4:44+ Thomas Dayspring, world renowned lipidologist ~ "ideally apo-b should be 30-40 mg/dL, that's the physiologic level, and for LDL-C the physiologic level would be 10-30 mg/dL. if we could all have lipids at those levels, there couldn't possibly be atherosclerosis, Lp(a) aside".
We should just be getting CT Angiograms and not rely on indicators. CVD correlates, very imperfectly, with APOb. FWIW I eat mainly plants, no dairy (or only fat free), no red meat, huge amounts of soluble fiber, exercise intensely 5 days per week, walk lots, 13% body fat, and I cannot get my APOb below 90.
When comparing this interview to the one with Dave Feldman and Bill Cromwell, Dr. Thomas Dayspring is precisely the guy not to listen to. While the former interview was full of context, nuance and doubt, as science should be, Dayspring offers none. He's got that "the science is settled" mentality that is behind everything he says. He's obviously completely shut off to new ideas that challenge his dogma.
@@zealous.yThis video is a small part of a bigger interview full of knowledge and nuance. Dave Feldman is a citizen scientist with a few years of experience, while this gentleman has decades upon decades of lipid research and knowledge behind him. And apoB is not a dogma,it is a consensus. To put it simply the amount of research and it's quality is so monumental there is simply no chance high apoB is benign. Dave Feldman's research is not capable of destroying that much evidence nor is it designed to do so. The best it can do is provide some nuance to lipid metabolism. Dave himself said he believes the totality of evidence on apoB being a significant risk factor for heart disease.
@@demonfedor3748 you're simply appealing to authority. I know of Dayspring's resume and have listened to hours of his interviews. Fact of the matter is he is an old dinosaur, expert in the minutiae of the science of lipoproteins, but always operating within the established dogma. In contrast, Dr Cromwell is also an established expert, but with a lot more humility as to what we know and what we don't know. There is so much we don't know.
@@zealous.y I knew you would say about appeal to authority,and you are right. It's more about the amount of knowledge and experience dr. Dayspring has on the topic compared to Dave Feldman. That amount of knowledge ( and scientific evidence to back it up)significantly increases the amount of confidence behind claims dr. Dayspring makes. Personally I am a fan of more cautious claims dr. Cromwell makes, however the claims of these two gentlemen mostly match, the difference is the level of confidence embedded in these claims.
@@zealous.y A better question is what _do_ we know? We know that ApoB is necessary but not sufficient for ASCVD. We also currently know that having a low ApoB has no detriment to human health. So the ideal path at this point is to lower ApoB (along with healthy BP, metabolic health) as much as possible to prevent ASCVD from ever developing.
@@TheProofWithSimonHill Alirighty then! Looking forward to the Lp(a) episode. One more thing, since LDL (hence ApoB) goes around the entire loop, arterial and venous.. why is there only plaque on the high-pressure side (arteries), wouldn't it make sense that if it's indeed the LDL that's causing the high risk, then the return path should be "plaqued" as well?
It would seem impossible for the vast majority of humans to reach the ideal ApoB and LDL levels recommended by your guests without pharmaceutical interventions. Should we all just be on statins? Sincere question.
Many an anti aging/longevity scientist type are on low dose statins. Some admit to it, some don't as they don't wanna deal with the BS. I have spoken with them in person on that issue. There's also now non statin drugs that work well with minimal to no side effects, which he mentions in the vid. Major drawback to them now is they're expensive, but for one he mentions. ApoB is key no doubt, addressing other known risk factors (e.g., inflammation, OS, BP, etc) are worthy of attention also. I find Dr Dayspring tends to be a bit dismissal about that aspect, but that's another topic...
@@CharlieFader I don’t think most people are able to get their LDL below 70 even with the most stringent of plant-based diets. I do not have genetically high cholesterol, and my doctors have never worried about my numbers, but my LDL sits around 90, which most guests of this pod would say is problematic. Even when I was orthorexic and eating an obsessively clean diet I couldn’t get below low 80s. When I eat off plan, I don’t go much above 90. I have triglycerides in the 40s and 50s and normal HDL. I know I am only one person, but I have had discussions with many people, all health conscious and interested in this topic, and not one of them has ldl under 70. Do you? I wonder how many people in these comments can say they have while eating a Mediterranean or similar diet, for example. The thinking on this changes every decade. I would need more evidence before I started taking a statin to reduce my LDL below its current level.
I am always amazed how medical doctors used flawed logic to justify al sort of nonsense. Saying that low ApoB in babies shows that low ApoB is adults is OK is similar to saying that not being able to walk is also ok because it is normal for babies.
The argument I get is that low cholesterol will prevent your brain and body development. But babies have very low cholesterol, and their brains and bodies are developing at a much faster rate.
Simon you’re an excellent host, and maybe you know him personally, but don’t you think it’s more respectful to call him Dr. Dayspring than Tom? Just a point.
He’s given me permission to call him either. I still generally use Dr as much as possible - especially if I was referring to him on another show/on social media.
@@TheProofWithSimonHillok, but I wonder did he say that after you asked him…can I call you Tom or do you prefer Dr? Or did he say call me Tom? I’m a nurse practitioner, worked with MDs for 50 years. I certainly call (most of them) by their first name in private but not in front of patients. TH-cam is exactly patients, but still its so public. He might allow it but it doesn’t mean he likes it. Not trying to shame anything thing here, just pointing out something I know from my many years. I’m almost as old as he is. 😂
Looks like the lab you did the test at used different units of measurement. Make sure it is in mg/dL if not use a conversion calculator. To me it looks more like g/L or mmol/L. 1 g/L apoB equals to 100 mg/dL.
@@TheProofWithSimonHill that is practically a flashing neon sign that says *MOAR STATINS!* I would like to see more focus on protecting our vascular endothelial glycocalyx. Running around with our shields down is a recipe for disaster.
Maybe I'm an idiot, but it seems this wonderful doctor actually thinks he's figured the whole answer to stop ASCVD. My counsel is take his advice until he's proven wrong by future science.
Good point. He might be referring to the concept that between birth and five years the growth is significantly more than between 5 and 25 but I could be wrong on that. I know this the physiological and other development before the age of five years, if stunted, mostly can never be rectified. Shame on parents who feed toddlers junk food.
what he meant is that the brain is actively laying down new neurons up through age 5 or so, increasing in size very significantly. beyond age 5, there is relatively little increase in size. toddlers have big heads.
Tsimane have the best hearts on the planet proven by modern medicine /CT scans. Their cholesterol levels are very low compare to us. It might be due to lots of fiber, physical activity, lean meats (wild animals are mostly lean) gut microbiome and also possibly due to worm parasites. Tsimane have LDL below 93mg/dL and total cholesterol below 143 mg/dL
@@kenmarriott5772 he we go again the old high ldl/apo b loop hole comes out again. i would bet in a year everyone on keto is going to be calling themselves a lean mass hyper responder. lol. pretty soon someone will come out with a supplement called the lmrh brotien
I’ve watched several presentations by Dr Dayspring but this one is the best.
He’s a gem
Thank you, Simon. These videos on cholesterol have been extremely helpful.
Glad you like them!
Great video - thank you!
top content!
4:44+ Thomas Dayspring, world renowned lipidologist ~ "ideally apo-b should be 30-40 mg/dL, that's the physiologic level, and for LDL-C the physiologic level would be 10-30 mg/dL. if we could all have lipids at those levels, there couldn't possibly be atherosclerosis, Lp(a) aside".
Thank You!!
What about someone with a liprotein a of only 39 but apob of 127? Which do you defer to?
We should just be getting CT Angiograms and not rely on indicators. CVD correlates, very imperfectly, with APOb. FWIW I eat mainly plants, no dairy (or only fat free), no red meat, huge amounts of soluble fiber, exercise intensely 5 days per week, walk lots, 13% body fat, and I cannot get my APOb below 90.
Same here.93 here but my ApoB/A1 is .64 so very good
@dustinirwin1 you should ask your MD to give you a statin. rosuvastatin (5-10 mg a day) can lower LDL-C by 35-45% according to gpt 4.
@@HakuCell why would I want a statin? Just had a CT Angiogram and, despite decades of “high” cholesterol, I have 0 CAC and no detectable soft plaques.
@@dustinirwin1 oh ok.
CT angiograms emit a non-zero amount of radiation and is very invasive. Just knock the ApoB with drugs if said drugs aren't causing you side effects.
I love this guy. what a mind. also, I love his accent. you can practically determine the zip code he grew up in based on it.
When comparing this interview to the one with Dave Feldman and Bill Cromwell, Dr. Thomas Dayspring is precisely the guy not to listen to.
While the former interview was full of context, nuance and doubt, as science should be, Dayspring offers none.
He's got that "the science is settled" mentality that is behind everything he says. He's obviously completely shut off to new ideas that challenge his dogma.
@@zealous.yThis video is a small part of a bigger interview full of knowledge and nuance. Dave Feldman is a citizen scientist with a few years of experience, while this gentleman has decades upon decades of lipid research and knowledge behind him. And apoB is not a dogma,it is a consensus. To put it simply the amount of research and it's quality is so monumental there is simply no chance high apoB is benign. Dave Feldman's research is not capable of destroying that much evidence nor is it designed to do so. The best it can do is provide some nuance to lipid metabolism. Dave himself said he believes the totality of evidence on apoB being a significant risk factor for heart disease.
@@demonfedor3748 you're simply appealing to authority. I know of Dayspring's resume and have listened to hours of his interviews.
Fact of the matter is he is an old dinosaur, expert in the minutiae of the science of lipoproteins, but always operating within the established dogma.
In contrast, Dr Cromwell is also an established expert, but with a lot more humility as to what we know and what we don't know. There is so much we don't know.
@@zealous.y I knew you would say about appeal to authority,and you are right. It's more about the amount of knowledge and experience dr. Dayspring has on the topic compared to Dave Feldman. That amount of knowledge ( and scientific evidence to back it up)significantly increases the amount of confidence behind claims dr. Dayspring makes. Personally I am a fan of more cautious claims dr. Cromwell makes, however the claims of these two gentlemen mostly match, the difference is the level of confidence embedded in these claims.
@@zealous.y A better question is what _do_ we know? We know that ApoB is necessary but not sufficient for ASCVD. We also currently know that having a low ApoB has no detriment to human health. So the ideal path at this point is to lower ApoB (along with healthy BP, metabolic health) as much as possible to prevent ASCVD from ever developing.
I would've thought Lp(a) would be the concern and not ApoB?
Both are! Look out for a new episode with Dr Dayspring on LP(a) out on the next month here
@@TheProofWithSimonHill Alirighty then! Looking forward to the Lp(a) episode. One more thing, since LDL (hence ApoB) goes around the entire loop, arterial and venous.. why is there only plaque on the high-pressure side (arteries), wouldn't it make sense that if it's indeed the LDL that's causing the high risk, then the return path should be "plaqued" as well?
It would seem impossible for the vast majority of humans to reach the ideal ApoB and LDL levels recommended by your guests without pharmaceutical interventions. Should we all just be on statins? Sincere question.
Many an anti aging/longevity scientist type are on low dose statins. Some admit to it, some don't as they don't wanna deal with the BS. I have spoken with them in person on that issue. There's also now non statin drugs that work well with minimal to no side effects, which he mentions in the vid. Major drawback to them now is they're expensive, but for one he mentions. ApoB is key no doubt, addressing other known risk factors (e.g., inflammation, OS, BP, etc) are worthy of attention also. I find Dr Dayspring tends to be a bit dismissal about that aspect, but that's another topic...
How did you reach the conclusion that it would be impossible for the vast majority of humans? Due to lifestyle or genetics?
@@CharlieFader I don’t think most people are able to get their LDL below 70 even with the most stringent of plant-based diets. I do not have genetically high cholesterol, and my doctors have never worried about my numbers, but my LDL sits around 90, which most guests of this pod would say is problematic. Even when I was orthorexic and eating an obsessively clean diet I couldn’t get below low 80s. When I eat off plan, I don’t go much above 90. I have triglycerides in the 40s and 50s and normal HDL.
I know I am only one person, but I have had discussions with many people, all health conscious and interested in this topic, and not one of them has ldl under 70. Do you? I wonder how many people in these comments can say they have while eating a Mediterranean or similar diet, for example.
The thinking on this changes every decade. I would need more evidence before I started taking a statin to reduce my LDL below its current level.
It’s easy. EAT ONLY PLANTS!!!!!!!!!
@@wfpbwfpb plants are trying to kill us, tho
Mine is even below the normal range. Well, at least I know that i will not die from a heart failure lol
I am always amazed how medical doctors used flawed logic to justify al sort of nonsense. Saying that low ApoB in babies shows that low ApoB is adults is OK is similar to saying that not being able to walk is also ok because it is normal for babies.
The argument I get is that low cholesterol will prevent your brain and body development. But babies have very low cholesterol, and their brains and bodies are developing at a much faster rate.
Simon you’re an excellent host, and maybe you know him personally, but don’t you think it’s more respectful to call him Dr. Dayspring than Tom? Just a point.
He’s given me permission to call him either. I still generally use Dr as much as possible - especially if I was referring to him on another show/on social media.
@@TheProofWithSimonHillok, but I wonder did he say that after you asked him…can I call you Tom or do you prefer Dr? Or did he say call me Tom? I’m a nurse practitioner, worked with MDs for 50 years. I certainly call (most of them) by their first name in private but not in front of patients. TH-cam is exactly patients, but still its so public. He might allow it but it doesn’t mean he likes it. Not trying to shame anything thing here, just pointing out something I know from my many years. I’m almost as old as he is. 😂
Mine 1.056 well less than 10. So not being between 10-30 is bad?
Looks like the lab you did the test at used different units of measurement. Make sure it is in mg/dL if not use a conversion calculator. To me it looks more like g/L or mmol/L. 1 g/L apoB equals to 100 mg/dL.
The physiologic level of ApoB in adults is not 30-40…
Suggested reading:
www.sciencedirect.com/science/article/pii/S2666667722000551?via%3Dihub
@@TheProofWithSimonHill that is practically a flashing neon sign that says *MOAR STATINS!*
I would like to see more focus on protecting our vascular endothelial glycocalyx.
Running around with our shields down is a recipe for disaster.
Can’t argue with a flat earther.
@@TheProofWithSimonHill why don’t we see these low levels of ApoB in even the healthiest of populations? Different countries? ‘Blue Zones’?
@@amueller585 Oh God, "Blue Zones"..
Maybe I'm an idiot, but it seems this wonderful doctor actually thinks he's figured the whole answer to stop ASCVD.
My counsel is take his advice until he's proven wrong by future science.
4:20 Um, the brain doesn't stop growing in size until the mid-late 20's, not when a person is 5 years old. Maybe he misspoke.
Good point. He might be referring to the concept that between birth and five years the growth is significantly more than between 5 and 25 but I could be wrong on that.
I know this the physiological and other development before the age of five years, if stunted, mostly can never be rectified.
Shame on parents who feed toddlers junk food.
what he meant is that the brain is actively laying down new neurons up through age 5 or so, increasing in size very significantly. beyond age 5, there is relatively little increase in size. toddlers have big heads.
@@monikakress3867 ,
Thanks for the clarification.
@@monikakress3867 Or maybe no increase in numbers of neurons? Any neurologist/neurosurgeon out there who can clarify?
High cholesterol has been correlated with longevity. Less stress, adequate sleep, active lifestyle important. Get a CT scan.
That’s reverse causation and discussed in the full length lipid series I did with Dr Dayspring
@@TheProofWithSimonHill Is high LDL of concern to lean mass hyper-responders or is the longevity data is not available at this time?
Tsimane have the best hearts on the planet proven by modern medicine /CT scans. Their cholesterol levels are very low compare to us.
It might be due to lots of fiber, physical activity, lean meats (wild animals are mostly lean) gut microbiome and also possibly due to worm parasites.
Tsimane have LDL below 93mg/dL and total cholesterol below 143 mg/dL
@@kenmarriott5772 The data is not available.
@@kenmarriott5772 he we go again the old high ldl/apo b loop hole comes out again. i would bet in a year everyone on keto is going to be calling themselves a lean mass hyper responder. lol. pretty soon someone will come out with a supplement called the lmrh brotien