I love the content and your channel. In the intro you said “heart disease is preventable.” I’m not sure if there’s a medical/scientific definition of “preventable” that means reduce the risk thereof but if not, it sounds like you’re saying you can prevent it totally which as I understand isn’t something one can guarantee. Perhaps “significantly reduce the risk of” would be better. Help me out if I’ve got it wrong.
I agree with all that. The intent of that comment was that the fact that heart disease is the number one cause IS PREVENTABLE. That doesn’t mean an individual could reduce their risk to zero, but at the population level, ASCVD is very much a preventable cause of disease, which is the most important message for public health! - Gary 🤝🏽
If LDL "causes" atherosclerosis please explain why plaque only forms in arteries and not veins?? The same blood with the same LDL is circulating in the veins back to the heart and you will never find atherosclerosis in veins?? If there is a clear reason for this please enlighten me. LDL is not the cause, it is a part of the repair process yes, to repair artery endothelial damage/dysfunction on the high pressure side of the heart, hence plaque never seen in veins, but it is not the root cause. Show me evidence of plaque forming in a perfectly healthy artery with no endothelial dysfunction. The message should not be lower cholesterol at all costs, it should be to eat a low inflammatory diet and live an active lifestyle, don't smoke, avoid alcohol among other things to help prevent endothelial damage in the first place, then the plaque process will not begin in the first place. LDL is too important to be lowering it, our body makes it for a reason. Why can't the mainstream medical establishments see this when it only takes some logical thinking, please take the blinkers off and look at the big picture.
1.) I’ve discussed this in detail previously re: arterial vs venous circulation, see here - instagram.com/reel/C61Rj-yIEij/?igsh=MWMwNDNtdDFlczNwbQ== 2.) There is indeed plenty of evidence demonstrating an increase in ASCVD based on LDL / ApoB in otherwise healthy individuals without other risk factors. Start with Fernandez-Friera et al. JACC. 2017 Dec, 70 (24) 2979-2991. 3.) This is a strawman. Nobody suggested lowering LDL at all costs. In fact, lifestyle is the first port of call for prevention of ASCVD, but medical management is very helpful too. Are you aware of any cardiovascular guidelines that don’t suggest healthy eating, exercise, smoking cessation etc. as being very important for both primary & secondary prevention? - Gary
@@TriageMethod So why are we not concentrating more on educating people on health and lifestyle instead of hammering on about this diet-heart hypothesis which has never been proven categorically. We all have LDL in our bloodstream from birth, it is essential for our survival, but apparently it's going to kill us if we don't keep it low, give me a break. People need real health advice instead of all this confusion and BS. As I said, eat a healthy diet, don't smoke, don't drink alcohol, stay active and forget about LDL.
@@Richleisa What do you mean? We have a whole channel and thousands of pieces of content across multiple platforms dedicated to education people on how to improve their lifestyle? LDL-particle count is actually incredibly low early on in life, despite this being the period of time that demands the highest amount of cholesterol for brain & neurological development, along with growth more broadly. You seem to have a very simplistic view of this subject that doesn't comport with either the advice provided or the causes of the disease. What would you suggest to an individual who is already eating well, not smoking, not drinking alcohol, fit and lean, but presenting with an LDL-C of 400mg/dL and concordant elevation in ApoB? Can you specifically lay out your management plan for this individual? (They are normotensive, insulin sensitive, no other risk factors of significance)
@@Richleisa Terribly poor advice to tell someone to focus solely on feelings regarding risk for long-term disease. If someone says "I smoke 40 cigarettes per day, but I feel great, in fact I feel better when I smoke", would you suggest that they should get on with life and ignore evidence of long-term harm?
You claim LDL = Atherosclerosis. Associative studies do not prove causation. Please cite evidence of causation. You should make it clear that it is your opinion and not proven. Watch Dr Abs video " Drug Companies Lies: Cholesterol = Heart Disease" for an alternate theory. Also for a lively debate on the issue I'm sure Professor Bart Kay would love to talk live.
Lol first please stop calling him professor 😂that title comes with certain profession which he does not do because he was thrown out of the university. The guy is simply aggressively calling out everyone and disproving everything without explaining anything. That guy is the plague of TH-cam and seriously platforms should consider bans for profiles such as that one. And btw there are tons of research papers focused on causation.
@@peterfialka5315 Professor emeritus, former professor, identifies as professor, doctor that lectured in a university. Whatever. Its the name of his TH-cam channel. Are there tons of research papers that prove LDL causes atherosclerosis? Or are there epidemiological studies that show weak association. And other conflicting studies that show none. And others that show lower all cause mortality in high LDL cohorts. Can you explain why veins don't get plaque while arteries do in specific areas? I'm for free speech. Let me hear differing hypotheses and decide for myself. The Professors content might not be for you, but try the Dr Abs video, its well presented and thought out.
This is pure pharmaceutical propaganda your information is 10 year old . The opposite of what this pharmaceutical propaganda please get your info elsewhere !!
I just updated my Lipidology / Atherosclerosis certification in line with the 2023 updates from the European Atherosclerosis Society, so if you could let me know what’s out of date, that would be helpful…
Great video doctor , what are your views on doctor Berg . He has done many videos about Cholesterol myth and eat butter and lower your cholesterol 😂😂 and he also says that dietary cholesterol has no relation with blood and serum cholesterol
Dr Berg is unreliable on medical & nutrition issues. Butter tends to lead to an increase in LDL-C & ApoB, so that’s patently false. As for dietary cholesterol, the relationship varies, as some individuals (~20-30%) are hyperabsorbers and display a greater response, whereas this is small in most. However, this is not to say there is no relation, this is false. - Gary
@@DrGaryMcGowan Where do I start. You don’t draw a distinction between the LDL fractions, you don’t point to that it is oxidised LDL that is the problem, saturated fats do not increase cholesterol, higher LDL is linked with longevity - the curve is U shaped, statins have a marginal effect on outcomes probably due to their anti-inflammatory effect, a by product of seed oil oxidation (you recommend seed oils) is 4HNE which is a known carcinogen.
@@simonwiltshire7089 Okay, let's take one point at a time. "Saturated fats do not increase cholesterol" - can you provide evidence to support this claim?
I love the content and your channel. In the intro you said “heart disease is preventable.” I’m not sure if there’s a medical/scientific definition of “preventable” that means reduce the risk thereof but if not, it sounds like you’re saying you can prevent it totally which as I understand isn’t something one can guarantee. Perhaps “significantly reduce the risk of” would be better. Help me out if I’ve got it wrong.
I agree with all that. The intent of that comment was that the fact that heart disease is the number one cause IS PREVENTABLE. That doesn’t mean an individual could reduce their risk to zero, but at the population level, ASCVD is very much a preventable cause of disease, which is the most important message for public health! - Gary 🤝🏽
Great video Dr. Gary, hopefully this helps a lot of people!
If LDL "causes" atherosclerosis please explain why plaque only forms in arteries and not veins?? The same blood with the same LDL is circulating in the veins back to the heart and you will never find atherosclerosis in veins?? If there is a clear reason for this please enlighten me. LDL is not the cause, it is a part of the repair process yes, to repair artery endothelial damage/dysfunction on the high pressure side of the heart, hence plaque never seen in veins, but it is not the root cause. Show me evidence of plaque forming in a perfectly healthy artery with no endothelial dysfunction. The message should not be lower cholesterol at all costs, it should be to eat a low inflammatory diet and live an active lifestyle, don't smoke, avoid alcohol among other things to help prevent endothelial damage in the first place, then the plaque process will not begin in the first place. LDL is too important to be lowering it, our body makes it for a reason. Why can't the mainstream medical establishments see this when it only takes some logical thinking, please take the blinkers off and look at the big picture.
1.) I’ve discussed this in detail previously re: arterial vs venous circulation, see here - instagram.com/reel/C61Rj-yIEij/?igsh=MWMwNDNtdDFlczNwbQ==
2.) There is indeed plenty of evidence demonstrating an increase in ASCVD based on LDL / ApoB in otherwise healthy individuals without other risk factors. Start with Fernandez-Friera et al. JACC. 2017 Dec, 70 (24) 2979-2991.
3.) This is a strawman. Nobody suggested lowering LDL at all costs. In fact, lifestyle is the first port of call for prevention of ASCVD, but medical management is very helpful too.
Are you aware of any cardiovascular guidelines that don’t suggest healthy eating, exercise, smoking cessation etc. as being very important for both primary & secondary prevention?
- Gary
@@TriageMethod So why are we not concentrating more on educating people on health and lifestyle instead of hammering on about this diet-heart hypothesis which has never been proven categorically. We all have LDL in our bloodstream from birth, it is essential for our survival, but apparently it's going to kill us if we don't keep it low, give me a break. People need real health advice instead of all this confusion and BS. As I said, eat a healthy diet, don't smoke, don't drink alcohol, stay active and forget about LDL.
@@Richleisa What do you mean? We have a whole channel and thousands of pieces of content across multiple platforms dedicated to education people on how to improve their lifestyle?
LDL-particle count is actually incredibly low early on in life, despite this being the period of time that demands the highest amount of cholesterol for brain & neurological development, along with growth more broadly.
You seem to have a very simplistic view of this subject that doesn't comport with either the advice provided or the causes of the disease.
What would you suggest to an individual who is already eating well, not smoking, not drinking alcohol, fit and lean, but presenting with an LDL-C of 400mg/dL and concordant elevation in ApoB? Can you specifically lay out your management plan for this individual? (They are normotensive, insulin sensitive, no other risk factors of significance)
@@DrGaryMcGowan Get on with life if you are feeling well would be my advice🙂
@@Richleisa Terribly poor advice to tell someone to focus solely on feelings regarding risk for long-term disease.
If someone says "I smoke 40 cigarettes per day, but I feel great, in fact I feel better when I smoke", would you suggest that they should get on with life and ignore evidence of long-term harm?
You claim LDL = Atherosclerosis. Associative studies do not prove causation. Please cite evidence of causation. You should make it clear that it is your opinion and not proven. Watch Dr Abs video " Drug Companies Lies: Cholesterol = Heart Disease" for an alternate theory. Also for a lively debate on the issue I'm sure Professor Bart Kay would love to talk live.
Lol first please stop calling him professor 😂that title comes with certain profession which he does not do because he was thrown out of the university. The guy is simply aggressively calling out everyone and disproving everything without explaining anything. That guy is the plague of TH-cam and seriously platforms should consider bans for profiles such as that one.
And btw there are tons of research papers focused on causation.
@@peterfialka5315 Professor emeritus, former professor, identifies as professor, doctor that lectured in a university. Whatever. Its the name of his TH-cam channel.
Are there tons of research papers that prove LDL causes atherosclerosis? Or are there epidemiological studies that show weak association. And other conflicting studies that show none. And others that show lower all cause mortality in high LDL cohorts. Can you explain why veins don't get plaque while arteries do in specific areas?
I'm for free speech. Let me hear differing hypotheses and decide for myself. The Professors content might not be for you, but try the Dr Abs video, its well presented and thought out.
This is pure pharmaceutical propaganda your information is 10 year old .
The opposite of what this pharmaceutical propaganda please get your info elsewhere !!
Which specific points in the video do you disagree with?
I just updated my Lipidology / Atherosclerosis certification in line with the 2023 updates from the European Atherosclerosis Society, so if you could let me know what’s out of date, that would be helpful…
He removed my responses. 🤣
Lol.
Great video doctor , what are your views on doctor Berg . He has done many videos about Cholesterol myth and eat butter and lower your cholesterol 😂😂 and he also says that dietary cholesterol has no relation with blood and serum cholesterol
Dr Berg is unreliable on medical & nutrition issues. Butter tends to lead to an increase in LDL-C & ApoB, so that’s patently false. As for dietary cholesterol, the relationship varies, as some individuals (~20-30%) are hyperabsorbers and display a greater response, whereas this is small in most. However, this is not to say there is no relation, this is false. - Gary
Completely wrong!
What specific points do you disagree with?
@@DrGaryMcGowan Where do I start. You don’t draw a distinction between the LDL fractions, you don’t point to that it is oxidised LDL that is the problem, saturated fats do not increase cholesterol, higher LDL is linked with longevity - the curve is U shaped, statins have a marginal effect on outcomes probably due to their anti-inflammatory effect, a by product of seed oil oxidation (you recommend seed oils) is 4HNE which is a known carcinogen.
@@simonwiltshire7089 Okay, let's take one point at a time.
"Saturated fats do not increase cholesterol" - can you provide evidence to support this claim?
@@DrGaryMcGowan Here is one. I am not getting into a debate about all of them. pubmed.ncbi.nlm.nih.gov/29914176/
@@DrGaryMcGowan pubmed.ncbi.nlm.nih.gov/31841151/
Even the AHA are supporting my view and not yours.