The answer is simple….Lipids don’t CAUSE atherosclerosis. Damage to the endothelial lining of your arteries … repeated damage …. and not enough time to repair the damage…. causes atherosclerosis. People who clot more aggressively are at greater risk. People who don’t have good oxidative stress response are at greater risk. People who are exposed to more toxins (which damage the endothelial lining) are at greater risk….AKA smokers, people who live in polluted cities, people who have heavy metals in their bodies…or glyphosate…etc are at greater risk. And now we are learning that people who eat industrially processed vegetable oils (canola, corn, cotton seed, sunflower, safflower, soy, grape seed oil and rice bran oil) are at greater risk! Lowering LDL is NOT a good strategy. It’s an absurd intervention.
@@KeepYourEyeInTheSky ghee, tallow are the best next to butter. if you must, you could opt for coconut, olive, or avocado oil but they aren't as healthy for you when heated.
@@KeepYourEyeInTheSkytallow, lard, butter, ghee.. all of course, the ruminant animals would need to be fed well.. no soy gmo etc.. grass fed and grass finished. Regardless, still better than veganism and vegetable/seed oils.
Absolutely! Truly appreciate you for coming on the podcast and sharing your valuable knowledge on this important topic. Looking forward to the next one 💪
I’m only seeing, RU-vidrs cherry picking studies to say they are right. We can find studies that say the opposite on any subject. Which means they are untrustworthy and don’t have it figured out yet. We will see these tests adjusted like many others as they learn. Like TSH, D25 etc.
@@LyingEyes-t3mWhen consistent biomarkers are revealed in the people who actually have cardiovascular events, that is the ultimate proof. Dr. Peter Attia did a meta study on this very issue. The study conclusively showed that people with a low HDL and high triglycerides WITH normal LDL had a high rate of heart attacks compared to people with high HDL and low triglycerides with higher LDL The HDL TRIGLYCERIDE RATIO correlates with LDL-P particle size and concentration. They found that larger LDL particles or pheno type A particles correlates to the HDL TRIGLYCERIDE ratio where HDL is high and triglycerides are low. With this type of biomarker, people had very few cardiovascular events....that's 100% proof.
The hypothesis that LDL is coming to the rescue like a "Band-Aid" after the endothelium of the artery has been inflamed by processed sugar, grains, seed oils, and other toxins seems to add up. It is super exciting to watch Dave Feldman's work and these conversations. For most of the people (like me) doing keto and low-carb, as I was eliminating the non-fiber sources of carbohydrates, I was unconsciously eliminating the seed oils and preservatives (and probably some RoundUp/Glyphosate) that come in the packaged grocery store foods. My HDL went up beautifully to 60-70 and Trigs dropped from almost 300 down to 60-70. My Apo B is 93 and LDL is hanging around 120. I hope I'm not hurting myself. Everyone says I look 10 years younger if that counts for anything.
I am 57, female and former smoker. My CAC was a 7. Had a CIMT last week and no plaque shown for cause of disease. My cholesterol has been high my entire life and I’ve never been on meds. I’m a dirty carnivore and once in a while have very small amounts of fruit now and again. Sometimes cooked broccoli some yogurt with blueberries. Wine now and again. Trigs and HDL ratio is good. I was also around second hand smoke my whole life as well. I feel great and will continue to be dirty carnivore. Lowered A1C which was prediabetic when I started in December 2023. Crp good as well.
I def know people who were metabolically healthy and had heart attacks and died around age 50 so idk. This is before I was interested in all this and knew my own ldl is high. One guy sticks out in my mind in particular because I thought he was so healthy, told me he had high cholesterol, and one day I found out he had a heart attack and died in his sleep. This was also pre COVID to take care of any questions about that. lol.
About 20 years ago I was comparing two States. Mississippi which had the highest death rates from heart disease, and Minnesota which had the lowest death rates. Further investigation revealed no statistically significant difference in cholesterol levels between the two States, yet the cardiovascular outcomes were drastically different.
According to Dr Malcolm Kendrick' book , The Clot Thickens, it's not LDL present on plaques. Rather its LP(a) which is almost identical to ldl except lp(a) has an apo A as well as an apoB but everyone sees the apoB and "assumes" it's ldl whereas in fact its lp(a) which means ldl does not and cannot pass through artery wall but lp(a) isnpart of the blood clotting process hence it can be found in the wall
Interesting note... I tried posting very similar facts on "The Proof with Simon Hill" recent RU-vid video (Dietary Fats... EP#326) and my comments mysteriously disappeared. There's some solid 'Proof' right there 😉. Keep up the great work Paul!.... and thanks for all that you do!
Yea and that is the reason why ignore scientific consensus because your comment that most likely got repeated in last 6 years on every video disappeared. Yea let’s believe this non practicing psychotherapist who sells supplements 😂👌
@@peterfialka5315 That's like saying that someone who teaches themselves to speak fluent Spanish, is not allowed to communicate in that language, if they're not a Spaniard! Paul has clearly established that he has the ability to learn to "speak another language"!
@@Iceman_66 then I guess you haven’t heard Simon speak enough. Like for example Simon will not even tell you that you should eat what he does. Like you do you and he just translates science so you can do dietary adjustments regardless the diet you follow
@@Iceman_66 or try someone who isn’t vegan like Nutrion made simple Gil Carvalho. He even spoke with this carnivore guy Ovadia or I am butchering his name but it was debunking in real life
@@peterfialka5315 Gil Carvalho is part of an organization that pushes plant based diet. So no, he is not unbiased, but he is good in making small minded people think that he is. It is very easy actually to play this "you do you, I only report" role while actually pushing an agenda.
No point, Peter Attia is not trained in this area and is wrong about cholesterol and lipoproteins. Paul should get Bart Kay on, someone who actually is trained and knowledgeable in this area.
My wife had a heart attack in July 4, 2024. We rushed her to the hospital, and they were able to put a stent in to open up the blocked artery. She gets a physical exam each year, and the only thing they said was that her HDL and LDL numbers were a little off. They weren't far enough off to put her on any meds or otherwise warn her that she was in any immediate danger. So, how can you know there is a problem developing?
I quit seeds oils a year ago, I am eating very healthy foods, no junk foods at all, no GMO, all organic, and am using beef talow, grass fed butter, EVOO, but my new blood work was high cholesterol and high triglycerides!!! Please can someone explain that to me ?? The doctor was super aware of the blood work results!!!
Can we hear more about low cholesterol and dementia? I've seen there's some information about some statins use connected to dementia. What other effects are there from low cholesterol long term?
I am a 49 year old in excellent shape. 6 feet tall, 180 pounds, 14% body fat, cardio 5x a week, strength training 5 times a week. Been doing that for 20+ years. I had a heart attack at 45 because of high cholesterol. 255 Total and LDL of 191. If any doctor is telling you that lipids don't matter and ldl doesn't matter.... RUN away from them
I have had cholesterol numbers exactly like you all my life. I am significantly older than you. Yet no heart disease. You might be interested in the story of Jim Fixx. He wrote the complete book on running back in the 70's. Very fit looking. Died of a massive heart attack while on one of his runs. He had one major flaw, he was a dedicated smoker. He quit but it was too late. I don't know what his lipid profile was. Sometimes it's another factor aside from lipids. In Jim's case his history of smoking was his biggest risk factor. Even if you don't smoke or never have, there are other risk factors outside of lipid profiles. I wish you the best. Take care.
I think the simple truth is that high LDL + damaged inflamed arteries is what causes plaque buildup and high risk of heart disease. This makes sense of all the paradoxes. Why does plaque never build up in veins? Why are people who just had a heart attack often have low cholesterol? How are there testimonials of people who have plaque and go carnivore then see their plaque REDUCE? Why do populations like the massai not have high rates of heart disease? Why is heart disease much higher than 100 years ago when we ate MORE saturated fat? But when most americans are unhealthy and inflamed, then the correlation would be high. But someone who us actually very lean and metabolically healthy without inflammation is not in the same demographic as most correlation studies on LDL and cholesterol. And we can recignize that statins are a simple way to reduce one of the two essential ingredients for plaque that makes a lot of money. So it can work fairly well and doesnt require giving up processed foods to be healthy.
We ate more Omega 6, thats the cause, not saturated fat. Look up the study „Dietary Saturated Fats and Health: Are the U.S. Guidelines Evidence-Based?„
@@mehranhassan3297 interesting comment. I had not considered that a hunter gatherer society may not have high LDL even though they have high meat consumption
Peter Attia has mentioned, I saw a clip, saying that its not causal but necessary which I think is fair and I think you've echo'd that as well. I think the big disconnect is how much weight you put into things like seed oils and the fact that Peter is very big on using pharmacology to lower his APO-B to levels where you then wouldn't ever have to worry about it. Which I think is fair as long as the short/long term side affects aren't crazy.
That’s the issue though, lipoproteins are under the control of your genes so if your levels are high then it’s supposed to be high. Thinking we know better than our genes and trying to artificially control it seems silly.
@@Coachdh6868LI don’t really like Peter Attia but he is legit persona who really has some voice. While Paul is a charlatan selling you overpriced supplements. Paul cherrypicks studies, picks mechanics instead of outcome in humans. He is a well known clown in the realm of nutrition science 😂
I didn’t do any studies and I found out everybody is going to die. Everybody is different, some lead a clean lifestyle and die early, some lead a “dirty” lifestyle and live into their 90s but in the end , everybody dies. I also found out, without any study, that the outcome of a study will depend on who is paying for the study and for every study saying one thing, you can find another study that says exactly the opposite.
Oh you’re soooo smart. You just do your thing. If you know anything about studies, and clearly you don’t, it’s easy to tell which ones are legit and which are BS designed to sell drugs
No. The graph shows you that when you get below 65 mg/dL of HDL the risk of an CAD event goes up regardless of your LDL. Therefore HDL, as Paul says at the beginning, is an indicator of your metabolic health (not perfect). Low HDL----> metabolic disfunction----> inflamation/ oxidative stress-----> CAD event
Inflammation causes cholesterol to stick to the surface of the vessels and organs. It's the same cascade that occurs when you have a trauma anywhere else in the body. High sugar levels causing microtrauma throughout the body in the presence of high cholesterol causes atherosclerosis.
The traumas actually cause the accumulation of cholesterol from the blood to "patch" the trauma. It's the same mechanism that would occur on a macro-scale for scab-formation if you had a cut on your arm.
Yea and you know what is great? Almost any diet that is not in excess of calories lowers the inflammation so for example going plant based is lowering inflammation as well even though this clown preaches against it. Uf that is some bias right otherwise he would have informed you about this 😂
You put up a graph from Framingham. Even for those with highest HDL, as ldl-c goes from 160 up to 220 you see risk increase by approx 80%. Of course the magnitude of increase will be greater if someone also has inflammation, insulin resistance, high BP etc. that’s stacking multiple risk factors. Your claim that the relationship goes away or is completely different when you have high HDL is wrong - per the graph you showed
I guess the participants of this study were not on a low carb or keotgenic diet? Maybe getting to an LDL level of over 200 on a standard diet indicates some other major issue in the body going on and thus the incease in CVD burden. But yeah, I'd also love to hear a response from Paul here.
If LDL were causal why is the relationship so vastly attenuated, Simon? Yes there is an increased risk, but this is not a perfect study. HDL is only a proxy for IR/metabolic dysfunction, some people in the highest HDL group could certainly have had underlying metabolic dysfunction or exposure to alcohol, heavy metals, and other environmental pollutants which damage LDL/endothelium. The point is that this and other studies which use any metric which approximates insulin sensitivity always show an attenuated relationship between LDL/CVD with better metabolic health. That's not causality, that's association. Yes, LDL/apoB is in the causal cascade but NO it's not causal- does not initiate atheroma.
Paul, I know this is off subject but it being your newest video, i have 2 questions. What do you think of blending instead of juicing? Can you do some study on (Vacuum blending) because im leaning towards that concept and it seems doing it this way takes out the most oxidative stress as well as pumping out air before storage in certain pump lid mason jars. I hear this type of storage can make your fruit juice last up to a week or beyond. I was going to juice but then found that the vaccum blending method seemed more efficient for nutrients and less oxidation. I have seen a technique were you take the vacuum blending mix then use a mesh bag to get more pulp out, thus making more of a juice, but i guess that would be a preference. Thankyou Paul or team memeber.
LDL is the bricks so to speak, but they need a construction worker to actually form a wall, right? In other words, we have to prevent the bricklayers to access the site.
Just everyone be honest with themselves. Stop trying to justify why it is ok to have high ldl. Have the best of both worlds. I am lean and healthy now. I have a high cac because of my past lifestyle and elevated ldl and lpa. So now I manage my ldl down to essentially 0 with psk9 inhibitor. Best of both worlds! Follow keto ish diet with low carb moderate protein and fat balance. Works for life and no need to swing to different approach for my body.
@@rtay0311personal choice. I think it makes sense to eliminate excess ldl in the blood that can hang around and oxidize. My body makes what it needs and turns it over fast. Healthy ldl for my cells. Less risk of arterial damage. Like a baby with low ldl. It only increases in circulation as we age. No benefit to that and likely can be a factor in aging. Works for me so I feel like I have the best of both worlds…fit from proper human diet and no excess ldl. Again I don’t need to find reasons to try to justify excess ldl…off the table as a risk.
Since going Carnivore'rish (low carb, high fat, high protein, animal based diet) over 6.5 years ago I have drastically improved several health issues and markers (A1C, acid reflux, sleep apnea, brain fog, neuropathy, and Triglycerides to name a few). With that, my Total and LDL have also drastically increased. I feel and look better at 52 than I did at 32. No longer T2D and no longer have the crazy issues I had before this way of eating. Is Total Cholesterol and LDL increases outweigh all the good? I don't think so, but my Dr disagrees. Also, my mother had "ideal" cholesterol numbers and had a heart attack and triple bypass a couple years ago. I don't have all the answers, but I'm not buying into the cholesterol scare. I would also love to participate in a study on this.
Why don’t you get Dr Dayspring? He seems to be the only one who knows lipids inside and out is knowledge is tremendous. I have not seen one person that has knowledge of Dr. Day spring in this area.
@@Jeffs60 so the science is settled stains are useless I don’t think it’s is I don’t trust all of theses Drs saying stains don’t work yet it’s going to take years before we know for sure proceed with caution
both my aunts lived to 100 with sky high cholesterol, one ate steaks and a small salad, with a martini each night. Other one was eggs, bacon and chocolate. LOL. They literally didn't eat anything else.
so when LDL-lowering medications undergo FDA trials, do they need to show a significant lowering of a major cardiac event in the patient? And if they do, what is the explanation, given this discussion?
Iam diagnosed dactylitis arthritis i been carnivore diet for 1 month my swollen joints are getting smaller now and i add eat fish for 2 days now i have leegs cramps for 5 days its ok i add fruits to my diet like papaya and saba banana here in Philippines my hometown are abundant of fish also fruits i have autoimmune dieses and iam soo skinny and underweight my height 5'2 male pls help me
Eat more protein in a single meal. Your kidneys require a sufficient rise in insulin for them to hold onto electrolytes. Eating a large amount of protein in a single meal will give you a sufficient insulin rise. Staying strict carnivore will help with arthritis.
@@lorddukesenio8459 They are made up of polyunsaturated fats which cause leaky cells because their structure is weaker and leads to inflammation. You were fine on carnivore and got worse when you reintroduced fish. Stay away from as many polyunsaturated fats as you can.
CAC scores are great and all, but they really only matter if you are over the age of 65. This is because they are pretty much the tip of the iceberg. They only show the calcium that has formed AFTER the plaque has done a number on the arteries. So, if you have a CAC score of zero at the age of 65, if is an indication that you are probably doing okay. At the age of 45 or 50, it really doesn't tell you much. (I had mine done at age 64 and got a zero so I'm not too worried about my high LDL.)
The solution is to not eat any oils at all. No pufa or saturated fat rich oils. All oils are ultra processed foods that cant be found in nature. Eat leaner meat to reduce saturated fat intake. Both saturated fats and omega 6 have a strong correlation with heart disease, and shorter telomere length.
No, saturated fats do NOT have a correlation with heart diseases, look up the study „Dietary Saturated Fats and Health: Are the U.S. Guidelines Evidence-Based?“
@@incrxdible9896 Go and read conflict of interest for this "study" and you will stop trusting it. Authors have recieved money from Nestlé S.A.; Ferrero SpA; Danone, S.A and more. These companies want you to believe that saturated fats are "healthy" as they have a long shelf life and create addictive foods that you come back and buy over and over again. If you dig deeper, you will discover that scientists use coconut oil to induce heart disease in animal studies. I write this to try to help you and others.
@@CanyonMitchell Which part is wrong? I write this to try to help you and others. Oils are not healthy, there are no healthy oils. Just less bad oils (olive oil etc.).
Derek has no idea what he’s talking about. He just repeats anything Peter Attia says because he thinks he’s cool. It’s clear how uneducated he truly is when you listen to him. Using big words does not make you intelligent. He literally makes things more confusing and misuses words trying to convince people he’s smart. Most fall for it unfortunately. I wouldn’t waste my time with him
What is a test to tell you if you have familial hypercholesterolemia? When i get blood work done and my results show high cholesterol and LDL, and HDL, the Dr says it's familial, or genetic.
I want you to look up Bob Harper. People who don’t know Bob, he was the male trainer on NBC’s hit show, The Biggest Loser. Bob was the picture of “metabolic health” (a gobbledygook term). Find out what happened to Bob.
He's an example of just because you look healthy, doesn't mean you are. Outward physical appearance is not an all-encompassing pointer to great cellular level health. Skinny fat is a thing, regardless of how you feel about the term
Calcium score 0 doesn’t mean anything. You could have tons of plaque that hasn’t calcified yet. Calicified plaque is actually safer than non-calcified plaque because it’s more stable meaning less likely to break off and cause a artery blockage. Just saying
My cholesterol is over 300, calcium score over 700 and take no meds and 59 years young. Took a stress test and had zero blockage! Cardiologist said they have no idea why some have blockage and others don't. True story!
A stress test will only detect blockages that are greater than 70%. The most accurate way to measure blockages/calcified plague is through right, or left heart catheterization.
I was told a stress test is not a very good test to determine risk. My cousin passed his just fine and a few years later ended up needing stents. CAC score seems more reliable.
Yogurt in general is good source of nutrients for humans. I would opt for raw yogurt if you can. If not, look for yogurt from pasture raised cows or goats
I have a question what do you know about Caster Oil Cod Liver Oil, can you do a video on this my mom use to take and give us Cod Liver oil everywhere day but we never got sick as kid so I guess I was good for something.
Paul i have FH age of 33 and a cac score of zero do you think i should take a statin? Im worried about this my doctors want to put me on a statin what should i do please help please respond!!
Biological reductionism for all that it has helped to improve our understanding, has truly stagnated us in our attempts to perfect our health. The sooner we dispense with it and focus on the more difficult task of systems biology the better.
I would like to know if people with low LDL also have the same amount of plaque burden on average? So my question is if you are NOT metabolically healthy and have a low LDL, are you still susceptible to plaque build up? So in essence do you theoretically need zero LDL to not have the plaque build up or is there a level where it’s not going to build up?
I would worry about fasting insulin, Lp(a), CAC score and inflammation before worrying about your LDL. Based on the research Mike and I reference, metabolic health is a much better predictor of heart disease. You can be at risk even if you have low LDL but you are insulin resistant.
Cut vegetable oils, eat a balanced diet (mostly whole foods) and exercise. It's quite simple - you don't need to make it complicated. Especially if you're quite healthy already.
Is it possible for you to have a podcast addressing this topic with Peter Attia? It sounds like he’s saying the opposite? A discussion would be helpful to understanding this challenging topic. Thank you for your posts.
And you say this proudly 😂 I wish you good luck because the majority of evidence points towards you having health issues in 20 plus years. But I get it these online charlatans seem very legit while they are selling you supplements
@@peterfialka5315what issues u mean obese people that consume seed oils and anti nutrients multiple times daily for their entire life? My total cholesterol is 400+ and I’m at 9% bodyfat and I feel like Superman and having high cholesterol has been liked to longevity in metabolically healthy people
Eat grass fed and finished meat, fruits and fruit juices, honey, milk, no bread, no alcohol, and exercise 3 hours per week minimum. Never take statins.
No it’s not bird brain. The bulk of the medical community view high ldl as the biggest risk factor to heart disease, and therefor the only thing that matters. Many doctors prescribe statins just by looking at ldl levels
@@logicbomb8977 Also high blood pressure, smoking, alcohol, diabetes, poor sleep… I’ve never heard a doctor say LDL is more important than blood pressure reduction or smoking cessation.
@@logicbomb8977 even if they overprescribe statins and oversimplify their treatment they’re not saying it’s therefore the only thing that matters, it’s multifactorial, that’s the mainstream
I hear the term metabolic health thrown around but what does it mean mechanistically? I’m guessing it has to do With our ability to convert macronutrients into energy (atp)?? I would like to know how metabolic health is measured. We have a lot of proxies but what about a direct test of the root cause?
What I think is interesting is how everyone demands RCT’s. Okay fair enough. The thing is someone has to pay for it and no one will for things like animal based, carnivore, keto. It’s kind of a beautiful system for mega food since they fund everything. Now it’s starting to change but it’s so slow. Also so much of this stuff can take decades to appear so it doesn’t even really matter at the end of the day.
Funded by vegetable companies lol man 😂 uuu big broccoli is the devil. Listen no one ever earns money from you eating more veggies. The meat lobby on the other hand has a potential to change legislation and funds studies on daily basis. So much money is revolving around meat.
Don’t shoot messenger if you disagree, and I would highly recommend just looking one of his videos up cause i may botch this but short answer is plant toxins. We evolved eating meat, fruit, and honey. That last part is for sure true. If you look into vegetables most of the ones we consume today were effectively created in the last few hundred years at the longest where fruit may be larger or more palatable but they’re still the same fruit that existed throughout our evolution. He discovered this experimenting on himself and eliminating his eczema on a carnivore diet but had some problems with electrolytes and testosterone. He added fruit and solved those issues. Remember he’s talking about fruit though. That includes eating things like squash which many think of as a veggie but aren’t. He’s honestly pretty misunderstood. I love his diet and I’ve never felt better. it’s way more sustainable than carnivore (at least for me). Oh yeah I forgot to mention I am biased so again I’d go watch a video on it he produced and then some counter videos to have a full picture. I used to get a bad rash under my armpits that is completely gone now so for me it helped a lot.
go on his website for detailed info with links and studied but TLDR plants develop toxins because they have to survive somehow from being eaten, animals can fight back or run away but plants cannot therefore they go extinct if they cant defend themselves with toxins