I posted the 20 best foods on earth. Many people saw it. The reply section exploded.
The carnivores said I included too many vegetables. The plant-based crowd said I included too much meat. Someone told me spinach was poisoning people. Someone else told me I should be in jail for recommending beef liver.
I listened to all of it. Went back to the data. This is Version 2. 40 foods. Updated.
Spinach is gone. Fermented foods are in. Organ meats expanded. Every plant on this list is low-oxalate or cooked to reduce antinutrients.
No tribe won. The science won. 🧵
This pyramid has been around for years. Most health professionals know about it. Almost none of them will share it with their patients.
Why? Because food is the most controversial topic in medicine. More divisive than statins. More political than vaccines. A doctor who tells you to eat more red meat risks their reputation. A doctor who tells you to cut carbohydrates contradicts the dietary guidelines. A doctor who says seed oils are a problem contradicts every processed food company advertising during the Super Bowl.
So they say nothing. They hand you a pamphlet from 1992 and move on to the prescription pad.
The pyramid is simple. The base is protein, fat, and whole-fat dairy. Animal foods. The foundation.
The middle is low-carb vegetables and fruits. Real plants. Not processed plant products.
The top is the smallest portion. Starchy vegetables, nuts, seeds, berries. The foods with the most carbohydrate load get the least space.
And outside the pyramid entirely: bread, pasta, corn, sugar, rice, beans, high-sugar fruits. The foods the USDA told you to build your diet around for 50 years.
Here is why this matters metabolically.
Every food you eat triggers an insulin response. The higher the glycemic impact, the harder your pancreas has to work. Do that for 20 years and you get insulin resistance. Do it for 30 years and you get Type 2 diabetes. Do it for 40 years and you get heart disease, Alzheimer's, and cancer.
93.4% of Americans are metabolically unhealthy. They followed the food pyramid. They ate the whole grains. They drank the orange juice. They avoided the red meat and the eggs and the butter.
The foods at the base of this pyramid are the ones with the lowest glycemic impact. The ones outside the pyramid are the ones driving the metabolic disease epidemic.
That is not a coincidence.
The Top 40 is not a diet. It is a menu of options.
If you are keto, everything on this list works for you. If you are paleo, the same. If you are carnivore, Tiers 1 and 2 are your world. If you eat plants, Tier 4 is built for you with the oxalate and lectin risks already removed.
The point was never to tell you what tribe to join. The point is to give you 40 foods that are metabolically safe, nutrient dense, and ancestrally proven regardless of what you call your diet.
Real food does not need a label. And it does not need a tribe.
What changed from Version 1 to Version 2.
Spinach removed. 970mg of oxalate per 100g. For kidney stone formers, that is a real risk. Replaced with kale (13mg), romaine (near zero), and zucchini (near zero).
Fermented foods added. Sauerkraut, kimchi, kefir, natto. Your gut microbiome is Pillar 3 of the 7 Pillars of Root Cause Health. You cannot fix metabolic health without fixing the gut.
Organ meats expanded. Beef heart added for CoQ10. Liver stays at number 1 because nothing on earth matches 27 essential nutrients per 100 calories.
Every plant on the list is now flagged as low-oxalate or marked as "cooked to reduce antinutrients." Because dose and preparation matter more than the food itself.
You asked for this. I listened.
Your doctor spent 8 years in medical school. They received an average of 19.6 hours of nutrition education across all 8 years.
19.6 hours. On the single most important input to your metabolic health.
Then they entered a system where the food companies fund the research, the dietary guidelines, and the medical education. Where a cardiologist can prescribe a statin in 7 minutes but cannot tell you which foods lower your fasting insulin.
They are not bad doctors. They are products of a system that was never designed to teach them what actually makes people healthy.
You have to learn this yourself. This list is a starting point.
40 foods. Five tiers. Zero processed ingredients. Zero tribal allegiance.
Keto, paleo, carnivore, Mediterranean. Stop arguing about the label. Start eating from this list. Your fasting insulin, your inflammation, your gut, and your metabolic health will tell you what is working.
The science does not care what you call your diet. It cares what you put in your body.
The truth heals.
Co-founders, Neo | HealthTruth
Dr. Philip Ovadia, Cardiac Surgeon @ifixhearts
Dr. Aseem Malhotra, Cardiologist @DrAseemMalhotra
Dr. Robert Cywes, Metabolic Surgeon @carbaddictiondr
Prof. Tim Noakes, Head of Science @ProfTimNoakes
The healthy pyramid to reverse metabolic disease, type 2 diabetes, insulin resistance, obesity etc
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I spent 6 years believing the same thing your doctor believes. That LDL cholesterol is the enemy. Lower it and you win.
Then I found the data they never show you.
They lowered LDL to 30. The lowest levels ever achieved in human medicine. And 80 percent of the cardiovascular risk was still there.
They did not call it a failure. They called it "residual risk."
I call it the twelve heads they never checked.
Here is what the clinical trials actually showed.
Eight randomized controlled trials. Statins versus placebo. Across all eight, 56 to 79 percent of patients still had cardiovascular risk after treatment (Yanai, Int J Mol Sci 2022, meta-analysis of major statin RCTs).
They tried harder. Three more trials. High-dose statins versus standard dose. In the high-dose arms, 78 to 87 percent of patients still carried residual risk.
Read that number again. They gave the maximum dose of the drug designed to solve the problem. And up to 87 percent of the risk remained.
So they built a more powerful weapon. PCSK9 inhibitors. Drugs that crush LDL to levels never seen in human history.
The FOURIER trial combined PCSK9 inhibitors with statins and pushed LDL to 30 mg/dL. Thirty. Most cardiologists would celebrate that number.
5.3 percent of patients had cardiovascular events within one year. 9.1 percent within two years (Sabatine, NEJM 2017, N=27,564).
They removed almost all the LDL from the bloodstream. The disease did not stop.
If LDL quantity caused heart disease, removing it should have cured it. It did not.
I have spent weeks building the case for root cause heart disease. The dragon. The forest. The genetics. The Nobel Prize.
Now I want to do something nobody on health X does. I want to test my own theory against every competing model. Honestly. No cherry picking. No strawmen.
If the unified theory survives, it is unchallengeable. If it has gaps, I want to find them before someone else does.
Ten theories. One test. Let us begin.
Theory 1: The Lipid Hypothesis. LDL quantity causes heart disease. Lower it, save lives.
Their strongest card: Mendelian randomization shows lifelong genetic exposure to higher LDL associates with higher risk. Four drug classes all show some event reduction.
Where it fails: 136,905 heart attack patients had normal LDL (Sachdeva). LDL ranked dead last at 1.4x in the Women's Health Study. FOURIER crushed LDL to 30 with zero mortality benefit. 60 trials, 323,950 patients, near zero mortality improvement.
Unified theory response: Lifelong elevated LDL increases the statistical opportunity for oxidation over a lifetime. That is a probability argument, not a causation argument. The disease requires the metabolic environment to oxidize the LDL. Without the fire, the sparks are harmless.
Verdict: Incorporated. LDL is present at the scene. The unified theory explains why it sometimes matters and sometimes does not. The lipid hypothesis cannot.
Theory 2: Response to Retention. LDL particles get trapped in the arterial wall based on concentration. More particles, more disease. ApoB is the better measure.
Their strongest card: Subendothelial retention is observed histologically. It is a real physical process.
Where it fails: Same ApoB, different outcomes. Person A (metabolically healthy) vs Person B (metabolically sick). The Women's Health Study ranks ApoB at 1.5x.
Unified theory response: Retention happens. It is a step in the process. But what happens AFTER retention determines disease. If retained LDL is not oxidized because the metabolic environment is clean, macrophages ignore it. Retention describes the geography. The unified theory explains the biology.
I have spent weeks explaining heart disease one piece at a time. The Nobel Prize. Oxidized LDL. The genetics. The metabolic crisis. The ApoB shell game. The 12 root causes.
Now let me show you how they all connect. Because once you see it, you cannot unsee it.
Heart disease is a 12-headed dragon. And we have been fighting it with one pill aimed at one head for 40 years.
Your endothelium is the forest.
The lining of your arteries is either wet and healthy, or dry and cracking. When it is healthy, LDL particles float past harmlessly. Sparks land on wet leaves and nothing catches.
When it is damaged, the endothelium cracks. LDL enters the wall. And inside that inflamed, oxidized environment, it becomes the oxidized LDL that Brown and Goldstein proved causes foam cells, plaque, and heart attacks.
The sparks were never the problem. The forest was.
Brown and Goldstein won the Nobel Prize in 1985 for proving this mechanism at the molecular level. Your immune system cannot see native LDL. The scavenger receptor stays locked. No recognition. No uptake. No disease.
Only when LDL is oxidized does the macrophage attack it. Foam cells form. Plaque builds.
The Nobel Prize told us the fire needs dry forest to burn. Medicine spent the next 40 years counting sparks.
Millions of doctors prescribe cholesterol lowering drugs. They are not stupid. They are not corrupt. Most of them genuinely believe they are saving lives.
So let me lay out their best argument and then test it against the data. Honestly.
The case FOR lowering LDL. Four different drug classes all lower LDL through different mechanisms. And all four show some reduction in cardiovascular events. When four classes all point the same direction, that is hard to ignore. The medical community calls this concordant evidence. It is their strongest argument.
Fair enough. Let me test it. 🧵
Test 1. If lowering LDL saves lives, we should see a clear mortality benefit.
Ennezat et al. reviewed 60 cholesterol lowering trials. 323,950 patients. Every drug class. Every dose. They reduced LDL by up to 80%.
The mortality benefit was near zero. In some trials, more people died.
If the relationship between LDL lowering and survival were strong, 323,950 people would have shown it.
They did not.
Test 1: Failed.
Test 2. If LDL causes heart disease, people with high LDL should have the most heart attacks.
Sachdeva et al. studied 136,905 heart attack patients. 75% had LDL at or below guideline targets at the time of their event.
If LDL quantity drove the disease, those patients should not have been in the hospital.
I am going to tell you something that will change how you think about heart disease forever.
In 1985, Brown and Goldstein won the Nobel Prize for discovering the LDL receptor. The exact machinery your cells use to take up cholesterol. One of the most important discoveries in the history of medicine.
But the science that grew out of it revealed the real mechanism of how plaque forms. And what medicine did with that mechanism is one of the greatest wrong turns in modern healthcare. 🧵
Native LDL cholesterol is largely invisible to your immune system.
It floats through your bloodstream and your body mostly ignores it. The macrophage, your immune system's cleanup cell, does not engulf healthy, undamaged LDL the way it attacks a modified particle.
No damage. No uptake. No foam cells.
LDL in its natural state is not the enemy.
But when LDL becomes oxidized, everything changes.
Oxidized LDL is recognized by the scavenger receptor. The macrophage engulfs it. It swells. It becomes a foam cell. And foam cells are what build the plaque that clogs your arteries and causes heart attacks.
This is not a theory. It has been proven in the decades since and confirmed by hundreds of studies.
The question was never "how much LDL do you have." The question was always "what is oxidizing your LDL."