1/4 Back-of-the-envelope:

There are now 32 NHANES participants with lipids & mortality data who have lived to at least age 100 (age + followup > 100yr.), thus earning the designation of "centenarian"

What was mean avg #LDL-C for this group from their bloodwork 15-20yrs prior?
2/4 What was the mean average #HDL #Cholesterol (#HDL-C) for this group from their bloodwork 15-20yrs prior?
3/4 What was the mean average #Triglyceride (TG) levels for this group from their bloodwork 15-20yrs prior?
4/4 BONUS -- while not a complete set, there are 19 of these 32 who also had fasting insulin levels taken.

What was the mean average fasting insulin levels for this group from their bloodwork 15-20yrs prior?

(I know I'll have @BenBikmanPhD attention for this one 😂)

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More from @realDaveFeldman

Nov 22
1/ Alright, let's chat the #NHANES (IV)

As usual, I'll give my caveats this is back-of-the-envelope on data I wrangled via CDC on this expansive dataset -- and it's associational, ofc (observational)

So what are the lipids like for those who live to 100yr in NHANES? Image
2/ Remember, these aren't the lipid levels taken *at* age 100+, it's what their levels where at the time of examination 15-20 years prior.

This is very relevant when considering reverse causality given this extreme gap in time for all who were reaching centenarian status.
3/ First up -- #LDL #Cholesterol.

Yes, 73% of you correctly guessed 130mg/dL is the mean average for these 32 individuals (lipids taken age 85 or earlier).

LDL mean average: 130 mg/dL

0% 25% 50% 75% 100%
72.0 102.5 126.0 154.0 215.0

Read 9 tweets
Nov 18
Standard caveat, ⚠️this isn't medical advice, ofc

My personal priority list:
1️⃣CCTA (CT Angiogram)
2️⃣CAC (Coronary Artery Calcium scan)
3️⃣Inflammatory markers
4️⃣Lipid markers
2/ CCTA gives a scan of both calcified and non-calcified plaque in the arteries of the heart.

There's an extremely small risk of adverse effects from the contrast dye, and a low exposure to radiation with the latest machines.

However, CCTA scans can be pricy (ie $500-1000)
3/ CAC is just the calcification of the coronary arteries, but it is surprisingly correlative to soft plaque AND is very predictive of future events. Check out @khurramn1's work on this for more info.

It also requires no contrast dye, is lower radiation, and typically $99-300.
Read 7 tweets
Nov 17
🧵 New paper on comparing advanced lipid testing (NMR) with body fat (adiposity) - ht @nicknorwitz

High adiposity associates with:
- ⬆️ #ApoB & #LDL-C
- ⬆️ #triglycerides
- ⬆️ levels of all fatty acids

How does this relate to #LEM? Let's unpack... /1

nature.com/articles/s4385…
2/ "Adiposity-related hypertriglyceridemia is mainly driven by increased numbers of triglyceride-rich VLDLs (which carry the largest proportion of triglycerides in blood). Concurrently, the cholesterol in these lipoproteins also seem to be higher at higher adiposity levels."
3/ And these next sentences are key -- take special note of the underlined text... Image
Read 7 tweets
Nov 8
1/ Respectful rebuttal 🧵:

I think you make valid points with regard to a diet community having bad actors that can reflect on it, @jerryteixeira -- but I'd push back that one has to tow the party line on high fat and/or high meat in #keto or get hammered.

Some examples...
2/ I myself have brought up #PlantBasedKeto many times over to raise awareness, even though I try to avoid the diet debates. But I've not suffered any repercussions from the keto community.

3/ DietDoctor.com is arguably the largest resource for #LowCarb diet, and in the last couple years have put out a great deal more material on higher protein with lower fat as a diet direction option. Many low carbers prefer this emphasis over higher fat as a %
Read 5 tweets
Nov 8
🚨New #LMHR Editorial in JCL!🚨

🙏Please RT🙏

- Cautious consideration for #LMHRs
- Calls for patient-centered approach
- Calls for more research on #LMHRs(!)

AND we raised money from the LMHR community to make this *open access*.

Let's unpack... /1 authors.elsevier.com/a/1g22A6tb2E2O…
2/ So why is this a big deal?

Two reasons:

For one, this editorial is the first of its kind to gather MDs and PhDs together to help develop a clinical position on the #LMHR phenotype and importance of expanding research around this phenomenon.

That's hard to understate!
3/ Typically, there have been just two positions on the topic of high LDL on keto, particularly LMHRs.

- Conventional: LMHR *must* lower LDL/ApoB

- LH skeptic: LMHR can ignore LDL/ApoB

This editorial concludes those with high LDL-c/ApoB from keto "should consider" lowering.
Read 10 tweets
Nov 1
🙌 Okay, it's Nov 1 -- I'm back! 🙌

A catch up 🧵

✅ Social Media Hiatus was nice (I recommend)

#LMHRstudy near recruitment goal

✅ 3 new research endeavors in works!

✅ Possible film project next year

Read on for the unpacking... /1
2/ The Social Media Hiatus...

I was originally shooting for a few weeks away, but it stretched into two months.

Honestly, I have to really credit @MichaelMindrum for inspiring me to really commit to this. It was easier than I assumed given the ongoing research efforts. Image
3/ The #LMHRstudy is nearing recruitment completion!

That said - we still have some participants to go to put us over the top!

So again, *please* visit LMHRstudy.com to see if you or someone you know is eligible for the study.
Read 5 tweets

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