Dr. Dayspring is a living encyclopedia for Lipids! People should be asking to have their apo(b) tested. This is the MOST important marker. Thanks Michelle for the post!
Thanks to you and Dr. Dayspring the Combustible Man. For something this complicated I suggest you add a table at the end summarizing key parameters and their limits so we don't misunderstand or overlook.
I’m glad you pointed out the trigs being a harbinger of insulin resistance. Whole foods plant based diet took my trigs to > 500mg/dL with bad blood glucose excursions. Came down to
I stick to whole food carb sources and do just fine. If someone has insulin issues then it is very likely they have excess body fat to lose, since it is pretty well established now that type 2 diabetes is due to reaching the bodies own body fat threshold point, which everyone as that is unique and set by genetics. It is essentially an energy excess issue.
I've yet to see anything convincing. There are studies that show that all-cause mortality increases below a certain point, but they don't control for reverse-causality: essentially very sick people, in addition to other health issues, see a drop in cholesterol levels, and then if they die, it's then counted as a strike against low levels. But there are lots of people with genetically low levels who live long healthy lives virtually immune to heart disease.
Weird. My trigs were over 700 on a diet heavy in meats, eggs and cheese and came down to 275 on a whole food plant based diet. Still too high, I apparently have something genetic going on, but wfpb brought it down vs heavy meats and cheese. My ApoB also crashed from 139 to 68. Guess we are all different.
What is weird about having trigs decrease when not eating much meat? It is what is to be expected, no? I was more surprised when the more plants I ate, the higher my LDL went. Getting tested soon; fingers crossed.
Bravo for getting it so far down!! Progress is progress. Even if you’re not in a safe zone at least it would reduce drug dosage and other therapies, right? And I’m sure other marked are improving. That’s amazing what our behaviors can help
Have you tried intermittent fasting. I imporved my lipid markers just by giving by body a rest from eating. HDL up TRigs down. and on a fatty diet. No sugar, no flour, no potatotes
I'm not impressed. He does not talk about oxidized LDL, as a result of inflammation, which is the problem. The other LDL gets taken up by receptors and/or swept up by HDL. What about the cleasing effect of HDL in the artery wall? Maybe he should listen to Ivor Cummins and other expert like Mike Hansen and Sten Ekberg. I agree with the comments on triglycerides. Very sadly yes (neglected). Because Trig/HDL ratio also a very good indicator of insulin resistence/insulin sensitivity. If your ratio is < 1, your most likely insulin sensitive, and in in a good space.
I'd love to see a discussion between Ivor and Tom. There seem to be a lot of....quacky personalities in the carnivore space, but Ivor seems very solid. I have reservations about LDL/apob being causative and "that's it". There are biased people promoting this narrative ie pharma and vegans. I've seen how pharma has doctored trials ie every single childhood vaccine (they've never even used a fucking placebo lol) I wouldn't feel comfortable with very high cholesterol/LDL like if I were a lean mass hyperresponder. Why not just eat more mediterranean in that case and add some fruit/potatoes/oats to an otherwise low carb diet.
I don’t understand why the hostess said at the end that this was about prevention. There was nothing in here about preventing these conditions. I’m sure that the medical profession could treat them and that’s the reason why deaths from heart disease have actually decreased but I don’t think they’re doing a very good job of having people prevent needing the medication‘s and the interventions.
The medical profession is not about prevention. The medical profession is about disease treatment which is surgery and medication. You must understand the difference between medical prevention and medical treatment. I had a neurologist once snap at me and tell me what did I expect from doctors. He said, 'We do two things: surgery and prescribe medications'. I agree with you that the medical industry is not doing a good job and that is why the number one killer is cardiovascular disease or as it is called the 'silent' killer because most people do not know they have it until it is too late. As for the prevention part that is on you. People need to take responsibility for their own health instead of expecting the medical industry to save them. That is why podcasts such as this are so important. Watch what you eat and have a positive lifestyle and understand what is going on inside your body so you can be captain of the ship.
Triglycerides and HDL are the only useful info from a standard lipid panel. Just calculate your Triglycerides/HDL ratio, using mg/dL units it should be under 2, preferably under 1. This corresponds to a low risk NMR Lipoprofile test. And I believe LDL levels (within reason) are meaningless, and actually levels are artificially set, levels made to sell statins or LDL drugs. Another value that is excellent indicator of CVD risk is VLDL or remnant cholesterol, that should be under 11. He right about Triglycerides being totally ignored, and the easiest to lower by lifestyle diet changes though.
How bloody outdated! Yes, triglyceride levels should be relatively low, HDL should be high, but LDL has subfractions of which only the small dense particles are damaging. I have LDL over 200, but none of it is of small dense variety.
So, the ApoB particles decide to commit "suicide" and hit artery walls once they realize that there are too many of them? That makes absolutely no sense to me. If the particle had the ability to enter the walls, everybody would accumulate plaque. Some particles would enter, the others don't. The more particles the more plaque. I have not heard any explanation how this magical threshold works that makes the particles misbehave. What is the physiological mechanism and cause for that, besides inflammation - which Dr. Dayspring rigorously brushed off in another video.
There is a few different things happening. 1. If there is too much the particles get stuck, like any plumbing system. 2. The body will start storing fat in odd places after a tipping point like in organs and around organs.
My problem with experts is that they don't see the bigger picture. They are entrenched in their expertise. So, are there big ApoB LDLs that are actually "good"? If there are (and I'm sure of it) - then maybe a high non-HDL cholesterol can be extremely healthy in such a person ? What about the long term harmful side effects of Statins? Do they accelerate dementia? Do they promote insulin resistance ? Myopathy - the heart is sort of a muscle as well... What if the person has no inflammation (as in, chronic) and a low blood pressure ? Do you really need statins if you have big ApoB LDLs that are protective and not atherogenic, have low BP and no inflammation? Lowering non-HDL per say is a questionable goal when out of context !!! In my opinion interviewing one person, an expert, is missing the point. If you're lucky, you get a piece of the puzzle right. We need a panel of experts from different expertise to tackle a subject from as many angles as possible. Sometimes halves truths can have a negative end effect.
I think the doc would prescribe a medication ; it’s possible to get it very low but it would take quite a rigorous lifestyle. Even the doc was quite heavy until Attia convinced him to do some serious modified fasting and carb restriction. The doc said he did not have that hard time with the modified fasting, but he was quite heavy when he started doing it. I have done that kind of fasting, and I did not find it easy. I did several rounds of it over a period of years and the last time, I said Never again. I hope my next blood test don’t make me take my words back.
Surely this put the final nail in the coffin for a ketogenic diet that is extremely high in saturated fat. I am on a LFHC diet and have been for the past 18 months, and guess what? My LDL is through the roof 249 or 6.45mmol/L. I have yet to see anyone on a LCHF diet who's LDL-P or APO-B hasn't skyrocketed. And I am fed up with this arrogant flat earther mentality that they are big and fluffy. Well all the science is pointing to the number of them trumps size. I think its time to wake up and see that extremely high diets in saturated fat are just far too extreme. Yes a keto diet does show a hell of a lot of positive results, i.e Lower blood pressure, fat loss, feeling better because you have cut out added sugar, highly refined carbs and highly processed food. But the rise in APO-B with a ridiculously high saturated fat diet simply cannot be ignored. You are literally playing Russian roulette with your arteries. Since yesterday I believe we should have a balance of everything natural. A bit of saturated fat, some mono and some poly, so a bit of meat and fish a few times a week and a lot of vegetables with most meals, the odd potato or apple and some fruit but not tonnes of the stuff. Don't eat massive meals and don't eat too often and don't eat massive meals. Fast randomly maybe 3 or 4 times a month. No highly refined carbs or added sugar and stay away from processed junk. I believe this is a more sensible diet with a bit of everything and all natural
The real question you have to ask yourself is WHY the LDL sticks? The answer is inflammation; LDL doesn’t stick to your arteries for fun, no, there is a cause. Most people who get heart attacks or heart disease are the same folks eating processed foods like sugar, seed oils, carbs and smoking.
Weird, I got an NMR and mine are way better than before. The standard panel just "calculates" stuff (Friedewald formula) - the NMR actually mesures it. HDL went way up and triglycerides went way down. My ApoB and ApoB are also very good. My Doc's not particularly pleased with the diet but is ecstatic over the numbers.
What he's saying isn't consistent with what I observe in my patients. Most of those with heart attacks and strokes have LDL less than 100, and those on statins who's LDL have dropped as low as 30s to 50s seem to get recurrent strokes and heart attacks.
Mega informative! Thank you both so much!
Our pleasure! Thank you for tuning in!
Dr. Dayspring is a living encyclopedia for Lipids! People should be asking to have their apo(b) tested. This is the MOST important marker. Thanks Michelle for the post!
Yes, ApoB, hsCRP and Lipoprotein(a) should be requested beyond the standard lipid profile. Thank you for your comment!
An excellent and brief introduction to the lipid panel - thank you
My pleasure! Glad it was helpful!
❤ thank you very much , Dr.Dayspring!😊❤
Great interview: I took notes. I am finally getting an understanding of what some of these important terms mean.
I am so glad! Thank you for tuning in!
Thanks to you and Dr. Dayspring the Combustible Man. For something this complicated I suggest you add a table at the end summarizing key parameters and their limits so we don't misunderstand or overlook.
Thank you for tuning in!
Really useful lecture. I was able to compare what was said with my lipid panel.
What a great man!
Yes, Dr Dayspring is a wonderful human being and has contributed so much to the field of lipidology. I appreciate and value him greatly.
I wish I could afford to see Dr Dayspring at Dr Attia’s practice. I’ve followed both fir 12 years.
Subbed. Great info for the length of video.
Thank you so much! I appreciate you tuning in!
I’m glad you pointed out the trigs being a harbinger of insulin resistance. Whole foods plant based diet took my trigs to > 500mg/dL with bad blood glucose excursions. Came down to
You can just reduce your carbs a bit and increase your MUFA a bit, that tends to bring Triglycerides back into normal range.
I stick to whole food carb sources and do just fine. If someone has insulin issues then it is very likely they have excess body fat to lose, since it is pretty well established now that type 2 diabetes is due to reaching the bodies own body fat threshold point, which everyone as that is unique and set by genetics. It is essentially an energy excess issue.
@@TruthsSakenot the bodies limit, just the livers limit.
My non HDL is 196 so I tested for APOB and it was 110. Not sure if I should go on statins.
he’ll no
Is it bad, or are there any downsides of having "too low" of cholesterol?
I've yet to see anything convincing. There are studies that show that all-cause mortality increases below a certain point, but they don't control for reverse-causality: essentially very sick people, in addition to other health issues, see a drop in cholesterol levels, and then if they die, it's then counted as a strike against low levels. But there are lots of people with genetically low levels who live long healthy lives virtually immune to heart disease.
More and more research is showing that the lower it is, the better. We need 20-40mg/dL on a biological level so I wouldn't go below that.
@@hearthealthwithmichelle I believe there are studies that use medications to lower it further than that with no adverse effects.
@@hearthealthwithmichelle do you have a source or research showing this?
could you enable automatic english subtitles?
I tried to do so, but the setting do not allow me to do so. I apologize about that.
You can do it yourself. There is an enable subtitles button on the TH-cam interface.
Weird. My trigs were over 700 on a diet heavy in meats, eggs and cheese and came down to 275 on a whole food plant based diet. Still too high, I apparently have something genetic going on, but wfpb brought it down vs heavy meats and cheese. My ApoB also crashed from 139 to 68. Guess we are all different.
Your body weight might have been different between those diets
@@JewStudios yes, each time I lose weight metrics seem to improve. Except cholesterol stays high on meat heavy diets.
What is weird about having trigs decrease when not eating much meat? It is what is to be expected, no? I was more surprised when the more plants I ate, the higher my LDL went. Getting tested soon; fingers crossed.
Bravo for getting it so far down!! Progress is progress. Even if you’re not in a safe zone at least it would reduce drug dosage and other therapies, right? And I’m sure other marked are improving. That’s amazing what our behaviors can help
Have you tried intermittent fasting. I imporved my lipid markers just by giving by body a rest from eating. HDL up TRigs down. and on a fatty diet. No sugar, no flour, no potatotes
I'm not impressed. He does not talk about oxidized LDL, as a result of inflammation, which is the problem. The other LDL gets taken up by receptors and/or swept up by HDL. What about the cleasing effect of HDL in the artery wall? Maybe he should listen to Ivor Cummins and other expert like Mike Hansen and Sten Ekberg. I agree with the comments on triglycerides. Very sadly yes (neglected). Because Trig/HDL ratio also a very good indicator of insulin resistence/insulin sensitivity. If your ratio is < 1, your most likely insulin sensitive, and in in a good space.
Cue the carnivore/keto crowd. SMH
I guess you’ll find out in 30 years. Let us know.
Sure, I'll be 97 then.
I think they should be listening to him. This is just the tip of the iceberg of this man’s knowledge.
I'd love to see a discussion between Ivor and Tom. There seem to be a lot of....quacky personalities in the carnivore space, but Ivor seems very solid.
I have reservations about LDL/apob being causative and "that's it". There are biased people promoting this narrative ie pharma and vegans. I've seen how pharma has doctored trials ie every single childhood vaccine (they've never even used a fucking placebo lol)
I wouldn't feel comfortable with very high cholesterol/LDL like if I were a lean mass hyperresponder. Why not just eat more mediterranean in that case and add some fruit/potatoes/oats to an otherwise low carb diet.
Fractionation test will verify if LDL is pattern A (good) or Pattern (B) bad
Which is irrelevant
Mam I m in 8th month pregnancy ,very high lipid profile total cholestrol 397
Ldl 263😢😢😢😢😢 I m worried plz help
I don’t understand why the hostess said at the end that this was about prevention. There was nothing in here about preventing these conditions. I’m sure that the medical profession could treat them and that’s the reason why deaths from heart disease have actually decreased but I don’t think they’re doing a very good job of having people prevent needing the medication‘s and the interventions.
The medical profession is not about prevention. The medical profession is about disease treatment which is surgery and medication. You must understand the difference between medical prevention and medical treatment. I had a neurologist once snap at me and tell me what did I expect from doctors. He said, 'We do two things: surgery and prescribe medications'. I agree with you that the medical industry is not doing a good job and that is why the number one killer is cardiovascular disease or as it is called the 'silent' killer because most people do not know they have it until it is too late. As for the prevention part that is on you. People need to take responsibility for their own health instead of expecting the medical industry to save them. That is why podcasts such as this are so important. Watch what you eat and have a positive lifestyle and understand what is going on inside your body so you can be captain of the ship.
Triglycerides and HDL are the only useful info from a standard lipid panel. Just calculate your Triglycerides/HDL ratio, using mg/dL units it should be under 2, preferably under 1. This corresponds to a low risk NMR Lipoprofile test. And I believe LDL levels (within reason) are meaningless, and actually levels are artificially set, levels made to sell statins or LDL drugs. Another value that is excellent indicator of CVD risk is VLDL or remnant cholesterol, that should be under 11. He right about Triglycerides being totally ignored, and the easiest to lower by lifestyle diet changes though.
How bloody outdated! Yes, triglyceride levels should be relatively low, HDL should be high, but LDL has subfractions of which only the small dense particles are damaging. I have LDL over 200, but none of it is of small dense variety.
Are you a lipid expert?
@nonsenseish No. Never claimed to be. However, scientific data is available to everyone with an interest.
WHAT DOES DR DAYSPRING EAT???
So, the ApoB particles decide to commit "suicide" and hit artery walls once they realize that there are too many of them? That makes absolutely no sense to me. If the particle had the ability to enter the walls, everybody would accumulate plaque. Some particles would enter, the others don't. The more particles the more plaque. I have not heard any explanation how this magical threshold works that makes the particles misbehave. What is the physiological mechanism and cause for that, besides inflammation - which Dr. Dayspring rigorously brushed off in another video.
There is a few different things happening. 1. If there is too much the particles get stuck, like any plumbing system. 2. The body will start storing fat in odd places after a tipping point like in organs and around organs.
@@Jay-kk3dv Both of which have nothing to do with particles going through the arterial walls.
My problem with experts is that they don't see the bigger picture. They are entrenched in their expertise.
So, are there big ApoB LDLs that are actually "good"? If there are (and I'm sure of it) - then maybe a high non-HDL cholesterol can be extremely healthy in such a person ?
What about the long term harmful side effects of Statins? Do they accelerate dementia? Do they promote insulin resistance ?
Myopathy - the heart is sort of a muscle as well...
What if the person has no inflammation (as in, chronic) and a low blood pressure ?
Do you really need statins if you have big ApoB LDLs that are protective and not atherogenic, have low BP and no inflammation?
Lowering non-HDL per say is a questionable goal when out of context !!!
In my opinion interviewing one person, an expert, is missing the point. If you're lucky, you get a piece of the puzzle right.
We need a panel of experts from different expertise to tackle a subject from as many angles as possible.
Sometimes halves truths can have a negative end effect.
Its all bs. The “experts” get paid to demonize lipids so they can promote bill gates vegan agenda
With due respect, Lipidologist with the very old conventional science ; lagging behind the recent scientific researches ....
LDL under 50,is that even possible without starving ????
Yes it is, it all depends on what you are eating. Not everything we eat raises LDL cholesterol, in fact many things reduce it!
I think the doc would prescribe a medication ; it’s possible to get it very low but it would take quite a rigorous lifestyle. Even the doc was quite heavy until Attia convinced him to do some serious modified fasting and carb restriction. The doc said he did not have that hard time with the modified fasting, but he was quite heavy when he started doing it. I have done that kind of fasting, and I did not find it easy. I did several rounds of it over a period of years and the last time, I said Never again. I hope my next blood test don’t make me take my words back.
Grandpa Munster thank you
Surely this put the final nail in the coffin for a ketogenic diet that is extremely high in saturated fat. I am on a LFHC diet and have been for the past 18 months, and guess what? My LDL is through the roof 249 or 6.45mmol/L. I have yet to see anyone on a LCHF diet who's LDL-P or APO-B hasn't skyrocketed. And I am fed up with this arrogant flat earther mentality that they are big and fluffy. Well all the science is pointing to the number of them trumps size.
I think its time to wake up and see that extremely high diets in saturated fat are just far too extreme. Yes a keto diet does show a hell of a lot of positive results, i.e Lower blood pressure, fat loss, feeling better because you have cut out added sugar, highly refined carbs and highly processed food. But the rise in APO-B with a ridiculously high saturated fat diet simply cannot be ignored. You are literally playing Russian roulette with your arteries.
Since yesterday I believe we should have a balance of everything natural. A bit of saturated fat, some mono and some poly, so a bit of meat and fish a few times a week and a lot of vegetables with most meals, the odd potato or apple and some fruit but not tonnes of the stuff. Don't eat massive meals and don't eat too often and don't eat massive meals. Fast randomly maybe 3 or 4 times a month. No highly refined carbs or added sugar and stay away from processed junk.
I believe this is a more sensible diet with a bit of everything and all natural
The real question you have to ask yourself is WHY the LDL sticks? The answer is inflammation; LDL doesn’t stick to your arteries for fun, no, there is a cause. Most people who get heart attacks or heart disease are the same folks eating processed foods like sugar, seed oils, carbs and smoking.
I haven't known anybody who could tolerate it for long enough to cause lipid abnormalities.
Weird, I got an NMR and mine are way better than before. The standard panel just "calculates" stuff (Friedewald formula) - the NMR actually mesures it. HDL went way up and triglycerides went way down. My ApoB and ApoB are also very good. My Doc's not particularly pleased with the diet but is ecstatic over the numbers.
What he's saying isn't consistent with what I observe in my patients. Most of those with heart attacks and strokes have LDL less than 100, and those on statins who's LDL have dropped as low as 30s to 50s seem to get recurrent strokes and heart attacks.
Evolution? 😂😂😂