thank you for this excellent fair, honest and balanced discussion of LMHR. I was aware of this phenom, but never did a deep dive because the discussion around it seemed so polarized and tribal. this answered all my questions and more. Nick Norwitz and Dave Feldman appear to be gentlemen, scholars, excellent scientists and true mensches! Wonderful video Chris. You are a scholar, gentleman and mensch yourself.
As a LMHR myself, I am very eagerly awaiting more results from these trials. I was sick as a longtime vegan and have a lot of warm feelings for the passionate and kind vegan community. It's where I found my love of gardening and yoga. However, I healed on keto and as I got very fit, my LDL went up. Gaining weight makes my LDL go down. FIber has no effect on my LDL Carbs make my LDL go down and make me feel lousy. BMI 21, HBA1c 5.1, LDL 220, HDL 89, VLDL 10, TG 50. Can teach 5 yoga classes in a row and feel awesome. Keep an open mind!
I would be very interested to hear whether you ate a lot of oats and various other grains when you were eating vegan? It sounds like you might have cealiac disease.
Interesting numbers. Can anyone answer my question if I'm a LMHR? I've always been very lean and quite muscular. Can eat whatever I want without gaining weight even without exercise. The slightest gain i weight is concentrated around the abdomen. I'm for sure a TOFI (Thin Outside Fat Inside) Normal healthy diet with carbs; Tot.chol 6,5 LDL 4,5 HDL 0,6 Trig 2 In attempts to increase my HDL I've tried a LCHF-diet/ketosis. My HDL-levels is raised but is still too low; Tot.chol 8 LDL 6 HDL 0,8-0,9 Trig 1,5 - 2 My lipids differ from the criteria LMHR with a low HDL. Any thoughts? Am I insulinresistent?
The moment he said his LDL can still be high without saturated fat I thought it must be some liver-related energy metabolism result of ketosis when there isn't fat stores to pull from. Later in the video it turns out that is part of their hypothesis. It's the only thing that makes sense given his information but the potential risk decades out could be massive. Was that Carnivore Kid guy with a six pack and a 95% clogged windowmaker artery a lean mass hyper-responder? I wouldn't be surprised if there isn't a 1:1 risk for LDL for people up around 400 or 500 in this situation but I would be astounded if there isn't a serious elevated risk that warrants trying other options. Additionally, I am concerned that this 1-year study is going to be taken as a golden ticket to not care about LDL despite the warning of being short term. If the subjects are younger when atherosclerosis progresses really minimally, will the age-matching miss detecting what could become rapid artery damage in middle age or as the age-related oxidative stress sets in? Yeah most of these CTA studies might be one year long but most are in middle-aged individuals. People might view it as an LDL pass for keto diets but as the LMHRs or even average high LDL keto dieters hit their 50s and 60s it could be atherosclerosis city. My other concern with this topic is that people (like Jenny Mitich who I just responded to) take cases of people like Nick in their 20s not having plaque on a keto diet as a reason that they will personally be fine with high LDL on a low carb diet. Nick seems to be concerned about LDL in these cases but that warning is not making it to or being taken seriously by keto people on the ground. They simply use his paper to deny any potential negative of high LDL. Total dismissal of LDL's risk is part of the ethos of these weight loss keto dieters and that is dangerous. I also can't help but wonder what particular option Nick has tried for his colitis and if he has looked into his gut biome. How could he eat carbs just fine until senior year? What happened? Maybe some bacterial dysbiosis is to blame? He also says that perhaps exogenous ketones are a therapy for his colon. Why not take the ketones and include enough carbs to lower his LDL for his main diet? That would be lowest LDL risk it seems, assuming the ketones prevent his colitis symptoms. Lastly, I would love to see how fiber would influence LDL levels in these people. Is it just LDL being clearly more slowly or is the reabsorption of biliary cholesterol in the digestive tract playing a role? If you don't have fiber to bind to it and remove it, would that be a missing explanation here for the carnivore dieters, etc.?
"Was that Carnivore Kid guy with a six pack and a 95% clogged windowmaker artery a lean mass hyper-responder?" - No he wasn't. I actually chatted with Michael R. after the event. Sad case. He went 'carnivore' AFTER he found out he had advanced disease. He has a strong family history and actually a mutation in one of the ANGPTL proteins involved in our LEM model to explain LMHR. In my convos with Michael I was clear that, while I couldn't give medical advice, his was a case in which I would have accepted treatment and - thought I didn't tell him this - were I him with his coronary findings I probably would be eating more tempeh and less buttered steak. His story has been distorted for propaganda, which is sad. Sorry not going to get to all your points... time pressed... trying to drive though some replies. Thanks for watching!
just seams to me that hes starting with a desperate need to find a result. that if you eat tons of sat fat but exercise and stay lean your not increasing your risk of heart disease. why would you get on a diet like that.
What a great and professionally conducted discussion. I have become very passionate about diet and health over the last couple years. My journey has led me to a very low carb, meat centric diet. I try very hard to stay open minded and watch videos from as many credible sources as I can find. I think it's so easy to become tribal and forget that we usually have much more in common than we don't. This video really helped me restore my faith in humanity. Keep up the great work!
I've been on a wfpb, sos-free diet since your video on hyper-palatability. I was an obese vegetarian 275 lbs, 6'2" at the start. But I've seen remarkable weight loss in the last 4 months, just recently hitting 233 lbs and falling, exiting my bmi range for obesity. My diet is loaded with starches, oats, whole grain pasta, beans, lentils, etc. as well as all the fruits, potato, corn. I eat as much as I'm hungry for, and whatever my body craves as long as it follows wfpb sos free. So you could say I'm on a high-carb diet and so far thriving! Although I understand 4 months is early days when talking about the rest of my life (in my early 30s). I tried a ketogenic diet in my early 20s with good early weight loss results, but I didn't have the meal planning skill at the time to stick to it, and I crashed hard into the SAD. I've since become convinced by your channel and Gil Carvalho that the preponderance of evidence shows that a wfpd diet is the most healthful diet. However I appreciate your inquires into other level-headed scientists who are looking in different directions, to make sure we're making the best possible decisions for our food-based health.
I appreciate that you are open minded in your search for the best foods for health. What I think I heard is that lean healthy people eating a keto diet are healthy on the keto diet. I would like to learn about benefits v risks for long term ketosis. I would like to see if it truly does what whole food plant based can: reversing type 2 diabetes, reducing inflammation. It is also interesting that keto helped his IBD, because I have had the same result with WFPB. Chris, thank you for your always enlightening channel!
Thanks Chris for your episodes. I am a practicing physician in Canada who has tried to promote healthy lifestyle including nutrition for 20+ years . Your episodes are much appreciated.
Thanks for the video. I enjoyed and benefited from it, even though I'm not smart enough to fully comprehend it. Thanks for introducing me to these two talented people. I'm thankful there's people like this doing this important work.
Many years ago, an overweight relative of mine saw how I ate a lot of vegetables and told me that eating too many vegetables are bad for you. A few years later, she started having chest pain and her cholesterol was 400 mg/dL!
I would love to see this level of ecumenical civility and dialogue in the realm of politics, not least in the US (it's a little better in Denmark but not much). That said, I am looking forward to a good explanation of how the high apo-B or LDL-c causes plaques, if not by the sheer concentration in the blood. Because, no matter what the reason of the high water level in the river is: a dam or a huge flow, the level IS still high.
Because its not Cholesterol that causes the damage. The Cholestetol is part of the repair mechanism so it shows up like a scab shows up from a cut on your arm. Lions and other obligate carnivores blood is loaded with lipids and cholesterol and yet they dont have plugged up damaged arteries.
This study is determining if this type of cohort has more plaque and baseline than controls, and if after a year there is more or less plaque progression than normal or in other cohorts. If it turns out to be much less plaque than expected, then it would suggest that the ldl is only damaging in a non LMHR context
@@CashMoneyMoore Rather that "... the high LDL-c is not damaging to arteries in LMHRs". There can be, and are, other scenarios where LDL-c is harmless as well, which the study does not address. I have been hyped for the study since well before it started. This question of the formation of plaques and other lipid deposits is very confusing. For example: do LMHRs get xanthomas or xanthelasma? What is really going on at the molecular level at the border between blood and arterial wall?
I was a lean mass hyper-responser when I was eating lower carbohydrate. I ate nowhere near a keto diet. I since have moved to a high carbohydrate diet since my body seems to response better. However, it was also due to high cost of meat since the start of the pandemic. Anyway, I went from eating three large servings of meat a day to two or three smaller ones a week. I eat most of my carbohydrates as fruits and vegetables. It took me three years to go from an ldl of over two hundred to one of around a hundred even with this change in diet.
that's brilliant! I went WFPB but with a little bit of oil and salt 4 years ago. I didn't have too much weight to lose, but I lost a couple of kilos. The more I think about the more sense it makes: for health, for the animals, for the planet.
How did it affect your trigs and HDL? I'm asking because my LDL went up a lot when I changed to low carb but my trigs decreased and my HDL increased. I am still a little bit overweight. All my other blood results are within the "normal" ranges, I'm now insulin sensitive and my liver tests are good. Thank you.
I find this study very interesting. I'm vegan, very active triathlete. I have what is considered good lipid numbers and fasting glucose. Never really had interest in a keto diet. I am not considered lean. However, I do believe that this study will give us some good insight. I am interested in the result even though I'd never choose this diet for myself. For the record, I'm the only vegan in a household of 4. I cook all sorts of non-vegan dishes for my family. This could really be a game changer especially for those with epilepsy or other health issues.
That’s excellent re: being vegan in a non-vegan household. I’ve been trying to transition to WFPB but slip here and there because of all the non plant-based dishes I prepare - and all those non PB ingredients at home. And as someone who has epilepsy in their family I agree that this is a fascinating study. Revolutionary even.
@@rambunctiousvegetableyeah...that's what i think when I see flesh... no longer appetizing... Diary doesn't make me as guilty as it should...but I'm still vegan ...for animals
@@rambunctiousvegetableHumans were hunter gatherers for hundreds of thousands of years. It's our evolutionary heritage and it's not wrong or evil. Stop denying our nature. The fact is most people find meat very delicious and nourishing and there's a good reason for that. It's an increadibly nutrient dense food. You won't change hundreds of thousands of years evolution in one generation. As for your care for animals, do you have any carnivorous pets? Do you feed them dead animals?
I was on low carb for a few years. I developed a Xanthelasma under my eyelid. Blood tests showed I had an LDL of 238. They also showed I had high lp(a) and very small LDL particle size and low HDL. In other words, I have a lipid disorder that leads to heart disease without question. I drastically reduced my red meat consumption, added in sweet potatoes, steel cut oats and fruit whilst keeping vegetables high. I also structured my meals in a way I have never seen anyone else do before. It is what I call dose response eating. My LDL went from 238 to 77 in 3 months without any drugs.
Two weeks ago my total cholesterol was 274, I went full plant based, just had cholesterol tested again today, came back 185. It is incredible how bad meat and dairy is.
It's so refreshing to see curious people ask interesting questions and acknowledge that we really don't know the truth yet. I still lean on the side of caution (correlations aren't causation, but sometimes I'm willing to take some stock on them), but I'm excited to see what we learn from this.
bart kay has talked numerous times about LDL. i highly recommend checking him out. he does have lots of experience working in the field of nutrition and cardiology. basically.. there is zero evidence that high LDL is causal for any disease. no properly done interventional study exists proving the claims that high LDL is a problem. even in the context of FH, its not actually high LDL that causes disease and mortaIity but rather the inability to properly take up and utilize LDL. LDL is tightly regulated by the body according to what is going with your life. what makes that so are your genes. those genes have survived for hundreds of thousands of years, tightly regulating LDL according to the bodys needs. it would be ridiculous to assume that high LDL is somehow causal for disease when the body deliberately raises it when appropriate. exercise and losing body fat can raise LDL. does that mean exercise and losing body fat is absolutely bad 100% of the time? being sedentary and eating lots of sugar can lower LDL. does that mean we should be sedentary and eat lots of sugar everyday? i am not concerned about LDL. my genes were passed on to me from my ancestors hundreds of thousands of years ago. those genes that regulate LDL according to my needs know very well what theyre doing.
I think it's important to point out that this possibly non-problematic increase in LDL occurs specifically on ketogenic diets where muscle glycogen is depleted (in addition to other adaptations). That is, if this theory is proven, it does not mean that LDL does not matter, it still matters a lot, if you do not eat well and your LDL is high, be concerned. The video refers to a very specific situation.
Yeah, I no longer worry about lipids. I am more concerned with insulin resistance and blood sugar levels. As long as we don't eat sugar or processed foods, most of us should do fine.
You're making an assumption that LDL still matters. I would argue it may not matter. The medical community may be wrong about it. It wouldn't be the first time.
What a thrill it is for me to see plant chompers speaking to cholesterol coders! I didn’t expect this conversation ever to happen, but it’s a credit to all three of you that it did. The only thing that would make me happier is for Tom Dayspring to join the discussion next time.
Isn't it interesting that Dayspring refuses to acknowledge I exist? In the past year+ on Twitter he's not replied to even one of my questions. I even had a Tweet naming him specifically w/ >200K impressions... and not a single comment
@@nicknorwitzPhD You’re only 2 degrees of separation away from Tom Dayspring, who I believe now works at Peter Attia’s clinic. Your associate Dave Feldman has been on Peter’s podcast. Perhaps try a more personal approach to contacting him through Dave and Peter?
@@brucerubenstein7843 I've tried several ways: direct question, intermediary messaging, etc. He's aware I exist. When he's prepared to chat he knows how to find me.
@@nicknorwitzPhDIn my mind this is clear evidence of 2 things, being 1. An inability to come up with a satisfactory answer and knowing it, and 2. An irrational and / or emotional attachment to the status quo.
The feeling I have after watching this and other videos plus some books is that scientists are victims of personal preferences of diets that worked for them personally or foods they have a taste for: Prof Tim Spector with his defence of red wine ,for example, or his special focus on sugar picks after he was diagnosed pre diabetic, Dr Mario Kratz also focus on diabetes and diets to control insulin resistance, Dr Gil Carvalho has a special focus on cholesterol, and diets that control it and some people with IBS orbit towards low carb diets. After that some followers of a specific diet become like religious converts searching for the ultimate "redemption" through food. And like religious groups they break up into more fanatical "pure" sub groups; Vegans-> raw vegan->fruitarians or Low carbs-> carnivore diet-> lion diet. It's interesting to step outside and look at the Human Play... hope it has a happy ending.
Great logic. It's called "confirmation bias". Dietary extremes (vegan and carnivore) are very vulnerable to it...both appear to have mental blocks to alternative info and research. Sick people seem to have success with "elimination diets" of which vegan and carnivore are both examples
6 years ago, stress induced IBS was diagnosed, cut things out added stuff back. Stable, for 4 years on pescatarian diet, with much reduced refined carbs. Then, one bad flare up and a diagnosis if inflammatory bowel disease. I am now on a mainly vegetarian diet, carbs pretty much inline with traditional food pyramid. All bread is now high quality grains and home baked. All symptoms gone. It seems to me the modern highly processed diet is not good for longevity and not good for coping with personal stress or emotional trauma. Our gut becomes sensitised by the toxic crap in modern food and we get to a point where even foods that are good for us cause inflammation.
Regarding Gil, I really like his open-minded approach. It’s pretty clear after you watch him for a while that he is vegan or nearly vegan, but I see him talk all the time about doing what works for oneself and how plenty of different foods can be part of a healthy dietary pattern.
I got a blood test for health insurance in the middle of going keto and losing a lot of weight fast and upping my cardio. Felt fantastic. My lipids were horrific. The doctor was stunned. I went off the diet. Four years later I was still needing to lose a bit of stubborn weight. IBS that was getting more frequent. Went back on keto, weight flew off, stomach issues disappeared. I am confused. Seems for me doing keto improves everything and makes me lean and happy. It’s a cruel twist if the very thing that improves everything else will kill me. I have decided to stick to the diet that makes my life better and not stress over something that is invisible to me.
sounds like it could be that your keto diet as accidentally an elimination diet for foods that you were sensitive to. Have you tried doing a proper elimination diet and slowly reintroducing foods, tracking them as you do to try and determine what specifically is causing GI issues?
@@MB10097 it could also save them from other diseases: on average, all-cause mortality seems lowest with an LDL level of about 150mg/dl, or 4 mmol/l, and HDL of about 75 mg/dl, or 1.9 mmol/l, and the risks go up faster the lower the numbers. LDL seems to vary quite a lot between individuals though, and is likely more of a marker than a cause of disease (which explains why all-cause mortality does not improve with statins). Plant sterols can also be used to lower LDL, but it is unknown to me whether that is actually beneficial, at least I haven't seen any long term data, unlike with statins.
@@sandywendelfred8260 It's no accident that removing factory food and going whole food, low carb, make you healthy. Health has only gone down as factorys making food increased
I've long respected Dave, and was on a strict keto diet for a while. I was never LMHR per se, but my trigs were in the 20s and my HDL around 60 or so. My cholesterol numbers were so bad (ApoB of 186), that my physicians all begged me to stop the keto diet. I've got two teenage kids, and I can't be experimenting with my health. So I switched to a more Mediterranean diet, mainly by adding two cans of legumes and a serving of steel cut oats per day - and my Apo B dropped to the 80s. Combined with good BP and being physically fit in my 60s, that's good enough for me.
If you don't have any specific issues that deserve some tuning or experimentation, a standard mediterranean-style diet is the safest bet. It contains all you need and leaves room for variation.
@@joesylvia607 it seems like everyone in the US is obsessed with diabetes, everything is about extremes there. If you eat sensibly you don't need to worry about that, nothing wrong with carbs for most people
DYOR. I have and discovered a lot of people have been carno/keto for years with no problems. Cholesterol was high. I think the medical community needs a reset on cholesterol. More and more evidence coming out is challenging the current establishment beliefs.
Thank you for taking so much time and care to put this data out to the public. over the years I been eating like a jerk, knowing I could be doing better but giving into convenience and indulgence. Your videos have helped tilt the balance on my dinner plate.
Thank you so much for what you do. I love watching you on Plant Based News, but only just found out that you have your own channel after seeing you on Switch 4 Good. Thank you for sharing your story with us there. I had a rough start too, but nothing like what you went through. I'm so grateful that you were able to get through it to the other side, and that those experiences informed who you are today. Because really, who you are is a gift to us. I think from some of your wanderings that we're practically neighbors, so hello from Sonoma County!
The one thing we should keep in mind. LDL as the only measurement of an issue is most likely wrong. It's a very mechanistic view of human health, but humans are not machines. We're biological organisms. A marker can show that there's an underlying issue, but it's the height of hubris to think an effect is the sole cause of something. We may bring a specific number down, but that doesn't mean the root cause is being addressed. It's also harder when hundreds of billions of dollars are being made on just that one metric. In the description of this video you asked "Your cardiologist just freaked out. Should you?" My cardiologist wanted to put me on statins when my LDL was 73. I was 58 and just had a cardio sonogram that showed I had little plague build up, consistent with a person my age. It's this shotgun approach to prescribing statins that is really disturbing, as the centenarian guy says. 7 out of 100 will benefit from a statin. But medicine can't narrow that down. Maybe to 7 out of 50 or 7 out of 10? I like the theory of take a statin to lower risk of heart disease, become diabetic as a side effect, which increases your risk of heart disease. Hmmm. Arnold might be, but we are not machines.
@@AdAm-cw3gi actually I do. Tell me why folks with lower LDLs still get heart attacks - from a 2009 UCLA study: Specifically, these patients had low-density lipoprotein (LDL) cholesterol levels that met current guidelines, and close to half had LDL levels classified in guidelines as optimal (less than 100 mg/dL). "Almost 75 percent of heart attack patients fell within recommended targets for LDL cholesterol, demonstrating that the current guidelines may not be low enough to cut heart attack risk in most who could benefit," said Dr. Gregg C. Fonarow, Eliot Corday Professor of Cardiovascular Medicine and Science at the David Geffen School of Medicine at UCLA and the study's principal investigator." ... Researchers also found that more than half of patients hospitalized for a heart attack had high-density lipoprotein (HDL) cholesterol levels characterized as poor by the national guidelines. ________________________ This is in line with current research. So what's your LDL level? How about in relation to your HDL level? Low HDL is also a risk for disease. Your triglycerides are important too, as well your level of insulin resistance. That same study stated "the risk of cardiovascular events increases substantially with LDL levels above 40-60 mg/dL". If you LDLs are higher than that, are you going to go on a statin? The American Diabetes Association in 2023 is currently recommending LDLs below 70, and what to see it down around 50. So when I had my stroke I was pre-diabetic (insulin resistant) and had hypertension. My LDLs were great, though my HDL was lower than the minimum recommendation. My triglycerides were high. I wonder why I had an issue with such great LDL numbers though... So please tell me exactly where I'm wrong. Easy to say that from your keyboard. Making an argument is a little tougher.
3 years back for about a year I started serious endurance cycling (at least 200KM a week) and for a blood test done just out of curiosity got my lipid panel done. I'd lost a considerable weight (from 76 KG to 62) and my diet was almost high carb vegan but somewhat calorie restricted, so I was puzzled to see my LDL 132, HDL 39, triglycerides 150. Although I was feeling quite healthy overall, I couldn't make any sense of data. I brought down LDL and Triglycerides below 100 with regular intake of soluble fibres (psyllium, chia, flax seeds, basil seeds) soaked in a glass of water with every meal, though I think it's just cosmetic. I guess lipid profile numbers don't mean what we think they mean.
My ldl was pretty high like 112 and I ate a ton of fiber but I was getting fat like 180 lbs like 26 BMI. I am cycling 6 days a week now and no more junk fats(I am assuming they are the culprit) from stuff like sweets, pizzas, and oils. My tris were also high as yours. I also added healthy fats like you flax seeds and walnuts. Will see how it affects me in 5 months.
@@KrazyKrzysztof Exercise will definitely improve your health but won't impact much on weight. It takes insane amount of exercise to burn miniscule ammount of fat. Also exercise will make you hungrier, so calorie control is a must. When I was doing mild calorie restriction what worked for me was Salads and soluble fibre drink, which filled my stomach mostly and reduced my cooked food intake. I don't even grind my chia seeds, basil seeds, so they don't provide me much healthy fats. They're just convenient fiber sources.
@mitesh8utube for sure. I am just eating good food while minimizing any junk. I have reduced my servings and I measure my food for things like smoothies because it's easy to overeat on stuff like peanut butter. I am lifting every third day and doing a lot of cardio. It will take time but I'm looking much leaner and less bloated at 175 5 foot 10
@@KrazyKrzysztofone great way to help lose weight is have a big salad before every meal. You won’t really have to deal with portion control then because your stomach will tell you that you are full sooner. Check our Dr. Greger’s book “How Not to Diet” it’s packed full of science backed information. A whole food plant based diet without added (or at least limited) salt, oil, and sugar is great. Dump the peanut butter in the trash and eat peanuts IMO. And chew your fruits and vegetables instead of drinking them, like with a salad before meals, it helps your brain get the signal that it had enough to eat unlike with drinking when you can easily chug down too much. This helped me lose the 50lbs I gained during the pandemic and kept it off.
As a fellow science nerd this is a fascinating look at the early steps of the scientific method. Observations have led to a question, further background research have led to a hypothesis, and they are now just setting out to test the hypothesis. This could be paradigm shifting, or could shed light on and support current consensus, or simply lead to further questions. Thankyou for a really interesting interview.
My weight is now normal and steadily headed for ideal, and my LDL was 70 even when I was overweight thanks to a moderate detour into "conventional" eating patterns. Thankfully cycling 50 to 100 miles a week was protective. I'm sticking to my vegan whole plant diet I adopted 42 years ago. I must be getting 15 portions of veggies a day and heavy tahini consumption gives my diet a Mediterranean macro balance. At 63 I'm fitter and healthier than anyone I meet.
Happy for you but it’s an extraordinary claim you make at the end of your comment. First it is a rather arrogant, and it is confusing because I have read many other UA-cam commenters making similar claims. In reality there is no objective way you could know that you are either fitter (undefined term), or healthier (also undefined term) than everyone you meet unless you meet only a extreme subset of the population. I guess you never meet very young very fit healthy athletes. And why would you even make this comparison? If you are are fit and healthy that’s the objective irrespective of anyone else’s condition.
@@marcdaniels9079 ok it's age related, but my 33 yr old niece is literally killing herself. It is heartbreaking when it's younger siblings. Even with their oldest brother as an example, they are trapped by their eating habits and maybe sign up for Weightwatchers yet again.... People think of vegetables as a garnish. The dietary recommendations are ridiculously conservative. One day I will exercise enough to justify adding bread back into my diet.
0:00: 😮 The video discusses the rise in LDL cholesterol in some people on ketogenic diets and the lack of understanding about its impact on arteries. 6:40: 📚 There is an inverse association between BMI and LDL cholesterol change on low-carb diets, and being leaner may be associated with LDL bumps in some people. 13:36: 🤔 The speaker discusses the importance of questioning and pushing for answers in scientific research. 20:21: 📚 The video discusses a study on lean mass hyper-responders and the use of coronary CT angiograms to measure plaque progression. 27:40: 📚 The video discusses the question of whether high levels of LDL cholesterol alone can cause plaque progression in heart disease. 34:26: 💊 The speaker's health was deteriorating, but they found a ketogenic diet that helped them regain their life and continue their academic pursuits, although it caused their LDL cholesterol levels to skyrocket. 40:59: 🗣 The speaker agrees with Walter Willett's statement and emphasizes the importance of considering individual cases when determining the benefits and consequences of interventions to lower LDL levels. 47:48: 📚 The speaker discusses their experience collaborating on a cookbook that combines Mediterranean and ketogenic diets. 54:21: ! The video explains the process of how VLDL becomes LDL and the role of triglycerides and cholesterol in this process. 1:01:14: 📚 The speaker discusses the lean mass hyper-responder phenotype and its connection to a low-carb diet. 1:08:25: 🔬 The speaker discusses a study on the relationship between being powered by fat and higher levels of LDL and ApoB. 1:16:01: 😳 The speaker is preparing to come out and has been experiencing emotional ups and downs. 1:22:33: 📚 Verbal precision and clear communication of data and hypotheses are important for experts in the field. Recap by Tammy AI
I could be a LMHR at BMI under 20, body fat ratio 11% with high LDL-C 165 with low TG 47, good HDL 67. Alas, going give up Keto as whilst I hope these guys right that it is safe, not worth me taking risks till proven. So switching to Mediterranean with Portfolio diet for better control
While their work is interesting the real question raised is "how do we build ketogenic diets", the result of the LMHR idea is that it reinforces ketogenic dieters not worrying about ldl and building their diets with high saturated fat foods like red meat and dairy. A more evidence based approach would be a lower saturated fat/ higher fiber approach with vegetables, avocados, fish, etc. Dave and Nick while interesting, are pushing keto dieters away from the second method whether they realize it or not. Most keto fans are NOT going to be LMHRs and are likely being hurt by building their diets in a sub-optimal way.
They are stating that proper responsible communication of their research should prevent what you are inferring. Bless them, they are wrong, as anyone who has taken even a passing glance at keto chat threads knows. I hope that community's ideas don't end up _corrupting_ their communication about their research.
I admit I have an inherent disrust of anyone promoting a keto diet to the general public. Sure it seems to help a few people with specific health issues. However most evidence suggests its not nessesary for good health and most people can live long healthy lives without it. Which, when you take into account its environmental impact, its an unacceptable diet for most people. Our planet simply cannot support everyone eating keto because of how prevalent animal products are in pretty much every keto plan (plant based keto is technically possible but every keto person I've met eats red meat at pretty much every meal and alot of the "advocates" have meat/dairy industry ties). I think anyone promoting a diet to the general public should consider is whole impacts, including the environment and animal welfare.
Yes, IBD is so rare I see multiple commercials about it. Also, why would big pharma spend billions if they could not make it back? Obviously, they saw a way to make lots of money and jumped on it. Your reasoning needs reconsideration.
I agree that there is not enough evidence (yet) to recommend keto to the general public without specific medical indication. Although there's also no solid evidence against. Moreover, with 11% of the US population having diabetes and a whopping 38 % prediabetes, keto is relevant for a large part of the population. The ecological argument against keto is flawed. It assumes that most people on a regular diet eat plant based and planet friendly, which is not the case. Most people in western societies eat a lot animal products AND a lot of carbs. I eat keto and consume meat maybe twice a week. I get most of my fat from eggs, olives, olive oil, avocado, cheese and nuts. Most people I know eat meat meat every day alongside their bread, pasta, rice etc.
There's also the matter of mental illness etc. I was very prone to depression. In almost 10y on lchf I've had zero depression. These effects are very real.
I can't wait to share this interview with my brother. We've had a long running dialog on the role SFA and high LDL levels on vascular health. He's been following a high SFA Keto diet and I've been on a low SFA plant strong diet. We are both seem to be doing well on our respective modalities.
@@CharlieFader We are both feeling well, and most of our bio-markers are good, but his LDL-C's are dimed while mine are in the cellar. There are SFA in all whole foods so they can't be avoided, but whereas I do my best to keep my SFA intake low, he embraces them. I'm worried about his SFA and dietary cholesterol intake. I believe that he's consuming considerably more than optimal, but he's believes differently so there you have it. I suppose I subscribe to the Grandmother Diet which is, "Eat you vegetables and lay off the meat!"
@@CharlieFader I’m sure you’re familiar with the justification. He believes that a high meat, low carb is the diet humans evolved eating and the reason that moderns in industrialized nations are getting sicker and fatter is because they’ve strayed from their natural diets. He’s experienced inflammatory pain, and this diet has ameliorated these symptoms and he has been able to obtain and maintain a healthy weight so he received benefits from this dietary pattern. His sources seem questionable and anecdotal, but it’s difficult to argue with success. Mindful of this, I do my best to engage him in conversations about research that recommend the benefit of lower SFA and dietary cholesterol intake, but it’s a nuanced and emotionally charged topic, and I am an engineer while he is an MD so I need to tread carefully when stating my case. I am well read and researching natural ways to avoid and treat health problems is a passion for me, but he is a doctor after all and this is his profession. He is deserving of respect for his training. It’s tricky.
After watching this, I’m scratching my head a bit. Most - maybe all - of your videos at the end I feel enlightened. Maybe this is over my head…most likely…but it seems like 90 minutes of talking that could be summarized in 10 minutes. There is a group of folks we’ll call LMHR who might tell us something about lipid mechanistic. We’ll study them some and maybe learn something. At this point we have no idea if their high LDL is an issue, we’ll find out. And it appears that the Keto diet helps at least one dude with this digestive issues. So is it worth learning more about…yes. Is it at this point a pointer that the “Keto” diet is healthy…no. Does it disprove any theories at this early stage…wasn’t clear to me it does.
Looking forward to the study’s results. Love this conversation. Do you think you’re having a harder time understanding, because you’re a bit resistant to the information presented? I agree, though, that this information doesn’t have to negate how and what you want to eat.
It seems that therapeutic diets as a subject is relevant to a whole lot of people to address a whole lot of conditions. I don't see anyone arguing about keto and epileptics. What is a little more cogent to the content of this channel is longevity, and the quality of a measurably longer lifespan. Nick made it clear he's chosen to live comfortably. Who wouldn't choose that? What would be interesting (along with this study) is to see how these fat-based diets affect the lifespans of the sick people they are helping. I wish I could live long enough to see if Nick makes it to 90, but .... And if we learn a bit more about ourselves, there's no limit to how many other people will be able to live longer and better lives.
As someone who reads drug trials and reads nutrition research articles as a hobby, there are many examples where dietary changes results in greater metabolic marker and outcome shifts greater than what is seem in clinical trials.
This is because clinical trials look at averages over many people and only look at one change in isolation. When you look at trials where results for each participant is shown, you can see this more clearly. On any given dietary change (keto, vegan, low fat, fasting, etc) you will have some people improve (usually most people - if the dietary change results in less processed food and fewer calories) and others get worse.
Well... thanks for admitting you were swayed by a false narrative. I'm not so bothered by the rumors and lies with concern to my ego... but I think it undermines good discussion. If someone wants to raise an accusation, I feel that's fair but it needs to be concrete, direct, and supported by evidence, e.g. 1:21:52.
If the LMHR study shows negligible plaque progression, then we have everyone with high LDL, thinking they LMHR (or close enough) so LDL doesn't matter. When this is a fairly nuanced, warranting more study.
" then we have everyone with high LDL, thinking they LMHR" - not if we communicate clearly. But the responsibility here is on both sides. Those - not to be named - who use the term "LDL denier" do more of the inappropriate clumping than those interested in LMHR
@@nicknorwitzPhD I expect it to be widely miss-used. Remember the Time "Butter is Back" cover. I wouldn't be surprised if Time has a "Cholesterol doesn't matter" cover...
This was fascinating even for a mostly non-medical person. I hope you will alert us and discuss the study results when they come out! I have all kinds of questions about people NOT in that specific group discussed and how the results will apply toward others. It makes me wonder if the low-fat craze has caused changes in our bodies causing health issues, including excess weight, and if a balancing of fats in any kind of a healthy diet, such as we see in a Med. diet, would be beneficial.
I have lean mass hyper responder. I'm lean but not on a low carb. My diet consists of 80 percent veggies, 15 protein and 5 percent fat. My LDL is a little high, HDL is very high and my triglycerides is very low. My doctor wants to put me on statins. I don't want to. I'm 66 yo woman. This might help your research.. I started drinking alcohol more in my 50s. That's when my LDL started to go up. I stopped alcohol 5 months ago and my LDL is starting to go down but still a little high.
LDL of about 150mg/dl, or 4 mmol/l, seems to be optimal, on average. From what I've read and heard of statins, their efficacy in terms of overall mortality, and the side effects, I'd never start them myself.
If you started eating keto, your lipids would probably go through the roof. Just make sure to avoid sugars and processed foods and get regular exercise to keep as healthy as possible. I refuse to take statins again.
Is his argument that there are a group of healthy young people who eat a keto diet and have a high LDL? I must be missing something. I don't understand why that's a revelation. And why it means that the keto diet should be applied to as high as 50 percent of the population.
Nick has inflammatory bowel disease, so he switched to a Keto diet after trying everything else and his symptoms significantly improved (I’m truly happy that he’s found a solution that offers him a better quality of life). But, now he’s latched-on to Dave’s LMHR nonsense to help ease his worries about developing cardiovascular disease from eating Keto.
umm a lot of the lmhr are not young, by the way. You have taken the 50% out of context. Yes, you are missing something as you haven't listened to the video properly. He says he could probably walk into a gym and turn 50% of the people there into lmhr. He did not say anything about 50% of the population should be keto.
You are correct! Young person with high ldl on Keto very common. This is the same guy that needs to eat keto or he would be in the hospital in his own words. The problem is this is the same man that goes on the high carb diets, even an Oreo diet regiment, to prove his LDL goes down. Yes, no brainer, but wait I thought if he ate like this he would be sick again. The two problems I see. People love to find good things about their bad habits, and number if he went on an elimination diet and then re-introduced carbs, he would probably not be sick. He also is usually immature on other channels, but not so much here. Also, he keeps saying people need to be open mined, can anyone be more open minded than Plant Chompers. Nick spends most of his time on shows that disagree with Plant Chompers, while buddying up with them. I found out I was a lean mass. Hyper responder on a ketogenic diet years before these two men came up with described as a phenotype. I realized when I was on the keto diet, how unhealthy it was, and I started eating more carbs and vegetable, and guess what my LDL went down. Was I a genius and didn’t even know. Lol. Maybe I should just eat Oreos.
Great discussion. Looking forward to reading the study when published. Many people seem to confuse the state of ketosis with a particular type of diet. Ketosis can be achieved with many types of diet, including vegan, although its more difficult. Common sense would tell me that our species was in ketosis for long periods of time regularly, probably the majority of existence. It's how we evolved, therefore that ensures me that it's a natural, healthy state. I always assumed ketosis was the default state for humans and that switching to predominantly glucose energizing of cells (low ketones) was rare and only occurred for most humans during the part of the year where we fattened up preparing for leaner times again. There is no way most of humankind had access to high carb foods the majority of each year. Even humans with no access to meat would have eaten plant based food that was nothing like it is today and very low in carbs.
Ketosis can also be achieved with fasting, which isn't too sustainable, I guess, but still. I'd even argue that people don't know their baseline lipid profile without a 2 day fast before a blood test (and that fast includes "no acutely unnecessary medication")
Dr. Greger's video Low Carb Diets and Coronary Blood Flow discussed the research study that showed that a healthy plant based diet for a year showed a 20 percent decrease in plaque, while a low carb diet showed a 40-50% increase in plaque in coronary arteries. Using actual imaging of the arterial blood flow to the heart. (Fleming, Boyd, "The effect of high protein diets on blood flow' Angiology 2000.)That's enough proof for me to recommend wfpb instead of keto to any non-epilectic adult.
Thanks to you, I just read that study. It doesn't seem to say anything whatsoever about keto? It talks about, as the study title implies, 'high protein diets.' And while the study defines the diet of the 'treatment group,' the 'high protein diet' is left undefined, with no mention of its composition made. It is left undefined because the so-called 'high protein group' went and did whatever they felt like. To cite the study; "At the conclusion of the study, it became apparent that 10 of the 26 individuals, despite receiving dietary instruction as outlined below, had adopted a high-protein diet throughout the study." And they apparently didn't adhere to whatever mystery diet they went with? To cite the study; "Patients who went on high-protein diets reported varying degrees of satisfaction. Family reports typically reflected initial patient satisfaction, the patients getting to eat foods they 'enjoyed' along with initial weight loss, but difficulty sustaining the dietary pattern for the entire year. Instead patients tended to adhere to the diet for several months at a time, return to prior eating habits, and then return again in an effort to lose weight." They also treated each individual with medication based on their blood work; "Medical management was individualized based on the blood work obtained every 6 weeks. Independent adjustment of medications was made as a result of each patient’s blood work and was not based on the patients dietary habits. Table I shows the treatment guidelines employed. For example, a patient with elevated triglycerides and lipoprotein (a) would be treated with fenofibrate while a patient with only elevated lipoprotein (a) would receive Lovastatin." And treated patients with medication for any other issues they might have; "Patients with anginal symptoms were treated with standard drug regimens including the use of long-acting nitroglycerine (Imdur, Ismo), slow calcium channel antagonists (Procardia XL, Diltiazem,), Beta--blocker (Tenormin, Atenolol), L-arginine (endothelial dysfunction), and macrolide antibiotics (Biaxin) for elevated C-RP with acute-phase antibodies to H. pylori, C. pneumoniae, or S. pneumoniae. " This study is useless for drawing any conclusion about keto, if only because it isn't about keto. As an aside; There's a small oddity in the study. Look at the first quote I have from the study. "At the conclusion of the study" they found out that 10 of the 26 were on their own diet throughout the study. But in the third quote from the study it says "Independent adjustment of medications was made as a result of each patient's blood work and was not based on the patients dietary habits." Why would they specify that? If they 'found out at the end' it would be literally impossible to 'treat their blood work based on the patients dietary habits.' Because how could they treat the blood work based on the patients dietary habits, if they didn't know their patients had changed dietary habits 'til the end? Thanks for the clarification, I guess? Now we're safe from the misapprehension that the study authors used their time machine to inform their prior selves about the diet change.
An important question that I don’t believe was asked,… What was Dr. Horowitz diet before he developed IBS? And was there a family history of IBS? Another amazing video. Thank you.
It's not irritable bowel syndrome, it's inflammatory bowel disease. After diagnosis I tried a least a dozen diets to help manage it, including low FODMAP, SCD, whole food vegetarian and vegan etc. Only a ketogenic diet has helped me. I would not generalize my experience, but since you asked...
Daniel from Lifting Vegan Logic had Crohn's disease and has been vegan for years. He has no symptoms whatsoever at this point and pretty amazing physique, too. Plant based diet is like heaven to me and I did low carb for 6 years which was pure nightmare. There is no one diet fits all.
@@Rose_Ou I am happy for you both! There is not one diet for everyone, I entirely agree! FWIW, I would love to have a platter of sweet potato with figs and goat cheese every now and then, but I'll do what I need to do for now to live life. If that means less sweet potato and more eggs, ago oil mayo, fatty fish (and maybe even some bugs sprinkled in - we didn't talk about entomophagy, but I'm a fan!), so be it! But if someone is thriving on Tempeh, Brussels and avocado, who am I to tell them otherwise.
A potential mechanism not covered here is the gut microbiome ecosystem. Perhaps bacterial lipo-polysacharides are carried by some types of fat and cleared by LDL cholesterol. Perhaps fiber can be added to mitigate some side-effects.
Not sure if they get to it in here, but lots of LMHR have shown that adding 50-100g of carbs (with or without replacing the fat calories) significantly drop those LDLs.
@@justinhale5693 Sure. LDL tends to drop, although fiber type matters. I did a YT video on this a while back (ua-cam.com/video/oBSzOaFvWGk/v-deo.html) In the short-term fiber rich foods may have an acute effect on increasing glucose area under the curve, but in a mixed diet condition the chronic effect tends to be lowering.
I'm LMHR and match the study's cohort averages. My diet is among many things I do to manage an alphabet soup of chronic conditions, including connective tissue, autoimmune and neurological disease. I'm leaner, stronger, healthier (bg, A1C, thyroid, etc all improved). My trigs are lower than my age. I have trouble believing that my heart health has suffered from these functional and biometric improvements. But even if my diet is risking my heart health, it's worth it. Y'all might as well study us, because many of us refuse to give up these gains. Why someone would even recommend statins in someone with a connective tissue disease or metabolic illness without a CT angio showing a need for them baffles me, but they do. I really, truly appreciate this work. Thanks for being open-minded to it and furthering the conversation.
Chris, this was a fantastic episode. Always fun listening to people who are actively doing research. Personally, like you, I'm the complete opposite of Nick although I'm in my 20s. Very lean/reasonably fit individual with a family history of heart disease (did you ever get diagnosed with a first degree heart block) on a WFPB diet but also had a very high ldl (~180). Going very low fat also had a marginal difference so, on a low dose statin atm. I don't understand the pushback from some people. It's not like more trials are going to hurt our understanding. Either the hypothesis doesn't pan out or it forces us to improve our models of heart disease/nutrition. There's very little downside.
Thank you. For the life of me, I can't understand what's wrong with taking a really outstanding researcher like Matt Budoff and studying these guys to see what we learn.
The 'downside' is people have been referring to this unsubstantiated hypothesis for the past 5+ years as a means to justify their high-risk lifestyle choices, often against their physicians' recommendations.
@@megavegan5791 The second guest explicitly stated that this discussion isn't a substitute for medical advice and both of them have said that this is an extremely rare occurrence which isn't applicable to most people. If others choose to misrepresent their stance and damage their own health, nothing can be done on that front. The risk of misrepresentation by people is present in almost every nuanced scientific discussion. Secondly, the entire point of the video and their conversation is that they're trying to substantiate the hypothesis. Trials take a significant amount of time and money, the latter can only be acquired after other people are on board. Science isn't done in a day.
There you go! The down side is that they may be right and the treatments advance and improve outcomes. Don't want that do we? That would mean that you would be wrong! Wait, what??? That would mean that all the money Medicare is WASTING treating diabetes instead of reversing it could be saved and directed towards more worthwhile interventions, and we certainly wouldn't want That. Please note that you are saying that this is hypothesis, but, they are also referring to the heart-diet HYPOTHESIS, fifty years later, ITS STILL AN HYPOTHESIS!!!!
@@waleedabbas4996 People with advanced CVD are throwing away their statins because they listen to charlatans who quote this hypothesis with no caveats. IT'S DANGEROUS.
Hi Chris, just posting a question for you here though probably small chance you might see it. I just watched your interview with Simon Hill which was amazing, your stories and anecdotes made for riveting viewing. In particular the insight you gave into Steve Jobs, a much analysed and discussed person, was the most enlightening I've ever seen on this contradictory man. You touched on his cancer and I've always wondered about this. There are lots of theories on why he developed this so young, from fad diet choices, exposure to chemical, or just unlucky. Do you have any more info on what his diet was really like over the long term? Also you made an intriguing comment about Dean Ornish perhaps being able to cure him. What did you mean by that? Thanks and keep up the good work, a voice of reason in a mad world. Ps I always think a good starting point for getting nutritional advice on you tube is if the person is fully clothed, if they need to show you a six pack, forget it!
I wonder how the speaker would do at True North with Alan Goldhammer, would he still react this same way to carbs after a full reset? Or has he tried living only off sweet potatoes for a while for instance (what drs. John mcDougall and Peter Rogers would recommend)?
I've bashed Dave in the past because I thought he was an ideologue trying to justify dangerous blood lipid levels without the science showing his hypothesis was right. Perhaps I was wrong. Will have to look into it more
oh no, he has never pushed this idea as a sure thing - he also emphasises that it is a hypothesis. He also says don't take his word for it, but that he is trying to learn more.
@@leenysnell8804 - unfortunately many low-carbers have been referencing Dave for a long time to justify their high-choleserol levels. Until the science is done they are risking their health on a hypothesis
@@yogiyoda if that is the case they are going against Dave's advice. In any case if they are whole food based they are still doing much more for their health than if they stayed on a diet full of processed foods.
@@leenysnell8804 - Maybe, depending on their particular situation, it's possible the low-carb diet drastically raising blood markers might be more dangerous
he tried vegan, but that's different from a low fat no oil whole food plant based diet. you can be 200 pounds overweight and sick with all kinds of things on a diet that's just vegan. @@what.the.bleep.do.i.eat.
I've tried. Unfortunately, WFPB did not work. When I say I tried... I do mean WFPB 0 UPF >6 weeks. I wish it did work. I honestly would love to chow on sweet potato with figs
@@nicknorwitzPhD I'm with you Nick. I would prefer a more plant heavy diet too but my IBS makes it essentially impossible. I really appreciate your research and your Mediterranean Keto book. I don't have to be fully Keto, just lower carb but I'm really trying to do it in a healthier way because I'm also not trying to speed run a heart attack. Cheers!
@@nicknorwitzPhDI’m with you, I daydream of baked potatoes piled high with beans, corn, fresh peas, bowls of oatmeal, rice and vegetables, and on and on. Those foods gave me over 30 years of painful digestion that put me to bed for days at a time with a heating pad. I wanted so much to be a starchivore or even just wfpb. No medical intervention and even abdominal surgery made a bit of difference. Like you, I cheer people who thrive with eating that way and I will fight for their right to continue without being maligned.
The trouble is most food is hyper processed. Everywhere you look, it said that most food is bad for you. No wonder people are confused about what to eat.
It's very simple My Aldi has everything I need right in front of the door. But I make room for canned beans and tomatoes. Walking past the weird pink stuff to get to the hummus is a bit unsettling. I wonder sometimes how I'm viewed as I pay for two huge IKEA totes of veggies.
If the target population is less than 1 percent of the general population and a tiny percentage of the keto practitioners, is the point of the research that the 'odd' situation involving the tiny population perhaps is indicative of some larger implications that apply beyond the tiny group?
Vegan ketosis is possible with or without refined oil. Without refined oil, getting the majority of calories from walnuts, flax, chia, sesame, almonds, hazelnuts, peanuts with greens can force endogenous ketone production. I mention this because there are conditions that are responsive to ketones and forcing endogenous ketone production is likely the only way to maintain consistent blood ketone levels. For now, evidence points to production of Apo-B100 containing non-HDL cholesterol being the body's response to saturated fat consumption, and Apo-B100 sticks in our endothelium leading to lesions. For almost all of us, the least harmful ketogenic diet is vegan and low in saturated fat.
Hi Plant Chomper. Do you believe your marathon or triathlon training could have anything to do with your high LDL? I watched a lecture from a cardiologist named O'Keeffe talk about how extreme endurance athletes tend to have significantly worse heart health and more plaque. He wasn't sure if it was because of all the calories they ate to fuel their performance or was the training actually harmful to the arteries themselves and causing inflammation. I know you said you eat a vegan plant based diet. How "clean" would you say it is? Is it per what Dr. Esselstyn recommends no oil no nuts? I'm very curious about this topic because my family history is terrible when it comes to heart disease diabetes cancer. But most of my family also smoked drinks doesn't exercise and eats processed food. My mom was told by her dr she has "genetically high" cholesterol. I don't remember the numbers but i think she was high 300s or even 400s and medication only brought it down a little. One statin did bring it down a lot but that one has sense been discontinued. I bring up Dr esselstyn because I got her his book and while she wasn't 100% compliant with his diet she saw a huge drop in cholesterol. It was still high but significant enough where the dr asked her what she was doing. Unfortunately i haven't been able to get her to commit 100%. I even told her she should do it 100% for a month and i would pay for the blood test to see what the result would be. Oh well. My cholesterol was never as high as my moms but it was going up with every physical. Doctor was starting to get concerned. When i went on esselstyn total dropped to 120. My LDL was like 65 or something. I also noticed how much better doing cardio felt. I did cardio pretty consistently for years but always hated it. About 2 weeks on the diet it suddenly felt much easier.
What do you think about Dr. Zach Bush's research suggesting that antibiotics/pesticides are a huge factor in metabolic health due to their disruptive nature to carriers in the metabolic systems?
I appreciate the researchers comment about the logic issue with the little girl who had a heart and very high LDL. The heart attack might have been unrelated to the LDL. It might have been caused by an undiagnosed congenital heart condition. It might have been caused by multiple factors, not only one. The very high LDL reading could have been a lab error. She might have secretly eaten before the bloodwork during a period of intended fasting before the blood draw. There are many unknowns that might have been contributors. She might have been on a medication or more than one that has heart-related side effects.
Interesting concept with certain outliers, but the river overflowing analogy cuts both ways. Regardless of the cause, it is overflowing and that in itself is a problem. Fortunate for the case study of the LMHR who didn’t develop any calcified or non-calcified plaque over two years of having sky high LDL, but it’s a tough bet that this can be banked on for a long life span.
@@Amshatelia88 if they can show no plaque build up after a year or two, and in multiple age groups, there is no reason to assume a significant change in longer term follow-up, though it would be interesting nonetheless
I feel like after watching this that everyone has some genuine 'skin in the game' with regard to heart and metabolic health. As stated, I think we can all agree that a lot of the success achieved on both sides, eating clean vegan or eating clean keto, is likely to be more about what we are subtracting and less about what we are adding. What is important about this study is that it has the potential to further enhance our understanding of lipidology because it seems that any good scientist knows that we don't know what we don't know so let's keep open minds and continue working the problem. The 'food fighting', name calling, finger pointing and click-baiting isn't doing anyone any good. Vegan and carnivore are not fighting words they are dietary and lifestyle strategies that real people are employing in an effort to resolve real health issues. I applaud anyone with the will and courage to make any change that includes cooking and consuming whole, nutrient dense foods instead of processed garbage. I appreciated the respectful discussion and inclusion of key references in this video podcast. Thank you!
It seems to me it would be more meaningful to try and figure out how to get people permanently out of their gut dysbiosis, rather than trying to find reasons to exonerate a generally unhealthy keto eating pattern, even if it's plant based keto.
@@saintwithatie "Very-low-carbohydrate diets are associated with marked risks. LDL-C can rise, sometimes dramatically. Pregnant women on such diets are more likely to have a child with a neural tube defect, even when supplementing folic acid. And these diets may increase chronic disease risk: Foods and dietary components that typically increase on ketogenic diets (eg, red meat, processed meat, saturated fat) are linked to an increased risk of CKD, cardiovascular disease, cancer, diabetes, and Alzheimer's disease, whereas intake of protective foods (eg, vegetables, fruits, legumes, whole grains) typically decreases. Current evidence suggests that for most individuals, the risks of such diets outweigh the benefits." - REVIEW article Front. Nutr., 16 July 2021 Sec. Clinical Nutrition Volume 8 - 2021 | doi.org/10.3389/fnut.2021.702802
I can save you 90 minutes. Yes. You should worry. Any reputable lipidoligist would not suggest otherwise. Now if you want to take your medical advice from an engineer and a wet behind the ears first year medical student, go ahead. He keeps saying that 665 is a scary number. 185 is a scary number. But he is a youngster. Hopefully he will learn.
Great episode. I'm thankful to Chris that he is open minded. In sum this episode arose more questions than it answered to me. Since the LMHR are so uncommon one might easily misinterpret this episode. It would have been great to end with a part that puts everything in the bigger picture. Does this have any implication for the moment for people who have high ApoB but are not a LMHR? As far as I understood it doesn’t. @PlantChompers how about you invite @thenutritional_advocate (Alan Flanagan) together with @nicknorwitzPhD for a next episode with the goal to try to get a bigger picture of this with the current evidence we have. Also it would be very interesting to discuss if being on a ketogenic diet over years and years has any evolutionary advantages. For my understanding the body or better the brain just had to have food in absence of carbohydrate, which is why it also functions on ketones, but this is just in case and not meant as a diet for decades. What are the thoughts around this? I hope there is a second episode that goes on with this thought and elaborates in in different directions.
Some very interesting stuff coming out of Harvard with keto diets for serious mental health. Check out Chris Palmer - this is using ketones as food for brain instead of glucose. Fascinating stuff!
Prior to the rise of agriculture 10-12 kya the human diet would have necessarily been low carb as not a lot of readily available high carb plants present in the wild. Couple that with food scarcity and it’s my hypothesis that ketosis would have been a state humans would have been in for significant periods of time. Carbs when consumed would have been fruit or maybe honey for a short period of the year when it was in season and ripe. Those living in higher latitudes particularly during ice ages much like the modern inuit would have had little access to plant foods. We can infer a lot from this information
1:14:50 He explains why he chose Oreos. It draws more attention to his experiment and (hopefully) makes it more clear that the experiment isn't a health intervention, its more in the realm of a diagnostic for his LMHR phenotype.
Chris, I think that you need to start doing followup videos for all the videos that you do. The science is too difficult for us to understand. It's not like we are completely uninformed, either. Maybe make follow up videos that state clearly each time: 1) what you previously believed before engaging with the new idea 2) what you now believe after engaging 3) summary of relevant information [I need to know how this affects our diets and what to think when we get blood tests and how to talk with our family doctors] 4) how this information relates to the teachings of Ansel Keyes, and the 22 countries study 5) respond to the comment section We need this. Otherwise you're speaking gibberish to us.
Thank you! I am " almost" a LMHR and have "scary" LDL numbers. I was pushed to carnivore by digestive issues, and have had severe side effects from statin therapy. I am very interested!
It's the microbiome? Along with a still strong metabolism? The healthy liver is working like crazy to process high cholesterol, pushing it away and then puling it in -through high HDL and high LDL, naturally. And no plaque formation, for the time being only. But the IBS surely shows dysbiosis, most probably with acetate-producers (Bacteroidetes) more numerous than butyrate-makers (Firmicutes), a ratio which switches sides when a keto-diet is adopted. Sounds typical for high-fiber, low-fat vegans who go keto. You then get a temporary relief with keto at the price of higher cholesterol& triglycerides values.And acetate (the most abundant SCFA) is a strong cholesterol-formation promoter, right? Due to high (lectin-loaded) fiber? A lectin-free WFPB would be a solution to the problem, I believe.
Unrealistic nutrition arguments always seem to boil down to a few metrics... Conveniently skipping holistic, long-term metrics of health to hide issues.
much of the info is anticipatory. We have to wait 3-5 years after these have been properly studied and analysed objectively, without corporate interference.
Nick gets all high on sugar,... which must be his youth,... 🙂 Because when I eat like a chocolate bar,.. my brain goes like: WHY???.... WHY did you do that??? I get sleepy for an hour, almost get a headache, I can't concentrate, but then it wears off quickly. It sucks. The chocolate tastes great. And sometimes the desire wins, but always I regret it afterwards.
He keeps saying “metabolically healthy” people with extremely high LDL. That doesn’t exist. The idiocy of these low carb propagandists is looking at young healthy people who can manage to survive having high LDL. Having prolonged high LDL isn’t something that kills your when you’re 25.
I agree metabolically healthy is a vague term that deserves clarification in certain contexts, although I think it's a colloquialism that resonates with many and that we used it appropriately. But if you want clarification, I meant that we observe high LDL in the absence of other markers of metabolic dysfunction or 'broken metabolism' (e.g. atherogenic dyslipidemia, elevated LPIR, HTN etc." Your proposition that high LDL is antithetical to metabolic health is a controversial but not indefensible position. What I'd say is, in the case of LMHR, the consequences are unclear and deserve further study. They may provide the strongest case for the lipid heart hypothesis. They may also provide an interesting exception. Either way, we learn. Name calling won't help your case BTW
@@nicknorwitzPhD Name calling is irrelevant to whether something is true or not - including whatever the name that’s called. People who pursue the “high LDL is good actually” do little to serve the infinitesimal group of humans with a genetic disorder and do incalculable harm to the average person who this kind of “research” is used to undermine proven and consistent science. E.g. this is just more fodder for the beef industry and the persons (and animals, I suppose) their influencers help to murder.
Chris, your interviewing people from the "other side!" Two of my favorites! Just when I was about to give up on you. As you like to say, "Whew, faith in humanity restored!" Just think, if both sides are represented instead of just one side, its a more balanced ,informed, discussion. The reason these two are doing these studies is to see if high LDL is the end all be all that big medicine/pharmacy want us to believe! Thank you for a great interview, which by definition is where the interviewer gets out of the way and lets the subject speak.
So, I went ahead and gave this a listen. Let me save you all the suspense and tell you the study they are currently conducting will not show any substantial increase in plaque blockages among the LMHRs. Cardiac and CT angiograms only detect plaques that restrict the size of the lumen. However, plaques develop and progress inside the walls of the arteries for years before they protrude into the lumen. I suspect Dave already knows this, which is the whole point.
I've seen several of your comments on this video. I was wondering if you have an issue with keto itself, or keto that includes animal products / high saturated fat?
@@saintwithatie All ethical issues aside, I don't care what people eat. I do have a huge issue with online influencers who 'misrepresent the truth' (I'll be generous here) and take advantage of vulnerable people (e.g., people suffering from lifelong obesity and/or chronic diseases) for financial gain. I think Keto would be much more respected if people would promote it for what it really is: a great weight-loss tool that significantly improves chronic symptoms in the short-term, but at the expense of long-term health risks, including increased risk of cardiovascular events due to chronic exposure to elevated LDL. If people would acknowledge that, or if they can eat lots of saturated fats and somehow keep their LDL levels low, then do you and enjoy.
If you're low carb and vegan, great. What I don't like is the fact that this kind of science will be used by those who eat meat to continue to promote that practice which is so harmful to the environment and has so many ethical problems. I respect the discovery of the truth aspect to this. It is also good to remember that diet has many ramifications in addition to physical health.
Just as the main narrative that meat is bad for health is being debunked, if you dig deeper into the environmental aspect of meat consumption and production but not from an ideological standpoint you could find very good evidence on why it is not as big of a problem as the liberal narrative tries to portray. Also it is very alarming how you want to control other people's lives and costumes. We should be speaking about improving industrial practices and not about forbidding other people do doing what you do not like, because of your biased arguments and data, without even ever listening to them with a sincere heart. What you are doing is no different from Nazism, they also thought they were imposing themselves for the grater good.
Are there ethical problems when a lion eats a zebra? If you don’t want to eat meat then don’t but hold your virtue signaling for those who make other choices. One has to eat yo live. The only reason you reject eating meat is those animals are more similar to you. You don’t think twice about killing plants. My guess is that plants would not be ok with their mass murder.
thank you for this excellent fair, honest and balanced discussion of LMHR. I was aware of this phenom, but never did a deep dive because the discussion around it seemed so polarized and tribal. this answered all my questions and more. Nick Norwitz and Dave Feldman appear to be gentlemen, scholars, excellent scientists and true mensches! Wonderful video Chris. You are a scholar, gentleman and mensch yourself.
Thanks for this!
Thanks for having us on, Chris - it was a fantastic discussion
As a LMHR myself, I am very eagerly awaiting more results from these trials. I was sick as a longtime vegan and have a lot of warm feelings for the passionate and kind vegan community. It's where I found my love of gardening and yoga. However, I healed on keto and as I got very fit, my LDL went up. Gaining weight makes my LDL go down. FIber has no effect on my LDL Carbs make my LDL go down and make me feel lousy. BMI 21, HBA1c 5.1, LDL 220, HDL 89, VLDL 10, TG 50. Can teach 5 yoga classes in a row and feel awesome. Keep an open mind!
Thanks for this reply!!!
I would be very interested to hear whether you ate a lot of oats and various other grains when you were eating vegan? It sounds like you might have cealiac disease.
@@annwilliams6438 I do not. Have been tested
Interesting numbers. Can anyone answer my question if I'm a LMHR?
I've always been very lean and quite muscular. Can eat whatever I want without gaining weight even without exercise.
The slightest gain i weight is concentrated around the abdomen. I'm for sure a TOFI (Thin Outside Fat Inside)
Normal healthy diet with carbs;
Tot.chol 6,5
LDL 4,5
HDL 0,6
Trig 2
In attempts to increase my HDL I've tried a LCHF-diet/ketosis.
My HDL-levels is raised but is still too low;
Tot.chol 8
LDL 6
HDL 0,8-0,9
Trig 1,5 - 2
My lipids differ from the criteria LMHR with a low HDL. Any thoughts?
Am I insulinresistent?
What did you eat on keto?
The moment he said his LDL can still be high without saturated fat I thought it must be some liver-related energy metabolism result of ketosis when there isn't fat stores to pull from. Later in the video it turns out that is part of their hypothesis. It's the only thing that makes sense given his information but the potential risk decades out could be massive. Was that Carnivore Kid guy with a six pack and a 95% clogged windowmaker artery a lean mass hyper-responder? I wouldn't be surprised if there isn't a 1:1 risk for LDL for people up around 400 or 500 in this situation but I would be astounded if there isn't a serious elevated risk that warrants trying other options. Additionally, I am concerned that this 1-year study is going to be taken as a golden ticket to not care about LDL despite the warning of being short term. If the subjects are younger when atherosclerosis progresses really minimally, will the age-matching miss detecting what could become rapid artery damage in middle age or as the age-related oxidative stress sets in? Yeah most of these CTA studies might be one year long but most are in middle-aged individuals. People might view it as an LDL pass for keto diets but as the LMHRs or even average high LDL keto dieters hit their 50s and 60s it could be atherosclerosis city.
My other concern with this topic is that people (like Jenny Mitich who I just responded to) take cases of people like Nick in their 20s not having plaque on a keto diet as a reason that they will personally be fine with high LDL on a low carb diet. Nick seems to be concerned about LDL in these cases but that warning is not making it to or being taken seriously by keto people on the ground. They simply use his paper to deny any potential negative of high LDL. Total dismissal of LDL's risk is part of the ethos of these weight loss keto dieters and that is dangerous.
I also can't help but wonder what particular option Nick has tried for his colitis and if he has looked into his gut biome. How could he eat carbs just fine until senior year? What happened? Maybe some bacterial dysbiosis is to blame? He also says that perhaps exogenous ketones are a therapy for his colon. Why not take the ketones and include enough carbs to lower his LDL for his main diet? That would be lowest LDL risk it seems, assuming the ketones prevent his colitis symptoms.
Lastly, I would love to see how fiber would influence LDL levels in these people. Is it just LDL being clearly more slowly or is the reabsorption of biliary cholesterol in the digestive tract playing a role? If you don't have fiber to bind to it and remove it, would that be a missing explanation here for the carnivore dieters, etc.?
hugely agree with the 2nd paragraph, these results can't be generalized to the larger group of ketogenic dieters but it is anyway
On dietary saturated fat: ua-cam.com/video/KgLoWJVuHTI/v-deo.html
"Was that Carnivore Kid guy with a six pack and a 95% clogged windowmaker artery a lean mass hyper-responder?" - No he wasn't. I actually chatted with Michael R. after the event. Sad case. He went 'carnivore' AFTER he found out he had advanced disease. He has a strong family history and actually a mutation in one of the ANGPTL proteins involved in our LEM model to explain LMHR. In my convos with Michael I was clear that, while I couldn't give medical advice, his was a case in which I would have accepted treatment and - thought I didn't tell him this - were I him with his coronary findings I probably would be eating more tempeh and less buttered steak. His story has been distorted for propaganda, which is sad.
Sorry not going to get to all your points... time pressed... trying to drive though some replies. Thanks for watching!
Average age of the study subjects is 55.
just seams to me that hes starting with a desperate need to find a result. that if you eat tons of sat fat but exercise and stay lean your not increasing your risk of heart disease. why would you get on a diet like that.
What a great and professionally conducted discussion. I have become very passionate about diet and health over the last couple years. My journey has led me to a very low carb, meat centric diet. I try very hard to stay open minded and watch videos from as many credible sources as I can find. I think it's so easy to become tribal and forget that we usually have much more in common than we don't. This video really helped me restore my faith in humanity. Keep up the great work!
I've been on a wfpb, sos-free diet since your video on hyper-palatability. I was an obese vegetarian 275 lbs, 6'2" at the start. But I've seen remarkable weight loss in the last 4 months, just recently hitting 233 lbs and falling, exiting my bmi range for obesity.
My diet is loaded with starches, oats, whole grain pasta, beans, lentils, etc. as well as all the fruits, potato, corn. I eat as much as I'm hungry for, and whatever my body craves as long as it follows wfpb sos free.
So you could say I'm on a high-carb diet and so far thriving! Although I understand 4 months is early days when talking about the rest of my life (in my early 30s).
I tried a ketogenic diet in my early 20s with good early weight loss results, but I didn't have the meal planning skill at the time to stick to it, and I crashed hard into the SAD.
I've since become convinced by your channel and Gil Carvalho that the preponderance of evidence shows that a wfpd diet is the most healthful diet.
However I appreciate your inquires into other level-headed scientists who are looking in different directions, to make sure we're making the best possible decisions for our food-based health.
Try popping all the food you eat on cronometer to see if you have any micro nutrient deficiencies of your diet.
Congratulations on the progress!
@@janco333 Thanks for the idea, I'm also planning on getting blood work done at the 6 and 12 month markers.
@@eugenetswong Thank you!
You're welcome. 😄@@williamdixon4936
I appreciate that you are open minded in your search for the best foods for health. What I think I heard is that lean healthy people eating a keto diet are healthy on the keto diet. I would like to learn about benefits v risks for long term ketosis. I would like to see if it truly does what whole food plant based can: reversing type 2 diabetes, reducing inflammation. It is also interesting that keto helped his IBD, because I have had the same result with WFPB. Chris, thank you for your always enlightening channel!
Thanks Chris for your episodes. I am a practicing physician in Canada who has tried to promote healthy lifestyle including nutrition for 20+ years . Your episodes are much appreciated.
Thanks for the video. I enjoyed and benefited from it, even though I'm not smart enough to fully comprehend it. Thanks for introducing me to these two talented people. I'm thankful there's people like this doing this important work.
Thanks! I wasn't smart enough either and had to do a lot of work to understand their model and study.
@@PlantChompers you definitely put the work in and it didn't go unrecognized!
@@nicknorwitzPhD Why don't you talk to Dr. Avi?
Many years ago, an overweight relative of mine saw how I ate a lot of vegetables and told me that eating too many vegetables are bad for you.
A few years later, she started having chest pain and her cholesterol was 400 mg/dL!
I would love to see this level of ecumenical civility and dialogue in the realm of politics, not least in the US (it's a little better in Denmark but not much). That said, I am looking forward to a good explanation of how the high apo-B or LDL-c causes plaques, if not by the sheer concentration in the blood. Because, no matter what the reason of the high water level in the river is: a dam or a huge flow, the level IS still high.
Because its not Cholesterol that causes the damage. The Cholestetol is part of the repair mechanism so it shows up like a scab shows up from a cut on your arm.
Lions and other obligate carnivores blood is loaded with lipids and cholesterol and yet they dont have plugged up damaged arteries.
This study is determining if this type of cohort has more plaque and baseline than controls, and if after a year there is more or less plaque progression than normal or in other cohorts. If it turns out to be much less plaque than expected, then it would suggest that the ldl is only damaging in a non LMHR context
@@CashMoneyMoore Rather that "... the high LDL-c is not damaging to arteries in LMHRs". There can be, and are, other scenarios where LDL-c is harmless as well, which the study does not address. I have been hyped for the study since well before it started. This question of the formation of plaques and other lipid deposits is very confusing. For example: do LMHRs get xanthomas or xanthelasma? What is really going on at the molecular level at the border between blood and arterial wall?
I was a lean mass hyper-responser when I was eating lower carbohydrate. I ate nowhere near a keto diet. I since have moved to a high carbohydrate diet since my body seems to response better. However, it was also due to high cost of meat since the start of the pandemic.
Anyway, I went from eating three large servings of meat a day to two or three smaller ones a week. I eat most of my carbohydrates as fruits and vegetables. It took me three years to go from an ldl of over two hundred to one of around a hundred even with this change in diet.
that's brilliant! I went WFPB but with a little bit of oil and salt 4 years ago. I didn't have too much weight to lose, but I lost a couple of kilos. The more I think about the more sense it makes: for health, for the animals, for the planet.
My BMI runs between 18 and 19 so definitely lean.
Why not eliminate all meat?
@@JakeRichardsong Why?
How did it affect your trigs and HDL? I'm asking because my LDL went up a lot when I changed to low carb but my trigs decreased and my HDL increased. I am still a little bit overweight. All my other blood results are within the "normal" ranges, I'm now insulin sensitive and my liver tests are good. Thank you.
I find this study very interesting. I'm vegan, very active triathlete. I have what is considered good lipid numbers and fasting glucose. Never really had interest in a keto diet. I am not considered lean. However, I do believe that this study will give us some good insight. I am interested in the result even though I'd never choose this diet for myself. For the record, I'm the only vegan in a household of 4. I cook all sorts of non-vegan dishes for my family. This could really be a game changer especially for those with epilepsy or other health issues.
That’s excellent re: being vegan in a non-vegan household. I’ve been trying to transition to WFPB but slip here and there because of all the non plant-based dishes I prepare - and all those non PB ingredients at home.
And as someone who has epilepsy in their family I agree that this is a fascinating study. Revolutionary even.
What a lovely human response. Thank you
@@rambunctiousvegetableyeah...that's what i think when I see flesh... no longer appetizing...
Diary doesn't make me as guilty as it should...but I'm still vegan ...for animals
@@rambunctiousvegetableHumans were hunter gatherers for hundreds of thousands of years. It's our evolutionary heritage and it's not wrong or evil. Stop denying our nature. The fact is most people find meat very delicious and nourishing and there's a good reason for that. It's an increadibly nutrient dense food. You won't change hundreds of thousands of years evolution in one generation. As for your care for animals, do you have any carnivorous pets? Do you feed them dead animals?
I was on low carb for a few years. I developed a Xanthelasma under my eyelid.
Blood tests showed I had an LDL of 238. They also showed I had high lp(a) and very small LDL particle size and low HDL. In other words, I have a lipid disorder that leads to heart disease without question.
I drastically reduced my red meat consumption, added in sweet potatoes, steel cut oats and fruit whilst keeping vegetables high.
I also structured my meals in a way I have never seen anyone else do before. It is what I call dose response eating.
My LDL went from 238 to 77 in 3 months without any drugs.
Can you explain a bit more what you mean by "dose response eating"? Sounds interesting, thanks.
Two weeks ago my total cholesterol was 274, I went full plant based, just had cholesterol tested again today, came back 185. It is incredible how bad meat and dairy is.
It's so refreshing to see curious people ask interesting questions and acknowledge that we really don't know the truth yet. I still lean on the side of caution (correlations aren't causation, but sometimes I'm willing to take some stock on them), but I'm excited to see what we learn from this.
Thanks!
bart kay has talked numerous times about LDL. i highly recommend checking him out. he does have lots of experience working in the field of nutrition and cardiology.
basically.. there is zero evidence that high LDL is causal for any disease. no properly done interventional study exists proving the claims that high LDL is a problem. even in the context of FH, its not actually high LDL that causes disease and mortaIity but rather the inability to properly take up and utilize LDL.
LDL is tightly regulated by the body according to what is going with your life. what makes that so are your genes. those genes have survived for hundreds of thousands of years, tightly regulating LDL according to the bodys needs. it would be ridiculous to assume that high LDL is somehow causal for disease when the body deliberately raises it when appropriate.
exercise and losing body fat can raise LDL. does that mean exercise and losing body fat is absolutely bad 100% of the time?
being sedentary and eating lots of sugar can lower LDL. does that mean we should be sedentary and eat lots of sugar everyday?
i am not concerned about LDL. my genes were passed on to me from my ancestors hundreds of thousands of years ago. those genes that regulate LDL according to my needs know very well what theyre doing.
I think it's important to point out that this possibly non-problematic increase in LDL occurs specifically on ketogenic diets where muscle glycogen is depleted (in addition to other adaptations). That is, if this theory is proven, it does not mean that LDL does not matter, it still matters a lot, if you do not eat well and your LDL is high, be concerned. The video refers to a very specific situation.
I mean if you're eating keto and your LDL is low, great, if it's high, great
Yeah, I no longer worry about lipids. I am more concerned with insulin resistance and blood sugar levels. As long as we don't eat sugar or processed foods, most of us should do fine.
You're making an assumption that LDL still matters. I would argue it may not matter. The medical community may be wrong about it. It wouldn't be the first time.
But it also kind of supports the idea that LDL is not causal, but triglycerides, right? Not a confirmation, but definitely a smoking gun.
What a thrill it is for me to see plant chompers speaking to cholesterol coders! I didn’t expect this conversation ever to happen, but it’s a credit to all three of you that it did. The only thing that would make me happier is for Tom Dayspring to join the discussion next time.
Isn't it interesting that Dayspring refuses to acknowledge I exist? In the past year+ on Twitter he's not replied to even one of my questions. I even had a Tweet naming him specifically w/ >200K impressions... and not a single comment
@@nicknorwitzPhD You’re only 2 degrees of separation away from Tom Dayspring, who I believe now works at Peter Attia’s clinic. Your associate Dave Feldman has been on Peter’s podcast. Perhaps try a more personal approach to contacting him through Dave and Peter?
@@brucerubenstein7843 I've tried several ways: direct question, intermediary messaging, etc. He's aware I exist. When he's prepared to chat he knows how to find me.
@@nicknorwitzPhDIn my mind this is clear evidence of 2 things, being 1. An inability to come up with a satisfactory answer and knowing it, and 2. An irrational and / or emotional attachment to the status quo.
The feeling I have after watching this and other videos plus some books is that scientists are victims of personal preferences of diets that worked for them personally or foods they have a taste for: Prof Tim Spector with his defence of red wine ,for example, or his special focus on sugar picks after he was diagnosed pre diabetic, Dr Mario Kratz also focus on diabetes and diets to control insulin resistance, Dr Gil Carvalho has a special focus on cholesterol, and diets that control it and some people with IBS orbit towards low carb diets. After that some followers of a specific diet become like religious converts searching for the ultimate "redemption" through food. And like religious groups they break up into more fanatical "pure" sub groups; Vegans-> raw vegan->fruitarians or Low carbs-> carnivore diet-> lion diet. It's interesting to step outside and look at the Human Play... hope it has a happy ending.
Great logic.
It's called "confirmation bias". Dietary extremes (vegan and carnivore) are very vulnerable to it...both appear to have mental blocks to alternative info and research.
Sick people seem to have success with "elimination diets" of which vegan and carnivore are both examples
6 years ago, stress induced IBS was diagnosed, cut things out added stuff back. Stable, for 4 years on pescatarian diet, with much reduced refined carbs. Then, one bad flare up and a diagnosis if inflammatory bowel disease. I am now on a mainly vegetarian diet, carbs pretty much inline with traditional food pyramid. All bread is now high quality grains and home baked. All symptoms gone. It seems to me the modern highly processed diet is not good for longevity and not good for coping with personal stress or emotional trauma. Our gut becomes sensitised by the toxic crap in modern food and we get to a point where even foods that are good for us cause inflammation.
Regarding Gil, I really like his open-minded approach. It’s pretty clear after you watch him for a while that he is vegan or nearly vegan, but I see him talk all the time about doing what works for oneself and how plenty of different foods can be part of a healthy dietary pattern.
I got a blood test for health insurance in the middle of going keto and losing a lot of weight fast and upping my cardio. Felt fantastic. My lipids were horrific. The doctor was stunned. I went off the diet. Four years later I was still needing to lose a bit of stubborn weight. IBS that was getting more frequent. Went back on keto, weight flew off, stomach issues disappeared. I am confused. Seems for me doing keto improves everything and makes me lean and happy. It’s a cruel twist if the very thing that improves everything else will kill me. I have decided to stick to the diet that makes my life better and not stress over something that is invisible to me.
sounds like it could be that your keto diet as accidentally an elimination diet for foods that you were sensitive to. Have you tried doing a proper elimination diet and slowly reintroducing foods, tracking them as you do to try and determine what specifically is causing GI issues?
@@MB10097 it could also save them from other diseases: on average, all-cause mortality seems lowest with an LDL level of about 150mg/dl, or 4 mmol/l, and HDL of about 75 mg/dl, or 1.9 mmol/l, and the risks go up faster the lower the numbers. LDL seems to vary quite a lot between individuals though, and is likely more of a marker than a cause of disease (which explains why all-cause mortality does not improve with statins). Plant sterols can also be used to lower LDL, but it is unknown to me whether that is actually beneficial, at least I haven't seen any long term data, unlike with statins.
@@sandywendelfred8260 It's no accident that removing factory food and going whole food, low carb, make you healthy. Health has only gone down as factorys making food increased
smart choice! It works because it's natural.
Stick to you diet. Use olive oil instead of saturated fats, and there are always cholesterol tablets to take if all else fails.
I've long respected Dave, and was on a strict keto diet for a while. I was never LMHR per se, but my trigs were in the 20s and my HDL around 60 or so. My cholesterol numbers were so bad (ApoB of 186), that my physicians all begged me to stop the keto diet. I've got two teenage kids, and I can't be experimenting with my health. So I switched to a more Mediterranean diet, mainly by adding two cans of legumes and a serving of steel cut oats per day - and my Apo B dropped to the 80s. Combined with good BP and being physically fit in my 60s, that's good enough for me.
If you don't have any specific issues that deserve some tuning or experimentation, a standard mediterranean-style diet is the safest bet. It contains all you need and leaves room for variation.
but how is your blood sugar??? you add these carbs you are susceptible to getting diabetes, i would stay keto, mediterranean is to much carbs
@@joesylvia607 it seems like everyone in the US is obsessed with diabetes, everything is about extremes there. If you eat sensibly you don't need to worry about that, nothing wrong with carbs for most people
DYOR. I have and discovered a lot of people have been carno/keto for years with no problems. Cholesterol was high. I think the medical community needs a reset on cholesterol. More and more evidence coming out is challenging the current establishment beliefs.
that's an eating disorder@@joesylvia607
Thank you for taking so much time and care to put this data out to the public. over the years I been eating like a jerk, knowing I could be doing better but giving into convenience and indulgence. Your videos have helped tilt the balance on my dinner plate.
Thank you so much for what you do. I love watching you on Plant Based News, but only just found out that you have your own channel after seeing you on Switch 4 Good.
Thank you for sharing your story with us there. I had a rough start too, but nothing like what you went through. I'm so grateful that you were able to get through it to the other side, and that those experiences informed who you are today. Because really, who you are is a gift to us.
I think from some of your wanderings that we're practically neighbors, so hello from Sonoma County!
The one thing we should keep in mind. LDL as the only measurement of an issue is most likely wrong. It's a very mechanistic view of human health, but humans are not machines. We're biological organisms. A marker can show that there's an underlying issue, but it's the height of hubris to think an effect is the sole cause of something. We may bring a specific number down, but that doesn't mean the root cause is being addressed. It's also harder when hundreds of billions of dollars are being made on just that one metric. In the description of this video you asked "Your cardiologist just freaked out. Should you?" My cardiologist wanted to put me on statins when my LDL was 73. I was 58 and just had a cardio sonogram that showed I had little plague build up, consistent with a person my age. It's this shotgun approach to prescribing statins that is really disturbing, as the centenarian guy says. 7 out of 100 will benefit from a statin. But medicine can't narrow that down. Maybe to 7 out of 50 or 7 out of 10? I like the theory of take a statin to lower risk of heart disease, become diabetic as a side effect, which increases your risk of heart disease. Hmmm. Arnold might be, but we are not machines.
Dude you don’t know what you are talking about 😂
@@AdAm-cw3gi actually I do. Tell me why folks with lower LDLs still get heart attacks - from a 2009 UCLA study:
Specifically, these patients had low-density lipoprotein (LDL) cholesterol levels that met current guidelines, and close to half had LDL levels classified in guidelines as optimal (less than 100 mg/dL).
"Almost 75 percent of heart attack patients fell within recommended targets for LDL cholesterol, demonstrating that the current guidelines may not be low enough to cut heart attack risk in most who could benefit," said Dr. Gregg C. Fonarow, Eliot Corday Professor of Cardiovascular Medicine and Science at the David Geffen School of Medicine at UCLA and the study's principal investigator."
...
Researchers also found that more than half of patients hospitalized for a heart attack had high-density lipoprotein (HDL) cholesterol levels characterized as poor by the national guidelines.
________________________
This is in line with current research. So what's your LDL level? How about in relation to your HDL level? Low HDL is also a risk for disease. Your triglycerides are important too, as well your level of insulin resistance.
That same study stated "the risk of cardiovascular events increases substantially with LDL levels above 40-60 mg/dL".
If you LDLs are higher than that, are you going to go on a statin? The American Diabetes Association in 2023 is currently recommending LDLs below 70, and what to see it down around 50.
So when I had my stroke I was pre-diabetic (insulin resistant) and had hypertension. My LDLs were great, though my HDL was lower than the minimum recommendation. My triglycerides were high. I wonder why I had an issue with such great LDL numbers though...
So please tell me exactly where I'm wrong. Easy to say that from your keyboard. Making an argument is a little tougher.
3 years back for about a year I started serious endurance cycling (at least 200KM a week) and for a blood test done just out of curiosity got my lipid panel done. I'd lost a considerable weight (from 76 KG to 62) and my diet was almost high carb vegan but somewhat calorie restricted, so I was puzzled to see my LDL 132, HDL 39, triglycerides 150. Although I was feeling quite healthy overall, I couldn't make any sense of data. I brought down LDL and Triglycerides below 100 with regular intake of soluble fibres (psyllium, chia, flax seeds, basil seeds) soaked in a glass of water with every meal, though I think it's just cosmetic. I guess lipid profile numbers don't mean what we think they mean.
My ldl was pretty high like 112 and I ate a ton of fiber but I was getting fat like 180 lbs like 26 BMI. I am cycling 6 days a week now and no more junk fats(I am assuming they are the culprit) from stuff like sweets, pizzas, and oils. My tris were also high as yours. I also added healthy fats like you flax seeds and walnuts. Will see how it affects me in 5 months.
@@KrazyKrzysztof Exercise will definitely improve your health but won't impact much on weight. It takes insane amount of exercise to burn miniscule ammount of fat. Also exercise will make you hungrier, so calorie control is a must. When I was doing mild calorie restriction what worked for me was Salads and soluble fibre drink, which filled my stomach mostly and reduced my cooked food intake. I don't even grind my chia seeds, basil seeds, so they don't provide me much healthy fats. They're just convenient fiber sources.
@mitesh8utube for sure. I am just eating good food while minimizing any junk. I have reduced my servings and I measure my food for things like smoothies because it's easy to overeat on stuff like peanut butter. I am lifting every third day and doing a lot of cardio. It will take time but I'm looking much leaner and less bloated at 175 5 foot 10
@@KrazyKrzysztofone great way to help lose weight is have a big salad before every meal. You won’t really have to deal with portion control then because your stomach will tell you that you are full sooner. Check our Dr. Greger’s book “How Not to Diet” it’s packed full of science backed information. A whole food plant based diet without added (or at least limited) salt, oil, and sugar is great. Dump the peanut butter in the trash and eat peanuts IMO. And chew your fruits and vegetables instead of drinking them, like with a salad before meals, it helps your brain get the signal that it had enough to eat unlike with drinking when you can easily chug down too much.
This helped me lose the 50lbs I gained during the pandemic and kept it off.
Yes. You are right.
For most people, psyllium husk intake as soluble fibre is good enough. 😊
You picked a couple of brilliant, hard working guys that have done a LOT for Keto folks and we are truly grateful for their continuing contribution.
Lol
Much Respect !!! we need more of this !!!!!
Hope you enjoy it
Thank you for bringing every direction of this field together, have your I love you for this video.
Thank you!
As a fellow science nerd this is a fascinating look at the early steps of the scientific method. Observations have led to a question, further background research have led to a hypothesis, and they are now just setting out to test the hypothesis. This could be paradigm shifting, or could shed light on and support current consensus, or simply lead to further questions. Thankyou for a really interesting interview.
No, this can never be tested experimentally as not all variables can be controlled.
Best episode ever. Best UA-cam I've watched in a very long time.
This is absolutely fascinating! I'm so glad this research is happening.
My weight is now normal and steadily headed for ideal, and my LDL was 70 even when I was overweight thanks to a moderate detour into "conventional" eating patterns. Thankfully cycling 50 to 100 miles a week was protective.
I'm sticking to my vegan whole plant diet I adopted 42 years ago. I must be getting 15 portions of veggies a day and heavy tahini consumption gives my diet a Mediterranean macro balance.
At 63 I'm fitter and healthier than anyone I meet.
congratulations. You seem to have a lucky set of genes
Happy for you but it’s an extraordinary claim you make at the end of your comment. First it is a rather arrogant, and it is confusing because I have read many other UA-cam commenters making similar claims. In reality there is no objective way you could know that you are either fitter (undefined term), or healthier (also undefined term) than everyone you meet unless you meet only a extreme subset of the population. I guess you never meet very young very fit healthy athletes. And why would you even make this comparison? If you are are fit and healthy that’s the objective irrespective of anyone else’s condition.
@@marcdaniels9079 ok it's age related, but my 33 yr old niece is literally killing herself.
It is heartbreaking when it's younger siblings.
Even with their oldest brother as an example, they are trapped by their eating habits and maybe sign up for Weightwatchers yet again....
People think of vegetables as a garnish. The dietary recommendations are ridiculously conservative.
One day I will exercise enough to justify adding bread back into my diet.
@@anawilliams7342 my own family are overweight and sick.
And veggies are YUMMY
0:00: 😮 The video discusses the rise in LDL cholesterol in some people on ketogenic diets and the lack of understanding about its impact on arteries.
6:40: 📚 There is an inverse association between BMI and LDL cholesterol change on low-carb diets, and being leaner may be associated with LDL bumps in some people.
13:36: 🤔 The speaker discusses the importance of questioning and pushing for answers in scientific research.
20:21: 📚 The video discusses a study on lean mass hyper-responders and the use of coronary CT angiograms to measure plaque progression.
27:40: 📚 The video discusses the question of whether high levels of LDL cholesterol alone can cause plaque progression in heart disease.
34:26: 💊 The speaker's health was deteriorating, but they found a ketogenic diet that helped them regain their life and continue their academic pursuits, although it caused their LDL cholesterol levels to skyrocket.
40:59: 🗣 The speaker agrees with Walter Willett's statement and emphasizes the importance of considering individual cases when determining the benefits and consequences of interventions to lower LDL levels.
47:48: 📚 The speaker discusses their experience collaborating on a cookbook that combines Mediterranean and ketogenic diets.
54:21: ! The video explains the process of how VLDL becomes LDL and the role of triglycerides and cholesterol in this process.
1:01:14: 📚 The speaker discusses the lean mass hyper-responder phenotype and its connection to a low-carb diet.
1:08:25: 🔬 The speaker discusses a study on the relationship between being powered by fat and higher levels of LDL and ApoB.
1:16:01: 😳 The speaker is preparing to come out and has been experiencing emotional ups and downs.
1:22:33: 📚 Verbal precision and clear communication of data and hypotheses are important for experts in the field.
Recap by Tammy AI
I could be a LMHR at BMI under 20, body fat ratio 11% with high LDL-C 165 with low TG 47, good HDL 67. Alas, going give up Keto as whilst I hope these guys right that it is safe, not worth me taking risks till proven. So switching to Mediterranean with Portfolio diet for better control
Plant chompers, hell yeah, an hour and a half episode, ohhhh yeahhhh
While their work is interesting the real question raised is "how do we build ketogenic diets", the result of the LMHR idea is that it reinforces ketogenic dieters not worrying about ldl and building their diets with high saturated fat foods like red meat and dairy. A more evidence based approach would be a lower saturated fat/ higher fiber approach with vegetables, avocados, fish, etc. Dave and Nick while interesting, are pushing keto dieters away from the second method whether they realize it or not. Most keto fans are NOT going to be LMHRs and are likely being hurt by building their diets in a sub-optimal way.
They are stating that proper responsible communication of their research should prevent what you are inferring. Bless them, they are wrong, as anyone who has taken even a passing glance at keto chat threads knows. I hope that community's ideas don't end up _corrupting_ their communication about their research.
I admit I have an inherent disrust of anyone promoting a keto diet to the general public. Sure it seems to help a few people with specific health issues. However most evidence suggests its not nessesary for good health and most people can live long healthy lives without it. Which, when you take into account its environmental impact, its an unacceptable diet for most people. Our planet simply cannot support everyone eating keto because of how prevalent animal products are in pretty much every keto plan (plant based keto is technically possible but every keto person I've met eats red meat at pretty much every meal and alot of the "advocates" have meat/dairy industry ties). I think anyone promoting a diet to the general public should consider is whole impacts, including the environment and animal welfare.
Yes...I think this episode is just "sweating the small stuff".... spending a lot of time focusing on a rare situation
Yes, IBD is so rare I see multiple commercials about it. Also, why would big pharma spend billions if they could not make it back? Obviously, they saw a way to make lots of money and jumped on it. Your reasoning needs reconsideration.
You kill animals what ever tf diet you in.
I agree that there is not enough evidence (yet) to recommend keto to the general public without specific medical indication. Although there's also no solid evidence against. Moreover, with 11% of the US population having diabetes and a whopping 38 % prediabetes, keto is relevant for a large part of the population. The ecological argument against keto is flawed. It assumes that most people on a regular diet eat plant based and planet friendly, which is not the case. Most people in western societies eat a lot animal products AND a lot of carbs. I eat keto and consume meat maybe twice a week. I get most of my fat from eggs, olives, olive oil, avocado, cheese and nuts. Most people I know eat meat meat every day alongside their bread, pasta, rice etc.
There's also the matter of mental illness etc. I was very prone to depression. In almost 10y on lchf I've had zero depression. These effects are very real.
We’ll go to great lengths to convince ourselves based on false beliefs and/or addictions.
Great conversion Chris. Can we get these guys back for a new chat as results are now published? Thanks
I am speaking at Dave's upcoming conference!
I can't wait to share this interview with my brother. We've had a long running dialog on the role SFA and high LDL levels on vascular health. He's been following a high SFA Keto diet and I've been on a low SFA plant strong diet. We are both seem to be doing well on our respective modalities.
When you say you both seem to be doing well, are you referring to health markers like LDL, or generally feeling well?
@@CharlieFader We are both feeling well, and most of our bio-markers are good, but his LDL-C's are dimed while mine are in the cellar. There are SFA in all whole foods so they can't be avoided, but whereas I do my best to keep my SFA intake low, he embraces them. I'm worried about his SFA and dietary cholesterol intake. I believe that he's consuming considerably more than optimal, but he's believes differently so there you have it. I suppose I subscribe to the Grandmother Diet which is, "Eat you vegetables and lay off the meat!"
@@joecaner that’s to be expected I guess. And what is his reasoning for choosing a high SFA intake?
@@CharlieFader I’m sure you’re familiar with the justification. He believes that a high meat, low carb is the diet humans evolved eating and the reason that moderns in industrialized nations are getting sicker and fatter is because they’ve strayed from their natural diets. He’s experienced inflammatory pain, and this diet has ameliorated these symptoms and he has been able to obtain and maintain a healthy weight so he received benefits from this dietary pattern. His sources seem questionable and anecdotal, but it’s difficult to argue with success. Mindful of this, I do my best to engage him in conversations about research that recommend the benefit of lower SFA and dietary cholesterol intake, but it’s a nuanced and emotionally charged topic, and I am an engineer while he is an MD so I need to tread carefully when stating my case. I am well read and researching natural ways to avoid and treat health problems is a passion for me, but he is a doctor after all and this is his profession. He is deserving of respect for his training. It’s tricky.
@@joecaner yes, I expected something like that. Him being an MD and using such a justification is even more bizarre though.
This was incredibly interesting, thanks for inviting these gentle man!
Appreciate it :)
After watching this, I’m scratching my head a bit. Most - maybe all - of your videos at the end I feel enlightened. Maybe this is over my head…most likely…but it seems like 90 minutes of talking that could be summarized in 10 minutes. There is a group of folks we’ll call LMHR who might tell us something about lipid mechanistic. We’ll study them some and maybe learn something. At this point we have no idea if their high LDL is an issue, we’ll find out. And it appears that the Keto diet helps at least one dude with this digestive issues. So is it worth learning more about…yes. Is it at this point a pointer that the “Keto” diet is healthy…no. Does it disprove any theories at this early stage…wasn’t clear to me it does.
Looking forward to the study’s results. Love this conversation. Do you think you’re having a harder time understanding, because you’re a bit resistant to the information presented? I agree, though, that this information doesn’t have to negate how and what you want to eat.
@@bonnieo8 yep you’ve got me pegged…oh wait nope, there is no definitive data yet.
I feel the same. No clear on what to take away from this for non-lmhr
It seems that therapeutic diets as a subject is relevant to a whole lot of people to address a whole lot of conditions. I don't see anyone arguing about keto and epileptics. What is a little more cogent to the content of this channel is longevity, and the quality of a measurably longer lifespan. Nick made it clear he's chosen to live comfortably. Who wouldn't choose that? What would be interesting (along with this study) is to see how these fat-based diets affect the lifespans of the sick people they are helping. I wish I could live long enough to see if Nick makes it to 90, but ....
And if we learn a bit more about ourselves, there's no limit to how many other people will be able to live longer and better lives.
As someone who reads drug trials and reads nutrition research articles as a hobby, there are many examples where dietary changes results in greater metabolic marker and outcome shifts greater than what is seem in clinical trials.
This is because clinical trials look at averages over many people and only look at one change in isolation. When you look at trials where results for each participant is shown, you can see this more clearly. On any given dietary change (keto, vegan, low fat, fasting, etc) you will have some people improve (usually most people - if the dietary change results in less processed food and fewer calories) and others get worse.
Most clinical trials are not scientific. In fact if you research it most of them are wrong or very flawed.
So pumped for this long episode 🎉 I’m gonna listen while I clean 😊
lol, me too! :)
Nick came across much more reasonably here than the preexisting image I had of him in my mind.
What image did you have of him and why?
@@saintwithatie Unscientific “low carb hack”. I think we need to get out of tribal echo chambers and have open dialogue.
Well... thanks for admitting you were swayed by a false narrative. I'm not so bothered by the rumors and lies with concern to my ego... but I think it undermines good discussion. If someone wants to raise an accusation, I feel that's fair but it needs to be concrete, direct, and supported by evidence, e.g. 1:21:52.
If the LMHR study shows negligible plaque progression, then we have everyone with high LDL, thinking they LMHR (or close enough) so LDL doesn't matter. When this is a fairly nuanced, warranting more study.
" then we have everyone with high LDL, thinking they LMHR" - not if we communicate clearly. But the responsibility here is on both sides. Those - not to be named - who use the term "LDL denier" do more of the inappropriate clumping than those interested in LMHR
Everything gets misunderstood, no matter what.
@@nicknorwitzPhD I expect it to be widely miss-used. Remember the Time "Butter is Back" cover. I wouldn't be surprised if Time has a "Cholesterol doesn't matter" cover...
That's my worry too. The LDL deniers will pick this up and use it in their propaganda.
@@MB10097 Can a glance be frightening? There are idiots everywhere, so what?
Oreo cookies study? Carbs? Junk carbs. No wonder he is not feeling well. I admire your openness of mind Chris.
It is to see what happens to his LDL, that is all.
People die from heart disease with a coronary artery calcium score of zero because soft plaque doesn’t show on the test but causes the same blockages
He said the study day will measure both soft and hard plaque
This was fascinating even for a mostly non-medical person. I hope you will alert us and discuss the study results when they come out! I have all kinds of questions about people NOT in that specific group discussed and how the results will apply toward others. It makes me wonder if the low-fat craze has caused changes in our bodies causing health issues, including excess weight, and if a balancing of fats in any kind of a healthy diet, such as we see in a Med. diet, would be beneficial.
I have lean mass hyper responder. I'm lean but not on a low carb. My diet consists of 80 percent veggies, 15 protein and 5 percent fat. My LDL is a little high, HDL is very high and my triglycerides is very low. My doctor wants to put me on statins. I don't want to. I'm 66 yo woman. This might help your research.. I started drinking alcohol more in my 50s. That's when my LDL started to go up. I stopped alcohol 5 months ago and my LDL is starting to go down but still a little high.
LDL of about 150mg/dl, or 4 mmol/l, seems to be optimal, on average. From what I've read and heard of statins, their efficacy in terms of overall mortality, and the side effects, I'd never start them myself.
If you started eating keto, your lipids would probably go through the roof. Just make sure to avoid sugars and processed foods and get regular exercise to keep as healthy as possible. I refuse to take statins again.
Is his argument that there are a group of healthy young people who eat a keto diet and have a high LDL? I must be missing something. I don't understand why that's a revelation. And why it means that the keto diet should be applied to as high as 50 percent of the population.
Nick has inflammatory bowel disease, so he switched to a Keto diet after trying everything else and his symptoms significantly improved (I’m truly happy that he’s found a solution that offers him a better quality of life). But, now he’s latched-on to Dave’s LMHR nonsense to help ease his worries about developing cardiovascular disease from eating Keto.
Thank you. I'm also glad he found a way to ease his symptoms and agree he turned his anecdotal story into something that can make him stand out.
umm a lot of the lmhr are not young, by the way. You have taken the 50% out of context. Yes, you are missing something as you haven't listened to the video properly. He says he could probably walk into a gym and turn 50% of the people there into lmhr. He did not say anything about 50% of the population should be keto.
Point taken. I listened to it at double speed, so probably miss things.
You are correct! Young person with high ldl on Keto very common. This is the same guy that needs to eat keto or he would be in the hospital in his own words. The problem is this is the same man that goes on the high carb diets, even an Oreo diet regiment, to prove his LDL goes down. Yes, no brainer, but wait I thought if he ate like this he would be sick again. The two problems I see. People love to find good things about their bad habits, and number if he went on an elimination diet and then re-introduced carbs, he would probably not be sick. He also is usually immature on other channels, but not so much here. Also, he keeps saying people need to be open mined, can anyone be more open minded than Plant Chompers. Nick spends most of his time on shows that disagree with Plant Chompers, while buddying up with them. I found out I was a lean mass. Hyper responder on a ketogenic diet years before these two men came up with described as a phenotype. I realized when I was on the keto diet, how unhealthy it was, and I started eating more carbs and vegetable, and guess what my LDL went down. Was I a genius and didn’t even know. Lol. Maybe I should just eat Oreos.
Great discussion. Looking forward to reading the study when published.
Many people seem to confuse the state of ketosis with a particular type of diet. Ketosis can be achieved with many types of diet, including vegan, although its more difficult. Common sense would tell me that our species was in ketosis for long periods of time regularly, probably the majority of existence. It's how we evolved, therefore that ensures me that it's a natural, healthy state. I always assumed ketosis was the default state for humans and that switching to predominantly glucose energizing of cells (low ketones) was rare and only occurred for most humans during the part of the year where we fattened up preparing for leaner times again. There is no way most of humankind had access to high carb foods the majority of each year. Even humans with no access to meat would have eaten plant based food that was nothing like it is today and very low in carbs.
Ketosis can also be achieved with fasting, which isn't too sustainable, I guess, but still. I'd even argue that people don't know their baseline lipid profile without a 2 day fast before a blood test (and that fast includes "no acutely unnecessary medication")
Dr. Greger's video Low Carb Diets and Coronary Blood Flow discussed the research study that showed that a healthy plant based diet for a year showed a 20 percent decrease in plaque, while a low carb diet showed a 40-50% increase in plaque in coronary arteries. Using actual imaging of the arterial blood flow to the heart. (Fleming, Boyd, "The effect of high protein diets on blood flow' Angiology 2000.)That's enough proof for me to recommend wfpb instead of keto to any non-epilectic adult.
👍
Thanks to you, I just read that study. It doesn't seem to say anything whatsoever about keto? It talks about, as the study title implies, 'high protein diets.'
And while the study defines the diet of the 'treatment group,' the 'high protein diet' is left undefined, with no mention of its composition made.
It is left undefined because the so-called 'high protein group' went and did whatever they felt like. To cite the study; "At the conclusion of the study, it became apparent that 10 of the 26 individuals, despite receiving dietary instruction as outlined below, had adopted a high-protein diet throughout the study."
And they apparently didn't adhere to whatever mystery diet they went with? To cite the study; "Patients who went on high-protein diets reported varying degrees of satisfaction. Family reports typically reflected initial patient satisfaction, the patients getting to eat foods they 'enjoyed' along with initial weight loss, but difficulty sustaining the dietary pattern for the entire year. Instead patients tended to adhere to the diet for several months at a time, return to prior eating habits, and then return again in an effort to lose weight."
They also treated each individual with medication based on their blood work; "Medical management was individualized based on the blood work obtained every 6 weeks. Independent adjustment of medications was made as a result of each patient’s blood work and was not based on the patients dietary habits. Table I shows the treatment guidelines employed. For example, a patient with elevated triglycerides and lipoprotein (a) would be treated with fenofibrate while a patient with only elevated lipoprotein (a) would receive Lovastatin."
And treated patients with medication for any other issues they might have; "Patients with anginal symptoms were treated with standard drug regimens including the use of long-acting nitroglycerine (Imdur, Ismo), slow calcium channel antagonists (Procardia XL, Diltiazem,), Beta--blocker (Tenormin, Atenolol), L-arginine (endothelial dysfunction), and macrolide antibiotics (Biaxin) for elevated C-RP with acute-phase antibodies to H. pylori, C. pneumoniae, or S. pneumoniae.
"
This study is useless for drawing any conclusion about keto, if only because it isn't about keto.
As an aside; There's a small oddity in the study. Look at the first quote I have from the study. "At the conclusion of the study" they found out that 10 of the 26 were on their own diet throughout the study. But in the third quote from the study it says "Independent adjustment of medications was made as a result of each patient's blood work and was not based on the patients dietary habits." Why would they specify that? If they 'found out at the end' it would be literally impossible to 'treat their blood work based on the patients dietary habits.'
Because how could they treat the blood work based on the patients dietary habits, if they didn't know their patients had changed dietary habits 'til the end?
Thanks for the clarification, I guess? Now we're safe from the misapprehension that the study authors used their time machine to inform their prior selves about the diet change.
What a Great conversation- thank you all for that.
An important question that I don’t believe was asked,… What was Dr. Horowitz diet before he developed IBS?
And was there a family history of IBS?
Another amazing video.
Thank you.
It's not irritable bowel syndrome, it's inflammatory bowel disease. After diagnosis I tried a least a dozen diets to help manage it, including low FODMAP, SCD, whole food vegetarian and vegan etc. Only a ketogenic diet has helped me. I would not generalize my experience, but since you asked...
Daniel from Lifting Vegan Logic had Crohn's disease and has been vegan for years. He has no symptoms whatsoever at this point and pretty amazing physique, too. Plant based diet is like heaven to me and I did low carb for 6 years which was pure nightmare. There is no one diet fits all.
@@Rose_Ou I am happy for you both! There is not one diet for everyone, I entirely agree! FWIW, I would love to have a platter of sweet potato with figs and goat cheese every now and then, but I'll do what I need to do for now to live life. If that means less sweet potato and more eggs, ago oil mayo, fatty fish (and maybe even some bugs sprinkled in - we didn't talk about entomophagy, but I'm a fan!), so be it! But if someone is thriving on Tempeh, Brussels and avocado, who am I to tell them otherwise.
I got the book yesterday! A much more scientific approach to cooking and now finally with an explanation WHY you should eat certain things. Liking it!
A potential mechanism not covered here is the gut microbiome ecosystem. Perhaps bacterial lipo-polysacharides are carried by some types of fat and cleared by LDL cholesterol. Perhaps fiber can be added to mitigate some side-effects.
Not sure if they get to it in here, but lots of LMHR have shown that adding 50-100g of carbs (with or without replacing the fat calories) significantly drop those LDLs.
FWIW I've been LMHR on as high at 40g fiber. It does have an impact (on me) but net carbs more so... far more so... hence the Oreos (in part)
Thank you for sharing. Can you elaborate: which metabolic parameter is impacted by fiber? LDL, glucose, etc? @@nicknorwitzPhD
@@justinhale5693 Sure. LDL tends to drop, although fiber type matters. I did a YT video on this a while back (ua-cam.com/video/oBSzOaFvWGk/v-deo.html) In the short-term fiber rich foods may have an acute effect on increasing glucose area under the curve, but in a mixed diet condition the chronic effect tends to be lowering.
I'm LMHR and match the study's cohort averages. My diet is among many things I do to manage an alphabet soup of chronic conditions, including connective tissue, autoimmune and neurological disease. I'm leaner, stronger, healthier (bg, A1C, thyroid, etc all improved). My trigs are lower than my age. I have trouble believing that my heart health has suffered from these functional and biometric improvements. But even if my diet is risking my heart health, it's worth it. Y'all might as well study us, because many of us refuse to give up these gains. Why someone would even recommend statins in someone with a connective tissue disease or metabolic illness without a CT angio showing a need for them baffles me, but they do. I really, truly appreciate this work. Thanks for being open-minded to it and furthering the conversation.
I had no idea about this hypothesis. Very interesting. Thanks Mr Chomper
The world needs a population reduction anyway so more processed foods, dairy, and meat for all. There will be more for the WFPB lifers!
Chris, this was a fantastic episode. Always fun listening to people who are actively doing research.
Personally, like you, I'm the complete opposite of Nick although I'm in my 20s. Very lean/reasonably fit individual with a family history of heart disease (did you ever get diagnosed with a first degree heart block) on a WFPB diet but also had a very high ldl (~180). Going very low fat also had a marginal difference so, on a low dose statin atm.
I don't understand the pushback from some people. It's not like more trials are going to hurt our understanding. Either the hypothesis doesn't pan out or it forces us to improve our models of heart disease/nutrition. There's very little downside.
Thank you. For the life of me, I can't understand what's wrong with taking a really outstanding researcher like Matt Budoff and studying these guys to see what we learn.
The 'downside' is people have been referring to this unsubstantiated hypothesis for the past 5+ years as a means to justify their high-risk lifestyle choices, often against their physicians' recommendations.
@@megavegan5791 The second guest explicitly stated that this discussion isn't a substitute for medical advice and both of them have said that this is an extremely rare occurrence which isn't applicable to most people. If others choose to misrepresent their stance and damage their own health, nothing can be done on that front. The risk of misrepresentation by people is present in almost every nuanced scientific discussion.
Secondly, the entire point of the video and their conversation is that they're trying to substantiate the hypothesis. Trials take a significant amount of time and money, the latter can only be acquired after other people are on board. Science isn't done in a day.
There you go! The down side is that they may be right and the treatments advance and improve outcomes. Don't want that do we? That would mean that you would be wrong! Wait, what??? That would mean that all the money Medicare is WASTING treating diabetes instead of reversing it could be saved and directed towards more worthwhile interventions, and we certainly wouldn't want That. Please note that you are saying that this is hypothesis, but, they are also referring to the heart-diet HYPOTHESIS, fifty years later, ITS STILL AN HYPOTHESIS!!!!
@@waleedabbas4996 People with advanced CVD are throwing away their statins because they listen to charlatans who quote this hypothesis with no caveats. IT'S DANGEROUS.
Hi Chris, just posting a question for you here though probably small chance you might see it. I just watched your interview with Simon Hill which was amazing, your stories and anecdotes made for riveting viewing. In particular the insight you gave into Steve Jobs, a much analysed and discussed person, was the most enlightening I've ever seen on this contradictory man. You touched on his cancer and I've always wondered about this. There are lots of theories on why he developed this so young, from fad diet choices, exposure to chemical, or just unlucky. Do you have any more info on what his diet was really like over the long term? Also you made an intriguing comment about Dean Ornish perhaps being able to cure him. What did you mean by that? Thanks and keep up the good work, a voice of reason in a mad world. Ps I always think a good starting point for getting nutritional advice on you tube is if the person is fully clothed, if they need to show you a six pack, forget it!
I wonder how the speaker would do at True North with Alan Goldhammer, would he still react this same way to carbs after a full reset? Or has he tried living only off sweet potatoes for a while for instance (what drs. John mcDougall and Peter Rogers would recommend)?
Great interview Chris! Have you noticed that you lower your voice slightly, when you interview people?
I've bashed Dave in the past because I thought he was an ideologue trying to justify dangerous blood lipid levels without the science showing his hypothesis was right. Perhaps I was wrong. Will have to look into it more
oh no, he has never pushed this idea as a sure thing - he also emphasises that it is a hypothesis. He also says don't take his word for it, but that he is trying to learn more.
@@leenysnell8804 - unfortunately many low-carbers have been referencing Dave for a long time to justify their high-choleserol levels. Until the science is done they are risking their health on a hypothesis
@@yogiyoda if that is the case they are going against Dave's advice. In any case if they are whole food based they are still doing much more for their health than if they stayed on a diet full of processed foods.
@@leenysnell8804 - Maybe, depending on their particular situation, it's possible the low-carb diet drastically raising blood markers might be more dangerous
You are one easily swayed fellow. The study isn’t done yet. Usually several studies has to be done…
I wonder if Nick Norwitz would have solved his health problems with a whole food plant based diet.
According to him, he did try.
he tried vegan, but that's different from a low fat no oil whole food plant based diet. you can be 200 pounds overweight and sick with all kinds of things on a diet that's just vegan. @@what.the.bleep.do.i.eat.
I've tried. Unfortunately, WFPB did not work. When I say I tried... I do mean WFPB 0 UPF >6 weeks. I wish it did work. I honestly would love to chow on sweet potato with figs
@@nicknorwitzPhD I'm with you Nick. I would prefer a more plant heavy diet too but my IBS makes it essentially impossible. I really appreciate your research and your Mediterranean Keto book. I don't have to be fully Keto, just lower carb but I'm really trying to do it in a healthier way because I'm also not trying to speed run a heart attack. Cheers!
@@nicknorwitzPhDI’m with you, I daydream of baked potatoes piled high with beans, corn, fresh peas, bowls of oatmeal, rice and vegetables, and on and on. Those foods gave me over 30 years of painful digestion that put me to bed for days at a time with a heating pad. I wanted so much to be a starchivore or even just wfpb. No medical intervention and even abdominal surgery made a bit of difference. Like you, I cheer people who thrive with eating that way and I will fight for their right to continue without being maligned.
The trouble is most food is hyper processed. Everywhere you look, it said that most food is bad for you. No wonder people are confused about what to eat.
It's very simple
My Aldi has everything I need right in front of the door. But I make room for canned beans and tomatoes.
Walking past the weird pink stuff to get to the hummus is a bit unsettling.
I wonder sometimes how I'm viewed as I pay for two huge IKEA totes of veggies.
In my country and my mind a hyper responder is a very fast ambulance. 😅
If the target population is less than 1 percent of the general population and a tiny percentage of the keto practitioners, is the point of the research that the 'odd' situation involving the tiny population perhaps is indicative of some larger implications that apply beyond the tiny group?
Appreciated this interview - as a LMHR I am very interested for my own health
I love the follow up content added after the interview. Very complete.
Fantastically nuanced interview.
Thanks!
Very interesting interview & info. Enjoyed this. Thank you.
That was a fascinating conversation.
Vegan ketosis is possible with or without refined oil. Without refined oil, getting the majority of calories from walnuts, flax, chia, sesame, almonds, hazelnuts, peanuts with greens can force endogenous ketone production.
I mention this because there are conditions that are responsive to ketones and forcing endogenous ketone production is likely the only way to maintain consistent blood ketone levels.
For now, evidence points to production of Apo-B100 containing non-HDL cholesterol being the body's response to saturated fat consumption, and Apo-B100 sticks in our endothelium leading to lesions. For almost all of us, the least harmful ketogenic diet is vegan and low in saturated fat.
True Ketosis only occurs with a diet of no diet, after a few days of fasting.
Hi Plant Chomper. Do you believe your marathon or triathlon training could have anything to do with your high LDL? I watched a lecture from a cardiologist named O'Keeffe talk about how extreme endurance athletes tend to have significantly worse heart health and more plaque. He wasn't sure if it was because of all the calories they ate to fuel their performance or was the training actually harmful to the arteries themselves and causing inflammation.
I know you said you eat a vegan plant based diet. How "clean" would you say it is? Is it per what Dr. Esselstyn recommends no oil no nuts? I'm very curious about this topic because my family history is terrible when it comes to heart disease diabetes cancer. But most of my family also smoked drinks doesn't exercise and eats processed food. My mom was told by her dr she has "genetically high" cholesterol. I don't remember the numbers but i think she was high 300s or even 400s and medication only brought it down a little. One statin did bring it down a lot but that one has sense been discontinued. I bring up Dr esselstyn because I got her his book and while she wasn't 100% compliant with his diet she saw a huge drop in cholesterol. It was still high but significant enough where the dr asked her what she was doing. Unfortunately i haven't been able to get her to commit 100%. I even told her she should do it 100% for a month and i would pay for the blood test to see what the result would be. Oh well.
My cholesterol was never as high as my moms but it was going up with every physical. Doctor was starting to get concerned. When i went on esselstyn total dropped to 120. My LDL was like 65 or something. I also noticed how much better doing cardio felt. I did cardio pretty consistently for years but always hated it. About 2 weeks on the diet it suddenly felt much easier.
really enjoyed this discussion. very thorough, very reasoned.
What do you think about Dr. Zach Bush's research suggesting that antibiotics/pesticides are a huge factor in metabolic health due to their disruptive nature to carriers in the metabolic systems?
I appreciate the researchers comment about the logic issue with the little girl who had a heart and very high LDL. The heart attack might have been unrelated to the LDL. It might have been caused by an undiagnosed congenital heart condition. It might have been caused by multiple factors, not only one. The very high LDL reading could have been a lab error. She might have secretly eaten before the bloodwork during a period of intended fasting before the blood draw. There are many unknowns that might have been contributors. She might have been on a medication or more than one that has heart-related side effects.
No, in this case it was clear homozygous FH. The distinction is between LMHR and known 'broken" lipid metabolism via 'smashed' LDL receptor
poor little girl, those doctors are so scary:((
Interesting concept with certain outliers, but the river overflowing analogy cuts both ways. Regardless of the cause, it is overflowing and that in itself is a problem. Fortunate for the case study of the LMHR who didn’t develop any calcified or non-calcified plaque over two years of having sky high LDL, but it’s a tough bet that this can be banked on for a long life span.
Exactly. Show me the LMHR data after 20 years of 500+ LDL. I'll wait.
@@Amshatelia88 if they can show no plaque build up after a year or two, and in multiple age groups, there is no reason to assume a significant change in longer term follow-up, though it would be interesting nonetheless
I feel like after watching this that everyone has some genuine 'skin in the game' with regard to heart and metabolic health. As stated, I think we can all agree that a lot of the success achieved on both sides, eating clean vegan or eating clean keto, is likely to be more about what we are subtracting and less about what we are adding. What is important about this study is that it has the potential to further enhance our understanding of lipidology because it seems that any good scientist knows that we don't know what we don't know so let's keep open minds and continue working the problem. The 'food fighting', name calling, finger pointing and click-baiting isn't doing anyone any good. Vegan and carnivore are not fighting words they are dietary and lifestyle strategies that real people are employing in an effort to resolve real health issues. I applaud anyone with the will and courage to make any change that includes cooking and consuming whole, nutrient dense foods instead of processed garbage. I appreciated the respectful discussion and inclusion of key references in this video podcast. Thank you!
It seems to me it would be more meaningful to try and figure out how to get people permanently out of their gut dysbiosis, rather than trying to find reasons to exonerate a generally unhealthy keto eating pattern, even if it's plant based keto.
Why is keto a generally unhealthy eating pattern?
@@saintwithatie "Very-low-carbohydrate diets are associated with marked risks. LDL-C can rise, sometimes dramatically. Pregnant women on such diets are more likely to have a child with a neural tube defect, even when supplementing folic acid. And these diets may increase chronic disease risk: Foods and dietary components that typically increase on ketogenic diets (eg, red meat, processed meat, saturated fat) are linked to an increased risk of CKD, cardiovascular disease, cancer, diabetes, and Alzheimer's disease, whereas intake of protective foods (eg, vegetables, fruits, legumes, whole grains) typically decreases. Current evidence suggests that for most individuals, the risks of such diets outweigh the benefits."
- REVIEW article
Front. Nutr., 16 July 2021
Sec. Clinical Nutrition
Volume 8 - 2021 | doi.org/10.3389/fnut.2021.702802
*Fantastic* conversation, gentlemen. 👏
Looks like an interesting rabbit hole for those in the field.
I can save you 90 minutes. Yes. You should worry. Any reputable lipidoligist would not suggest otherwise. Now if you want to take your medical advice from an engineer and a wet behind the ears first year medical student, go ahead. He keeps saying that 665 is a scary number. 185 is a scary number. But he is a youngster. Hopefully he will learn.
Great episode. I'm thankful to Chris that he is open minded. In sum this episode arose more questions than it answered to me. Since the LMHR are so uncommon one might easily misinterpret this episode. It would have been great to end with a part that puts everything in the bigger picture.
Does this have any implication for the moment for people who have high ApoB but are not a LMHR? As far as I understood it doesn’t.
@PlantChompers how about you invite @thenutritional_advocate (Alan Flanagan) together with @nicknorwitzPhD for a next episode with the goal to try to get a bigger picture of this with the current evidence we have.
Also it would be very interesting to discuss if being on a ketogenic diet over years and years has any evolutionary advantages. For my understanding the body or better the brain just had to have food in absence of carbohydrate, which is why it also functions on ketones, but this is just in case and not meant as a diet for decades. What are the thoughts around this?
I hope there is a second episode that goes on with this thought and elaborates in in different directions.
Some very interesting stuff coming out of Harvard with keto diets for serious mental health. Check out Chris Palmer - this is using ketones as food for brain instead of glucose. Fascinating stuff!
@@leenysnell8804 If you have his book look on the first couple pages... you'll see I wrote an endorsement. Chris is a friend.
Prior to the rise of agriculture 10-12 kya the human diet would have necessarily been low carb as not a lot of readily available high carb plants present in the wild. Couple that with food scarcity and it’s my hypothesis that ketosis would have been a state humans would have been in for significant periods of time. Carbs when consumed would have been fruit or maybe honey for a short period of the year when it was in season and ripe. Those living in higher latitudes particularly during ice ages much like the modern inuit would have had little access to plant foods. We can infer a lot from this information
Maybe I missed it, but why would someone use OREOS by way of carb introduction? Why not steamed potatoes? or rice?
This confused me too. Oreos are highly processed and high in saturated fat. Would make more sense to use a low-fat whole food carb sources.
@MB-yu6ir possibly. Definitely seems like he is setting it up to fail. No one in the plant based community thinks things like oreos are healthy.
1:14:50 He explains why he chose Oreos. It draws more attention to his experiment and (hopefully) makes it more clear that the experiment isn't a health intervention, its more in the realm of a diagnostic for his LMHR phenotype.
@@williamdixon4936 Thanks! Perhaps I should’ve watched the entire video before commenting. Perhaps it'll all make sense once I have.
@@el-bov8034 absolutely, its a reasonable concern! Hope you enjoy the rest of the interview, I sure did :)
Chris, I think that you need to start doing followup videos for all the videos that you do. The science is too difficult for us to understand. It's not like we are completely uninformed, either.
Maybe make follow up videos that state clearly each time:
1) what you previously believed before engaging with the new idea
2) what you now believe after engaging
3) summary of relevant information [I need to know how this affects our diets and what to think when we get blood tests and how to talk with our family doctors]
4) how this information relates to the teachings of Ansel Keyes, and the 22 countries study
5) respond to the comment section
We need this. Otherwise you're speaking gibberish to us.
Thank you! I am " almost" a LMHR and have "scary" LDL numbers. I was pushed to carnivore by digestive issues, and have had severe side effects from statin therapy. I am very interested!
It's the microbiome? Along with a still strong metabolism?
The healthy liver is working like crazy to process high cholesterol, pushing it away and then puling it in -through high HDL and high LDL, naturally. And no plaque formation, for the time being only.
But the IBS surely shows dysbiosis, most probably with acetate-producers (Bacteroidetes) more numerous than butyrate-makers (Firmicutes), a ratio which switches sides when a keto-diet is adopted. Sounds typical for high-fiber, low-fat vegans who go keto. You then get a temporary relief with keto at the price of higher cholesterol& triglycerides values.And acetate (the most abundant SCFA) is a strong cholesterol-formation promoter, right? Due to high (lectin-loaded) fiber?
A lectin-free WFPB would be a solution to the problem, I believe.
Unrealistic nutrition arguments always seem to boil down to a few metrics... Conveniently skipping holistic, long-term metrics of health to hide issues.
Everything on a low carb diet typically improves except LDL. hba1c, blood pressure, weight etc. etc.
much of the info is anticipatory. We have to wait 3-5 years after these have been properly studied and analysed objectively, without corporate interference.
@@CashMoneyMoore but why follow a diet that raises LDL? You can get improvements in all of them following a low saturated fat low carb diet.
@@CharlieFader saturated fat does not increase LDL
@@defeqel6537 it certainly does, it’s very clear.
Nick gets all high on sugar,... which must be his youth,... 🙂
Because when I eat like a chocolate bar,.. my brain goes like: WHY???.... WHY did you do that???
I get sleepy for an hour, almost get a headache, I can't concentrate, but then it wears off quickly. It sucks. The chocolate tastes great. And sometimes the desire wins, but always I regret it afterwards.
He keeps saying “metabolically healthy” people with extremely high LDL.
That doesn’t exist.
The idiocy of these low carb propagandists is looking at young healthy people who can manage to survive having high LDL. Having prolonged high LDL isn’t something that kills your when you’re 25.
I agree metabolically healthy is a vague term that deserves clarification in certain contexts, although I think it's a colloquialism that resonates with many and that we used it appropriately. But if you want clarification, I meant that we observe high LDL in the absence of other markers of metabolic dysfunction or 'broken metabolism' (e.g. atherogenic dyslipidemia, elevated LPIR, HTN etc." Your proposition that high LDL is antithetical to metabolic health is a controversial but not indefensible position. What I'd say is, in the case of LMHR, the consequences are unclear and deserve further study. They may provide the strongest case for the lipid heart hypothesis. They may also provide an interesting exception. Either way, we learn. Name calling won't help your case BTW
@@nicknorwitzPhD Name calling is irrelevant to whether something is true or not - including whatever the name that’s called.
People who pursue the “high LDL is good actually” do little to serve the infinitesimal group of humans with a genetic disorder and do incalculable harm to the average person who this kind of “research” is used to undermine proven and consistent science. E.g. this is just more fodder for the beef industry and the persons (and animals, I suppose) their influencers help to murder.
You can't even be metabolically healthy on keto. You are always insulin resistant as hell.
Chris, your interviewing people from the "other side!" Two of my favorites! Just when I was about to give up on you. As you like to say, "Whew, faith in humanity restored!" Just think, if both sides are represented instead of just one side, its a more balanced ,informed, discussion. The reason these two are doing these studies is to see if high LDL is the end all be all that big medicine/pharmacy want us to believe! Thank you for a great interview, which by definition is where the interviewer gets out of the way and lets the subject speak.
Thank you for this great discussion.
Thank you!
So, I went ahead and gave this a listen. Let me save you all the suspense and tell you the study they are currently conducting will not show any substantial increase in plaque blockages among the LMHRs. Cardiac and CT angiograms only detect plaques that restrict the size of the lumen. However, plaques develop and progress inside the walls of the arteries for years before they protrude into the lumen. I suspect Dave already knows this, which is the whole point.
I've seen several of your comments on this video. I was wondering if you have an issue with keto itself, or keto that includes animal products / high saturated fat?
@@saintwithatie All ethical issues aside, I don't care what people eat. I do have a huge issue with online influencers who 'misrepresent the truth' (I'll be generous here) and take advantage of vulnerable people (e.g., people suffering from lifelong obesity and/or chronic diseases) for financial gain. I think Keto would be much more respected if people would promote it for what it really is: a great weight-loss tool that significantly improves chronic symptoms in the short-term, but at the expense of long-term health risks, including increased risk of cardiovascular events due to chronic exposure to elevated LDL. If people would acknowledge that, or if they can eat lots of saturated fats and somehow keep their LDL levels low, then do you and enjoy.
@@megavegan5791well said
Great discussion! Thank you. Enjoyed it so much.
If you're low carb and vegan, great. What I don't like is the fact that this kind of science will be used by those who eat meat to continue to promote that practice which is so harmful to the environment and has so many ethical problems. I respect the discovery of the truth aspect to this. It is also good to remember that diet has many ramifications in addition to physical health.
Just as the main narrative that meat is bad for health is being debunked, if you dig deeper into the environmental aspect of meat consumption and production but not from an ideological standpoint you could find very good evidence on why it is not as big of a problem as the liberal narrative tries to portray.
Also it is very alarming how you want to control other people's lives and costumes. We should be speaking about improving industrial practices and not about forbidding other people do doing what you do not like, because of your biased arguments and data, without even ever listening to them with a sincere heart.
What you are doing is no different from Nazism, they also thought they were imposing themselves for the grater good.
Are there ethical problems when a lion eats a zebra? If you don’t want to eat meat then don’t but hold your virtue signaling for those who make other choices. One has to eat yo live. The only reason you reject eating meat is those animals are more similar to you. You don’t think twice about killing plants. My guess is that plants would not be ok with their mass murder.
It’s been a trip
Great interviews
Keep up this fantastic work
No, I don't worry. 4+ years carnivore and I have no idea what my cholesterol is 🤣
Ignorance is bliss.
Knowing you have high numbers will just make you anxious. Just exercise and no junk foods. Good luck.
@@megavegan57915+ years now and I still have no idea what my cholesterol is :)