Gil, I wanted to write this out for you in the chance you get to see this, as well as for anyone else who may be in the comments who can relate. I am almost 30 years old, have a BS in computer science so I have a background in lots of logic and reasoning, analyzing data. During COVID I started getting heavily into nutrition with my extra time, experimenting and being exposed to these new trends of intermittent fasting, prolonged fasting, low carb, keto, carnivore, "ketovore", early Time Restricted Feeding, and all the other variations of the trends. I listened to many, many hours of podcasts on the hate for seed oils, that saturated fat getting the bad rap in the 50s and 60s was a mistake, that processed foods are the enemy. I couldn't say how many hours I was spending listening to discussions on nutrition and long term health. I believe it was one of your videos on saturated fat I found first, almost two years ago. And at first, my thought was "here we go again, another biased doctor being paid to go against the trend that's actually helping people". At this point I had lost 100 lbs after being morbidly obese for 15 years, gained muscle, improved my flexibility, decreased my A1C to well into the low normal, same with blood pressure, drastically improved my stiffness and inflammation, constantly got told I look even younger. It would be easy to put myself on a pedestal at this time. I wanted to dislike your videos, because you were saying things that made me yet again challenge some of my beliefs, such as carbs, too much saturated fats, and grouping all seed oils together, using the appeal to tradition ("we ate this way for thousands of years, so it has to be the best" argument). You helped me with not just your data, but explaining why to stay critical in a respectful and inviting way. I continue to watch your videos not just for your content, but because you felt like my older experienced online brother scientist to me, helping me be a better researcher, and stay more true to trying to be a proper scientist, not caught up into just looking for what I want to hear. So that you for taking time in your videos, and even making special videos, to explain what makes something more or less credible, why an argument doesn't work, what to look for in studies as well we reminding the hierarchy of types of studies. You are doing great work. 💙
This!! So many people only look at the evidence that already supports their beliefs, and get stuck in a nutrition lifestyle tribe. What you said can be really hard to admit, especially in the comments section. Respect!
Why would he? Keto is the only diet that reverses heart disease and almost any other disease. I have reversed diabetes, NAFLD and chronic headaches. Keto for life ❤@@williamburnell529
"Ask them why they're not showing you the evidence. Demand better content and vote with your clicks." Such a strong ending!! I enjoy your content so much, thanks for everything you do!
Absolutely agreed! If there is no evidence, there should be a dislike. If this absence of high-quality evidence - as opposed to singular low-quality studies - is consistent, unsubscribe and don’t take them seriously. Anecdotes such as ‘I did this and it helped’ or the opposite - ‘I only eat meat and have 400 mg/dl LDL levels and my arteries are doing great’ are poor sources in information if longevity and health are your goals.
I love the summary at the end of the video, that not only talks about what not to eat, but also focuses on what to actually eat. Thanks a lot for making the research accessible!
I ate as you recommend for over 40 years, never smoked never drank any alcohol, never took drugs, gave up red meat 45 years ago..exercised... but now at 77 developed an ascending aortic aneurism and am showing plaque? My cardiologist just said I did well but everyone over 60 will show plaque. the aneurism at this point does not require surgery just monitoring. getting old sucks!😵💫😵💫😕😕
As expected, we got a well-documented, thoughtfully presented composite video that examined and extracted the BEST information available. You are a master at distilling and presenting without the fluff or nonsense. Thank you yet again for doing the work to bring us valuable, useful information.
I have familial hyperlipidemia, and I was treating it with a WFPB SOS free diet for about 10 years. But I could never get to normal lipid levels. 3 months ago at age 69 I had a heart attack and 4 stents. I’m doing well now, still on the same diet, but with the addition of 2 cholesterol drugs, a drug for triglycerides and blood thinners and a beta blocker, and the results with the drugs are amazing. I have low blood lipid levels now, normal blood pressure and my CRP is very low. I’m also doing cardiac rehab and it’s going great. So I was so happy to hear you promoting drugs as well as lifestyle for those of us who are genetically predisposed to heart and vessel disease. I wish I had done both drugs and lifestyle before, but I was afraid of the drugs. I’m feeling much more optimistic about my future now. Thanks
I also was afraid of medication for many years and I have genetic hyperlipidemia according to the test, not off the charts. I am 74 and in 19 I was diagnosed with peripheral artery disease. I now take a small dose of meds and eat a mediterranean diet. My diet prior to my diagnosis was pretty much awful. They just tested me again and all my lipids went down and my plaque in my leg did not increase. I am glad I caught it in time. One thing I do is eat one nut a day. I picked Brazil nuts because I don’t like them so I won’t eat the whole jar😊. I lost 70 pounds before I started medication and it did not affect my lipids or the peripheral artery disease. Fear is powerful and I’m glad we both are better. Sending healing vibes from hawaii.
@@MarilynMayaMendoza Thanks for your comment, I’m glad your lipids are mostly controlled with diet and a few meds. I hope in a year or so I can reduce some of my meds too. But it’s amazing to see my LDL down to 44, from about 275, and my triglycerides down to 148 from 650. So I know it’s super helpful to keep lipids low after stents so they don’t get all full of plaque again. I’m happy to still be here and mostly living a normal life again.
I had the same issue. Plant based diet, 6’ tall, 160lbs, high cholesterol. 2 doctors resisted request for statin and literally said “you might as well eat what you want”. ! Went on low dose rosuvastatin and cholesterol dropped to low end normal range in 6 weeks. I have familial high cholesterol. So, yes, if you’re eating garbage, overweight and not exercising, fix all that but statins can help
@@marksmith8942 Congratulations on reducing your cholesterol. There seems to be this anti statin theme on social media. Whilst it's true that statins are not always required, there are patients who do need them, in order to bring their cholesterol levels to the normal range. No shame it that. Many people are not aware that statins also provide an anti-inflammatory benefit. "Well done" to you.
Glad to hear you’re doing better. Would you mind giving your opinion on what caused your health issues? Like what foods did you eat, did you exercise often and your weight/body type?
I tremendously appreciate your focus on actual data and results instead of stories. *This* is why I watch the channel and place a lot of weight on your conclusions. Stories are nice but not when I am contemplating my continued existence above ground. Thanks so much Dr. Carvalho.
Excellent video and great channel. So many vloggers push fads and not facts. This channel is my most trusted UA-cam source of health advice. Thanks Gil!
I anxiously awaited a study that was between a low carb group who were in a state of nutritional ketosis and who burn fat for energy vs a low fat group that was not in nutrition ketosis and burned glucose for energy. Alas none of the studies met that criteria. Why? Benefit of the doubt is that one does not exist in the scientific literature as of 10/2024. Hopeful that may change in the future. Thanks for the video. Carpe Diem.
This is more an intervention diet plus also very new so longitudinal info is missing (cardiac events /cancer/ alzheimer's ). Plus I think is not suitable for world populous and ethical reasons . Hugely costly and impractical for most of world. also hard to achieve if travel a lot. Most people worldwide rely of wheat ,rice, sorghum , soya , potatoes to just get enough calories. Putting this diet on young children is tantamount to child abuse with just trust me vibes . But yes seems to help some coming from a bad place ( overweight , diabetic etc ). We now have enough info that Kids if eat well without all the hidden sugars/salts , substituting for more complex carbs and keeping active can still have a very varied and flexible diet. The keto diet is very very restrictive and not easy for many people. Only really works when gets calories right down ( where maybe a lot of the benefit is coming from , ie big weight loss ) . Better to have a more flexible diet then eat 1200 calories for a week once every 2 months to get a similar cleaning.resetting effect IMHO
@@revivecleaning399 Yes, ketosis generally only occurs when eating no, or very few, carbohydrates. As an n of 1, my angina became worse when I used a ketogenic diet for weight loss. I only beat it with exercise and a fairly low fat plant-only diet.
@@dj.h7424same for me. I tried keto and carnivore, and I lost over 100 pounds, but I got so much worse from a health standpoint. Arrhythmia, high BP, sky high cholesterol, migraines, type 2 diabetes, and other issues. Went low-fat, WFPB and everything has resolved or vastly improved. I get that keto apparently does well for some, but it definitely did not for me.
As for eggs, it has been shown that one egg or 10 (or 100) doesn't make a different with MOST people's cholesterol numbers. For some, like me, any speck of cholesterol (and plant sterols) is absorbed into my body like a sponge. I am a hyper absorber of both of those sterols. We need to understand that we are all different and a one size fits all dietary plan does not make for a great 'individual' dietary plan, but it's a start.
Eggs do increase cholesterol but the effect can be hidden by selecting participants that already consume a high cholesterol diet. If you watch this channel’s interview with a cardiologist he stated that 20% of dietary cholesterol is absorbed 👍
The fact that general guidelines don't work for all humans gets tossed by most healthcare providers. It's like they are so trained in "the research shows" that they forget that we are individuals. We react differently to to the same stimuli.
How did you learn this? I'm recently doing a 2 month 2 egg a day test on myself to test how much impact it has no on me. I think eggs are probably the least harmful animal product, unless you are an hyperabsorber.
Thanks for this channel. I like the way it rids me of unconcious fears I developed around food throughout the years because of this endless stream of information I am exposed to.
Great informative video. Thank you. Thing is... my 62 year old husband ate this way all his life. And no added sugars, avoided red meat & so much of the saturated fats or butter etc. Fruits, vegetables, whole grains, steel cut oats, no processed junk, etc. He ate while foods so his life, the Mediterranean Diet full of whole grains beans, legumes olive oil etc But pretty high carb. He's NEVER smoked, he'd have maybe a couple glasses of red wine in a week, never did drugs. He did have high BP & had been on meds for that since his 20's & had always been super lean like his entire immediate family. All very lean. He's at 10% body fat. He's retired now since July but had a sedentary desk job for 39 years but always been active hiking, biking, kayaking, ice hockey, certified diver, water skiier etc. And guess what? He had a heart attack a year ago this past May! 3 blockages. 90% in the widow maker plus 100% in 2 other areas. He got 3 stents put in. All I've done is research research research & I truly believe it's hyperinsulinemia that's caused the inflammation in his arteries through time due to all the carbs. We've decided to now try a directly opposite root... He's gone ketogenic because we can't continue to have him eating & doing the same things that got him that way. I'm just so disappointed that everyone & all the experts keep advising us how he needs to eat the Mediterranean diet when that's EXACTLY what he's been doing ALL HIS LIFE. Going keto, he's been doing GREAT! I 🙏 pray this will at least help in no more progression of this disease. I feel we have no other choice. Thanks for your content.
What was his LDL? This seems the perfect person to be on a statin… it would have been worse if he wasn’t eating that way; maybe a heart attack at age 30
Interesting. My question is... what were they eating before the new diets? And did the fact that they were not eating that anymore, have an impact? So was the results because of the new diet or the lack of the old diet? Thanks... great video.
@@TC-by3il Surely it matters. If I had a diet of junk food for thirty years and I stop eating that and eat all healthy food instead, there would be an impact due to the fact that I don't eat junk food anymore. So is the impact from not eating junk food anymore, ot eating the healthy diet.
@@KevsArtStuff They were compared to a control groups of similar cohorts. Whether or not they ate junkfood, both groups likely had similar dietary patterns before the intervention, so we can compare them. In addition to thay, regardless of their previous diet, the _change_ is what made the difference. Whenever you stop eating junkfood, you have to replace it with something else. Lastly, many of the studies showed that those with higher adherence to the healthy diet had better outcomes, which leads us to believe that there may be a dose-response towards the healthy diets. So based on all that, I fail to see the importance of knowing exactly what their previous diet was like.
That is such an obvious point that is missed in so many studies and it's frustrating!! Thanks for bringing this up, hopefully this gets addressed one day. I believe that for instance EVOO might also lose some of its glamour if we control for that.
We as doctors wait and expect such trial too...but there is huge problem with financing ...Dean Ornish haf the same problem to gather bugdet before 1990... Nobody makes good bussiness on effective prevention...
I would strongly recommend also measuring the degree of chronic inflammation in each subject! In my opinion, it’s the inflammation process that initiates the addition of plaque with the addition of an induced immunological response to these sites within the blood vessel linings. The amount of inflammation alone should also be measured by measuring highly sensitive C-reactive protein and perhaps other red flags indicating the degree of inflammation.
hi, some of the trials did measure CRP. Inflammation is a risk factor for heart disease, although not a necessary precondition, see ua-cam.com/video/NU7rfhGi-T4/v-deo.html
An outstanding video summarizing the latest in the science of diet and its relationship to cardiovascular disease. For my money the best you tube channel on the internet. Cuts through all of the confusion with succinct, practical advice for those of us suffering from the disease.
I truly believe that this video alone should serve as advice for anyone interested in arterial health. There are so many videos with (not real) doctors talking about eating or not eating this or that, but nowhere is there any science behind it. So many people get confused or just believe what these (not real) doctors say on social media. I'm glad I found your channel because I was sick of these non-medical videos like everyone else. :)
Thank you for these impactful and meaningful videos that not only help clear the noise, but are solely fact-based. People don't appreciate how much work this takes. Grateful 🙏🙏🙏
thank you; 2day just got a good bill of health from My cardiologist, (2 yrs. ago mitral valve repair). I got a mini lecture on why I should be taking My atorvastatin as prescribed. I don't like being on it. (from genetics & smoking tobacco since a young age, quit since 2017) I have some plaque in my system. My cholesterol levels are within normal range. My chart reads; 2nd degree AV aorta block. I had no symptoms/I trucked through a post winter storm on foot about 4 miles to do some errands, pick up scripts 2 days b4 My surgery. Slowly but surely working My way out of a major depression. I am so happy to hear you saying some of these factors can possibly be reduced? !!! ~ thanks for your informative posts, I watch most when I can
A whole food, plant based diet, walking 3 miles/day made the varicose veins in my feet and legs shrink down and soften. I can’t afford angiography, so I’m going by what I can see happening and staying on it.
Good vid. I've followed Dr Essy's pretty much for about 15 years. So far so good. I have not followed up with another angiogram. Nobody does that if they don't have to.
I always appreciate you researching all the studies. I totally agree. I think too many variables to just say one diet fits all. also like Dr, William Li's take on what foods to heal & why. Moderation I believe is one of the Biggest factors in all diets. Again ,Thank you so much for doing the work for us ,so we can make the best choices for our over all health 👍
Great information, as usual!! Love your wrap up at the end with the foods that should be avoided for heart health - no matter what dietary pattern you follow, everyone can agree on that point! Thank you 😊
Male 60 here. 2 and a half years ago I had crippling angina. Being a hunter I was a big meat eater. Over night I went to a whole food plant based diet. The chest pain stopped after only 4 months and my LDL went from 5.8 to 1.9 . Today I run 4 km each morning, Row 1 km, walk my dogs 5 km and MTB plus do resistance training twice a week. I got my life back. BP is 115/70. heart rate 55 BPM, BMI is 20 and the A-fib I was having stopped. No meds as I am skeptical about any possible adverse effects long term. I eat Natto beans, 5 gram of creatine, B12, Vegan EPA/DHA and grow my own garden. Lots of greens, fruit, nuts, sweet potato, mushrooms, grains and nothing processed. No salt, caffeine, sugar, dairy or oils. Works for me. Good luck if you are on a similar journey.
Excellent! I’m glad for your success. I think different people have different diet needs. The key is clean whole food. I have some clean meat, but am mostly plant based. The only thing I would add is that our bodies need sodium, not table salt, but salt like sea salt. Celtic salt is probably the best, because of all the trace minerals for your body. You just need a dab for nutrients. I take it with extra Virgin olive oil. Best!
Yeah, with such a wide variety of preferences/tastes in patients, I lean toward offering whole food options that align with what they like/gravitate towards. Otherwise, they'll just revert back to ultra-processed junk.100% agree about exercise. Meds are beneficial, though getting patients off meds asap is the aim. Acute care, not chronic care. Great video Gil- thianks!
Fantastic channel & content. Thank you! I am 54 & have HCM and last year had a septal myectomy-- feeling like 90% better- very little breathlessness anymore- and exercise is much easier! I also have hypertension and some plaque in arteries (angiogram was done at surgery time) Any suggestions for diet/exercise ( i try to keep low salt/sugar/calories and exercise 45 min./day- intense walking, stair climbing, pushups and isometrics)
OMG I am so excited, I just have to share this! a year ago I had a carotid ultrasound which showed more than 15% plaque in my RICA and 50 to 69% plaque in the left internal carotid artery (LICA) Asked for a repeat Ultrasound in a year. Bragged that I could get those numbers down, but was scared I might not. BUT I DID IT! less than 15% in the right (based off other numbers, I reduced the plaque burden by almost half!!) For the LICA, now just slightly over 15% in the right. Greater than a 50% reduction of plaque in the left carotid!! I DID IT! and it was EASY. I ate well and was always satisfied. FOLKS diet and lifestyle work! no meds- I am not on ANY medications, 69yrs old.
I needed this. I spoke with my Cardiologist today, and we're battling medications. While I am definitely not willing to do Repatha or Leqvio, I am taking a Statin 3 times a week, due to side effects. But after watching this, I might see if upping my Statin gradually, might cut down the return of the side effects. At the end of the day, diet is what I feel will work, but I love my food - which is what got me into this situation to start with. I love your videos. They have helped me, no end.
I have heard full fat dairy is better as long as you're not in a major calorie surplus. It is overall healthier and I do believe hearing about a study where full fat dairy had an improvement in LPa when low-fat did not. Sorry I don't remember the study offhand though.
@@alexandrustefan9059 Bullshit. Low fat milk is by no defintion heavily processed, and low fat yoghurt is just the product of low fat milk. In my region you can also find "Quark" with 0.1% fat which is also a low processed milk product with lots of protein.
After a high calcium score for my age (I’m 46) I radically changed my diet. I’ve seen improvements across the board. I also exercise far more now. I typically eat whole foods and lots of fish, fruits, vegetables, and healthy fats. My macros are typically around 20% carbs, 45% fats, and the rest protein. I do allow myself a cheat day once per week because it helps keep me on track. The only thing I haven’t done is start the statins. After doing my own research my doctor agreed to let me do 5 mg every other day of the statin. I know it’s probably necessary but dreading the side effects.
Vegan for animals for 15 years and will be for life. Im healthier than ive ever been in my life. Its amazing when you do things for others the things you get in return ✌️❤
Thank you very much for your very useful, life saving work. However, I am disapponted by the tiny results. The risk reduction is of course relative...However, it is better to face reality, without false expectations.
Would you consider doing a series about diets during cancer treatments? Like keto, or vegan, or fasting (I don't mean for prevention, but for possible effects for cancer patients).
Lower mToR might help cancer patients, but also muscle loss and other things cause their own problems. Though most people aren't of healthy weight to begin with.
Dear Gil, Thank you for your informative content. I'm 41 years old and recently received my lipid profile results: HDL - 77.0 mg/dl, LDL - 253.7 mg/dl, triglycerides - 163.0 mg/dl, and total cholesterol - 363.1 mg/dl. My fasting blood sugar was 100.8 mg/dl. My doctor prescribed Atorvastatin (40 mg) for three months. After researching cholesterol, I have a few questions: 1. Should I consider additional tests beyond ApoB for an accurate assessment? 2. Can ApoB and LDL levels diverge (e.g., high ApoB with low LDL or vice versa)? If so, does this imply different dietary approaches for managing LDL and ApoB? Would low ApoB levels justify stopping statin medication? 3. What test detects arterial plaque and provides detailed information about it, if present? Thank you for your expertise. Best regards
Hi dr Gil. Useful, clear and fantastic as always… well, even more! One question, did any trial look for correlation between frequency of daily meals and results? Or time of eating and results or events? Just a curiosity. Thank you so much! ❤❤❤
I'm watching and am just on the first trial. Something seems obvious to me. It needs to be known what happens with the control group. For example, if they get 3% worse and the trial group gets 3% better, then the true benefit is 6% better, because without the trial lifestyle changes, they would have ended up as the control group.
@Randsurfer @rajnz explained thoroughly. This is an example of a very fundamental, basic tenet of experimental human research. I recommend studying the scientific method in order to become familiarized with at least the fundamentals of the system it uses so that you have a stronger grasp on how and why we structure these systems in this way.
Gil, I know that you don't want drama or controversy so I will not bring it to you, but it makes me so mad to see so many "experts" and health "gurus" on the internet spreading lies. I know that you kind of inderectly challanged them in the end, and a couple of names and faces came to my mind, but again, I won't comment on it because we are better than those people and I will vote with my likes and my attention. It's just frustrating as a nutritionist myself and someone who genuinly wants to help people get better, to see so many lies and deception about something so important. Amazing work, as usual, we are fortunate to have you.
Yup. High protein for us old folks (I'm 76); I exercise routinely, and fortunately I LOVE it; I also feel fortunate that the best diet is still economical.
I have tended toward Esselstyns diet, which is harsh and difficult to maintain, causing me to have very unhealthy cheats when I do cheat, ( maybe once every month or 2) - like donuts or sweets. I think if i use an approach influenced by these additional studies it will help dxponentially with compliance which seems to create a sizeable benefit in EACH of the studies. Thank you for all of your research and help in this area!!
You're awesome, Gil! The same questions I ask my physicians: What would you do if you or your loved one is in my situation? And not what the guidelines say.
Would have been nice to know what their LDL-C was during the trial, hsCRP, and BP. My impression of the literature is that the combination of low LDL-C, low inflammation, and low BP is best combination for regression ad avoiding progression.
Add low blood glucose to the list. All those things reduce LDL movement into the artery wall. But you can do even more, and specifically target certain cholesterol pathways with diet. For example, green tee will increase the bile acid synthesis. Barberries will inhibit PCSK9, and so on.
I would love to know if the reduction in plaque correlated with a reduction in LDL levels? Since most of us can only rely on LDL and other blood tests, are these reliable indicators that indicate reduction in plaque size? Thank you for your videos!
@NutritionMadeSimple Doc, I appreciate your channel and your opinion on selecting an optimal heart health diet. It sure would be nice to see an Ornish vs Mediterranean diet study. If the Mediterranean diet allows for more fat and more fun in the diet and if it is as good or better than Ornish, then that would be hugely beneficial to know!
Great overview, thanks! Interestingly Dr Esselstyn's patients with severe CAD on a whole food plant based diet (no oil OR nuts) saw huge improvements but this was reversed if they started eating nuts or oils again. So for some, nuts and oils may not be a good idea. Also, there's misunderstanding about the proportions of foods to consume in a true Mediterranean style diet, its 90 percent fruit, vegetables, wholegrains etc and the balance of 5 to 10 percent is the optional extras like fish or lean meat, nuts and seeds, dairy, olive oil ❤
What I see is that one needs to do their utmost for a long time (or perhaps for ever) to achieve in best case a (small?) reduction of plaque (or a less fast growing). The question remains; is that the bast we can do or are there better ways. If food has such a small effect on plaque, I wonder if it is the major player or just a close bystander.
Isn't the stiffness of the arteries the ultimate cause. And thus the question becomes what diets favor the stiffing of the arteries? Or alternatively, what diets favor the flexibility of blood vessels?
Not necessarily. The most important results are events, which works as a proxy for whatever direct physiological cause is the best. If events come down, then the diet was effective.
I like the approach you take about commonality of findings in trails. It is not surprising at all to find that lifestyle and reduction in food which increases cholesterol in the blood stream should reduce heart attacks. Nor indeed surprising that drugs lowering blood fat should do the same. However all this is rather perplexing to even the educated viewer since the so called experts don't agree among themselves as to the best diet in this respect. More important to know is that NO ONE so far has provided satisfactory and undisputed reasons for the formation of plaque in the arteries for the otherwise healthy person other than the usual references to lifestyle, genetic tendency and stress extra. Much is said about high blood sugar damaging the lining of arteries being the culprit, hence the keto diet craze! and the demonization of carbohydrates. But can anyone point to real research establishing the actual cause of damage to arteries apart from the blindingly obvious!
personally I have high CAC and am taking high D+K, Lumbrokinase, Nattokinase, and Serrapeptase while trying to walk at least 30 minutes per day. doc has me on 5mg rosuvastatin and 10mg ezetimibe and what was a total cholesterol of 250+ is now around 110 with LDL under 70
I do the same ( D+K, Lumbrokinase, Nattokinase, and Serrapeptase, plus quercetin, berberine, fermented black garlic extract, Mg etc.) but cannot take rosuvastatin, it causes horrible cramps. And WFPD with 3-5 % fat.
@@mesterferenc2688 yep, also take those too. Have high Lp(a) and a genetic mutation that doesn’t allow my body to metabolize statins which is why I only use 5mg+zetia otherwise my CK levels shoot over 1000 and my body starts destroying itself. Zetia has really helped bring the ldl down in leau of higher statins without the side effects of bad joint pain and cramps. Might try swapping out the rosuv for bempedoic acid if my doctor agrees. Found out about the genetic mutation through 23andme of all things.
A consistent theme from health experts is a diet high in fruits and vegetables, some grains, small amounts of dairy combined with strength training and cardio type exercise (walking, biking, etc.)
Your point about the names of the diets being less important and to look at the commonalities is a very good point that I think more healthcare professionals need to emphasise. I feel like some of the names (especially Mediterranean) tend to take the conversation off topic into cultural and lifestyle anecdotes rather than concentrating on the overall formula that the diet follows that can be tailored to an individual's needs and location.
I already do your dietary recommendations, except NO dairy, red meat only maybe 3-4 times a year(grass fed only), 4 eggs a week & very low fats. Lots of whole grains, chicken breast ,and Norwegian or Tasmanian salmon. Green salads almost daily and lots of cooked veggies for dinner.
I wonder if there are studies on high fat diets and low carb diets like Atkins diet, or intermittent fasting diet plans with all kind of foods but with fasting as the commonality, or Dr Caldwell Essellstyn diet i.e. whole foods plant based and no nuts and high plant fat where there is more cardiovascular issues
Hi Gil, thanks a lot for another banger. Question : do you know of any studies that compare olive oil to actual low fat diet? Seems that EVOO is very often compared to SAD in studies but that doesn't tell us the whole story.
Gil, I wanted to write this out for you in the chance you get to see this, as well as for anyone else who may be in the comments who can relate. I am almost 30 years old, have a BS in computer science so I have a background in lots of logic and reasoning, analyzing data. During COVID I started getting heavily into nutrition with my extra time, experimenting and being exposed to these new trends of intermittent fasting, prolonged fasting, low carb, keto, carnivore, "ketovore", early Time Restricted Feeding, and all the other variations of the trends. I listened to many, many hours of podcasts on the hate for seed oils, that saturated fat getting the bad rap in the 50s and 60s was a mistake, that processed foods are the enemy. I couldn't say how many hours I was spending listening to discussions on nutrition and long term health. I believe it was one of your videos on saturated fat I found first, almost two years ago. And at first, my thought was "here we go again, another biased doctor being paid to go against the trend that's actually helping people". At this point I had lost 100 lbs after being morbidly obese for 15 years, gained muscle, improved my flexibility, decreased my A1C to well into the low normal, same with blood pressure, drastically improved my stiffness and inflammation, constantly got told I look even younger. It would be easy to put myself on a pedestal at this time.
I wanted to dislike your videos, because you were saying things that made me yet again challenge some of my beliefs, such as carbs, too much saturated fats, and grouping all seed oils together, using the appeal to tradition ("we ate this way for thousands of years, so it has to be the best" argument). You helped me with not just your data, but explaining why to stay critical in a respectful and inviting way. I continue to watch your videos not just for your content, but because you felt like my older experienced online brother scientist to me, helping me be a better researcher, and stay more true to trying to be a proper scientist, not caught up into just looking for what I want to hear. So that you for taking time in your videos, and even making special videos, to explain what makes something more or less credible, why an argument doesn't work, what to look for in studies as well we reminding the hierarchy of types of studies. You are doing great work.
💙
This!! So many people only look at the evidence that already supports their beliefs, and get stuck in a nutrition lifestyle tribe. What you said can be really hard to admit, especially in the comments section. Respect!
So how are you eating now, and have you continued to lose weight?
Agreed here, I really love his emphasis on trying to find high-quality data and looking at either RCTs or meta-analyses.
Why would he? Keto is the only diet that reverses heart disease and almost any other disease. I have reversed diabetes, NAFLD and chronic headaches. Keto for life ❤@@williamburnell529
"Ask them why they're not showing you the evidence. Demand better content and vote with your clicks." Such a strong ending!! I enjoy your content so much, thanks for everything you do!
Absolutely agreed! If there is no evidence, there should be a dislike. If this absence of high-quality evidence - as opposed to singular low-quality studies - is consistent, unsubscribe and don’t take them seriously. Anecdotes such as ‘I did this and it helped’ or the opposite - ‘I only eat meat and have 400 mg/dl LDL levels and my arteries are doing great’ are poor sources in information if longevity and health are your goals.
I love the summary at the end of the video, that not only talks about what not to eat, but also focuses on what to actually eat. Thanks a lot for making the research accessible!
It was great!
Agree. There is so much info out there, that it is helpful to distill it all down to a simple summary
I ate as you recommend for over 40 years, never smoked never drank any alcohol, never took drugs, gave up red meat 45 years ago..exercised... but now at 77 developed an ascending aortic aneurism and am showing plaque? My cardiologist just said I did well but everyone over 60 will show plaque. the aneurism at this point does not require surgery just monitoring. getting old sucks!😵💫😵💫😕😕
As expected, we got a well-documented, thoughtfully presented composite video that examined and extracted the BEST information available. You are a master at distilling and presenting without the fluff or nonsense. Thank you yet again for doing the work to bring us valuable, useful information.
I have familial hyperlipidemia, and I was treating it with a WFPB SOS free diet for about 10 years. But I could never get to normal lipid levels. 3 months ago at age 69 I had a heart attack and 4 stents. I’m doing well now, still on the same diet, but with the addition of 2 cholesterol drugs, a drug for triglycerides and blood thinners and a beta blocker, and the results with the drugs are amazing. I have low blood lipid levels now, normal blood pressure and my CRP is very low. I’m also doing cardiac rehab and it’s going great. So I was so happy to hear you promoting drugs as well as lifestyle for those of us who are genetically predisposed to heart and vessel disease. I wish I had done both drugs and lifestyle before, but I was afraid of the drugs. I’m feeling much more optimistic about my future now. Thanks
I also was afraid of medication for many years and I have genetic hyperlipidemia according to the test, not off the charts. I am 74 and in 19 I was diagnosed with peripheral artery disease. I now take a small dose of meds and eat a mediterranean diet. My diet prior to my diagnosis was pretty much awful. They just tested me again and all my lipids went down and my plaque in my leg did not increase. I am glad I caught it in time. One thing I do is eat one nut a day. I picked Brazil nuts because I don’t like them so I won’t eat the whole jar😊. I lost 70 pounds before I started medication and it did not affect my lipids or the peripheral artery disease. Fear is powerful and I’m glad we both are better. Sending healing vibes from hawaii.
@@MarilynMayaMendoza Thanks for your comment, I’m glad your lipids are mostly controlled with diet and a few meds. I hope in a year or so I can reduce some of my meds too. But it’s amazing to see my LDL down to 44, from about 275, and my triglycerides down to 148 from 650. So I know it’s super helpful to keep lipids low after stents so they don’t get all full of plaque again. I’m happy to still be here and mostly living a normal life again.
I had the same issue. Plant based diet, 6’ tall, 160lbs, high cholesterol. 2 doctors resisted request for statin and literally said “you might as well eat what you want”. ! Went on low dose rosuvastatin and cholesterol dropped to low end normal range in 6 weeks. I have familial high cholesterol. So, yes, if you’re eating garbage, overweight and not exercising, fix all that but statins can help
@@marksmith8942 Congratulations on reducing your cholesterol. There seems to be this anti statin theme on social media. Whilst it's true that statins are not always required, there are patients who do need them, in order to bring their cholesterol levels to the normal range. No shame it that. Many people are not aware that statins also provide an anti-inflammatory benefit. "Well done" to you.
Glad to hear you’re doing better. Would you mind giving your opinion on what caused your health issues? Like what foods did you eat, did you exercise often and your weight/body type?
You are a level above all other UA-camrs and influences! Thank you for your time and effort!
I tremendously appreciate your focus on actual data and results instead of stories. *This* is why I watch the channel and place a lot of weight on your conclusions. Stories are nice but not when I am contemplating my continued existence above ground. Thanks so much Dr. Carvalho.
Same here!!
I appreciate you using an older trial as your first example to show that this information has been around for a decent amount of time.
That smoking and alcohol cause cardiovascular disease?
Thank you for always using science in all your videos to help us better understand how to stay as healthy as possible.
.....one of my favorite , real doctors on UA-cam. Excellent content. Thank you for what you do for us❤❤❤❤❤
Excellent video and great channel. So many vloggers push fads and not facts. This channel is my most trusted UA-cam source of health advice. Thanks Gil!
I anxiously awaited a study that was between a low carb group who were in a state of nutritional ketosis and who burn fat for energy vs a low fat group that was not in nutrition ketosis and burned glucose for energy. Alas none of the studies met that criteria. Why? Benefit of the doubt is that one does not exist in the scientific literature as of 10/2024. Hopeful that may change in the future. Thanks for the video. Carpe Diem.
"a low-fat group that was not in nutrition ketosis" is this usually what happens? I've never heard of this before it's new to me. Genuinely asking
@@revivecleaning399 Ketosis requires a high fat low carb diet, you can't achieve it if you are eating low fat
This is more an intervention diet plus also very new so longitudinal info is missing (cardiac events /cancer/ alzheimer's ). Plus I think is not suitable for world populous and ethical reasons . Hugely costly and impractical for most of world. also hard to achieve if travel a lot. Most people worldwide rely of wheat ,rice, sorghum , soya , potatoes to just get enough calories.
Putting this diet on young children is tantamount to child abuse with just trust me vibes .
But yes seems to help some coming from a bad place ( overweight , diabetic etc ).
We now have enough info that Kids if eat well without all the hidden sugars/salts , substituting for more complex carbs and keeping active can still have a very varied and flexible diet.
The keto diet is very very restrictive and not easy for many people. Only really works when gets calories right down ( where maybe a lot of the benefit is coming from , ie big weight loss ) . Better to have a more flexible diet then eat 1200 calories for a week once every 2 months to get a similar cleaning.resetting effect IMHO
@@revivecleaning399 Yes, ketosis generally only occurs when eating no, or very few, carbohydrates.
As an n of 1, my angina became worse when I used a ketogenic diet for weight loss. I only beat it with exercise and a fairly low fat plant-only diet.
@@dj.h7424same for me. I tried keto and carnivore, and I lost over 100 pounds, but I got so much worse from a health standpoint. Arrhythmia, high BP, sky high cholesterol, migraines, type 2 diabetes, and other issues. Went low-fat, WFPB and everything has resolved or vastly improved. I get that keto apparently does well for some, but it definitely did not for me.
As for eggs, it has been shown that one egg or 10 (or 100) doesn't make a different with MOST people's cholesterol numbers. For some, like me, any speck of cholesterol (and plant sterols) is absorbed into my body like a sponge. I am a hyper absorber of both of those sterols. We need to understand that we are all different and a one size fits all dietary plan does not make for a great 'individual' dietary plan, but it's a start.
Eggs do increase cholesterol but the effect can be hidden by selecting participants that already consume a high cholesterol diet. If you watch this channel’s interview with a cardiologist he stated that 20% of dietary cholesterol is absorbed 👍
Because their LDL was already high.
How was your hyper- sensitivity to cholesterol identified?
The fact that general guidelines don't work for all humans gets tossed by most healthcare providers. It's like they are so trained in "the research shows" that they forget that we are individuals. We react differently to to the same stimuli.
How did you learn this? I'm recently doing a 2 month 2 egg a day test on myself to test how much impact it has no on me.
I think eggs are probably the least harmful animal product, unless you are an hyperabsorber.
Thanks for this channel. I like the way it rids me of unconcious fears I developed around food throughout the years because of this endless stream of information I am exposed to.
Great informative video. Thank you. Thing is... my 62 year old husband ate this way all his life. And no added sugars, avoided red meat & so much of the saturated fats or butter etc. Fruits, vegetables, whole grains, steel cut oats, no processed junk, etc. He ate while foods so his life, the Mediterranean Diet full of whole grains beans, legumes olive oil etc
But pretty high carb. He's NEVER smoked, he'd have maybe a couple glasses of red wine in a week, never did drugs. He did have high BP & had been on meds for that since his 20's & had always been super lean like his entire immediate family. All very lean. He's at 10% body fat.
He's retired now since July but had a sedentary desk job for 39 years but always been active hiking, biking, kayaking, ice hockey, certified diver, water skiier etc.
And guess what? He had a heart attack a year ago this past May! 3 blockages. 90% in the widow maker plus 100% in 2 other areas. He got 3 stents put in. All I've done is research research research & I truly believe it's hyperinsulinemia that's caused the inflammation in his arteries through time due to all the carbs.
We've decided to now try a directly opposite root...
He's gone ketogenic because we can't continue to have him eating & doing the same things that got him that way. I'm just so disappointed that everyone & all the experts keep advising us how he needs to eat the Mediterranean diet when that's EXACTLY what he's been doing ALL HIS LIFE. Going keto, he's been doing GREAT! I 🙏 pray this will at least help in no more progression of this disease. I feel we have no other choice. Thanks for your content.
have you checked lp(a)?
also his ApoB needs to be kept quite low given existing risk
@@NutritionMadeSimple
Yes, we've checked it & still watching it. Thanks for the prompt reply & for your informative videos & content
What was his LDL? This seems the perfect person to be on a statin… it would have been worse if he wasn’t eating that way; maybe a heart attack at age 30
I'm 46 now, and while I was on a 1.5 year of Keto I suffered a heart attack. Be careful!!!
I had a heart attack at 41 on keto@frankiegunnz8066
I hope I could like it 100 times to help with the algorithm! Thanx for what you are doing doc. 🙏
Thanks for your scientific approach to nutrition. I appreciate your worthful time , energy and patience to make these precious videos 🌸🌸🌸👏👏👏
Interesting. My question is... what were they eating before the new diets? And did the fact that they were not eating that anymore, have an impact? So was the results because of the new diet or the lack of the old diet? Thanks... great video.
That doesn't really matter though, as they defined what to exclude from the diet as well. So either is accounted for.
@@TC-by3il Surely it matters. If I had a diet of junk food for thirty years and I stop eating that and eat all healthy food instead, there would be an impact due to the fact that I don't eat junk food anymore. So is the impact from not eating junk food anymore, ot eating the healthy diet.
Great point!...
@@KevsArtStuff They were compared to a control groups of similar cohorts. Whether or not they ate junkfood, both groups likely had similar dietary patterns before the intervention, so we can compare them. In addition to thay, regardless of their previous diet, the _change_ is what made the difference. Whenever you stop eating junkfood, you have to replace it with something else. Lastly, many of the studies showed that those with higher adherence to the healthy diet had better outcomes, which leads us to believe that there may be a dose-response towards the healthy diets. So based on all that, I fail to see the importance of knowing exactly what their previous diet was like.
That is such an obvious point that is missed in so many studies and it's frustrating!! Thanks for bringing this up, hopefully this gets addressed one day. I believe that for instance EVOO might also lose some of its glamour if we control for that.
Meta analysis shows that regression/reduction of 1% of plaque leads to 20% risk reduction
Cra cra right?
crazy
A hundred thumbs up. 👍🏽👍🏽 Very important to watch video, practical and factual. The color coded summary was also very cool. Thank you.
I would really like a low fat WFPBD mixed with exercise RCT to see if the difference is bigger or similar to these results.
We as doctors wait and expect such trial too...but there is huge problem with financing ...Dean Ornish haf the same problem to gather bugdet before 1990... Nobody makes good bussiness on effective prevention...
Or, eat lots of small fatty fish, keto anti inflammatory whole foods diet with regular exercise.
@@RC-qf3mp Im going to let other creatures remain alive :)
@@johncrondis4563 nothing remains alive. Everything is part of various life cycles. To deny that or disparage it is nihilism.
@RC-qf3mp I still dont have to end any creature's life early or pay for them to suffer, thus I wont.
I would strongly recommend also measuring the degree of chronic inflammation in each subject! In my opinion, it’s the inflammation process that initiates the addition of plaque with the addition of an induced immunological response to these sites within the blood vessel linings. The amount of inflammation alone should also be measured by measuring highly sensitive C-reactive protein and perhaps other red flags indicating the degree of inflammation.
hi, some of the trials did measure CRP. Inflammation is a risk factor for heart disease, although not a necessary precondition, see ua-cam.com/video/NU7rfhGi-T4/v-deo.html
An outstanding video summarizing the latest in the science of diet and its relationship to cardiovascular disease. For my money the best you tube channel on the internet. Cuts through all of the confusion with succinct, practical advice for those of us suffering from the disease.
Love how you simplified at the end. if it was my health, or a loved one, this is what I would do.👍👍👍👍
Brilliant approach to this problem ...again, thank Gil!
I truly believe that this video alone should serve as advice for anyone interested in arterial health. There are so many videos with (not real) doctors talking about eating or not eating this or that, but nowhere is there any science behind it. So many people get confused or just believe what these (not real) doctors say on social media. I'm glad I found your channel because I was sick of these non-medical videos like everyone else. :)
Thank you for these impactful and meaningful videos that not only help clear the noise, but are solely fact-based. People don't appreciate how much work this takes. Grateful 🙏🙏🙏
thank you; 2day just got a good bill of health from My cardiologist, (2 yrs. ago mitral valve repair). I got a mini lecture on why I should be taking My atorvastatin as prescribed. I don't like being on it. (from genetics & smoking tobacco since a young age, quit since 2017)
I have some plaque in my system. My cholesterol levels are within normal range. My chart reads; 2nd degree AV aorta block. I had no symptoms/I trucked through a post winter storm on foot about 4 miles to do some errands, pick up scripts 2 days b4 My surgery. Slowly but surely working My way out of a major depression. I am so happy to hear you saying some of these factors can possibly be reduced? !!! ~ thanks for your informative posts, I watch most when I can
A whole food, plant based diet, walking 3 miles/day made the varicose veins in my feet and legs shrink down and soften. I can’t afford angiography, so I’m going by what I can see happening and staying on it.
plant based is what we all eat anyway. do you mean vegan? what do you mean. Most humans eat about a 70 percent plant diet anyway.
Yup, 23 years for me and I am uber healthy at 53. Perfect blood work and high normal testosterone.
You can eat chicken and fish
You increased activity and ate less calories....thats why
Can I ask what plan you've using specifically? My mum has been wanting to start a wfpb diet, but we're not sure where to begin?
💯
It’s all about commonalities among different diets! Thanks for yet another great video!👍👍
Good vid. I've followed Dr Essy's pretty much for about 15 years. So far so good. I have not followed up with another angiogram. Nobody does that if they don't have to.
Please discuss which medications will reduce plaque. Thanks!
I always appreciate you researching all the studies. I totally agree. I think too many variables to just say one diet fits all. also like Dr, William Li's take on what foods to heal & why. Moderation I believe is one of the Biggest factors in all diets. Again ,Thank you so much for doing the work for us ,so we can make the best choices for our over all health 👍
Great information, as usual!! Love your wrap up at the end with the foods that should be avoided for heart health - no matter what dietary pattern you follow, everyone can agree on that point! Thank you 😊
Extremely valuable information. Thanks for doing this Gil.
Male 60 here. 2 and a half years ago I had crippling angina. Being a hunter I was a big meat eater. Over night I went to a whole food plant based diet. The chest pain stopped after only 4 months and my LDL went from 5.8 to 1.9 . Today I run 4 km each morning, Row 1 km, walk my dogs 5 km and MTB plus do resistance training twice a week. I got my life back. BP is 115/70. heart rate 55 BPM, BMI is 20 and the A-fib I was having stopped. No meds as I am skeptical about any possible adverse effects long term. I eat Natto beans, 5 gram of creatine, B12, Vegan EPA/DHA and grow my own garden. Lots of greens, fruit, nuts, sweet potato, mushrooms, grains and nothing processed. No salt, caffeine, sugar, dairy or oils. Works for me. Good luck if you are on a similar journey.
Excellent! I’m glad for your success. I think different people have different diet needs. The key is clean whole food. I have some clean meat, but am mostly plant based.
The only thing I would add is that our bodies need sodium, not table salt, but salt like sea salt. Celtic salt is probably the best, because of all the trace minerals for your body. You just need a dab for nutrients. I take it with extra Virgin olive oil. Best!
@@davegibbs6423what is clean meat? Organic?
Why natto what does that do?
@@mkme2358Natto contains an enzyme that breaks down proteins and fibrous matter that forms blocks.
Good sir. You rock. Thanks for caring and sharing!
Yeah, with such a wide variety of preferences/tastes in patients, I lean toward offering whole food options that align with what they like/gravitate towards. Otherwise, they'll just revert back to ultra-processed junk.100% agree about exercise. Meds are beneficial, though getting patients off meds asap is the aim. Acute care, not chronic care. Great video Gil- thianks!
Fantastic channel & content. Thank you!
I am 54 & have HCM and last year had a septal myectomy-- feeling like 90% better- very little breathlessness anymore- and exercise is much easier! I also have hypertension and some plaque in arteries (angiogram was done at surgery time) Any suggestions for diet/exercise ( i try to keep low salt/sugar/calories and exercise 45 min./day- intense walking, stair climbing, pushups and isometrics)
Many thanks for another awesome video Dr Carvalho. Much appreciated as always!
Great video....great analysis....great conclusion....thanks !
OMG I am so excited, I just have to share this! a year ago I had a carotid ultrasound which showed more than 15% plaque in my RICA and 50 to 69% plaque in the left internal carotid artery (LICA) Asked for a repeat Ultrasound in a year. Bragged that I could get those numbers down, but was scared I might not. BUT I DID IT! less than 15% in the right (based off other numbers, I reduced the plaque burden by almost half!!) For the LICA, now just slightly over 15% in the right. Greater than a 50% reduction of plaque in the left carotid!! I DID IT! and it was EASY. I ate well and was always satisfied. FOLKS diet and lifestyle work! no meds- I am not on ANY medications, 69yrs old.
I needed this. I spoke with my Cardiologist today, and we're battling medications. While I am definitely not willing to do Repatha or Leqvio, I am taking a Statin 3 times a week, due to side effects. But after watching this, I might see if upping my Statin gradually, might cut down the return of the side effects. At the end of the day, diet is what I feel will work, but I love my food - which is what got me into this situation to start with. I love your videos. They have helped me, no end.
Fantastic breakdown. Thanks to you and your Team! You did a great job!
So excited to watch this. Is there any research on full fat dairy vs nonfat dairy for those with elevated lipoprotein a ?
I have heard full fat dairy is better as long as you're not in a major calorie surplus. It is overall healthier and I do believe hearing about a study where full fat dairy had an improvement in LPa when low-fat did not. Sorry I don't remember the study offhand though.
Non fat means heavily processed
@@alexandrustefan9059 Bullshit. Low fat milk is by no defintion heavily processed, and low fat yoghurt is just the product of low fat milk. In my region you can also find "Quark" with 0.1% fat which is also a low processed milk product with lots of protein.
@@YaYippieYeahlow fat greek yogurt has a lot more sugar than regular fat greek yogurt
@@rjmclean1979 If you buy the one with added sugar. Your fault.
10:51 A plant-based diet combined with proper exercise is truly the golden key to heart health Thank you for the valuable insights
Cant wait to watch this after work. Gil is the GOAT 🐐
Bonjour from France.. Great video...Great comparisons.. What macros would you recommend ... Merci
After a high calcium score for my age (I’m 46) I radically changed my diet. I’ve seen improvements across the board. I also exercise far more now. I typically eat whole foods and lots of fish, fruits, vegetables, and healthy fats. My macros are typically around 20% carbs, 45% fats, and the rest protein. I do allow myself a cheat day once per week because it helps keep me on track. The only thing I haven’t done is start the statins. After doing my own research my doctor agreed to let me do 5 mg every other day of the statin. I know it’s probably necessary but dreading the side effects.
You can also try more fiber. Instead of fish, take algae oil, and eat more legumes.
Gil, thank you very much for presenting this very important video that will benefit so many people 🙂
Thanks for summarizing the studies!
Vegan for animals for 15 years and will be for life. Im healthier than ive ever been in my life. Its amazing when you do things for others the things you get in return ✌️❤
15 Years here also. Age 60 with perfect bloodwork. There's no healthier diet than WFPB
Kudos! Like most vegans I wish I had started sooner. I'm only about 8 years so far. I'll never go back.
@@terryjackson9395 Sure there is. A whole food animal-based diet.
@@terryjackson9395lol
@terryjackson9395 awesome brother stay well 🤘❤️
Dr Carvalho: Please interview Dr Joel Fuhrman on this topic. I believe he would love to do it.
Thank you very much for your very useful, life saving work. However, I am disapponted by the tiny results. The risk reduction is of course relative...However, it is better to face reality, without false expectations.
Thank you for another excellent video.
Thank you for this! I'm grateful for your channel. It is such a huge help in making informed lifestyle choices.
Would you consider doing a series about diets during cancer treatments? Like keto, or vegan, or fasting (I don't mean for prevention, but for possible effects for cancer patients).
Lower mToR might help cancer patients, but also muscle loss and other things cause their own problems. Though most people aren't of healthy weight to begin with.
Greger has a number of videos on cancer.
@@sci-life-art-ru I know but he is also a doctor that only cares about science when it suits his biases.
Dear Gil,
Thank you for your informative content. I'm 41 years old and recently received my lipid profile results: HDL - 77.0 mg/dl, LDL - 253.7 mg/dl, triglycerides - 163.0 mg/dl, and total cholesterol - 363.1 mg/dl. My fasting blood sugar was 100.8 mg/dl. My doctor prescribed Atorvastatin (40 mg) for three months.
After researching cholesterol, I have a few questions:
1. Should I consider additional tests beyond ApoB for an accurate assessment?
2. Can ApoB and LDL levels diverge (e.g., high ApoB with low LDL or vice versa)? If so, does this imply different dietary approaches for managing LDL and ApoB? Would low ApoB levels justify stopping statin medication?
3. What test detects arterial plaque and provides detailed information about it, if present?
Thank you for your expertise.
Best regards
Many thanks for your high efforts in bringing us great quality content! Much appreciated 👍
Hi dr Gil. Useful, clear and fantastic as always… well, even more! One question, did any trial look for correlation between frequency of daily meals and results? Or time of eating and results or events? Just a curiosity. Thank you so much! ❤❤❤
Isn’t calcified plaque also called hardening of the arteries and is bad also?
Excellent presentation. Now it’s down to us!
I'm watching and am just on the first trial. Something seems obvious to me. It needs to be known what happens with the control group. For example, if they get 3% worse and the trial group gets 3% better, then the true benefit is 6% better, because without the trial lifestyle changes, they would have ended up as the control group.
You are missing the point. Better or worse than what? Answer the control group. The measure or the yardstick is the control group.
@@rajnz Precisely; hit the nail on the head. Ty kindly for sharing!
@Randsurfer
@rajnz explained thoroughly.
This is an example of a very fundamental, basic tenet of experimental human research.
I recommend studying the scientific method in order to become familiarized with at least the fundamentals of the system it uses so that you have a stronger grasp on how and why we structure these systems in this way.
You are the BEST!!! Thank you ❤
Absolutely your BEST video you have made to date, thank you very much for all your presentations, your the BEST!!
Gil, I know that you don't want drama or controversy so I will not bring it to you, but it makes me so mad to see so many "experts" and health "gurus" on the internet spreading lies. I know that you kind of inderectly challanged them in the end, and a couple of names and faces came to my mind, but again, I won't comment on it because we are better than those people and I will vote with my likes and my attention. It's just frustrating as a nutritionist myself and someone who genuinly wants to help people get better, to see so many lies and deception about something so important. Amazing work, as usual, we are fortunate to have you.
Excellent summary and big picture summary of the topic.
Hi Will. Nice to see you here.
Yup. High protein for us old folks (I'm 76); I exercise routinely, and fortunately I LOVE it; I also feel fortunate that the best diet is still economical.
I have tended toward Esselstyns diet, which is harsh and difficult to maintain, causing me to have very unhealthy cheats when I do cheat, ( maybe once every month or 2) - like donuts or sweets. I think if i use an approach influenced by these additional studies it will help dxponentially with compliance which seems to create a sizeable benefit in EACH of the studies. Thank you for all of your research and help in this area!!
The only trustworthy source
You're awesome, Gil! The same questions I ask my physicians: What would you do if you or your loved one is in my situation?
And not what the guidelines say.
Would have been nice to know what their LDL-C was during the trial, hsCRP, and BP. My impression of the literature is that the combination of low LDL-C, low inflammation, and low BP is best combination for regression ad avoiding progression.
Add low blood glucose to the list. All those things reduce LDL movement into the artery wall. But you can do even more, and specifically target certain cholesterol pathways with diet. For example, green tee will increase the bile acid synthesis. Barberries will inhibit PCSK9, and so on.
Best as always.
Great job again! Many thanks Dr. Carvalho!
Excellent. I was not clear on the second tier of foods, olive oil, fatty fish, etc Did he say they can be included or not?
I would love to know if the reduction in plaque correlated with a reduction in LDL levels? Since most of us can only rely on LDL and other blood tests, are these reliable indicators that indicate reduction in plaque size? Thank you for your videos!
Top notch content, best most comprehensive nutrition channel on You Tube.
@NutritionMadeSimple Doc, I appreciate your channel and your opinion on selecting an optimal heart health diet. It sure would be nice to see an Ornish vs Mediterranean diet study. If the Mediterranean diet allows for more fat and more fun in the diet and if it is as good or better than Ornish, then that would be hugely beneficial to know!
I would like to know if their are any trials that measure artery plake after fasting
If anything, prolonged fasting is akin to a high-fat diet, and not beneficial to plaque reduction.
Great overview, thanks! Interestingly Dr Esselstyn's patients with severe CAD on a whole food plant based diet (no oil OR nuts) saw huge improvements but this was reversed if they started eating nuts or oils again. So for some, nuts and oils may not be a good idea. Also, there's misunderstanding about the proportions of foods to consume in a true Mediterranean style diet, its 90 percent fruit, vegetables, wholegrains etc and the balance of 5 to 10 percent is the optional extras like fish or lean meat, nuts and seeds, dairy, olive oil ❤
Very helpful and simple, Glad i found this video
What medications are you referring to?
Can you do an analysis of vitamin d supplementation for health? Thanks.
Depends on your natural levels, probably yes with K2 if you don't live in a sunny climate or have really dark skin.
Great video, thanks!
In terms of medication, what in general then is recommended?
What I see is that one needs to do their utmost for a long time (or perhaps for ever) to achieve in best case a (small?) reduction of plaque (or a less fast growing). The question remains; is that the bast we can do or are there better ways. If food has such a small effect on plaque, I wonder if it is the major player or just a close bystander.
Isn't the stiffness of the arteries the ultimate cause. And thus the question becomes what diets favor the stiffing of the arteries? Or alternatively, what diets favor the flexibility of blood vessels?
High simple carbs / sugar foods promote glycation, therefore promote rigidity of the arteries and plaque formation.
Not necessarily. The most important results are events, which works as a proxy for whatever direct physiological cause is the best. If events come down, then the diet was effective.
I think you have your answer
Yes, the interventions may have reduced arterial stiffness, which may decrease the number of events even though the plaques remain the same.
When it comes to events, that does makes a difference. Increasing N2O make a big difference.
17:58 is the most important bit if you're in a rush 😊
I enjoyed this video. Practical in real life.
Fantastic content once again. You're saving lives.
I like the approach you take about commonality of findings in trails. It is not surprising at all to find that lifestyle and reduction in food which increases cholesterol in the blood stream should reduce heart attacks. Nor indeed surprising that drugs lowering blood fat should do the same. However all this is rather perplexing to even the educated viewer since the so called experts don't agree among themselves as to the best diet in this respect. More important to know is that NO ONE so far has provided satisfactory and undisputed reasons for the formation of plaque in the arteries for the otherwise healthy person other than the usual references to lifestyle, genetic tendency and stress extra. Much is said about high blood sugar damaging the lining of arteries being the culprit, hence the keto diet craze! and the demonization of carbohydrates. But can anyone point to real research establishing the actual cause of damage to arteries apart from the blindingly obvious!
personally I have high CAC and am taking high D+K, Lumbrokinase, Nattokinase, and Serrapeptase while trying to walk at least 30 minutes per day. doc has me on 5mg rosuvastatin and 10mg ezetimibe and what was a total cholesterol of 250+ is now around 110 with LDL under 70
Any specific brand(s)?
I do the same ( D+K, Lumbrokinase, Nattokinase, and Serrapeptase, plus quercetin, berberine, fermented black garlic extract, Mg etc.) but cannot take rosuvastatin, it causes horrible cramps. And WFPD with 3-5 % fat.
@@jahiddle thorne d+k, arthur andrew medical neprinol, Canada RNA Boluoke
@@mesterferenc2688 yep, also take those too. Have high Lp(a) and a genetic mutation that doesn’t allow my body to metabolize statins which is why I only use 5mg+zetia otherwise my CK levels shoot over 1000 and my body starts destroying itself. Zetia has really helped bring the ldl down in leau of higher statins without the side effects of bad joint pain and cramps. Might try swapping out the rosuv for bempedoic acid if my doctor agrees. Found out about the genetic mutation through 23andme of all things.
@@darylfortney8081 Thanks!
A consistent theme from health experts is a diet high in fruits and vegetables, some grains, small amounts of dairy combined with strength training and cardio type exercise (walking, biking, etc.)
Your point about the names of the diets being less important and to look at the commonalities is a very good point that I think more healthcare professionals need to emphasise. I feel like some of the names (especially Mediterranean) tend to take the conversation off topic into cultural and lifestyle anecdotes rather than concentrating on the overall formula that the diet follows that can be tailored to an individual's needs and location.
I already do your dietary recommendations, except NO dairy, red meat only maybe 3-4 times a year(grass fed only), 4 eggs a week & very low fats. Lots of whole grains, chicken breast ,and Norwegian or Tasmanian salmon. Green salads almost daily and lots of cooked veggies for dinner.
I like the recap at the end it was really helpful!
I wonder if there are studies on high fat diets and low carb diets like Atkins diet, or intermittent fasting diet plans with all kind of foods but with fasting as the commonality, or Dr Caldwell Essellstyn diet i.e. whole foods plant based and no nuts and high plant fat where there is more cardiovascular issues
Thank you. I appreciate your work.
Great vid! Makes sense. I'd be interested in knowing what type of exercise was used and research compairing exercise types.
What an excellent video
100%
Hi Gil, thanks a lot for another banger. Question : do you know of any studies that compare olive oil to actual low fat diet? Seems that EVOO is very often compared to SAD in studies but that doesn't tell us the whole story.