How to lower your apoB

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This clip is from 276 ‒ Special episode: Peter on longevity, supplements, protein, fasting, apoB, statins, & more.
In this special episode of The Drive, Peter discusses a variety of topics, breaking away from the typical deep-dive format to explore a wide range of common questions submitted by listeners.
In this clip, we discuss:
- Do you need pharmacology to lower your apoB?
- What foods to cut to lower your apoB
- What Peter takes to lower his apoB
- And more
--------
About:
The Peter Attia Drive is a deep-dive podcast focusing on maximizing longevity, and all that goes into that from physical to cognitive to emotional health. With over 70 million episodes downloaded, it features topics including exercise, nutritional biochemistry, cardiovascular disease, Alzheimer’s disease, cancer, mental health, and much more.
Peter Attia is the founder of Early Medical, a medical practice that applies the principles of Medicine 3.0 to patients with the goal of lengthening their lifespan and simultaneously improving their healthspan.
Learn more: peterattiamd.com
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Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional healthcare services, including the giving of medical advice. No doctor-patient relationship is formed. The use of this information and the materials linked to this podcast is at the user's own risk. The content on this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they have, and they should seek the assistance of their healthcare professionals for any such conditions. I take conflicts of interest very seriously. For all of my disclosures and the companies I invest in or advise, please visit my website where I keep an up-to-date and active list of such companies. For a full list of our registered and unregistered trademarks, trade names, and service marks, please review our Terms of Use: peterattiamd.com/terms-of-use/

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2 июн 2024

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Комментарии : 935

@tonycrouse6544 7 месяцев назад

For most people all you need is a balanced diet of minimally processed foods. I do believe some supplements are beneficial like vit D, vit K2 and fish oil. Don't panic about all these lab numbers because no one knows when your time is coming. I worked 30 years in cardiac critical care and saw many pts who had excellent lipid panels but still developed heart disease. When I worked in general care I saw many older pts who had crappy lipid panels and NO heart disease. Try to find joy in life and embrace gratitude.

@rodcc 7 месяцев назад

There are always outliers - like you I worked in critical care and general internal medicine for decades. Too many people are “enjoying life” by over eating and living an unfit lifestyle - take a good look at how these people are “living” their life - if you can call it living. I use to be morbidly obese. Today, im more fit then ever, 16 percent body fat, ruck 10 miles with 45 pounds, resistance train five days a week, and eat a very healthy diet - and I have never felt as good in my life. Attia is SPOT ON.

@tonycrouse6544 7 месяцев назад

@@rodcc He's a smart guy but pushes drugs too much. You can live a happy, health life without all the drugs.

@rodcc 7 месяцев назад

@@tonycrouse6544 absolutely, but knowing what we know as physicians, most people don’t follow through with what it takes. I’m an advocate for the least meds as possible. It’s terrible how people live their last decade of life, or having a stroke in their 40s and 50s. Just terrible. And boy was I a mess for decades and the damage is done; just trying to mitigate have someone toilet me and spoon feed me tapioca pudding in my 70s and hopefully 80s. Life goes fast

@tanvir6356 7 месяцев назад

How about smoking? Many people live a long life despite smoking so it must not be bad for you

@tonycrouse6544 7 месяцев назад

@@tanvir6356 Nah crack cocaine is much better. Try some.

@amyhoop9651 3 месяца назад

Thank you Dr. Attia for the detailed description about how the liver receptors respond to apoB

@doubleunderfire7964 7 месяцев назад

Love the level of detail provided in these videos. Excellent video.

@MsQ275 7 месяцев назад

Super appreciate the LPa pharma info!

@cyclingmaven 7 месяцев назад

Mate, you're a keeper and your courage is recognised and appreciated.

@lotfibouhedjeur 4 месяца назад

Thank you, Peter. Really, thank you!

@BrianCobb-xk8bv Месяц назад

I am doing research on my husband and he claims his doctor didn’t explain what or how to get a lower numbers! Thank You! You took a lot off my Mind and heart. My husband is my Best Friend and I would be lost without Him! ❤😢

@jimmccall8030 7 месяцев назад

Great information, thank you.

@acktionjackson666 13 дней назад

I wonder how my Grandfather who was born in 1911 in a farm in Russia was able to live through 3 wars, a 30 year factory job at Ford, being an alcoholic for most of that time, and who ate plenty of saturated fat was able to live until 2007 without a heart attack, stroke, diabetes, or cancer. No Statins or APoB lowering drugs either. Same for my Grandmother.

@critical_eye1 8 дней назад

Bingo. Natural foods growing up. No fast food industry nor big pharma. In addition to the epidemic of mental health problems worldwide, greatly caused by social media. And now we are shortening lifespan in our modern obsession with extending it.

@thomaskingschillerlein7843 3 месяца назад

1. Repatha (evolocumab) 2. Nexlizet (bempodoic acid) 3. Ezetimib (blood thinner like compounds? but w/o statin)

@daviddelguercio8458 3 месяца назад

What would it cost to take these?

@MrDmitry4ever 3 месяца назад

nexlizet has both 2 and 3

@deborahhall9744 3 месяца назад

Ezetimibe is already generic and inexpensive so take that for starters (along with statin or PCSK9i) while waiting for Bempedoic Acid to come down in price.@@MrDmitry4ever

@7371301 2 месяца назад

Repatha is $1,000/month. My insurance company said no without further justification

@oisteinthomassen Месяц назад

Ezetimibe lowers plasma cholesterol levels by inhibiting the uptake of cholesterol in the intestine. Pubmed: pubmed.ncbi.nlm.nih.gov/19443695/

@cyclingmaven 7 месяцев назад

I respect any 'expert' who says "probably" and "I don't know".

@wocket42 6 месяцев назад

If you watch his older videos from some years back, you'll realize he didn't know anything then and most likely doesn't know anything true today. Until he gets to 100 years he will switch his medication and life style 180 degrees a couple of times. That's what will happen if you follow the leading edge of science and experiments.

@flyingsodwai1382 4 месяца назад

As has been said many times by different philosophers over the years, it's just a sad fact of society that the wise are full of doubts and the fools so damn sure of themselves.

@johannesswillery7855 3 месяца назад

@@flyingsodwai1382 GOAT comment!

@kddidit08 2 месяца назад

@@flyingsodwai1382 "The best lack all conviction, while the worst are full of passionate intensity." Yeats

@flochfitness 2 месяца назад

@@flyingsodwai1382damn. Good point

@mertonhirsch4734 5 месяцев назад

ApoB and blood sugar have a multiplicative effect on CHD risk. ApoB can be higher if your blood sugar peak levels are lower. It is even plausible that ApoB is only problematic because it correlates to glycosylated ApoB.

@meiocheng817 6 месяцев назад

61yrs old, got my first CardioIQ test. Only had standard lipid panels before, HDL 71, Tri 68, LDL 131. All my other stuff is good. Then just found out yesterday my Lp(a) 49nmol, seems good, ApoB 103mg seems moderately bad. I'm not on low-carb. I don't count calories, but I did cut back on carbs, since I used to always eat rice, bread, potatoes, pasta etc. Now, I still eat those, but try to eat them less often. I'm going to cut back on the saturated fats, a little, and see how the labs go in 5months when I see my PCP next. If still concerning, maybe a CAC score next.

@karlhungus5554 4 месяца назад

That seems like a good dietary strategy you're employing. I've been thinking of doing the same, though I've been dragging my feet about it. Regarding the Coronary Artery Calcium (CAC) test you mentioned, another possibility you may wish to investigate and consider is the CT Coronary Angiography (CTCA) test. I learned about that from Peter Attia in a different video. No matter which path you take, I wish you success and good health.

@BornAgainBride 19 дней назад

Have been doing more of a keto-type, carb-light diet about one month, limiting sugar/carbs significantly. I also have been eating sauerkraut and red cabbage prior to my dinners (doing intermittent fasting 18:6 or 19:5 also). Heavy on GRASS FED BUTTER & RED MEAT, and pasture-raised eggs. 1 piece of Rye toast in the AM, and a touch of some starch with dinner. Fruits too (which I don't like, but they have lots of nutrients). Good exercise (gym 3 X week, dancing 1 x week, and I'm a 66 YO female, about 105 lbs, reasonably fit for age. ) On this regimen, my TG dropped from 71 to 58, my HDL went from 97 to 104, my TC shot up to 400! And my LDL is like 205, crazy. My doc is going to have a fit (she's on vaca). I am asking her to test me for LDL A v. B. I suspect my A is high and my B is low. My TG:HDL ratio is crazy low, which I hear is excellent. Keto, or low carb will change your lipids, but I suspect for the better in most folks, depending on that TG:HDL raio, so I hear.

@allencrider 2 месяца назад

I eat a whole food vegan, salt, oil and sugar free diet. I tested my ApoB and it was 73. I'm 70 years old and have abundant energy to do whatever I want.

@isabellezablocki7447 2 месяца назад

Great Job!

@bobwilliams9061 20 дней назад

Which whole food diet guru do you typically follow? T. Colin Campbell?

@allencrider 20 дней назад

@@bobwilliams9061 McDougall & Esselstyn

@RichardMullin-ly1we Месяц назад

I found this very informative. My LDLc went up significantly after loosing 75 pounds and getting to sub 13% body fat, but I started drinking 64 oz plus of black coffee a day. Will cut back the coffee and tweek the diet more. Thanks

@jjuniper274 7 месяцев назад

Dr. Attia, would you kindly address dry eye and complications from it like permanent damage to the cornea that are directly correlated to some statins and ACE inhibitors, and other BP meds? I have been trying to find information on how to correct this. Help please. Thank you.

@wocket42 6 месяцев назад

He will tell you that statins are well tolerated and that you need to man up if you want to live to 100.

@MiguePizar 7 месяцев назад

As someone who was morbid, had high cholesterol, pre diabetes and things like that, and now have excepcional blood work, it all started with losing weight, Intermittent fasting, and working out, and I eat quite lot of meat and carbs, but because I do what I said before, my blood work is very good, and no drugs. Best

@WhatsIQ 7 месяцев назад

The fasting has no effect

@MiguePizar 7 месяцев назад

@@WhatsIQ for me it is, my blood markers are better with fasting, I'm not saying is the cure, just better blood work. Best

@utubevenky 7 месяцев назад

@@WhatsIQ its ridiculous statement. fasting helps the body to cleanse itself and cleansing helps the body to be at its peak that it can be at a given point of time. even if it may not be a permanent cure it can atleast help one to have a high performing body for a longer time. autophagy is the minimum benefit one gets from fasting apart from the better inter-cellular connection and reduced inflammation

@llkoolbean4935 7 месяцев назад

@@WhatsIQit does for me as well

@joerenner8334 7 месяцев назад

I have never been fat and exercised all my life. High Cholesterol is 100% inherited

@aquamarine99911 7 месяцев назад

I was in good shape on a strict keto diet, with an ApoB of 186. I added two cans (~600 g) of beans/lentils per day, cut out red meat and eggs, and dropped my ApoB down to 85. Apart from reducing SFA and dietary cholesterol - for those of us who are hypersensitive to such things - the easiest way to drive down cholesterol is dietary fiber. Since I am fit with good BP in my 60s, I'm happy to have my ApoB in the 80 to 90 range. I don't want to take drugs, because then I wouldn't follow my diet so strictly. I just want to feed my body what it seems to want.

@qilinwang5889 7 месяцев назад

Thanks for posting this and I will try the same steps and hopefully it can bring down the apoB

@wocket42 6 месяцев назад

How high is your CAC score?

@aquamarine99911 6 месяцев назад

@@wocket42 I haven't had it measured. A cardiologist prescribed one when my LDL was high, but now I don't really have any indicators of a heart problem and my BP is 110/69, without medication. So I didn't follow through with it.

@GlennMarshallnz 6 месяцев назад

Hi Andrew, interesting and insightful comment. In the space of six weeks on carnivore, daily grass fed meat, free range eggs, butter and sardines my cholesterol doubled to 352 total, 278LDL. I was eating six to 12 eggs per day and 1-2 kilos of beef. I’ve decided to switch to 90% whole food plant based, with legumes, old fashioned rolled oats, vegetables and fruit, chia and flax seeds, plus sardines and other fish once a day. I honestly found that after six weeks my skin had also become very oily and smooth. My dad had very high cholesterol and took statins. My BP is similar to yours at 110/72. What does your average daily diet look like? Regards Glenn

@aquamarine99911 6 месяцев назад

@@GlennMarshallnz Hey Glenn. I too eat fish every day, but it's red fatty fish - wild Pacific salmon, Artic Char, or rainbow trout. I love sardines, but they cause me gout. I have my mercury levels checked regularly and found I can't eat tuna, even supposedly "low mercury" tuna. So you may want to watch for that. Every morning, I eat berries 20 minutes before my main breakfast of fish with an ounce of walnuts (to balance the Omega 3s with the 6s), steel cut oats (supposedly better than rolled oats), and 142 g mixed green salad with olive oil and .ACV. Both lunch and dinner ~300 g if lentils or one can (~250 g) of kidney, black or pinto beans or chick peas, alongside ~500 g of cruciferous vegetables (red cabbage, broccoli, cauliflower or brussels sprouts). For dinner I'll add 50 g of chicken breast. That's the basic plan, and I like it, but I'll vary things up sometimes. The important thing is to meet your Omega 3, protein and fiber targets. Legumes and fish are the perfect foods for doing so.

@Mike-du1dc 7 месяцев назад

As always very informative! Thank You!

@pb7762 7 месяцев назад

it would be great to see you have a podcast with Dr Paul Mason

@milenasenov6228 7 месяцев назад

Or Dr. Nadir Ali

@Nicksonian 7 месяцев назад

No, Mason has a very prejudiced, closed-minded view of science. He is a subscriber to and spreader of the litany of low-carb conspiracy theories, many of which are based on questionable or non-existent science. I don’t always agree with Atilla, but at least he identifies saturated fat as “one of the horsemen of the apocalypse.”

@hugoanderkivi 7 месяцев назад

@@Nicksonian Any evidence or just opinion? What you have said is ridiculous.

@HobzyMcRuse 7 месяцев назад

absolute nonsense. Sat fat is the ancient fat source we evolved with. The studies are so weak and biased that blame it.@@Nicksonian

@wocket42 6 месяцев назад

@@Nicksonian Science says saturated fat is fine. If Peter says otherwise, that's his personal opinion, not science.

@ClayTallStories 5 месяцев назад

I was on OMAD keto for 3 years then went to a whole plant-based diet, oil/ sugar/dairy-free diet, and lowered my LDL 64% and Triglycerides 22%. No statins are needed. Those levels have remained for 19 months and the Angina I had has been gone for a year and I am back in the hills hunting again and running around with my dogs on the farm.

@MountBlueice 4 месяца назад

Wondering what kind of fats were you on Keto? I had assumption Keto increases LDL no matter what?

@user-ij5ky4lr3x 3 месяца назад

Makes sense. Be careful. A lot of people assume that because EVOO is healthy, they can have as much as they want in their diet. It still has some saturated fat. If you eat enough of it, you will get too much saturated fat. Seems like a lot of people are missing this now and drenching everything in EVOO and avocado oil

@ClayTallStories 3 месяца назад

I was eating too much animal fat and dairy@@MountBlueice

@TheRst2001 3 месяца назад

This is really what I should be doing , whats your favourite main meal of the day out of interest ? I like pulses sometimes tofu just wondering what else I can cook :)

@Shabana-hv9ic 7 месяцев назад

Super interesting facts regarding the effects of statins at high doses vs low. Both my parents are on 40mg of atorvastin and their A1C always comes back high regardless of being on a low sugar diet. Will def discuss lowering their dose with their doctors. Thank you Peter for sharing such vital health information all the time.

@TB-rx1ue 7 месяцев назад

How are statins and A1C related?

@MT-sq3jo 7 месяцев назад

@@TB-rx1ue Some folks could worsen their insulin resistance by taking statins, even though the effect is not huge as far as I understand.

@MT-sq3jo 7 месяцев назад

You did not mention if your parents baseline A1C levels before starting statins… So we could not say if max dose statins has anything to do with your parents insulin resistance. Nevertheless, A1C level should be easier to control than high APOB/LDL-c. For example, exercise has great effect on my blood glucose levels, but zero effect on my blood cholesterol levels.

@echase416 7 месяцев назад

@@TB-rx1ueRead up on metabolic syndrome

@wocket42 6 месяцев назад

@@TB-rx1ue most statins cause diabetes.

@richardnimo Месяц назад

Love the way Peter speeds up when he saying unnecessary jargon. Very impressive, even though 99 percent of the listeners may have no idea what what he's saying or whether it makes any sense. I am so impressed with the difference between his intelligence and my stupidity! Pity it doesn't teach me anything.🙂

@Marx1963 4 месяца назад

My apo b went from 121 to 80 on 3 months of low saturated fat . 60 yo Trig - 38 LDL 88 HDL 54 Total 147

@drott150 4 месяца назад

@marxp2216 Great work! Especially through natural dietary means instead of drugs.

@rosetulip1231 3 месяца назад

So awesome

@nhtathinfbntb2746 3 месяца назад

what did you eat daily/weekly?

@mysidestitches 2 месяца назад

Keto diet?

@Marx1963 2 месяца назад

@@mysidestitches depends what you call keto . I’m not about the medical version which is high fat which I think is ridiculous.( unless you’re using it for medical purposes like epilepsy). I’m high protein low fat but make sure I consume / supplement w/essential fatty acids like omega3s . On average I consume the following - I’m 60 ,5’11 190lbs bodybuilder. Protein - 220-280grams Carbs under 50 grams Fats under 60 grams Averages for 7 days 👆

@paulgachot587 6 месяцев назад

Great information. Thank you! If I have familial hypercholesterolemia / familial combined hyperlipidemia with crazy high apolipoprotein a levels (169 ml/dL most recent) and high LDL (228 most recent) arePeter's combo of the PCSK9 Inhibitor Repatha and the combo drug Nexlizet recommended over traditional statins? I avoid statins because of NAFLD and the other associated risks.

@GlobalDrifter1000 7 месяцев назад

I am in a trial of Olpasiran by Amgen. Phase 3 trial of a siRNA. in phase 2 it recuced lp(a) 95%. A subcutaneous injection once every three months- fingers crossed.

@wocket42 6 месяцев назад

Does it also reduce overall mortality and improve general well being? Will be interesting to find out what reducing a associative marker really does. Do you know what the control group gets? It's not double blinded or you don't know if you've got it?

@vickistonehouse2218 6 месяцев назад

How long is the trial you are in going to run before the results are released? Do you know how (what the protocol for this study is) the participants were chosen? Or where I can search for this study?

@williamhenry3337 7 месяцев назад

What about APOE2? I have the E2/E3 combination. No one in my family has has heart or alzheimers issues (all died from cancer). I am 75 years old and have held a 19.5 BMI my entire life.

@tackletalkmenshealth 7 месяцев назад

What do you think about low dose colchicine to decrease endothelial inflammation?

@alpinelove6225 3 месяца назад

I am a carrier of two copies of ApoE4. I consumed a predominantly whole food, plant based diet that includes egg whites and fish. My diet is high in COMPLEX carbohydrates and low in saturated fats......my ApoB, my A1c and my triglycerides are all low. I think that it's very important to distinguish between complex carbohydrates and simple. There is a vast difference when speaking about lowering carbs. I thrive on a high carb diet....but complex carbs, very little or no simple carbs. Because I am a carrier of two copies of ApoE 4, I also thrive on a diet low in saturated fats.......not everyone needs to eat more saturated fats to lower ApoB.

@StatzGee Месяц назад

Excellent point

@etmax1 3 месяца назад

I've been on various statins (along with the muscle pain and bleeding), Ezetimibe and Evolocumab (at half dose monthly) and the only one that actually made a dent in my cholesterol was Evolocumab. Now 6 months into that I'm getting serious cramps in almost every part of my body, (hands back, Thighs, calves and feet) (6 months of Evolocumab??). It also has been scrambling my brain, so now we're trying to see whether half dose 6 weekly is going to be a better balance. Watch this space.

@arubaga 20 дней назад

Become a lean mass hyper responder and get rid of statins.

@billytheweasel 7 месяцев назад

Thanks team Attia, so glad Dr Dayspring is here now too.

@Joseph1NJ 7 месяцев назад

Where?

@billytheweasel 7 месяцев назад

@@Joseph1NJ With the channel and available for us to hear publicly. When he left clinical practice and lectured only, as we were told, I didn't hear from him for years... publicly. He's in Peter's practice now, they've said.

@straightgarb 6 месяцев назад

Bempedoic acid side effects: Tendon problems, including swelling, inflammation, or rupture can occur in the shoulder (rotator cuff), upper arm (biceps tendon), or Achilles tendon at the back of the ankle, within days or months after starting treatment with bempedoic acid.

@KTravRuNEr 21 день назад

Thank you. No way would I take this drug as an athlete

@luismarioteixeira658 7 месяцев назад

To low apoB, reduce Applebee’s first

@lukeuseforce 7 месяцев назад

😐

@ananavarrete7218 7 месяцев назад

😅

@michaelbishop9157 7 месяцев назад

diet isn't enough to be meaningful in reducing most people's risk

@Seanonyoutube 7 месяцев назад

@@michaelbishop9157yes it is.

@amberweber6369 7 месяцев назад

@@michaelbishop9157 But diet is still very important. Food is information for our biology and processed food aka fake food is not optimal for our health.

@reason3581 3 месяца назад

How long after a diet change should you wait before re-testning your ApoB? How long till you see the maximum effect?

@daviddelguercio8458 2 месяца назад

3 months

@danielcisco 7 месяцев назад

I have an ApoB of 146 😢 TG is between 55-75. Going to speak to my DR because I have been working hard on lowering it for more than a year.

@Sa7biUK 7 месяцев назад

136 here brother. 39 years old and thin my whole life and mildly active. I feel you. I've ordered Citrus bergamot, fish oil, and vit c to try and lower it. Lots of psyllium husk too but I think statins are on the horizon...

@danielcisco 7 месяцев назад

@@Sa7biUK Yeah I have been taking fish oils and Niacin for a while now. Nothing I do seams to make things better at this point. I am avoiding statins. If I do start it would be a low dose 5mg a day as explained in this video it has diminishing returns as soon as you go above it.

@FeFeronkaMetallica 7 месяцев назад

I am 26, active, lean, eating well at 151

@critterdude311 7 месяцев назад

Are you guys doing Keto or Carnivore diets by chance? I did a 4 month carnivore diet, loved it, but my LDL and ApoB readings went through the roof, presumably from the excess saturdated fats (trigs were low as OP mentioned here). My doctor wants me to revert my diet back and retest blood in 6 months.

@FeFeronkaMetallica 7 месяцев назад

@@critterdude311I do low carb 0-100g daily (some days carbs some not) but I use only olive oil, so I dont think the sat. fats are issue in my case. My triglycerides are in low 30s, my ApoA is also around 150

@kellyshannon375 2 месяца назад

Former cardiac nurse here, now practicing functional medicine, and the daughter of a life-long cardiac nurse . . . statins do not prevent CVD or keep people from having repeat CV events! LDL particle size is how you know your true risk of CVD. Statins inhibit production of protective cholesterol - not good! Genetics definitely play a role. Inflammation is the largest predictor of CVD and disease of all forms. Focus on lowering inflammation through managing stress, getting enough sleep, minimizing toxic burden, avoiding high inflammation foods (gluten, dairy, processed oils, processed and fast food, junk food, pesticides), pay attention to how foods affect you (do you break out after, feel bloated after, feel tired/hungover after, does your heart race after, does your face get red after, are you itchy, do you sneeze after . . . all signs that food is inflaming to you!), get sunlight everyday, get a good sweat going most days of the week, drink clean, reverse osmosis water, replenish your nutrients (minerals, electrolytes, antioxidants), eat minimally processed, grass-fed meats, eat organic whenever possible (EWG Dirty Dozen and Clean 15), move your body regularly . . . I could go on and on. Disappointed at the statin push in this video. That's like putting people with weight loss resistance on ozempic . . . there is so much more to do to achieve weight loss than a drug that has known risks and creates metabolic dependance. UGH!!!! Check the thyroid, check the gut, check stress/cortisol, check hormones!

@paulabranson6530 Месяц назад

I sure would like for you to help me. Am 60 yrs old and they put me on 10mg of Crestor I have very low blood pressure my Trie is very low, Total is 234 LDL 159 HDL 70 lipo a is 190. My dad had and his side of family all had heart issues. Should I stay on statins I hate them already only 2nd day. I work out everyday.

@StatzGee Месяц назад

I'm with you. BUT, I think if your bloodwork isn't changing after lifestyle habits have been altered, or numbers are so out of line that you are incurring a lot of damage, it might be tge best route available if there is urgency.

@paulabranson6530 23 дня назад

What is best electrolytes to get

$@braydenfracchia96$

@braydenfracchia96 18 дней назад

I don't think you get it. Go listen to his book

@cheriemiller-kling4654 17 дней назад

I live in a ‘medical community’ and there are no functional medicine doctors if there were my insurance wouldn’t cover. Very frustrating. Like Covid treatment, our experts, have failed us. We live in a pharma world, so sad. Thanks for the information.

@user-vp9hm6bf6c 7 месяцев назад

Please explain why APOB is simply not just a marker? Most everyone I listen to speak of it implying it as causal. Meaning, speak of lowering VLDL LDL for most and Lpa where possible and therefore, lower triglycerides and LDL...lower carbs , low sat fat, fish oil, lots of fiber and statins when necessary.

@dougcane4059 5 месяцев назад

How do you explain the fact that people with higher cholesterol live longer than people with lower cholesterol?

@soylentgreenb 3 месяца назад

That’s mainly confounders and the fact that total cholesterol is a poor indicator of heart disease risk ti begin with. Confounders are things like people who are dying from heart disease being given large amounts of statins; people dying bareöy eating etc. It is difficult to get rid of confounders, but you’ll be all confused if you’re including the people who have low cholesterol because they are dying.

@psarakis340 3 месяца назад

It doesn't help his narrative 😂

@AlwaysSeekingTruth13 3 месяца назад

Dr. Attia isn't pointing the finger at cholesterol; he's saying that high ApoB is casually related to heart disease.

@evramirez87 2 месяца назад

Hello Doctor. I would like to know your opinion about my case. Total Col. 234 / LDL 159 / HDL 64 / Trig. 54. APOB 106. Fasting glucose 90 HgA1c 5,5, Lip(a) 5.1 PCR = 0, Cortisol 8am 9. I do CrossFit and running (8-10h/week). No alcohol, no junk food, regular and sufficient sleep. Weight:67kg 169cm). My LDL never goes down, should I worry? What can I do differently? Thank you

@NAKMUAYACADEMY Месяц назад

What supplements can I take and diet for : Low testosterone Fatty liver Low GH High blood glucose IBS Lack of sleep ( sleep problems for years ) Apreciate any advice

@tama5570 7 месяцев назад

Where does joy come into all of this Peter?

@sectionalsofa 7 месяцев назад

Joy raises ApoB by 25%. Just kidding.

@4plum 7 месяцев назад

Joy from living healthily in to your 90s, if you're lucky 😅

@qilinwang5889 7 месяцев назад

Well you are not a nerd then because I can totally understand the joy of experimentation, getting information and make a bet on best information

@Abby-ug4xc 4 месяца назад

The idea that bingeing junk and living recklessly is the only way to experience joy is one of the most toxic ways of thinking around. Vegetables are delicious, exercise gives you energy and sports provide you with community and fun :D

@tama5570 4 месяца назад

I dont think a single person consciously believes/ experiences junkfood etc = joy...those are just unconscious habits, like many other unconsicous habits. My point is - is Peter Attia experiencing a significant state of real joy? Doesn't come across joyful to me. Living physically healthy into your 90's is of course an ideal....but what about joy? All this health science is great...but I think joy, above just feeling good, is much rarer, much more valuable, and much more needed. @@Abby-ug4xc

@julianalima2751 5 месяцев назад

Hey Doctor, how about the progress of arteriosclerosis after statin use? Do you have concerns regarding that?

@WolverineTraining 2 месяца назад

Thank you Dr Attia. I understand that cholesterol is used for all of the bodies repairs, new cell formation, etc. how do statins affect this process?

@davidking7606 2 месяца назад

I have been doing keto for 3 months to lower triglycerides, as well as taking a lot of Berberine and phosphatidylcholine. My triglycerides did drop from 169 to 147, but my ApoB went up from 119 to 120, and my A1c went up from 5.6 to 5.8. My LDL went from 118 to 134. My Omega 3 is high, and my Omega 6 is within normal range. I have also been intermittent fasting for a couple years, with an eating window between 10:00 a.m. to 6:00 p.m. I am an athlete with under 10% body fat and work out 7 days a week in one form or another, so I do eat a lot of calories. The past few months I have doubled the Salmon, Cod, tuna and sardines. I eat 4 eggs per day and eat lean bison and elk 2-3 days per week, along with non starchy vegetables; i.e. broccoli, culliflower, cabbage, brussell sprouts, spinach, mixed greens, carrots, onions and mushrooms. Any thoughts?

@daviddelguercio8458 2 месяца назад

Your eating way too many carbs. Your A1c indicates you have prediabetes. Blood sugar control is much more important than cholesterol. You need to lower the carbs

@davidking7606 2 месяца назад

@@daviddelguercio8458 Thank you for the reply. I have not eaten carbs in 3 months. No bread, rice, flour, fruits, etc. So that is where I am confused. My triglycerides have dropped 20 points, which makes sense getting rid of the carbs. But my other numbers going up does not.

@jessicagriffin5920 2 месяца назад

@@davidking7606I think you need cut down on the calories overall and do intermittent fasting

@davidking7606 2 месяца назад

@@jessicagriffin5920 I have been intermittent fasting for over 2 years. Usually eat my first meal around 10:00 a.m. (sometimes later), and always eat my last meal by 6:00 p.m.

@AncestralFuel 2 месяца назад

Need to know your fasting insulin to determine your insulin resistance- your pancreas could be working overtime to produce insulin, which could be 10x of optimal- 2 to 3. The way you determine IR is multiply blood sugar by your insulin number and divide that number by 405. It’s called the HOMA-IR calculator. If that score is 2 or above, you are still insulin resistance and need to cut carbs so that the pancreas beta cells can heal. Plant-focused diets always involve eating a lot of carbs so as to get adequate nutrition. My HOMA-IR score is .7 and I the only carb I consume is organic balsamic rice from California. The only thing I want out of the plant kingdom is about 60-100 carbs a day (based on activity). White rice is clean in that organic balsamic rice is mostly free of arsenic and phytic acid with a mild to moderate glycemic index. I don’t buy Peter’s view that saturated fat is bad - a view shared by many doctors and researchers - but has since been debunked in at least one major meta-analysis on the subject. The need to treat number for antibiotics is typically 1, while the need to treat numbers for cholesterol lowering drugs is close to 200 plus for a 70 year old like myself. No thanks I do not want to be one of the 199 who have no impact, only side effects.

@betterplacetobe7896 3 месяца назад

I’m 47 years old, 220 pounds 12% BF, I eat whole food plant, cardio 6x per week 1hr per session, 25000 steps per day, lifting weights for 2hr 6x per week. I use some supplements to complete my diet and I take 10mg Lipitor. Last year I had a CT coronary arteries scan with a calcium score of 0, echocardiogram and everything came back optimal, stress test and I max out the machine. I do bloodwork 3x times per year and my LDL, ApoB and triglycerides are really low. So everything I do work for me.

@chopchopbc 2 месяца назад

Yeah bru , but can you paaaaaaarty!🎉

@betterplacetobe7896 2 месяца назад

@@chopchopbc I don’t need to party it’s useless

@chopchopbc 2 месяца назад

@@betterplacetobe7896 file under “fun at parties”

@robflel 2 месяца назад

@@betterplacetobe7896how about your sense of humour what’s the score on that?

@betterplacetobe7896 2 месяца назад

@@robflel 👎🏻

@haripriya2485 6 месяцев назад

I listened a lot to Attia a few years ago and the way he speaks now about pharma first has me wondering if someone ‘made him an offer he couldn’t refuse’. Seeking opinions on whether this shift is gangstas at work or simply a natural progression of his own journey of discovery. Thanks in advance.

@Icipher4 5 месяцев назад

You mean because he's not a conspiracy theorist that thinks the drug companies are out to get people?

@johnd5941 4 месяца назад

He used to say it doesn't matter if you're vegan and eat vegetables alot . That it was just energy inputs that matter. Now he sits here and says lowering saturated fat intake helps lower your APOb. If higher fiber and less saturated fat intake lowers your ApoB he should just say...eat less meat and eat more vegetables. Yes, big pharma or the meat mafia has him under control.

@juukame 4 месяца назад

I'll admit, I've always valued Peter's knowledge and have taken much of it to heart like zone 2. VO2 max training etc. But the one area that I don't align with is his eagerness to go right for the drug treatment path when it comes to statins and lipid management. I can't help but wonder also if there might be some financial conflict of interest

@Stormie33 4 месяца назад

@@juukame It's very concerning when the evidence for the efficacy of statins is so overwhelmingly weak. They DO lower ldl, no doubt, but the resulting boost in health outcomes is extremely slim. Factor in the potentially very serious side effects and they appear to be a neutral proposition at best. I think Peter is so focused on lowering apoB at all costs that he can't see the forest for the trees right now.

@karoshitv7506 3 месяца назад

@@Stormie33 Actually its the exact opposite. Multiple large meta-analyses have shown that statins reduce not just ldl/ApoB but also real cardiovascular disease events (ie. myocardial infarctions and strokes). The degree to which they reduce CVD events is proportional to their ApoB lowering effect. The side effects for statins are generally overstated, such as rhabdomyolysis, which occurs at around 0.5-13 cases per 1000000 prescriptions. The most common side effect which is muscle pain occurs at around 10% and can be fixed either by trying a different statin, such as a hydrophilic one, reducing the dose, or using another lipid lowering med entirely. I personally take a statin for Familial Hypercholesterolemia and have no side effects. ApoB is unequivocally a causal factor in CVD risk and most people are not willing or able to employ a super strict diet or cutting out all saturated fats to reduce it, which is likely why Dr Attia recommends pharmacotherapy for most.

@MichaelN726 3 месяца назад

What do you think of Fenofibrate to reduce triglycerides ?

@jeffm.8134 5 месяцев назад

We are all different biochemically. I personally do not do well with saturated fat. I was eatin 2 eggs a day and my APoB is about 99 and ldl is 115. When my my LDL is good my APoB is also always good. When I cut back to one egg a day my LDL is usually normal along with APOB.

@peterrecchia6830 7 месяцев назад

If my lipid numbers (including APO B) are within "normal" range, am I likely to have a pharmacological intervention prescribed and then covered by insurance?

@BozzleyOfficial 7 месяцев назад

Are you likely to what?

@wocket42 6 месяцев назад

So you are trying to heal an illness that you don't have?

@peterrecchia6830 6 месяцев назад

if we are looking at illness as binary, you have it or you don't perhaps. If we are looking at it on a continuum no. I already have some arterial plaque, but i have not yet had a negative cardiac event or diagnosis. I would like to keep it that way. @@wocket42

@kevinstarski1598 4 месяца назад

I didn't fall off the turnip truck but relay all this knowledge on us in a simple manner. I tell guys in my line of work to avoid abbreviations, jargon because they aren't meaningful to most people...Don't make yourself sound smart, the goal is to spread knowledge among people and hopefully improve their health (this is in reference to other videos I see out there)

@bearclaw5115 4 месяца назад

Look up the terms if you need to. I have never watched any of his videos before and I knew what he was talking about.

@davidflorez1196 3 месяца назад

There are terms and things that you need to search up to really understand some topic deeply so the audience also need to put some effort, I don't have any back in medicine I'm not a lipidiologist but I can understand most of what is discussed because I search up some terms and I'm exposed to the topic in the media

@knutevids 3 месяца назад

Try NutritionMadeSimple channel with Dr. Gil Carvalho for more user-friendly reviews and interpretations of the available science. He claims no financial ties to drugs or supplements and speaks in plain language about as much as can be expected with this very complicated subject material.

@philipsmith6152 4 месяца назад

Great video, I’m a 64-year-old male in good physical shape. I have familiar hyper cholesterol, I have two stents in the left descending artery which are 10 & 12 years old, my last CT angiogram 18 months ago was clear. I was part of the worldwide clinical trial for PCSK9 Repatha here in Australia, and since then I have been on fortnightly 80 milligrams injections since. My cholesterol levels have not gone down below 6, my question is, you mentioned two other drugs to use in conjunction with Repatha, could you please tell me what those drugs are and what the likely outcomes, might be? Many thanks Phil

@dbpantani 4 месяца назад

Thr drugs lower APO B . The group of lipoproteins that transport cholesterol. Don't focus on cholesterol but rather your APO B levels. Peter is recommending around 30 to 40mg per decilitre.

@philipsmith6152 4 месяца назад

Thanks @@dbpantani

@hypnotiqpits13 3 месяца назад

My Lpa fluctuates 317 to 570 month to month The psk9 inhibitor raised it after 2 months

@cadupradoo 4 месяца назад

I know anedoctes are not relevant, but since Peter mentioned his own, I'll mention mine: I've had a non-HDL of 200mg/dl, which is absolutely high!! I didn't have a ApoB test back then. Now, after 5 years of healthy low saturated fat nutrition, my Apob is less than 50 only with lifestyle changes (non-HDL under 75). It is possible!

@boriszolah3770 4 месяца назад

Incredible! Great on you!!!

@dawngonzalez508 4 месяца назад

Nice! What is your diet like?

@cadupradoo 4 месяца назад

@@dawngonzalez508 since I've peaked the non-HDL at 200 at age 28 with also hypertension, I've done many changes. First I dropped the smoke and excessive alcohol (but still drinked) and started exercising for the first time in decades. Ive cut down on coke and many other ultraprocessed foods and most calories would come from animal protein and fat (low carbo, but no ketogenic) and got to a non hdl of 150 mg/dl (apob of 101 mg/dl), which was a considerable improvement. I've kept the other changes and then changed to plant based diet. One and a half month on it and non hdl dropped from 150 to 74 mg/dl. After one year improving the overall quality (replacing refined carbohydrates for whole carbs and lowering total fat) I got non hdl to 63mg/dl. Then I've decided to be more receptive of poli and mono unsaturated fats and went from a low fat to a regular fat (but still very low saturated fat) wfpb diet, which I've been for a year. The 63mg/dl increased and kept stable at around 75 mg/dl (apo b at 45mg/dl). Sorry for not getting ApoB data at all times, but I didn't know its role back then!

@ngana8755 4 месяца назад

Maybe you should do a video on how you got yours to go lower.

@HisrealnameisLukeFury 7 месяцев назад

Had a recent blood test and I have have a HDL of 1 and my LDL is 3.6 (should be below 3.0). My non HDL is 3.9. Total cholesterol is 5.0 which is just on the limit. My Triglycerides are 0.9 which is excellent. Have never had my ApoB checked so no idea what it issue. My total and LDL cholesterol is quite stubborn & very hard to get down and I don’t know if I should be worried about it or not - there’s so much conflicting info out there. I’m an omnivore and dunno if I should cut saturated fat out completely. I’m very active (resting HR of 41 at 41 years of age!) and find it hard to keep weight on so I’m very reluctant to cut out the animal products completely and become an malnourished skeleton. My sugars and HBa1C were absolutely fine as well, even eating a teaspoon or two of raw honey a day along with other carbs like oats in the morning. The doctor marked the blood test as normal & no further action but I’d still like them to be better than they are.

@zerog4261 7 месяцев назад

Im 55 and am just a tad higher than yourself, so I know your concerns. I've been steady for years and have no history of any heart disease in my family. I think, should I take something but as you say, there is so much conflicting info out there. Ive got a decent vo2 max for my age, still pretty lean and have always kept fit. But...... A dunno, Doc took blood pressure, height, weight and family history and said don't worry about it. As for APOB, I'm from the UK, it's never been mentioned, by anyone. Ive tried private hospitals but doesn't seem to be available

@Sa7biUK 7 месяцев назад

@@zerog4261 Hello geezer. I am also from the UK. You can get it here, but from posh clinics on Harley street. I personally got mine from Budapest. Cost about £15 and the results came in 4 working days. I was in Budapest for work so I managed to get it done on the side no hassle in a state of the art place called 'Medicover'. Hope this helps

@HisrealnameisLukeFury 7 месяцев назад

@@zerog4261I think we’re known as the worried well… The internet has engendered a lot of neuroticism in us all! I’m in the North of Ireland and you’re right, Ap0B is barely mentioned, neither are CAC scans. The Americans commenting on these videos seem to get these tests done quite routinely, the NHS would probably only test these as a last resort. But no problem on private healthcare insurance I would guess. In regards to diet, I’m may have to cut out animal products (I don’t eat massive amounts as it is) altogether to get LDL down, but I’m not really thrilled at the thought because of how feeble & frail vegans always appear. You’re damned if you do & damned if you don’t. From what I see, different diets lower some blood markers & Raise others which makes it doubly difficult. It’s a real mind fuck if I’m honest. I do know I’m metabolically in Good shape, proper weight for height, sugars, HBa1C, triglycerides all in check but it’s the LDL that slightly bothers me.

@Mikolas649 7 месяцев назад

Total cholesterol at 5 is not high, you need it, but trigs are to high for most at. 90

@CallumCornick 7 месяцев назад

Have you ever had your APOE genotype checked? Your numbers sound very similar to mine, and I have recently found out I am E4/E4. So now I’m curious if this is linked, as I’m generally very healthy.

@leadimentoobrien1221 7 месяцев назад

I bought ur book expecting u 2 to discuss med thal minor but u did not. I wanted 2 c if it affects A1C. I read elsewhere it does but decreases it, and mine increased.

@citadelo5ricks 4 месяца назад

Is there a chart/graph of the relationship of saturated fat to cholesterol production? Such that we can understand what is the cost / benefit of saturated fat reduction.

@citadelo5ricks 3 месяца назад

I've come to believe it doesn't exist because it's just not that simple to measure.

@victorbaez3688 4 месяца назад

What do you think about Red Yeast Rice doc?

@AlwaysSeekingTruth13 3 месяца назад

I take it and it's been very helpful for lowering as ApoB. Just make sure you get a brand that actually has the natural statins (e.g., HPF Cholestene).

@diceymaan 6 месяцев назад

Low carb @ low saturated fats is not that difficult if you follow a modifies meditterranean diet. Eat chicken, fish, and lean beef with an abundant amount of olive oil. Olive oil only has 13g of saturated fats per 100g, so you can use it quite freely.

@andyerbz3979 3 месяца назад

My doctor wants me on a Mediterranean style diet now to help bring my cholesterol and ldl down but also put me on 20mg rosuvastatin I told him why not just see what the diet does first to bring it down he says if it goes down along with the diet I will take you off the statins in 3 months time smh

@keithwilkinson5707 3 месяца назад

According to a recent blood test my ApoB was too low. i.e. below the normal range.Any suggestions of a healthy way to increase it welcome.

@AlwaysSeekingTruth13 3 месяца назад

I'd do some research, but I don't think it's a problem if your ApoB is lower than usual. Babies are born with a low/ideal level of ApoB; I'd check out some of Dr. Attia's prior comments on this.

@spdowntown 4 месяца назад

Please point me toward a test that will assess whether or not I have a genetic predisposition to CVD, thanks!

@Lucas_Jeffrey 27 дней назад

Ask your doctor for a referral to a genetic counselor. Looking for: - FH (familial hypercholesterolemia), second most common genetic condition leading to CVD - LPA genetic risk score, the first most common genetic source of CVD

@scasti70 7 месяцев назад

@PeterAttiaMD : doesn't the ratio of LDL towards HDL matter any more, when it comes to cholesterol considerations?

@Seanonyoutube 7 месяцев назад

No.

@wocket42 6 месяцев назад

No. Sales would go down.

@nancyevans5176 6 месяцев назад

Nurse here. You forgot the LDL Particle Count, and the Small and Medium LDL Particle Count. ApoB is very important. Very. But did you know you could have a ApoB of 95 and yet a LDL Particle count of 1600. And Small LDL count double the normal value. This wold be huge on whether or not to be treated. A Coronary Calcium Scan would be needed to discover with those high Particle Counts on whether or not you do have disease. Just saying along with Apoe B get a LDL Particle Count. Google or RU-vid this.

@user-zq3qd8ui5o 6 месяцев назад

Wait, I’m confused. There was a study that examined longer duration type exercise & found that it helped to increase HDL, & that the longer the duration in exercise, the better.

@Tita_jackie 6 месяцев назад

I had muscle pains with 10 mg rsouvastatin. I thought I just lacked exercise

@generalx-ray7833 7 месяцев назад

Peter, have you talked/written about the work of David Diamond, PhD and others who seem to think elevated LDL-C / apoB may not always be problematic?

@wocket42 6 месяцев назад

Doesn't fit his ideology. Can't change your longevity life style by 180 degrees every couple of years or you will lose credibility.

@RogueCylon 6 месяцев назад

He doesn’t want to follow those studies that Dr Diamond believes in. He’s moved away from preaching that.

@karoshitv7506 3 месяца назад

The studies that David Diamond subscribes to are of poor quality and run counter to the overwhelming body of evidence that show that elevated ApoB is causal of CVD risk. Dozens of trial have been performed showing that if you lower ldl/ApoB you lower MI and stroke risk. Peter would be a fool to listen to contrarians who ignore the preponderance of high quality evidence that has been collected over the past several decades on this subject.

@butchgalvez6242 6 месяцев назад

Does MCT oil raise apo-b?

@gordonv.cormack3216 3 месяца назад

So my AboB is 78, through lifestyle. Are you suggesting I should medicate myself lower?

@sugahillind 2 месяца назад

this video was awesaome

@carmenross1077 6 месяцев назад

I thought these negates the principles most doctors I listened to like Dr.Lustig on METABOLICAL HEALTH, most doctors have not ordered APOB TEST TOO. Statins that I used to take years ago very low dose ,the side effects are tremendous in years to the point of one day I’m unable to move my left arm, and NP that saw me that day says Stop the statin sure enough I did. Lo and behold overtime I am able to move my arm. Very scary I was on low dose of statin. Changed my diet to no sugar ,low carb, moderate protein,exercise diligently strength and cardio,resistance band. Doing alright thank God I’m moving my 4 extremities. I like this guy to have a discussion to Dr. Berry, Dr. Diamond, Dr. Lustig,Dr.Hyman, Dr. Longo , tandoori that cardiologist that Dr. Berry spoke to can’t think of his name that sounds like His name Attia hmm Dr. Avenida whose book title stay away fro my operating table.

@bearclaw5115 4 месяца назад

Most of the docs you cite aren't reliable for scientific truth. Some of them cherry pick studies and mischaracterize them to create a marketable spiel they can sell.

@HocDolliday 7 месяцев назад

Repatha & Nexlizet

@zack_120 7 месяцев назад

Blood TG concentration doesn't necessarily go together with LDL/ApoB. My TG dropped below 100 through diets along with vigorous exercises, both aero- and anaerobic, but LDL didn't.

@MT-sq3jo 7 месяцев назад

same boat here… Vigorous exerciser with a generally healthy plant dominant diet, low TG but APOB remained higher than desired at 100. Finally overcame the hesitation and started taking a baby statin/ezetimibe combo - APOB dropped below 70 in 2 months. I’m not telling anyone that they should not try lifestyle changes. But at the end, when all else fails, you have to make a smart decision if you want to keep status quo, or take pharmaceutical intervention.

@zack_120 7 месяцев назад

@@MT-sq3jo 👍 Congrats on the + result and sharing. One thing left for me to try: cut saturated fat intake like lard as I don't have genetic background by lab tests.

@MT-sq3jo 7 месяцев назад

@@zack_120 I would recommend you test Lp(a), which would have been ‘lumped’ with LDL or even ApoB in less sophisticated tests. High Lp(a) is purely genetic and is part of the reason why my ApoB was consistently high despite my healthy lifestyle. Lp(a) is even more atherosclerotic than run-of-the-mill ApoB particles. By the way, my plant dominant (not plant exclusive) diet is automatically lower in saturated fat without trying. Good luck with your journey.

@edsadowski6307 6 месяцев назад

Saying to lower “carbohydrates” is misleading, without distinguishing between good (whole food, unprocessed) and bad (processed, refined) carbs. In other words, eating less broccoli and salads is not what you need to do, it’s eating fewer cookies, pastries, chips, and high-carb bread that is important.

@michaelwatts1186 7 месяцев назад

See I'm getting mix reviews on if APOB being high is a bad thing.... If your other blood markers are in optimal range. Im really trying not to think that many Drs dont know how the lipid suite really works due to the different variances of different diets.

@Valoric 7 месяцев назад

Think triglycerides being high is much more important. Meaning you’re not utilising your energy properly. Cholesterol is a problem when you have crazy amounts, lots of stress or high inflammation. In thirty years imo half or most of the markers we think are important today will be joked about. In twenty years, nutrition has been turned upside down almost from government recommendations.

@HobzyMcRuse 7 месяцев назад

I'm not convinced anyone has a clue of an optimal range. Many low carb athletic types have crazy high LDL and apoB with absolutely no signs of heart disease.

@voksic13 7 месяцев назад

I dropped my ApoB to 0,67umol/L (35ish mg/dL) with fasting, high protein/fat, low carb, weight lifting and swimming. Which one of those is the most important one? I do not know, but my ApoB/ApoA is 0,4. I dropped 25kg in the process (while increasing muscle mass by 2kg). At the age of 42.

@Seanonyoutube 7 месяцев назад

What was your ApoB at baseline before you did all of this?

@voksic13 7 месяцев назад

@@SeanonyoutubeI did not know what ApoB was when I started so I didn't track it :/. I was also more focused on glucose and insulin levels (dropped from 130 to 50) as well as HOMA index (5,2 to 1,9). 2 months after I started (-10kg at that time) I did first basic lipid panel. TG was 1,2 (now 0,5) and LDL was 3,3 (now 2,5).

@Seanonyoutube 7 месяцев назад

@@voksic13 so your baseline for LDL-c was already in the normal range. Seems like you are blessed with great genetics to be able to lower it that much with just lifestyle. Congrats! I could never get mine that low without pharmaceuticals.

@nimblegoat 5 месяцев назад

For those wanting to go keto ( not my style ) by lots of meat , eggs , butter etc - very important to go low carb hard except berries etc - also the main benefit really kicks in when slim - being slim lowers LDL - think no matter the diet choice, getting low triglycerides is always going to help heart and limit other effects - Muscles soak up glucose - and strength exercise can benefit body for a day or 2 , I dropped red meat except as a guest when offered - so more Mediterranean - I think even if ok for heart with qualifiers - I wouldn't enjoy it that much - plus I think need to keep it less processed to avoid say cancer problems ( Cancer data can take decades )- glad you found something that worked for you

@voksic13 5 месяцев назад

@@nimblegoat by BMI metrics, I'm still obese. And yet, my TG and LDL (ApoB too) went to normal before I lost significant amount of weight. And I can raise them with just few days of bad diet, without significant weight gain. I agree, muscles soak up the glucose, and I can see that with CGM and different way my body behaves nowdays, compared to before. I also agree that keto is not necessery, it worked for me combined with TRF/IF/whateverwecallit. And it's not just processed food. I come from one of the mediterranean countries (btw, we eat more meat than fish) and there's not that much processed food; we cook every meal. One exception would probably be bread. One significant thing that I changed in my diet is swapping sunflower oil with what my grandparents used; homemade pork fat and butter (I added ghee too).

@jarsenault6418 3 месяца назад

I am 78 they have me on a statin 40 mg 2 x a day. I don't take them as gave me bad digestive prob. Never been over weight, never smoked, no high BP. Chlosterol and blood sugars always perfect. Been on med diet since age 30. Yet I have calcium in my arteries re a CT angiogram. A bit dismayed. Going to try Vit K2.

@djm55 17 дней назад

Dr. Attia, thank you -- but as a patient, I'm still a bit confused how we should analyze the results from advanced lipid panels. I'm male, in his 50s. For example, I currently have an ApoB of 56mg/dL, which according to this video is in the optimal range. However, my LDL Total Particle Number is 1372, which is "high" according to the reference range (normal is

@sectionalsofa 7 месяцев назад

My jaw drops at the comments below. So many folks are on low carb diets-- keto and carnivore-- and don't know why their ApoB is elevated. What would you expect? A diet high in fiber and phytonutrients and low in saturated fat is the way to lower APO B with diet. Not that it will necessarily get you to goal, but at least it will point you in the right direction.

@flynnoflenniken7402 7 месяцев назад

My diet's basically just in line with the standard dietary guidelines most countries have. Whole foods and minimally processed foods from a variety of food groups (veggies, fruits, grains, dairy, meat) with the bulk of the diet being fiber rich stuff (plants) and saturated fat and sugar being kept at a minimum. I used to eat less fiber and consume more saturated fat, but my parents have cholesterol issues now, and I didn't actually know what causes cholesterol issues or how to prevent it, so I did some research and cut saturated fat mostly out of my diet and boosted fiber intake. Just trying to see if I can avoid some of their problems as I age. My go-to foods are things like rolled oats soaked in milk overnight, beans, peas, carrots, onions, brown rice, apples, greek yogurt, chicken. Fried rice is my main go-to dinner with the rice, beans, other veggies, and chicken because it's easy and tastes good. Overnight oats for breakfast. Apples and yogurt for either snacks or dessert. No qualms about eating less healthy stuff now and then if I'm socializing though. Thanksgiving's coming up soon lol.

@qilinwang5889 7 месяцев назад

Like Peter, I really hate the low carb vs high carb fight, and I think everyone should be nuanced about this. Food source only accounts for fairly small amount of cholesterol, and even though saturated fat causes ApoB to increase we should know that it is particularly detrimental to the hyper-responsive. For the rest it is a cost that must be weighed against the benefits of keto and carnivore, because they do offer unique benefits in other areas. At the end of the day, sugar + high carb is devastating, sugar + high saturated fat is also devastating, if you are eating sugar a lot then the fight on diet style is almost irrelevant.

@reason3581 7 месяцев назад

@@qilinwang5889 A whole food plant based diet lowers ApoB and has no downsides. No reason for keto or carnivore.

@qilinwang5889 7 месяцев назад

@@reason3581 There is plenty of well documented downside such as lack of source of B12 and lower quality of proteins etc. It does not mean that it is not doable, but I hate the lack of nuance and the ideological fervor that is disguised as scientific thinking.

@reason3581 7 месяцев назад

@@qilinwang5889 There is no evidence that a plantbased diet causes deficiency in any essential amino acid. The term high quality protein has no real world relevance. Regarding the B12, most people take some kind of supplement anyway. And a keto diet (not to mention carnivore) will probably need significantly more supplementation than a WFPB diet.

@bryanspencer4856 7 месяцев назад

What about using red yeast rice?

@AlexM-vh2pu 7 месяцев назад

Not regulated plus a lot of supplements out there test high for heavy metals. Keep in mind that statins are made out of red yeast rice. Your better of just taking the statin.

@qilinwang5889 7 месяцев назад

Well China has a local product derived from red yeast rice and it is nothing but a natural form of statin😂

@drshanep 4 месяца назад

Great info, my concern is how to people afford Nexlizet and Repatha both very $$$ meds? You are talking about $1K a month for those.

@drott150 4 месяца назад

Who cares? Attia's bosses need the money. Time to pay up. But if you can't, don't worry. Studies will start flowing right after the patents run out showing the drugs have less efficacy and more long-term side effects than previously reported. And that you should take the new patented drug that replaces the old unpatented drug that finally "fixes" those issues. Rinse, repeat, etc.

@liz9147 3 месяца назад

Don't live in the USA. Live in a society that has socialised medicine and controls pharma costs.

@drshanep 3 месяца назад

yeah...not even possible for billions of people @@liz9147

@jabon112 7 месяцев назад

Thank you- wish you were my doc. I had no idea there were alternatives, my doc just put me on a low dose statin.

@Joseph1NJ 7 месяцев назад

I think we regularly underestimate the influence of diet in managing lipid levels. Of course every~body is different, but you don't need to be vegan or vegetarian, just smart about what you ingest, along with some trial and error.

@Sa7biUK 7 месяцев назад

Yeah but Dr Attia mentions at the start that diet isn't going to do a lot and that statins are necessary

@DessicatedCadaver 7 месяцев назад

And I think we regularly *overestimate* the influence of diet in managing lipid levels. I've had terrible lipids all my life, and no matter what I do with my diet, including vegan, cutting out saturated fats, carbs, monkeying around with low fat, different poly and mono fats and on and on and on, massive exercise, never smoked, with and without alcohol, epic amounts of fiber and so on. Nothing helps. So I really resent the "diet and lifestyle blah, blah, blah" stuff that's repeated ENDLESSLY, everywhere, ad nauseum. NO IT IS NOT ENOUGH for tons and tons and tons of people. That's why we have pharma. Statins help my lipid levels but it's not enough. I can't wait for more and better pharma solutions. I'm happy for those who can manage their lipids through diet, exercise and other lifestyle interventions, but there are vast numbers of us who can't despite our best efforts. When I get my lipid panel blood tests back, there's always a computer generated "advice" from a bot nutritionist "cut out saturated fat". Since I have cut out saturated fat from my diet as far as vegan and beyond for decades now (I try to cut out even vegetarian sources of stearic saturated fat that DOESN'T raise your cholesterol levels!) I find this "advice" highly irritating. It's like when you go to the doc with some issue and they rattle off a string of things to do and not do to solve the issue, and often the biggest one is to "stop smoking" - since I've NEVER smoked and still have the problem I tell them that I'll TAKE UP smoking just so that I can quit smoking and they can chek off the box on their form that says "stop smoking", that way we can move on to real solutions since the problem is still there after "stopped smoking".

@HisrealnameisLukeFury 7 месяцев назад

@@DessicatedCadaverI’m with you. I also think we overestimate the value of diet in managing lipids. Genetics is king.

@Rachel_2112 7 месяцев назад

@@DessicatedCadaverhave you checked for familial hypercholesterolemia?People with it need medication

@Joseph1NJ 7 месяцев назад

@@DessicatedCadaver You've obviously had a lot of experience with your genetic propensity to hyperlipidemia. While your frustration is understandable, it's not in the majority, or so says many experts in the field whose names I'll refrain from mentioning. The good news like Peter said, is statins are no longer the only treatment.

@simonphuket7782 7 месяцев назад

Insane! Still subscribing to the cholesterol myths. I follow the GAPS diet formulated by Dr. Natasha McBride, she regards cholesterol as protective and we do not fear high cholesterol. I recently did a CAC test my results were 0 in every artery. My cholesterol was about 290, slightly higher than usual as I had an infection at the time. I have been doing the GAPS diet for over 8 years. I take no pharmaceuticals and 2 supplements which are food based: probiotics and cod liver oil. I am in my late 50s and was in 0-25% for the CAC test. Good luck with your method! BTW, before I discovered the GAPS diet p, I was probably on my way to a stroke, taking far too many supplements without fully understanding their effects on in the body in particular the microbiome.

@Seanonyoutube 7 месяцев назад

Insane! Still subscribing to the round earth myth (insert anecdote here)

@HobzyMcRuse 7 месяцев назад

I agree. All this modern heart disease tracks perfectly with the SAD diet recommendations from the 1950's. Way too many processed carbs and seed oils.

@llicit1833 6 месяцев назад

Look up familial hypercholesterolemia. These people have lifelong high LDL due to their genetics and can lose decades of life, with the worst form (homozygous) seeing people die in their 20's (ie around 60 years of life lost) without treatment. Seems pretty clear cut and nothing to do with big pharma, greedy doctors and all the usual stuff trotted out

@wocket42 6 месяцев назад

@@Seanonyoutube even a single anecdote like this falsifies the hypothesis that any cholesterol level above a really low minimum is sufficient to create heart disease even at young ages within a short time. Insane is just to pretend it's otherwise.

@diceymaan 6 месяцев назад

There's very few people on the planet who knows more about Cholesterol and Atherosclerosis than Attia, and he is not out here trying to sell you a course, book, or diet. He does not sell the drugs either. I recommend you watch more of his videos to understand how deep his studies are.

@tbrown4762 2 месяца назад

I talked to my doctor about getting these items to lower my ApoB and she was fine with writing me the prescription, but my medical insurance was not willing to pay a cent. The cost of these items was going to be $1200 out of pocket for a monthly supply. This is not reasonable for most people except the ultra wealthy. Does anyone else know of some alternative knock off brands and/or other ways to get access to this? Or perhaps other recommendations in how to lower your LDL and ApoB that don't require extreme amounts of money?

@hccparamedic1985 7 месяцев назад

Does this combination of meds lower cardiovascular inflammation like rosuvastatin does? My understanding is that is also a benefit of rosuvastatin

@qilinwang5889 7 месяцев назад

Saw an article saying that ezetimibe does not pcsk9 does. Basically anything that works on your ldl receptors works; blocking absorption does not

@tommydinob 7 месяцев назад

I’m limited financially. Dropped rosuvastatin from 20mg to 5mg daily. Eat low carb. Run regular release niacin 1000mg twice daily. My numbers are sweet despite the fact that I eat a lot of meat.

@randyalbertsw1992 7 месяцев назад

Rosuvastatin is generic and cheap. I’d suggest substituting beans for meat, lots cheaper and the soluble fiber in means will probably lower apob.

@Joseph1NJ 7 месяцев назад

Yeah, I used to take a lot of Advil for headaches because I was banging my head with a hammer. I still bang my head with a hammer, just slightly less, so I need slightly less Advil. At least they can't call me a meathead. 🍖🍔🥩

@tommydinob 7 месяцев назад

@@Joseph1NJ I don’t get the metaphorical significance of your statement. It infers something is being done incorrectly? Would you be kind enough to elaborate the specifics of what should be changed. I ask in complete earnestness.

@tommydinob 7 месяцев назад

@@randyalbertsw1992 beans are a bit too high in carbohydrates for me these days. For decades I did the low fat, low cholesterol diet thing and never had good labs. When I switched to a very low carbohydrate keto diet, my triglycerides sank (as described by Attia). When I added niacin, my LDL dropped down to 80. HDL is strong. I practiced pharmacy for 30 years. Attia is spot on about the rate of diminishing returns with elevated statin use. A low dose mitigates side effects, and is clinically effective, whilst decreasing cardiovascular inflammation.

@kenhicksjr 7 месяцев назад

Slow carb diet tim ferriss talks about isn't bad. I cook lentils in an instant pot. I'll add a pack of gravy mix for flavor sometimes

@akirby2886 26 дней назад

Sorry what is ApoB ?

@annarebecca3384 Час назад

Apo B is carrier of VLDL and LDL. The ApoB is the car and the cholesterols are the passengers.

@gerard6629 5 месяцев назад

What do you have to say about the new lean mass hyper responder study?

@Sheeshening 7 месяцев назад

What are the names of the drugs he takes? I find it difficult to find the correct spelling with these unusual names

@ep5058 3 месяца назад

Pcsk9, bempidoic acid

@GJJC13 6 месяцев назад

Great info. I have good levels of Triglycines at 49, HDL 73, VLDL 3... BUT LDL 304, Apo-b 177! These bad markers started shooting up since I started a "18 hr/day intermittent fasting", about a year ago to lower my LDL, then at 130. My HDL and Triglyceride levels improved, though. .I'm 66 and weigh 130 lbs since year 2000. Eat all the good fish, olive oil, all color veggies, very low carb, walnuts, almonds, peanuts, no red meat, no simple carbs, etc... How worried should I be, given the good markers? How come my LDL and Apo-B are so bad while the HDL and triglyceride levels seem to be good? Since HDL and Trigl levels are good, might I be OK? I want to avoid the "automatic" statin treatment that my Dr will surely suggest. Thank you. I subscribed!

@giovannigreenard8008 6 месяцев назад

I had my first test back, and I'm the same, all my markers are good apart from LDL, I also fast 18-20 hours a day. I've stopped now, to see if on the next test they drop. Really starting to question LDL as a marker if no family history of heart attacks or symptoms, ill get a better lipid breakdown done and a calcium scan.

@GJJC13 6 месяцев назад

@@giovannigreenard8008 I also thought about stopping the fasting. The whole LDL increase started when I started fasting, but then I read that high LDL is not bad if your Triglycerides are low and your HDL is high. I also read that LDL tends to raise when you start fasting, but then it goes down, but in my case, the more I internittent fast, it seems to go up higher. I've been daily IT for almost a year now, from Monday to Friday. It should have gone down, but went up from 191 to 304! By the way, yesterday I read that there is a correlation of high LDL / heart attack WITHIN patients with high triglycerides, low HDL and insuline resistance. Its like there are 2 schools of thought...

@MartinSKatz 6 месяцев назад

If you took your blood panel while fasted for 18+ hours your LDL and APOB will be significantly elevated. Retake the test fasted for between 8 to 10 hours. Also, check out what Dr. Paul Mason says about higher LDL and APOB.

@newyorkguy158 5 месяцев назад

I think your HDL is high based on something I heard Dr. Dayspring say. He is a lipid expert. He said that HDL at 60 and above is too high and indicates too much cholesterol in the blood. Since I don't know what else you are eating, I would suggest going off intermittent fasting to see how it affects these numbers.

@GJJC13 5 месяцев назад

@@newyorkguy158 Thank you very much. I totally agree with your suggestion.

@bartl.7390 7 месяцев назад

Wait a minute, hold on. I love Peter Attia but I have to disagree here. Low carb doesn't necessarily lower apoB, it's the low glycemic index/load that probably contributes to the actual lowering. Fiber is a carbohydrate and it actually lower apoB. Beans are loaded with carbs and in studies lower cholesterol and apoB along with other sources of soluble fiber.

@Seanonyoutube 7 месяцев назад

Specifically, the ingestion of soluble fiber lowers Apo-B, and the ingestion of high amounts of refined carbs and sugar raise it.

@zsuzsuspetals 2 месяца назад

right. So it's confusing that he's saying to lower carbs in general. He should have been more specific and what tyeps of carbs. And mentioned that things like fiber and beans can actually lower apob. @@Seanonyoutube

@Seanonyoutube 2 месяца назад

@@zsuzsuspetals yeah he’s not very good with the nutrition side of things.

@gtm5650 3 месяца назад

How long will Dr Attia take these drugs?

@oolala53 Месяц назад

I don’t know my ApoB, but recent total cholesterol just tipped over to 212, and LDL-C has risen but triglycerides remain low. I had been keeping saturated fats to under 10% of total caloric intake the last year, and I cut nearly all sugar and ultra processed foods during lockdown and haven’t gone back. That was after eight years of maintaining a 40-lb. loss by moderate means though little exercise. I’m disappointed that he says exercise has a negligible effect on lipids, as after all I have done and cut out, I just can’t see reducing my unprocessed grains and legumes that I feel add variety of texture and satisfaction. With cutting carbs to around 26% of my diet which meant very little grain, legumes, or fruit for around 18 months, my A1c went down by only 1/10 of a point and my LDL-c went up because I was eating more saturated fat foods for variety. I hated it. I never long to reincorporate desserts and most packaged stuff, but much more narrowing of the diet, and I start understanding much heavier people fearing cutting down/out their highly palatable staples. I know from experience with that that I could still experience a lot of pleasure from food without those, but I’ve tried out the alternatives with just regular food by going almost all plants to moderately low carb And it has not been satisfying. I don’t feel better and feel like I’m in fighting invisible battles. When I lost that weight, I was still able to go out to restaurants and do normal stuff, but in moderation that brought my weight down over time. Now I feel like being social around food is like going through a minefield. I worked for years, trying to develop a more diverse social network, but that has proved harder than changing my diet. Ok, enough whining to strangers. Best wishes to all!

@lauriell2297 7 месяцев назад

Are the alternatives to statins that lower Apo B proven to decrease heart disease with certainty?

@wocket42 6 месяцев назад

It's all guesswork and mostly associative anyway. If you want prove, you need to find a human that follows the diet for their life time and lives healthily to 100. As soon as you use "causal markers", all bets are off. No matter what you pretend.

@homerroad 5 месяцев назад

Life on Earth? No certainty. Sorry.

@realfoodcures 6 месяцев назад

High non-hdl cholesterol increases "risk" of heart disease but has no effect on mortality. So trying to keep ldl and apob down is chasing ghosts. Also, seed oils are promoted as heart healthy because they lower LDL yet study after study shows they damage tissue throughout the body including causing atherogenesis. Add to that high fructose sweeteners causing fatty liver and now you have CAUSES. Seed oils and high fructose are causes. High LDL and ApoB are not causes but rather side effects of these causes. Relying on statins shows incomplete understanding of causes and physiology.

@joshydillens148 3 месяца назад

What study’s are you talking about?

@AlwaysSeekingTruth13 3 месяца назад

ApoB is casually linked to heart disease. Just like smoking is casually linked to lung cancer.

@evalpoul1470 7 месяцев назад

My husband had a thalamic stroke 7 mo. ago and he cannot take statins due to rhabdo. We're in Ontario Canada and so I'm wondering if there is a more natural supplement route to explore.

@stevenharris9177 7 месяцев назад

Yes, there is ! It's called The portfolio diet out of Toronto University. Please check it out

@videoagogo1 6 месяцев назад

B3 Niacin (Nicotinic Acid) will reduce Lp(a) by about 20% and depending on your genotype up to 68%

@michaelmurphy2795 Месяц назад

Dr.Attia, As someone who’s trying to improve my life span, I went to my PCP and requested a ApoB and he looked at me like I was crazy. Is there any way that you could create a printable one page explanation that a PCP would be able to understand.

@sabine8419 6 месяцев назад

My grandmother made it to 98. She had terribly high blood fats. She died of complications from a traumatic fracture.

@Seanonyoutube 6 месяцев назад

Did she take any meds to lower them?

@simonround2439 6 месяцев назад

A new Swedish study which followed a group from the age of 65, found that those who made it to 100 had higher average cholesterol than tghose who didn't. So maybe your grandmother's cholesterol helped her reach that age.

@Seanonyoutube 6 месяцев назад

@@simonround2439 did they exclude people with low cholesterol due to medications from that study?

@simonround2439 6 месяцев назад

@@Seanonyoutube They looked at people who lived long lives and what those people had in common from the age of 65 onwards. Two striking things they found were that they had higher than average cholesterol and lower than average blood glucose.

@Seanonyoutube 6 месяцев назад

@@simonround2439 you didn’t answer my question

@johnrobinson4445 3 месяца назад

Short version: use drugs to reduce apoB.

@krisvq 2 дня назад

My father had a severe heart event because of crestor within 4 days of taking it. The issue cleared withing 4 days of stopping it. I'd say there is a considerable risk in taking that. I would try alternative things and meds and diet before I resort to dangerous drugs.

@user-xk9ic5xg6e 7 месяцев назад

What do you feel about taking Repatha mixed with a statin to reduce triglycerides?

@jrkob1156 7 месяцев назад

Statins and Repatha do not have any any TRG lowering power. I have been on both (20mg rosuvastatin and Leqvio, the modern version of PCSK9 that Peter talks about that is being injected twice a year instead of twice a month) for the past 4 month, my LDL has collapsed but my TRG and HDL are exactly the same as what they used to be before. Which is normal, these drugs do not target TRG.