Designing Low Carb diets for Heart Health | Dr. Ethan Weiss
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- Опубліковано 5 чер 2024
- Low Carb doesn't have to equal high cholesterol and heart disease risk. Low Carb cardiologist Dr. Ethan Weiss shares his heart-healthy Low Carb diet.
Dr. Ethan Weiss, cardiologist and Prof. of Medicine at UCSF and low carb dieter for ~5y
last week’s video on cholesterol and saturated fat on low carb + low carb diet by a professional in heart health
ApoB. fats like cholesterol and triglycerides travel in our blood in lipoproteins
lipoproteins can enter artery wall and cause plaque. ApoB is a blood test that gives us a count of the number of those problem lipoproteins
is high cholesterol a problem on low carb? Dr. Weiss goes by ApoB given its implication in cardiovascular disease
is high cholesterol ok as long as HDL-c is also high and triglycerides are low? what’s your ApoB? HDL-c is a good marker of risk but probably not a mediator, not a cause
triglycerides appear to be mainly a reflection of the lipoproteins that carry them, ApoB
new trial: lowering triglycerides without changing ApoB didnt affect cardiovascular risk, targeting triglycerides per se may not be very useful for heart disease, the goal is to get the lipoproteins, the ApoB, in the healthy range
saturated fat and low carb: saturated fat raises ApoB, so Dr. Weiss looks at ApoB
calcium score: CAC=0 more meaningful in an older person. a young person with a high calcium score is a concern
calcium is not a good test of whether exposure to high cholesterol for a few years raises risk. statins raise calcium score while lowering cardiovascular risk. Statins have a plaque-stabilizing effect, the calcification may be related to this
are LDL particles harmless if not oxidized? Dr. Weiss considers measuring oxidized particles in circulation and trying to change that value a distraction, best evidence hasn’t shown an effect on cardiovascular risk. apoB in the healthy range is likely to get oxidized anyway
practical ideas on how to eat low carb while minding heart health. low carb doesn't have to mean high cholesterol, we’re not forced to choose between diabetes & high cholesterol
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Animations: Even Topland @toplandmedia
References:
1-www.ncbi.nlm.nih.gov/pmc/arti...
2-jamanetwork.com/journals/jama...
3-www.nejm.org/doi/full/10.1056...
4-www.jacc.org/doi/abs/10.1016/...
Disclaimer: The contents of this video are for informational purposes only and are not intended to be medical advice, diagnosis, or treatment, nor to replace medical care. The information presented herein is accurate and conforms to the available scientific evidence to the best of the author's knowledge as of the time of posting. Always seek the advice of your physician or other qualified health provider with any questions regarding any medical condition. Never disregard professional medical advice or delay seeking it because of information contained in Nutrition Made Simple!.
#NutritionMadeSimple #GilCarvalho
0:00 Intro
0:30 ApoB
1:03 Recap: Cholesterol and saturated fat on low carb diets
4:00 Recap: the calcium score (CAC) and statins
5:30 Recap: oxidized lipoproteins
6:34 Dr. Weiss´ diet: Low carb for heart health
12:11 Fat types: oil & butter
14:10 Salt
15:18 Risk factors & importance of not settling
I started Keto diet last month and started losing weight (and especially fat around belly) at insane rate, but saturated fat controversy on youtube (Berg, Ekberg, Jamnadas) confused me as their claim contradicted everything else I found on the topic. These two videos (part 1 and part 2) really cleared things up, and especially that I can stay on keto diet without eating tons of saturated fat.
I used to follow Dr Berg advice all the time but recently changed a bit as my LDL was going up and couldn't find sufficient data that proves that cholesterol and saturated fats are not linked to heart disease. But now I'm a vegetarian with fish twice a week for omega 3s and I've tested my blood glucose many times 1hr and 2hr after eating huge amount of carbs (whole bread, legumes, blueberries) and found that my glucose level never went over 103 and usually I barely get over 100 after eating a lot of calories and fat. You can certainly have low insulin spikes on a plant based diet version of keto.
Ek(Berg)
@@imhassaneinsulin level is also important
Exactly, great info here 👍
@@imhassanewhat is your Protein sources ?
His "numbers" (apoB, LDL etc.) would have been interesting.
cook at home from scratch really solves so much. buy ingredients no pre-made food. A crockpot and a pressure cooker saves more time than it takes to order food. throw in a crockpot go to work, instant dinner
This is gold ! Thank you for your time here, i am learning so much.
Despite telling the docs for 3 years that I have one Apoe4 allele (they don’t even know what it is) they’ve only just tested me for ApoB. It is 130 😮 Doc wanted to put me on statins but I said no, give me 3 months to see if I can bring it down naturally. So I’m eating a tonne of fish, greens and EVOO. combined with 18:6 fasting. No more processed food,saturated fat or alcohol. Plus strength training as I’ve read that brings it down. Wish me luck!
Have you looked into the portfolio diet?
result? have you lowered it?
@@descai10 Yes! by a significant amount and now I'm the high end of normal. By doing all the things I described above. However I fell off over Christmas so have to get back on it!!
@@joaninha3484 Yay! Good for you. :)
Summarizing the points in the interview at the beginning and end of the vid is indeed helpful.
I'm a UCSF residency graduate in Fresno. We seem to have a perk down here that Dr. Weiss doesn't have up there. Rather than having to bring my lunch from home I'm able to order a great salad straight from the hospital kitchen. Here are the boxes I check on my phone order: Spring mix, tofu, tomato, mushrooms, cucumber, carrots, and avocado with balsamic dressing. I also get the side vegetable which today was shredded brussels sprouts, and a fresh fruit cup of honey dew and red grapes.
I love this Ethan Weiss guy! He's extremely reasonable and marries it with the science. He seems like he can perfectly manage the space between loving life and preserving health.
Watched the other video too. The guy being low carb helped me overcome my cynicism and I'm going to get my ApoB checked. I have been keto for 6 years, have heavy cream in my coffee in the morning. Only eat full fat yoghurt, cheese and milk, enjoy a variety of meats including steaks and 3-4 eggs per day. Wish me luck!
u alive?
When you get your results can you update? I have diabetes and heart disease.
How was your test result?
any updates on the ApoB test results?
I believe that your ApoB will be high. Low carb absolutely works to reduce weight in the short term, but these high saturated fat and animal protein diets are high risk in the long term. In addition to ApoB, red meat has a higher risk of cancer and an overall higher all cause mortality rate.
The summary of the last discussion was great! Thanks.
thanks for the numbered reference pop-up captions, very helpful
This is sooo helpful to see what a renowned Cardiologist eats! And it’s actually very affordable when you take out all the other things. Thank you for sharing.
Thanks for making it simple! Great format this time.
Very helpful video! Thanks for the introduction to Dr. Weiss, Dr. Carvalho! also I like the samba!
Thanks for clearing up all my keto confusions. Incredibly informative video.
These videos are immensely helpful, thank you.
This is so informative, I love your channel. Thank you.
Thanks for your summary, you explanations are clear and useful.
These discussions are very helpful, thank you.
This is very helpful, thank you so much! (And, I ❤ your accent!)
This was so helpful!
As someone who just started a ketogenic diet this kind of content is extremely valuable. Thank you.
Keep an eye on ApoB. Mine spiked to 186 while on a strict keto diet, so I backed off.
Are you epileptic?
@@aquamarine99911
Where you nearly zero carb?
Thank you for that excellent summary of the first video. It was a little hard to follow and scattered, even though the information was there, but you did a fantastic job of pulling it together in a very digestible form.
I was on standard Keto diet for 6 months and my LDL exploded. I didn't have massive weight issues I was on it more for the mental/focus benefits as I have way more energy when I'm in ketosis. I switched to a more heart healthy keto plan and the results where phenomenal. The bit of stubborn weight I did have hanging around the stomach was blasted away in a matter of weeks. Everyday I eat Steamed broccoli, Cauliflower, Sprouts usually with Salmon and a Bone Broth soup as a starter. Tuna / Chicken Salad with lots of rocket leaf & green salad everyday for lunch. Fats I get from Salmon, Olive Oil, Nuts, Avocado. I use a healthy margarine instead of butter. Ill also eat turkey sausages, Turkey burgers, eggs when I fancy a fry up. No matter the diet high LDL ain't good so there was no chance I wasn't going to go blindly down the keto rabbit hole and hope for the best. I also didn't want to lose the benefits of ketosis so I just switched it up. I suppose my diet now is a mix of the Mediterranean diet and a ketogenic diet. A bit restrictive though so I do it 3 months on and 3 months off which seems to work well
Margarine is not healthy.
@@pambbrown Yeah that's just not true. Newer plant sterols margarines made with mono- and polyunsaturated fats are perfectly fine to eat. Stanol-based margarines will lower LDL cholesterol. Margarines with plant sterols or stanols reduce the risk of heart disease by one quarter.
@@shanegarland3954 Can you provide a link to some resources? I'm interested in moving more your direction.
So what happened to your LDL in detail?
Plant sterols for those with cholesterol hyperabsorbsion isn't a good thing, as it bypasses normal blockers of plant sterols and the body tries to use them structurally, which is bad. Hydrogenation is also very very bad. Stick to olive oil and not margarine. Make mayo from it if you wish to have a good spread.
@@shanegarland3954
Thank you so much for this interview which highlights the many versions of a healthy diet. It is interesting to note for example that Dr John McDougall favours plenty of starchy vegetables and Dr Caldwell
Esselstyn bans the use of any oil.
However I am sure everyone agrees that processed food should always be avoided.
All of them agree on a plant based diet.. different forms of plant centered diets.. and that's a win win for me..
Thank For The Great Review 😊👍
Very informative, thank you.
great video, thank you.
Nice job on the recap!
Always very reasonable advice and not far away from everyday life!!! Must have my APO-B testet!!
Awesome video doc.
Thank you guys so much for clearing up the notion that you have to be gobbling down fat on a keto diet. Great info here, lot's to learn from 👏
Thank you!
Great video really helps clear things up. I eat about 2 to 2 1/2 pds of wild caught salmon every week for the last 2 years and just had my mercury checked . Less than 10 is considered acceptable mine number was less than 2.5 so was very happy with that. The salmon I eat is almost all Alaskan canned wild caught(can heat it on the grill with onions and lemon slices) and packaged at Walmart and its not costly at all.
These are really great conversations. Thank you. What I have never seen at least commonly is no one talks about the harsh chemicals, pesticides, growth harmones, wax coating and colouring agents used in agriculture/to grow veggies... Don't know why. Could you please cover this topic as well.
Fantastic video. Despite following your channel, and the academic literature for a while I found the recap very useful. For further discussions it would be useful to define "low carb". Dr. Weiss mentioned eating plenty of vegetables and that conflicted in my head with a low carb diet.
Keto diet is less than 50g of carbs(not counting fiber) per day.
Many vegetables easily fit into that.
low-carb is less than 130g of carbs per day as far as i know.
Thanks folks, I guess the mental gap had to do with fiber not being counted in “low carb”. Aka, he is eating very fiber rich or otherwise low carb vegetables (high percentage of water)
There IS a lot of confusion and mixing of terms - keto 'diet' vs low carb. Keto would mean one is in 'x' level of ketosis, which varies vastly by individual in response to their dietary inputs. Low carb could be below 'x' level of glucose forming veggies, which is interesting in itself, as protein will become glucose in the end, if eaten in large enough amounts (over one's requirements at that point in time).
And the kicker for me is all this reference to 'intermittent fasting', which really and truly should be called Time Restricted Eating TRE, as that is all it is. One is not fasting in any serious way by skipping breakfast or lunch, or both ; ).
For myself, I hit ketosis all too quickly, maybe because I am low weight? (anyone familiar with low bmi ketosis?) and it will affect my sleep negatively.
I have to find a protein/fats/carb ratio which only provides mils ketosis. OR take a small extra carb bite or two at the evening meal. (tonight it was 1.5" of a banana w/a few walnuts/pecans, after the broc/lamb/leeks etc main meal.
Really wish I were overweight, it's so much easier to do these diets when one knows the weight loss will result and is beneficial, rather than harmful. AND that once can easily pack the weight back on, unlike we thin folk.
@@eugeniebreida1583 Why would you go on a low carb or keto diet if you're not overweight? Just eat plenty of vegetables, fruit, beans, nuts & seeds and minimal processed foods. In other words: aim for a healthy diet and be happy that you don't get overweight easily. Even if that doesn't make you immune to heart disease.
Nice video. It seems myself and Dr. Ethan eat the same and even use the same oils. One difference is, I saw your video on salts Dr. Gil and switched to using Potassium Chloride salt for my food.
Invaluable channel.
great video Dr
Awesome video! Just subscribed...but i would love to know what the diet should be for a person like me with lipoprotein a and MTHFR issues? I literally can't find a clear answer. 😢
I like that he doesn't push extreme avoidance, those diets are hard to keep. I like that he's mostly common sense healthy with a little vice thrown in that shouldn't make a difference unless you have a specific issue that that particular thing could aggravate. I think people sometimes try to go extremely restrictive without having a specific need for it and that's setting one up for failure, or at least a tough go. I eat much like he does, but I have a sweet tooth for dessert after a meal and that's my battle. Some green apple slices with some natural peanut butter has been my latest dessert trend.
When he was talking about salt, he forgot to mention that there’s also concern for stomach cancer and artery dysfunction even without a raise in blood pressure.
Very true, too much salt can lead to ischemic stroke. It’s the one that happens in your brain which is very dangerous and can lead you to be very disabled.
@Betty Amber who said anything about having too little sodium? Humans need very little sodium to be healthy unless there is a medical condition. There’s enough sodium in whole foods without needing to add any salt.
@@imMantous UNLESS you sweat a lot, ie frequent sauna use, sweaty cardio sessions etc... So may ppl get in trouble with this advice not accounting for how much salt they excrete!
@@imMantous Quite a lot of people like me suffer from hypotension (low blood pressure) and can get dizzy when standing (I have even fainted for no other apparent reason) so a little extra sea salt can be beneficial.
Thanks for this conversation with Dr. Weis. As someone who has struggled with my eating and weight most of my life, it was great to have someone who has eating down with no drama or controversy to model my low carb lifestyle after.
My takeaways:
- Olive oil for eating
- Avocado oil for cooking/baking
- walnuts
- lots of veggies!
- cut down on the saturated fat (been working on it!).
- get the ApoB below 60.
- get more fish in my diet!
- avocado daily.
I need a good cardio routine that doesn't involve my feet - currently suffering from bone spurs. I can walk, but anything over 4K steps a day has me hobbling the next day or two later. Any suggestions?
Rowing
love rowing, also ‘resistance walking’ or other workouts in torso height water (pool/shoreline)
@@eugeniebreida1583 Thanks, I can't do rowing either, but I was thinking about a pool workout, punching bag, that rope thing that looks pretty popular. Cycling is okay if I can find an a$$ friendly seat - lol!
APo B ranges from Quest Diagnostics are more generous than the 60 mg/dL stated in this video. Risk: Optimal = 120 mg/dL;
Cardiovascular event risk category cut points (optimal, moderate,
high) are based on National Lipid Association recommendations Jacobson TA et al. J of Clin Lipid. 2015; 9: 129-169 and Jellinger PS et al. Endocr Pract. 2017;23(Suppl 2):1-87.
He didn't mention it specifically, but you can use flax seed, chia seed and psyllium husk when ground very finely as a substitute for wheat flour in things like crackers and bread. People do really miss these things on lower carb eating plans. Lots of recipes online. I would have been very interested in Dr Ethans view of legumes, but judging from his fairly relaxed approach I am guessing it would be 'I wouldn't forbid them and I do eat them, wouldn't be very often though'
You can also use almond, coconut, or soy flour, or some combo of all those things.
True. Husb enjoys all above and enjoys whole complex carbs daily and one thin pc good sourdough bread for breakfast w/pure peanut butter and loves avos, olives and fermented foods. SD bread shown to not spike blood sugar and level it out again fair quickly. Husb is older and very healthy, no meds, and looks much younger. Prob good microbiome from feeding healthy bugs (almost same # as cells). He’s never smoked, doesn’t drink alcohol or coffee (doesn’t like either) and avoids junk food except for odd good qlty fresh baked good from local market or local bakery. He’s not fanatical or dogmatic and pretty relaxed. ✌️
Oat fiber is also excellent (and is zero calories, to boot): I use it in combination with almond flour to make keto crackers.
It seems to me he has just found a way to do calorie restriction that suits him. If an active guy needs about 2,500 kcal per day then he'd have to eat maybe half a kilo of salmon (1,000 kcal) a kilo broccoli equivalent (340kcal) and drink 100ml of Olive oil (800kcal) to even approach that. Anyone who makes it through a work day on some yoghurt and nuts for breakfast, salad for lunch and roasted, non-starchy veg with salmon in the evening is pretty much on a crash diet. It would be interesting to have some numbers on his caloric intake. Does he personally get through 3kg salmon, 10kg of non-starchy veg and 1l of olive oil every week?
I love your content, very glad I found it. I'm a vet and the VA has been telling me for a few years I need to take a statin for cholesterol. I don't because I think I could fix it. I lost weight on keto but my numbers got worse. So I'm following closely to figure this all out
Just because it's not working for you doesn't mean its not effective for others.
@@tsuyax6054 I think I was speaking just me, not anyone else.
I recommend watching all his videos they helped alot
For 80% of us, diet and exercise can greatly influence and improve biomarkers such as lipids. Generally speaking weight loss can lower cholesterol. Since keto only exasperated your lipids despite the weight loss, maybe it's time you cut fat, especially saturated fat, and slowly and incrementally add fiber to your toleration. I said slowly because some people need to go slow especially coming from a low fiber diet. From personal experience, fiber is magic when it come to lowering LDL and total cholesterol. Heck, as little as a half cup of oatmeal a day can have significant improvement in just 90 days. Good luck, good health, and Thank You for your service!
@@Joseph1NJ thank you. Yes I'm eating oatmeal for breakfast with banana chia seeds normally, sometimes a small scoop of peanut butter. Now that I've gotten that in place in working on my other meals. Getting started on walking too, did a mile today. So I'll see how I feel tomorrow, lol
OMG. how many of your videos videos have I watched, and I don't remember your name. LOL... but thanks for your content. As a result of the infor in your videos, I have started moderating my saturated fat intake, and increasing my intake of olive oil. I feel confident this is the right thing to do. I recently escaped the insanity in the US, and now live in Portugal, and OMG, the olive oil here is amazing. People should be informed about how to select the best olive oil.
Thanks for these videos very helpful . What's your take on Nitric oxide and arteriosclerosis
THIS is the video I've been looking for. I'm a very active person with a healthy weight, but high cholesterol LDL-C (220) and ApoB (170). I've been low carb for a while, so need to figure out how to keep that but also lower ApoB.
I’d love to hear what brand of delicious plant based yogurt is out there. I bought one and it was awful. So I’ve never tried another. I really enjoyed this interview. Thanks ☺️
1. avocados
2.salads with olive oil
3. omelet egg with butt sometimes
4. walnut or sunflower seed
5. repeat
nice. I pulled the genes on salt responsive hypertension. In the Americas, people descendant from those who were living near the coast do not over respond to salt, but people descendant from those living in the mountain areas may over respond to salt. The genes are showing up in China also. Although online the focus is on food, we cannot ignore exercise.
I put salt on everything including in my coffee and sometimes eat it strait with a water chaser but I hike and run and SWEAT profusely 4 days a week. Sometimes if my sweat does not taste salty I get cramps (hence the strait with water chaser)
I eat some fish - probably 3-4 x weekly, usually in the form of sashimi or oysters. Other than that, I'm mostly vegan. I've never cared for sugar, so it's not an issue. I enjoy a glass or two of wine daily.
In spite of my family history of FH, all of my blood lipids are under control. My calcium score is 0, as it should be as I am relatively young. My ApoB is 95.
I try to stay informed and will make modifications if it becomes necessary.
3:47 Isn´t he stating there, that according to Dr. Weiss, ApoB should be around 60 ?
I have read that the benefits of olive oil come from its polyphenols, not the oil itself. It is mostly Omega 9 poly which is not essential, unlike Omega 6 and Omega 3 which are.
Thirty or so years ago when my doctor reviewed my blood work with me - everything was right in the middle of the range except cholesterol - my cholesterol was in the 220 range. He told me to cut back on eggs. I didn't, and realized my doctor (GP) was not well versed on this particular subject. I had a cac test done at age 63. My score was/is ZERO. I'm still concerned because my father died early from heart disease and complications of "hardening of the arteries". I was always concerned about my health because of this.
10:31 That stupid little container is a godsend 😂. The oxo good grips on the go lunchbox. Anyone that makes a packed lunch knows how difficult it is to find a consistently reliable bentobox/lunchbox that won't leak. 👍
Thanks Gill, good vid, like the examples. Never thought of throwing my nuts into the salad, sounds good, alternative crunch to croutons, which I don't use anymore.
I pretty much eat the same thing except i throw some 1 tablespoon of virgin coconut oil in my salad once a day or i use 2 tablespoon of extra virgin olive oil 1 tablespoon of grassfed butter in omelet or whenever i need to stir fry. I eat tons of fish the salmon belly it has the most fats, mackerel i slow cook in extra virgin olive oil with herbs, grilled pampano and chicken thigh in soup or air fry and 200g beef once a week. Broccoli and Cauliflower and spinach is also part of my daily meal.
Really good stuff !!! Can we maybe have a video about cooking and heating stuff, especially nuts and seeds? Some ppl claim it is the way to go, for better digestion, while others claim it makes cancerogen substances in the seeds and some oils in it are prone to oxidation while heated....
The question u should ask is:
oxidized oil vs saturated fat and cholesterol
which is worse? Dr Esselstyn would avoid oil due to his experience with his patients
What's the data on human says: those cooking butter and lard die 10 years earlier than those cooking in vegetable oil in North Karelia project in Finland
why Finland? cuz they beat the USA in life expectancy shortly after they made guidelines change
Wonderful couple of videos, thanks to both for making those. However, at 7:00, isn't that much salmon a real problem for inflammation as well as the mercury? Interested in (respectful and sensible) comments.
I certainly wouldn't be eating salmon.
Nice video. I think exercise is the angel in the room. Any video on its effect on all diets?
Dr. Peter Attia has an episode with Layne Norton that discusses this in depth. The big takeaway is that resistance training in particular has fantastic benefits on your health. Even obese powerlifters have been shown to have very good insulin sensitivity for example.
good stuff doc. can you do a video (or have you done a video on salt and high blood pressure). also.. I loooove butter.... I grew up with it. How bad am I with my cholesterol?
This video is very helpful! But don’t forget to give us occasional updates on your mother (going through a similar situation).
thanks!! she's doing well overall :)
Great video and summary Gil! His suggested level for Apo b is lower than the 2021 Canadian guidelines of 80 mg/dL and I am wondering what drives his suggested level of 60 mg/dL?
My ApoB right now is between 85 and 95, and my (Canadian) doctor says that's fine. Where did you see that guidelines number? From what I can tell, the ApoB target depends on how high-risk the patient is. For high risk patients, the target is
@@aquamarine99911 Yes, does depend how high risk you are. I have the numbers from the 2021 Canadian cardiovascular society guidelines publication for March. I can put the link in but I don't think UA-cam would let me but it's an easy Google. I am told the new European guidelines are even lower for Apo(B) who are more high-risk. I fall into the high risk category.
Thanks again mate. I eat heaps of Salmon too
I have been on Lo Carb/Keto diet for approx 1 1/2 yrs now with 40 lb wt loss, getting off all type 2 diabetes meds, getting off high BP meds, and feel great. The one remaining problem I have is high triglycerides and low HDL (historically 23-28). Low HDL was not changed by training for and running marathon yrs ago. I tried MCT oil supplementation and HDL went even higher ~ 500! I am now wondering where to go as the keto diet is working wonderful and I feel great but worry about the low HDL/ high Triglyceride combo. Any ideas would be appreciated! BTW i also int fast 16/8 and keep carbs to 20-30 per day most days.
Thanks for another informative video. It is indeed unfortunate that healthier food options most often equate to more expensive food options. And there, quite likely lies a significant part of the problem...
You are so correct, honestly
Bad food is cheaper and much more affordable...so sad!
Not true. I eat a ton of oatmeal, beans, rice, nuts, veggies and fruits. My food bill is peanuts (pun intended). If you want to eat 13 servings of wild caught salmon purchased from Whole Foods, then your bill will skyrocket. That much fish is not good for anyone (even Ethan admitted the risks). Shop and eat smart…. Longer life, save money, feel better, kind to the planet, etc.
@@KsazDFW experience may vary depending on where in the world you live. And we're not talking luxury items like salmon. Where I am even the basics , fresh veges are pretty pricey these days. And I too eat oats regularly etc, though nuts are actually very expensive!
@@KsazDFW Where I live (UK) sardines are very cheap and being smaller have much less risk of toxicity from mercury, etc.
@@dennisward43 black beans and brown rice are amazingly cheap. Full of fiber, protein, vitamins, phytonutrients (not found in animal products) and even full complement of essential amino acids (protein).
Thanks. Great video as always. We don't always agree but that is perfectly fine. Your videos are great.
I went plant based 10 years ago because of casein. I thought this summary was very helpful. TY. Also w fish not just mercury but what about microplastics in fish?
Also the absence of fibre. :|
I love doing Keto as I feel much sharper but everytime I do blood work from my dr. my triglycerides are over 375. Any recommendations?
That's a classic low carb diet pattern. I eat a very similar profile. Once you stop buying cereal, bread, rice, pasta, processed foods, and anything sugary, the alternatives are automatically healthy. My cholesterol went up, so my doctor put my on statins, but only 10 mg doses. Regularity also decreased to twice per week...that was the main adjustment to deal with.
So what tests exactly should one do and what are the normal ranges ?
Thank you for recapping and explaining last weeks video that gave a lot of clarification, so my question to you is if you are a tri athlete, who swims bikes and runs are an athlete that bikes four days a week swims four days a week and lift suites five hours to six days a week Wouldn’t a large low carb diet. Would that be affective or would that not be effective for endurance workouts? Thanks for any insight you’re willing to give. Also when it comes to sodium and working out, do you want to look for a sodium that has potassium and magnesium like Redman salts? And is it true that pink Himalayan salt is very high in iron?
Typically, athletes perform better on carbohydrates. Some studies and anecdotes suggest that individuals in Ketosis (close to 0 carbs) may have some extreme endurance benefit (Ultramarathon competitors). Sodium and other electrolytes (Potassium, Magnesium) may be useful during bouts of long duration exercise (2-4 hours, with a lot of sweating). The concentration of minerals in alternative salts (e.g. Himalayan) is probably negligible.
Here's a rationalization I'm hoping to be correct: If you're operating in a caloric deficit, where you're burning more than you're consuming, does this lessen the consequences of eating saturated fats? If you're burning those fats up then they're supposedly not floating around in your bloodstream in excess and not thickening your vessel walls,,,
Basing this on the content of "Nutrition Made Simple" and the Peter Attia podcast (in particular the episodes with lipid researchers and Layne Norton) ... your rationalization is probably incorrect. The body can only immediately utilize a small number of calories from eating a meal (200-400 IIRC). The rest must be stored in some form (fat, glycogen, etc). Lipds will most easily store into fat stores. But.. if you are in a caloric deficit, and therefore working towards a healthy weight, it is fair to say that your overall risk factors are decreasing. Even more so if you are performing resistance training (the hazard ratios -e.g. the level of risk or lack thereof - for including resistance training are almost on par with quitting smoking). So yes, probably work towards decreasing saturated fat in a sustainable way and check your lipids / apoB for more info. Not a Doctor, just a nutrition nerd.
@@PatrickPoplawska Thx for your input,,, that segues nicely into my backup rationalization which is the "net positive" outweighs the negative of too many saturated fats. I've already dropped triple digits in weight so I feel confident this was worth it, but I do need to transition over to more heart friendly long term eating. Weight training is a part of my normal routine now.
checking your ApoB (and/or its surrogates like LDL-c and nonHDLc) is a straightforward way to assess the physiological effect of the amount of saturated fat you're taking in, since saturated fat is thought to affect cardiovascular risk mainly via serum cholesterol/ApoB
weight loss tends to improve lipids, but there's only so long you can be in a caloric deficit. having high ApoB for a couple months is not that big a deal, but over years/decades you'll eventually hit caloric balance and ideally want to have your lipids in the healthy range for the long haul
Love your videos and the knowledge you impart. Thank you! There is a new oil on the market that is a “fermented oil”. It claims to be 90% MUFAs with a high smoke point…made sustainably. Zero acre. Can you look into it?
Are there more videos coming from the interview?
I really liked these videos. Dr. Weiss is obviously intelligent but approachable and reasonable. Therefore he doesn't belong on You Tube. I do wish that you had asked more about protein sources because wild caught seafood is prohibitively expensive for most people. Basically he's eating a low carb blue zone diet. Please interview him again in 50 years.
Hi Dr does high insulin contributes to high cholesterol levels?
why would you wait for apob to be out of range to limit saturated fats, if you know its the main correlation? It's amazing how the desire of keeping some habits affect the simple logic.
He has access to the laboratory and can do regular checkups unlike regular people
The way Ethan talks on Twitter and the way he talks in this interview seem different. I like how he just looks at the blood values and uses the logic: If it's all good,.. keep doing what you're doing.
And the way he eats seems pretty good as well. It's low carb high protein, but not religiously on the low carb. Most people who have settled into a comfortable low carb lifestyle eat like that.
It seems somewhat more practical than your, more theoretical, view on things. Do you eat similarly to what he eats?
I think he eats mostly plant-based but sometimes he includes some animal foods (he's not vegan at all)
Basically, it boils down to the fact that most of this is genetic. Certainly if you eat an unhealthy diet… I.e. sugar and excess fats, alcohol and few vegetables and roughage in general, you will, undoubtedly exacerbate any existing proclivity towards heart, disease and diabetes, but extreme dietary restrictions have not been shown to have any profound effect . In other words, a balanced diet, and moderate exercise seem to be a prudent course of action.
On the topic of tuna fish and mercury, there's a brand called "Safe Catch" that is worth investigating.
If eating fish, I would add some extra selenium. One Brazil nut per day would do it.
So what can we do to lower a apob? Mine is high and I’m only 40.
Interesting, whenever someone says "low carb" I automatically assume high fat, low fiber. But his diet seems quite balanced, maybe more Meditarrien? I would've liked to have heard about his proteins sources other than eggs, salmon, and yogurt.
Very good summary of the last episode: around minute 4:00. Thanks Dr. Carvalho…you mom must be so proud. :-)
Thank you for the summary. I did finish your last video not completely understanding it. I do have a question - would eating 13 servings of fish (I am assuming 3.5 oz of fish as a serving) a week raise his vitamin D level too high? Does one have to do regular D testing when eating that kind of volume of fish?
There would be no D overload, the toxins are another matter.
(I took 20k of d3 today (balanced w/A, K, E, omega 3’s and even a little MCT oil), as I’d slacked a bit recently, and we’re in the thick of the holiday/flu whack-a-mole season going forward.
Likely will move down to 10k/day … but experimenting w/higher D pulses to modulate my overzealous autoimmune state…
Great conversation with Dr. Weiss. If ApoB level (regardless of whether it has been damaged by oxidation/glycation) is the most reliable marker of heart disease, and all LDL particles have 1 ApoB protein, doesn't that bring us around again to saying that it comes down to LDL levels in the blood? And given that we need LDL to deliver cholesterol to our cells, it would help to know what the atherogenic mechanism is here. Under what specific conditions does LDL get deposited as plaque? Is it just when the level of LDL passes a certain threshold (and not because of damage to ApoB, for instance)? If so, do we know why it occurs at that threshold and less problematically before then?
You are one of the most thinking viewers :)
I wish this was answered
What is the apob number you should be Looking for. Is under 100 normal andunder 90 ideal.
Thoughts on coconut oil…. Especially for cooking?
Based on my CAC score, family history, and apoB I suspect I'll get a few stents around 62. I'm 52 now and just started taking a statin. Hopefully before a surprise heart attack. I'm saving now for the eventual surgery bill.
Why not invest in healthy food rather? Or you already do with no offence? :)
@@radoslavsk8591 I eat fairly heart healthy and lift heavy, but based on family history is seems inevitable. I'll get another CAC scan next year.
Check out Dr Caldwell Esselstyn and have a nice vacation with the money you’ll save on statins and heart surgery.
@@Enigmavelo Are you a vegan?
I was vegetarian keto and now vegan yes. My health has improved immensely. I followed all the diet gurus pushing keto for 2 years and started to regain weight after about 18 months. Keto is really Atkins with a different badge, the saturated fat in the cheese butter and eggs was driving me towards heart disease. Whole food plant based has so many studies into the long term affects. If you try it for a few weeks what have you lost? It is also a cheaper grocery bill so you win all round.
Is measuring ApoB a separate test? I now have a detailed Lipid Test showing HDL-P (total), Small LDL, LDL Size, LP-IR Score, LDL-P, LDL-C, HDL-C. Does any of this give me my AopB? Thanks.
LDL-P is virtually the same as ApoB, very little difference
please talk about statin drug... will it cause dangerous side effects?
there are so many people in youtube taking about the danger of taking statin... thank you
Hello I was wondering If you could talk about red yeast rice on your show. I recently discovered i have high cholesterol and a friend of mine says she has been using this with good success but I would love to know what you think.
Dr. Gil Carvalho: please do address red yeast rice? In my clinical experience, purity of this product is problem. We cannot get the FDA to really focus onto food supplements.
Please make videos on blood pressure
I wonder whether he eats plant-based yogurt because he doesn't want the saturated fat or because he doesn't want dairy. Because if it's the former, there are great alternatives such as skyr, which has basically 0 fat
I'm curious as to how many carbs per day are considered "low carb". Low carb doesn't necessarily mean Keto. What Does Dr. Ethan suggest? Possibly 1 small carb (grain) per day, or strict Keto with 22 carbs or close to that?
Sorry if I missed this, does eating more of an ethelstein type of diet basically eliminate whether or not APOB matters? So, I believe him when he talks about how much it matters, but does a whole food plant-based diet eliminate the need to even measure it?
No. The larger point is that apoB is the most up to date and accepted marker. There is a high likelihood that if you are on a whole food plant-based diet that your blood lipids are low.
Would you be able to ask him what kind of yogurt he consumes? Plant-based, no sugar added, keto friendly yogurt seems like it would be hard to find.