Nick Norwitz PhD Profile picture
Nov 6, 2022 11 tweets 8 min read Read on X
🚨 NEW! Lean Mass Hyper-Responder Editorial🚨

👉 10 MD & PhD authors from 4 countries🌍coming together for 1st of it's kind Consensus Statement on #LMHR

👉 Published in official Journal of the National Lipid Association @LipidJournal

A thread 🧵👇
authors.elsevier.com/a/1g22A6tb2E2O… Image
2/ A bit of background to catch some of you up

Over the past 6 years a population of people has emerged who demonstrate ⬆️ LDL on a #ketogenic diet in the context of ⬇️TG +⬆️HDL

Phenotype was first observed by @realDaveFeldman and (historically) named Lean Mass Hyper-Responders Image
3/ 1 year ago, we started researching #LMHR more formally, and in this year, we've published 4 prior papers

Cohort Study
pubmed.ncbi.nlm.nih.gov/35106434/
Case Report
pubmed.ncbi.nlm.nih.gov/35498420/
Cholesterol drop protocol
pubmed.ncbi.nlm.nih.gov/35938774/
Lipid Energy Model
pubmed.ncbi.nlm.nih.gov/35629964/
4/ With this editorial we take the NEXT STEP in providing an expert consensus of 10 MD + PhD authors on topic of #LDL in #LMHR on a #ketodiet, including incredibly highly respected members of the Lipidology community
authors.elsevier.com/a/1g22A6tb2E2O…
5/ Major take-aways:

A prudent PATIENT-CENTERED clinical approach is required for managing #LMHR patients

The #LMHR phenomenon deserves FURTHER RESEARCH, both on mechanism and risk, and has potential to teach us much about human lipid metabolism and ASCVD
6/ Some of my favorite linesare as follows 👇

"LMHR provide[s] a unique opportunity to understand LDL-c dynamics beyond what has previously been possible”

“where there are competing medical conditions, weighing of treatment options should be an individual matter” ImageImageImageImage
7/ It was a true pleasure to put together this editorial with my coauthors @MichaelMindrum, Dr. Giral, Professor Anatol Kontush, @AdrianSotoMota, @DrRagnar (Tommy Wood), @DominicDAgosti2, Dr. Manubolu, @BudoffMd, and Dr. Ronald Krauss. I cannot speak highly enough of this team Image
8/ I also want to give a HUGE shout out to the LMHR Facebook group + @realDaveFeldman who collectively helped to fund the open access fee despite being blinded to article itself and purely out of a devotion to open-access science and in moving this particular discussion forward
9/ Also, check out Dave's 2:29 min video here. Always high production quality!

10/ I will have more to say on this editorial in the coming days and weeks, but for now I encourage you to read it for yourself (it's concise!) and help to amplify this important discussion! 🙏🙏🙏
authors.elsevier.com/a/1g22A6tb2E2O…

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More from @nicknorwitz

Jun 14, 2023
1/10) 🚨NEW! #Keto for Anorexia🚨

We report on 3 patients who achieved remission from treatment-resistant anorexia using animal-based keto diet 🥩🍳

👉BMIs 10 - 13 kg/m2

👉Each gained ≥20kg

👉+Dramatic improvements in mental health

insulinresistance.org/index.php/jir/…

Read & Share🧵🙏 twitter.com/i/web/status/1… Image
2/10) Background 👇

Anorexia is a devastating condition that increases risk of death >5X and is associated w/ high rates of relapse

There is desperate need for more effective treatment options
3/10) Common knowledge posits patients w/ anorexia should be discouraged from practicing food group restriction

But anorexia can be framed metabo-psychiatric condition that may benefit from treatment w/ metabolic health interventions w/ neuromodulatory properties, i.e. #ketodiet Image
Read 10 tweets
Mar 22, 2023
1/ NEW RCT shows that Fat-Sugar mix

👉 Alters reward circuits in human brain

👉⬇️ preference for lower fat-sugar food and ⬆️ response to milkshake

👉These changes were independent of changes in body weight or metabolic health

... A thread🧵
cell.com/action/showPdf… Image
2/ In this study, normal-weight participants were exposed to EITHER a high-fat/high-sugar snack OR a low-fat/low-sugar snack for 8 weeks in addition to their regular diet. The snacks were to be consumed 2x per day and were isocaloric. Image
3/ After the intervention, they first tested fat & sugar preferences & found, compared to baseline:

High Fat-Sugar intervention ⬇️ wanting for lowest but also highest fat food

Snacking intervention in general (both high-fat- sugar & low fat-sugar) ⬇️wanting for low sugar food Image
Read 6 tweets
Mar 11, 2023
1/ As time has passed and positions have evolved, I’d like to do another thread 🧵 on Satiety Per Calorie (SPC) covering:

👉 Utility vs. Limitations

👉 Issues w/ messaging, “evolutionarily normal” “open-minded”

👉 And to get at sense of prevailing opinions (Poll!)
2/ First, I’d like to say I’m not against SPC as a HEURISTIC and ABSTRACT concept

Reflecting on what food nourishes and satisfies you is a good exercise, in line with mindful eating. That’s the utility!
3/ However, once you start giving foods particular SCORES, you necessarily run into issues

I’ll review a few, and you can also see prior threads...

Prior threads/vids



Read 13 tweets
Feb 6, 2023
🚨Carbohydrate insulin model “dead,” OR is it misunderstood again? 🤥

1/ Doctor Tweeted “that the carbohydrate-insulin theory is completely dead” ☠️⚰️

I recently watch the interview with that doctor, and it was surprising the degree to which s/he got the facts wrong…
2/ The CIM does posit that a high glycemic load diet drives high insulin to glucagon ratio state… as a result energy available in the bloodstream is driven downwards in the late postprandial phase leading to “hormonal, hunger” & overeating…
3/ Doc said: “This whole process of fattening all the way down the line, you’ve actually got MORE fuel in your bloodstream… than someone who is not getting fatter.” ... the “decrease EA in the blood "has never been documented because it’s not really there!” Thus, CIM is dead!
Read 10 tweets
Feb 4, 2023
1/ How to poo 💩! Was listening to the new @hubermanlab with @DrGottfried this AM (at 3:37) on hormones and #constipation & was inspired to do a little thread on my top #6 tips for dealing with constipation ... hopefully this thread helps at least 1 silent sufferer
2/ This is a topic I'm interested in is bc as someone with a hx of proctitis + cecal patch (form of ulcerative colitis strongly linked to constipation), it's something I've struggled w/ at times. It's not fun & a far more prevalent problem than people realize 4 obvious reasons
3/ Let's start the list.

#1 tip has nothing to do with diet, but technique!

In normal seated position with knees at 90o, your puborectalis muscle strangles your rectum. If you squat with the assistance of a squatty potty (or 'toilet yoga') you receive this strangle-hold
Read 10 tweets
Feb 3, 2023
1/4) “Satiety score” score suggest macadamia nuts are more likely to promote weight gain and prevent weight loss than cheesecake?! (higher = more satiety) 🧐

Macadamia = 17
Cheesecake = 19

Battered fried shrimp = 35
Apple juice = 32
Fried zucchini fritters 27

#satiety
2/4) First, lest address the science. Do macadamia nuts cause weight gain?

In a 4 week interventional trial in which people were instructed to eat 40-90 grams of macadamia there was actually a net weight loss.

Try getting those results with cheesecake…
3/4)

Over past few days, I’ve gotten dozens of messages expressing disappointment in the new satiety scoring system

It’s a reasonable concept at best, but definitely not ready to be available as a public tool if it’s promoting cheesecake and apple juice over raw nuts.
Read 4 tweets

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