic -- so let's unpack...

I personally believe the coming #LMHRstudy will be neither one of these:

1) A categorical end to the lipid hypothesis
2) Completely meaningless
2/ If it seems like there's a wide spectrum of possibilities between those two endpoints, it's because there is

Sure, I do think this may end up testing if the lipid hypothesis can be taken as "dose-dependent, log-linear" in every context. But that's not testing it categorically
3/ For example, it could well be we observe a very low progression of plaque in LMHRs for reasons none of us are aware of yet, but of which don't apply to those with atherogenic dyslipidema in original sense (thus, mixed outcome, new mechanistic aspects yet to be determined, etc)
Read 11 tweets
29 Jun
1/ Watching this episode of @PeterAttiaMD's podcast with @garytaubes...

On "Pathological Science"...

Taubes: “One of the defining characteristics of pathological science is — people commit themselves publicly to a result based on premature evidence…”
2/ “…So it’s not ironclad, they haven’t locked it down, there’s still a chance they could be wrong and they don’t understand the likelihood of that chance, no one ever does until you get very good at this when you realize that chance is enormous.”
3/ “And so once you go public, science is supposed to be hypothesis and test, right? You’re supposed to rigorously test your hypotheses and ideally you’re trying to prove that you’re wrong..."
Read 10 tweets
24 Jun
1/ Ethan would like me to comment on whether I'd take a statin if I had a heart attack, which is commonly considered "secondary prevention"

I can't do that as I avoid discussing use of medication, except (ironically) in a few non-cholesterol Rx.

That said, a few things...
2/ First, I definitely DO NOT want anyone to interpret anything I've said as reflective of analysis with secondary prevention. I'm quite upfront that I prefer looking to lipid research with regard to so called, "primary prevention" (populations without prior heart attacks)...
3/ Second -- and as always -- I want everyone to work with your doctor. Yes, I do think your doctor needs to likewise work with you and your health goals, but this is a given.

If I had a heart attack, I'd definitely be working with my doctor and considering all the options...
Read 5 tweets
24 Jun
1/ Thank you for the invitation, @chadinabhan.

I've now listened to the episode and was a bit surprised at a few points, but also less so with others.

Cholesterol is a very emotionally charged topic, and understandably so...
2/ For me, this journey started 6 years ago with alarmingly high total and LDL cholesterol following my going on a ketogenic diet. I became obsessed with trying to understand why and begin reading everything I could on lipidology...
3/ I found through a series of experiments there was quite a bit of change I could induce based on dietary patterns. As I developed and executed this "citizen science" research, I turned it around back to the community to hopefully help us in advancing this important topic.
Read 25 tweets
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

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