1/ This is especially important timing.

As many of you know, we're conducting a study on #LMHRs (link later in thread) who not only have extremely high #LDL #Cholesterol, but many (likely most) have diets quite contrary to this advice by the @American_Heart.

Let's unpack...
2/ First, and most importantly, we do not know what the outcome of this prospective study is. So while I'll be outlining commonalities we observe with #LMHRs, this isn't an explicit endorsement of the diet nor any altered lipid levels as a result.

With that said...
3/ We have a lot of data between our standing survey, submissions to CholesterolCode.com, and CC and LMHR Facebook groups (7.7k and 7.5k members, respectively).

Diets are often:
1) Low to no fruits & veg
2) Low to no grains
3) High animal protein
4) Low in plant oils
4/ @NutritionMadeS3 points to an especially strong statement in the paper:

I'm a bit surprised by this statement given how much data we have with @virtahealth at this point, particularly with regard to high risk populations and ASCVD outcomes on #keto.
5/ But that said, it's certainly true we don't have data on *low risk* populations and progression of #atherosclerosis, particularly longitudinal, where consuming a diet considered suboptimal (or even overtly dangerous) by many nutrition experts today.
6/ Hence the importance of the #LMHRstudy.

It's well past time we look to the populations of interest directly.

-

<Naturally, I should insert the obligatory plug here: please contribute to CitizenScienceFoundation.org to complete our funding for this study - we're almost there!>

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More from @DaveKeto

22 Oct
1/ 👉 "HDL Triglycerides"
or rather HDL-TG
-- As in, triglycerides onboard HDL particles

↗️ Highly associated with: total TG, glycerol, fatty liver index. ↘️Opposite w/ HDL-C/-P

And ofc 👉"Patients with carotid plaques also showed higher HDL-TG."...

pubmed.ncbi.nlm.nih.gov/31252694/
2/ @josefagirona, @lluismasana et al conclude the abstract with:

"HDL-TG should be considered a biomarker of metabolic and cardiovascular risk and could be a marker of HDL dysfunction."

If I can offer a different hypothesis (again, consistent with the #LipidEnergyModel)...
3/ Consider these HDL particles with higher levels of triglycerides aren't really that unique.

They more likely a downstream result of metabolic dysfunction as opposed to a distinct species of particle.
Read 8 tweets
12 Oct
1/ Posting this hypothesis for posterity:

I now suspect #PlantBasedLowCarb (PBLC) isn't as low carb as originally thought.

Before getting started in this thread, I should emphasize I wouldn't consider this a good or bad thing in and of itself, but it is of interest, ofc... Image
2/ Moreover, I've regularly pointed to people following my work who are both (1) very interested in a low carb diet, but (2) would prefer to keep their #LDL low to consider PBLC as a "third option", as I commonly see it associates with this outcome.

Now to my hypothesis...
3/ PBLC generally has two major features separating it from "typical" #keto/#lchf:

1) More fat sourced from mono and polyunsaturated fatty acids (M/PUFA) instead of saturated fatty acids (SFA)

2) A lot more soluble and insoluble fiber via plants
Read 11 tweets
25 Sep
1/ New #LipidEnergyModel video on ANGPTL proteins via @nicknorwitz

And a few added thoughts...

ANGPTLs are *all* inhibitors. They are applying the breaks to the Lipoprotein Lipase (LPL) in particular.

So consider this analogy...
2/ Imagine a room full of people at tables being served with trays of food regularly coming from the kitchen moved around the room by waiters.

No one is particularly famished, but they aren't especially full either, so they are absently taking food off the trays to maintain...
3/ However, a few guests at one table leave to get some exercise and return quit hungry.

And here's the catch: You can't tell specific people to do specific things (including the waiters), but you can say things to the entire room. Is there a way to solve this puzzle?
Read 5 tweets
16 Sep
1/ Okay, finally getting around to this experiment video by @ScepticalDoctor

Naturally, this has many things I'm interested in -->
- N=1
- #Lipids (esp #Cholesterol)
- and not least of all, Anna and I have many respectful, kind debates (more of that plz, #NutritionTwitter)
2/ "But this experiment is mainly for entertainment purposes. Self experiments like this are irrelevant from a scientific perspective."

Unsurprisingly, I do disagree on this wording. I think it's fair to say self-experiments have "limited" relevance (depending on design)...
3/ ... But a well designed N=1 can provide quite a lot of scientific value, even if primarily hypothesis-generating.
Read 15 tweets
5 Sep
1/ Yes, my answer to the poll by @nicknorwitz was "Gain 4% body fat". And honestly, it was a pretty easy one when compared to the others.

But to be fair, I also have quite a bit of direct data on this in particular... let's unpack...
2/ First, if you didn't already know this about me, in 2018 I literally gained almost 20lbs of fat for the Weight Gain Experiment. cholesterolcode.com/weight-gain-ex…

(As an aside, I realize now I did presentations on the findings for this experiment, but didn't do a write up. Bad Dave!)
3/ But spoiler alert -- my total and LDL cholesterol did indeed go down where having gained weight and back up where having lost it.

To be sure, I think there are thresholds to "active fat gain/loss" vs standing, stable fat mass, but we'll save that for another thread.
Read 8 tweets
2 Sep
1/ Wow -- it's been quite a week! I announced the #LMHRstudy six days ago. And in case you missed it -- visit here for more details:

CitizenScienceFoundation.org/study

I'm going to provide some updates and answers to frequent questions of the last several days...
2/ "Dave, can you get me in the study?"

No! You have to contact Lundquist directly through the proper channels and they will decide based on the study design whether you qualify as prescribed by existing eligibility criteria we all determined in advance.
3/ While myself, @DrNadolsky and @DrRagnar developed the protocol in collaboration Lundquist, we in no way can (or should) influence any decision making regarding individual considerations -- and that's a good thing. We want this study as fair and objective as possible.
Read 7 tweets

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