Nutrition versus The Lipid Problem: Response Video
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- เผยแพร่เมื่อ 1 ต.ค. 2024
- Prior Response video: • Nuanced Response to Pe...
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I believe Atia is wrong on this.
Attia is wrong about everything…
Indeed, he's a you tube salesmen, the 20 something dude bros love him
He was awesome years ago, but he sold out.
Attia is about the sound bite and selling books. Anyone with a faint knowledge about nutrition would understand that you cannot separate nutrition from lipids.
Suggest Attia use Oreo therapy.
Attia is to medicine and nutrition what Robert Kiyosaki is to finance: good at using jargon and sounding insightful. However when you step back and think about what he's actually saying, you realize that most of it is empty and very simplistic.
Intelligent, rational, polite and logical ... keep it up! I have confidence that wherever the science lands, we will get straight answers within the constraints of the study design. Great job!
Thanks!
Attia has admitted 50% of what he learned in med school is wrong. He can’t see that maybe 50% of what he knows now is also wrong.
I stopped listening to Peter Attia a long time ago.
Attia seems to have talked himself into a position where he's saying effectively eat to avoid metabolic problems, the lipid situation is out of your hands so just take statins to patch it up. The idea that everything else can look good (healthy BMI / waist circumference, low body fat, good blood pressure, good glucose / insulin levels, we exercise and have good VO2 max etc) and we have no apparent health problems, _yet we should be on statins because of LDL levels_ seems deranged honestly and a good indication that something is wrong with the lipid model.
Show me one study which measures insulin while assesing CVD risk...
Yes, this is the part from Attia's reasoning that is most difficult to accept for me, i.e. that you need some drugs even if you are healthy.
Deranged is the right word
To the OP: If the understanding is that high ApoB over the course of many decades is a necessary component of the build up of arterial plaque that causes heart disease, then his assessment is not "deranged" in any way. Just because you seem healthy now, does not mean that if you maintain status quo, you will remain healthy in 30 years. Now, I don't know if Peter is correct, but there is nothing deranged about his thought process on this.
Finally someone who gets it.
A polite yet very hitting comment on Peter Attia. Zero ad-hominems or strawman stuff - one of your most easy to follow. Thats from a very non-science-degreed, but rather tech degreed, uber-"health interested forever" retiree. I've struggled to keep up with your points from the first vid of yours I saw. The effort has been amazingly productive for me. You three: You, Dave Feldman, and the big-shot heart-imagining Doctor who lead the "big drop" study - all of you have been truly impactful to me on my "ketovore" path.
Thank you very much!
As a person at 56 yrs. old, with CAD from a lifelong SAD and moderate unhealthy living, I can say that I have done the whole pharmacological regime diagnosed and recommended by the standard medical industry. This included weight loss (BMI 22.3) and eating the suggested Mediterranean Diet. I can say as an (n=1) experiment, I was never so sick as when I was on the prescribed statins and even sicker on the pcsk9 inhibitors. It wasn't until I took my health into my own hands, I stopped the prescribed drugs and started eating a zero-carb high fat animal product diet. This is when I was becoming healthier. I can literally feel and see my body becoming stronger each day, with so much more energy that I hadn't felt in 30 years. I have gotten rid of a multitude of physical problems on this diet, too many to address here. And yes, my cholesterol is extremely high according to standard medical numbers.
I don't have any idea how much longer I might live on this diet, but even if it is for only a month it is still a thousand times better then living the way I felt with the standard medical interventions. I know that food is the real medicine and Nick and Dave are on a path that I'm willing to bet will show this to be truth. Thank you, Nick.
So you gave up the meds AND the Mediterranean regimen when it was ‘the meds making me sick’ and switched to the high sat fat?
The Mediterranean eaters are the longest lived with fewer medical interventions. Peter Attica himself has ditched the low carb lifestyle.
A lot of people are pretty invested in non-nutrutional solutions to the lipid problem...
That's probably the dumbest thing I've ever heard Attia say, and he says a lot of super arrogant, dumb things.
I've followed Attia for a quite long time and would never have him as my doctor. Why? Here are some reasons:
1) He is fashionably faddish. For a long time, he was big on rapamycin, then big on Metformin. But when gets on a fad, he goes religiously whole hog. This is evidenced by he admitted that he overdosed on Metformin and got very sick. You can also see it in his exercise: First body building as opposed to weightlifting. Then swimming. Then cycling. Then intermittent fasting. Then fasting. Now it's Zone 2. Sure it's fine to change your mind in the face of new data. It's not OK to experiment in ways that risk damaging health and broadcasting it to millions of people.
2) He is glib in a calculated, rehearsed way to sound more informed and intelligent than he is. See him when he hasn't rehearsed and he's more likely to stumble on his recitations of biochemical pathways and other near facts.
3) He thinks of himself as a superb cardiologists and gets into dueling debates when he gets one on his shows. He knows more about APoB than anyone on this face of this earth. Just ask him.
4) His shows are elaborate, time consuming and voluminous. I don't know a single practicing doctor who would have time for this. Is he a doctor or is he an influencer? Those are remarkably different things.
Absolutely, just treating LDL separately is treating a symptom and not the ultimate cause so you still have all of those other issues surrounding insulin resistance, and poor metabolic health…
Absolutely. This is where modern medicine is going for a long time now: Spot a marker you can measure - Spend millions developing patentable drugs to lower the marker (while disrupting the patients' health) - Sell the drugs to make a lot of money - Sell other drugs to treat the first drugs' side-effects to make even more money - Marker fixed, health problem persists - Back to step one
@@NimrodGilAd,
You got it.
From a fat family, when few were fat, despite huge amounts of exercise I was fat most of the time till I was 62. I cut sugar out of my diet and lost 20lb but continued to be plagued by depression. After a slow regain of 7lb I went on LCHF and the magic happened. I lost all my excess weight and have kept it off for almost 10y AND my depression disappeared and has stayed gone.
This is my point. The nutrition problem and the depression problem were the same problem. A nutrition problem.
It is also probably true for the lipid problem and the nutrition problem. The same problem. I wouldn't be at all impressed by Peter Attia. It's not anything he's done, but he has just as much right to be wrong as any other doctor!
The fact that Attia will not have a conversation with you on this, tells all. Hard not to imagine a financial incentive behind his current views… I find more and more that social media is becoming like mainstream media in that it elevates these so called gurus (and there are quite a few of them) by giving them a platform to push a certain narrative without the rigour of scientific ‘or even common sense’ debate…. Thanks for your take on these views!!
He's a rando with 14k subscribers on TH-cam. Peter probably doesn't even know this guy exists, y'all need to calm down.
I think Peter Atia gets more credit than he deserves.
He is just a talking head albeit with larger than average active vocabulary.
That's it. No more, no less. The same goes for Ronda Patrick.
Personally nowadays I try to avoid both of them.
I do find it disappointing Peter feigns 'trying to understand' the nuances I'm trying to draw, while overlooking them and not replying to my messages (on X or email).
I was quite a fan of Peter Attia, but I think he has run out of ideas.
@@neatengineering@tiredlookingforname I concur.
Happy to donate some of mine for the cause ;) @@neatengineering
@@nicknorwitzPhD,
Cognitive dissonance will make it hard for those who would benefit most from your contribution to accept it. Or, as Mark Twain described it, "It is easier to fool someone than to convince them that they have been fooled." Thank you for the work you are doing.
When you see Attia make these statements you have to wonder is there some pharma funding hiding in his closet. He seems to be playing to the average person on a SAD diet who want to believe the problem is beyond their ability to resolve so just give them a pill.
I did find the statement that he'd rather fake a grand mal seizure than talk about nutrition ~14:21 in @plantchompers video review of his book shocking
You don't need pharma if you are brainwashed by Thomas Dayspring.
Agree! My thoughts as well
@@nicknorwitzPhD Yeah, Peter Attia is more about fitness and weight training. He does attempt to learn about and maintain healthy nutrition, but reluctantly. He likes his lean jerky. Have you ever attempted weight training? It's also good for health and longevity. Or do you believe gyms are a waste of time?
Atia continues to be debunked..
Peter Attia is not the type of person who is interested in being proven wrong. You might as well be yelling at a fence.
Nickolas, I am just a laymen in this field but I can read. What makes sense to me looking/reading from the outside - Endothelial failure, causing a clot that leaves a scar that the endothelium grows over. Repeated injury in this area will build layers of scars called plaque. Similar to Sickle cell children who live to 9 or 10 and are riddled with plaque. Plaque is the remnants of a clot, including LDL Not because of LDL. Also, nitric oxide deficiency that many people have... how can that affect the endothelium? Put people into hypertension perhaps? That and constantly elevated insulin leading to water retention and increased hypertension? Keep the blood pressure low and exercise, don't smoke. Perhaps your arteries will escape damage.
As far as Peter is concerned, If he does not support the LDL narrative he will be immediately shunned/canceled by the big money/power protecting their rice bowl. And perhaps decades of deceit. Getting people to change their diet is like dealing with addicts, good luck with that. This also could be in Peter's thinking.
I think the study and your model/experiment are both applicable, our genetics/systems when faced with constant abundance and unknown food/chemicals react unpredictably. In ways that do not make sense. The charlatans can take advantage. The real test is elimination diets stripped down to adequate but basic (whole food ) nutrition. Alas, such a study over along term will never happen or be pulled off with accuracy. So we sit in this morass, where the only help is self help.
this is pretty much my hypothesis as well
Yes, self help indeed.👍
Self help is the best help but many r too lazy or too stubborn to change their lifestyle despite the fact it is slowly killing many. Get more active and eat more whole foods seems to be a pretty easy thing to understand and do but many just "do not do"
I’ve been listening to Peter for many years. He can be a big jerk at times. He’s been working on not being “the Doctor that gives Doctor’s a bad name”. He interviewed Dave Feldman a few years back. Prior to the broadcast, he gave a long preamble on why he disagreed with Dave. This was before he played the interview. During the interview, he kept asking Dave the same question and Dave would simply say, “I thought that I answered this for you”. I lost respect for Peter after that interview.
Yep. That was the point in time I realized Attia has an agenda and doesn't play fair. His treatment of Dave was entirely disrespectful and underhanded.
Yes. I unsubscribed as well.
When I discovered keto there were not many people talking about it, dom dagostino, Tim Ferriss, Robb Wolf, Peter attia (later I discovered as delauer berry). The moment Peter treated Dave so badly I lost all trust….
Seems like Atia is doubling down on his love for Thomas Dayspring
My triglycerides/hdl ratio used to be 5, now it is 1 thanks to my changes in nutrition. Keto diet has been amazing. I'm a LMHR. I'm happy with my high LDL I never get viruses or infections anymore.
Same, when eating low carb, not even talking keto level, my trigs dropped down to 47 and my ratio 3.0. I eat a lot of eggs.
Dang, that's good. What's your HDL in absolute terms?
Yes I decided this month to increase my carbs so I could try and reduce my LDL a bit. I got my LDL down to 290. I got sick only a few days in. Hadn’t been sick in almost 2 years. Definitely not worth it. Not doing that again!
@@truehealth992 You figure the increase in carbs made you sick?
@@buckjones4901 Yes I do. And I ate relatively healthy carbs. A whole orange and pumpkin. I used to get sick all the time before keto. I was trying to make my regular Dr. happy. Plus my joint pain came back again. Pain is starting to go away again now that I've reduced my carbs. My quality of life is more important than labs.
Peter talks like a politician ... full of you know what.
I went from feeling shit mentally and physically on a ‘whole’ food plant based vegan diet to 100% carnivore, solely grass fed ruminant meat, pastured eggs and sardines in water. My triglycerides halved, HDL doubled, LDL also doubled to 273. Was already lean though pudgy in the midsection, lost fat, increased muscle, feel massively better, yet my doctor wanted to put me on statins.
You can never parse Attia's words. Even he doesn't
know what they mean. He's a clown.
P.A. is gifted in speaking nonsense in a very impressive, noble way.
What did he say that was nonsense? Specifically which claims?
Nicholas - I'm counting on you to debunk the lipid theory of Heart Disease that has been so profitable for the pharmaceutical industry.
A lot of people say statins have severe side effects. Did you have any?
Since reading The Clot Thickens by Malcolm Kendrick I don't pay much attention to the Attias of YT. They will have to provide more mechanistic evidence of how LDL can injure endothelial tissue.
This is very threatening to the income and bottom line of the lipid/cardiology industries multi-billion dollar industry not to mention the Pharma industry. Big Food based on carbs/sugars multi-billion dollar industry is at stake here!
Nutrition trumps medical intervention. It is much fast. The effect are nearly instantaneous. Drug therapy is hit and miss, and very often takes several years to decades to make any real difference.
Take type 2 diabetes. By giving up all, and I do mean ALL carbohydrates, diabetes just goes away.
I use myself as an example.
I was diagnosed with type 2 diabetes in August of 2017. At Dx, my blood glucose was 594, with an HbA1c of 11.8%. After six hours in the ememrgency room my blood glucose was bought down to 300. I was allowed to leave at that time. After one month of medical directed diet and drugs (metformin), my average daily BG reading was 250, measured every hour. I sat not on my as this entire month. I studied. I read everything I could about type 2 diabetes. I discovered two schools of thought. One was fat caused, the other sugar caused. I went with sugar as being the problem, seeing as my blood sugar was the problem. On October 1 of 2017, I went cold turkey on all carbohydrates. Carbonongrata. Full on carnivore. The next day, some 30 or so hours later, my BG had dropped from 250 to 85 measured every hour. Non diabetic levels. Not even pre diabetes levels. GONE! This was later confirmed at my 4 month follow up as having and HbA1c of 5.5%. Cured. A change in nutrition is all you need to do sometimes. And it works much faster than medications.
I have followed Peter for years and it is interesting to watch his evolution. As he has gained popularity and increased lifestyle costs., he seems to be moving more towards a conventional approach given that it expands his audience base. I did not appreciate how he treated Dave Feldman in a podcast. Dave is plowing a new path and I think it threatens the conventional approach of which Peter is increasingly embracing, It’s hard to fight the system - it can hit you in the pocketbook, I do appreciate some of his work around TRT and other longevity subjects. But, as it related to the whole LDL-is-the-main-causal-factor-in-heart-disease argument, I think he has gone over to the dark side.
I also seem to lose what respect I had (and I had a lot) for Peter Attia.
The whole notion of treating what is unequivocally a lifestyle problem with drugs, is simply appalling. Lifestyle problems should first and foremost be treated with lifestyle corrections. Only when that is impossible or rejected for good reasons, should drugs (and/or supplements) be used, carrying the obvious warning that this is a suboptimal treatment that carries potential negative consequences.
LDL does NOT cause heart disease. Bad (SAD...) diets do. Eat right to live right (or simply to live).
- it's becoming common knowledge that atherosclerosis is caused by injury to arterial wall when deficient in vitamin c for collagen synthesis, then lipo a patches it, and then if you have too much inflammation the clot grows over time.
- Thus the four major risk factors are thick blood viscosity, lack of arterial elasticity, too much oxidation, and hyper inflammation.
- Linus pauling insisted that high doses of vitamin c would prevent and in combination with certain amino acids even heal atherosclerosis. Because it keeps the arteries collagen rich and elastic and able to repair damage.
- Others see tocotrienol vitamin e as the second most important way to avoid atherosclerosis. As vitamin e lowers blood viscosity, is the antioxidant in the oil part of our cells, and prevents blood clotting.
-Others see chelation with edta to remove arterial calcification (stiffening) and lead (huge oxidant load and another highly correlated data point with atherosclerosis) to be the third most important factor.
-Some see methylated b vitamins to combat homocysteine levels to be vital.
- And finally, there was the whole blood viscosity cure where it was recommended to give blood every two months to lower blood viscosity. That guy.. .kinsey.... died from his blood getting too thin however and getting a brain bleed. He was taking aspirin I believe at the time.
- So if I had the time and a perfect world I would take liposomal c and tocotrienols every day, get chelation once a year, and donate blood maybe every three months. Prolonged fasts also trigger healing of the vascular system through ketone signaling.
- I feel that this entire lipid fixation is a red herring by pharma. It's all downstream of the actual mechanisms. It's the same with inflammation. If you crush my knee with a hammer, the proper response is not to get rid of the pain and inflammation with drugs and leave the injury to fester. The proper thing to do is fix my knee and after it heals there will be no need for anti inflammatories and pain meds. Any intervention that is focused on changing blood lipids directly almost feels like superstition... the links and mechanisms are so weak. If metabolic diseases cause messed up lipid levels... directly intervening to change the lipid levels won't help the disease. The person will probably be worse because the lipids were an adaptive response by the body. That's my gut instinct. I know, in some indirect ways changing lipids and statins can help certain factors... but I'd rather just have a good metabolism and clean arteries.
There has been no mention of Lp(a) in any of these LMHR discussions. I’m confused how this very important biomarker that is obviously closely related to a “standard” LDL particle is never discussed. Obviously as someone with high Lp(a) I would love the topic to come up.
Every human being is born in ketosis
but everywhere they are in carbs
Elevated LDL-C in the general population is just a symptom of defective mtiochondria in the liver spilling out large amounts of citrate.
Citrate is then converted into AcetyCoa in the cytosol which then can be converted either into fat (triglycerides) or into cholesterol which both are pushed out of the liver in a (V)LDL particle.
All of this is just a symptom of high insulin ⇒ mitochondrial dysfunction. That is also what actually causes atherosclerosis.
I don't know if this is true for individuals or not, but this provably incorrect at the population level. If what you're saying was the case, you would never see CVD outside of cases of insulin resistance. There are hundreds of studies that control for insulin resistance and still find incidence of CVD. Is insulin a high risk factor? Yes, certainly, but it's not the only risk factor. Mendelian randomization studies have shown us explicitly that absent insulin resistance or type 2 diabetes people can still develop CVD with high ApoB.
Just a few of many studies that directly contradict your assertion:
PMID: 36640254 - Insights into Causal Cardiovascular Risk Factors from Mendelian Randomization
PMID: 33131310 - Association of Cardiovascular Risk Factors and Lifestyle Behaviors With Hypertension: A Mendelian Randomization Study
PMID: 34911345 - Cardiac Risk Factors for Stroke: A Comprehensive Mendelian Randomization Study
PMID: 36303257 - The relationship between lipoprotein(a) and risk of cardiovascular disease: a Mendelian randomization analysis
@@nichtsistkostenlos6565
"If what you're saying was the case, you would never see CVD outside of cases of insulin resistance."
Yes, that is correct.
"There are hundreds of studies that control for insulin resistance and still find incidence of CVD."
Wrong.
"Mendelian randomization studies have shown us explicitly"
No. Mendelian randomization is the same BS as any epidemiological nonsense. It cannot infer on causation...
Thank you, Nick. This is a much needed discussion on many levels. I hope Dr. Attia will agree to engage with you and Dave, in view of his “encouragement” of Dave in the early days of the LEM hypothesis to “go and learn more about lipidology” in the podcast episode of 2018.
Dave definitely stepped up!
@@nicknorwitzPhD He certainly has!
Yes, I hope Dr. Attia responds and helps make Nick a youtube sensation. Nick has definitely been reaching out to all the youtube celebs for more exposure. He'll have 100k subs in no time.
I appreciate the work that’s been done for the LMHR phenotype, but I struggle with how this relates to others. For example, I’m an ApoE 4/4 which supposedly means I don’t manage lipids well at all and have a 50-90% chance of getting Alzheimer’s. My genotype variant is only 1-2% of the population. So, does lipid management require a customized approach where each person has to know the details of their phenotypes/genotypes? I’ve got cardiologists telling me to go on statins, Carnivore doctors telling me to eat as much fat as possible to feed my brain, and functional medicine doctors telling me to eat a Mediterranean diet low on saturated fat. I’m exhausted at all of the information and wonder how anyone can make sound decisions on nutrition
For me personally, having tried various low fat and calories restriction diets, which ultimately didn't work and just led to weight regain; on carnivore I can now turn down junk food completely, I've lost 50kg, my blood pressure has dropped to 120ish from 148ish. The benefits to my risk profile far outweigh the small potential risk from LDL even if you believe LDL is at all a risk in the first place. I may never completely heal the damage from my old diet, but I'm comfortable I've made the best choice going forwards, I'm completely convinced that LDL is only associated with heart disease in combination with a high carb diet and that it's the high carbs causing the damage, not the LDL.
I'm 3/4 and am paying the price for decades of the SAD. When I get confused I think about how my northern European ancestors ate for the preceding thousand generations. Then I cook ruminant meat.
Back when I was a typical person who get my information from the mainstream media, I was so afraid my husband had high LDL and his maternal grandfather died from a heart attack as well as having his mother survive a quadruple bypass, I gave him some red yeast supplement to lower his LDL. He is an avid runner and can still run a mile in 5 minutes in his 50s. He told me that he doesn't feel good; his muscles was hurting. I knew immediately that it was the statin like supplement I gave him. We later change our diet and we are both LMHR. I've learned enough being in this lifestyle for 6 years. He is an apoe4/3 and I'm 3/3. We took CAC score 2 years into keto and both scored 0. What we check annually: We check our inflammatory markers (hsCRP and homocystein), NMR lipid profile, and we've always had triglycerides/HDL ratios less than 1. Our ALT/AST are in the teens. We don't worry about LDL, but we prefer all our markers to be ideal or close to it and are metabolically healthy (no hypertension).
@@TheShumoby Interesting. My husband’s a 2/3, went Keto, went off, and then went Carnivore when he got back a 288 CAC Score. Here I am, a 4/4. Doctors have checked my Calcium score several times because they can’t believe I’m not riddled with blockages. But having eaten predominately Keto for several years I come up with a zero CAC score every time.
My total cholesterol is 233, LDL-p 1824, LDL-c 153, HDL-c 62, triglyceride to HDL ratio is Triglyceride to HDL Ratio - 1.6 (tiny bit high want below 1.5 anything above 2.5 you have a problem), Small LDL-P - 424, LDL Size - 21, LDL-P - 1824 (high want below 1000), LDL-C - 153 (high want between 0-99), CAC - 0, ApoB - 121 (high want below 90). HsCRP and homocysteine are fine. Certainly not LMHR. My numbers aren’t great, but not sure what else I could be doing to improve. Whereas my husband has great test results as a 2/3 and has a 288 CAC score. Weird.
Being a LMHR the "food" if you want to call it that, is way more effective than drugs at lowering LDL. Case and point: my LDL as a junk food burner was 82. As a LMHR carnivore LDL 250...
100% 👍 Same here. I went from feeling shit mentally and physically on a ‘whole’ food plant based vegan diet to 100% carnivore, solely grass fed ruminant meat, pastured eggs and sardines in water. My triglycerides halved, HDL doubled, LDL also doubled to 273. Lost fat, increased muscle, fell massively better, yet my doctor wanted to put me on statins.
Great to see such great signal (science) to noise (ad hominem) ratio. Great video. I winced once, at the Peter LIbby quote where he didn't define what he meant by carbohydrate. We would never do that for fat or protein. Did he mean carbs with the fiber (another carb) removed? He doesn't say in his paper and provides no references. Nor does he mention the very large, well-studied populations who eat high carbohydrate diets and have very low incidence of atherosclerosis or metabolic syndrome.
So intelligent and articulate
There is no lipid problem. The problem is with arterial damage that alows plaques to form.
All explained in the book “The Clot Thickens”
Since the issue of familial hypercholesterolemia is the body’s impaired uptake of LDL by the liver due to a defect and the body placing the unused LDL cargo and deposits the cargo in different parts of the body like tendons, knuckles and eyes. Why do we conflate the two things as if it’s the same issue? The only thing common is high LDL levels.
Let me think, heart attacks are have only been a problem starting a little over 100 years ago when our diet increased grains sugars and seed oils. Is Peter saying we are suffering from a metforman deficiency? Peter is very smart but he is drinking the big pharma coolaid.
@artsteale3443 Speaking of drinking kool-aid. "heart attacks are have only been a problem starting a little over 100 years ago"
Yes yes....almost zero heart attacks prior to WW1....coinciding with the invention of radio waves. TV and radio waves may be the real reason for most of the heart disease.
Sponsored by Oreo.
Kidding kidding. Put down the pitchforks.
From a totally unscientific perspective, isn't it just a matter of freedom of choice? If people have the desire to take statins, eat inappropriate foods and support a sick care agenda, shouldn't they be allowed to do so? I choose to eat less carbohydrates, more meat and stay away from sick care. But then I am a contrarian I guess 😀
Nobody is talking about mandates or prohibitions. Just the answer to the question what to do to maximize healthspan.
@@markotrieste,
"Nobody is talking about mandates..."
Nobody? When it comes to restricting consumption of animals worldwide, I think you're missing something. In fact, they are doing more than just talking.
@@kelvliximab2362,
Apparently a lot of people do those self-destructive things even when not "allowed to".
@@kelvliximab2362,
"... Why restrict anything?"
Because doing so makes those (indisputably) harmful things less accessible to young people who are not yet mature enough to appreciate how dangerous they are.
It does not eliminate access to them and the damage done by them, but does reduce it. Although that didn't work out too well with alcohol prohibition, it seems kind of cruel to just let kids go for a Darwin award without putting up some guardrails.
@@ArcoZakus I was referring to the specific topic addressed in this video.
Great topic, Nick! Can't wait to see the results of your Oreo cookie study! That sounds like Diet may have a pretty strong impact on your lipid profile. 😬
I think Atia is trying to satisfy the audience of the old school lipid experts, playing both sides so to speak, and thus walking a line in between rational thought and group think, maybe without even being entirely conscious of it.
Peter admits he loves alcohol and drinks 7-8 drinks per week, in this same interview, and he admits alcohol has no benefit. That being said it's no wonder he can't stay on a low carb WOE and has to supplement this with statins to keep his cholesterol down. So it follows that if you're going to keep drinking and take statins then you may as well eat a ton of carbs too and work out excessively to stay ahead of his health/longevity curve (it will eventually catch up to him mind you). As an (ex) alcoholic if I ever admitted I only had eight drinks a week you can bet I was either binge drinking all eight or doing at least double that. It's the same thing I've seen before with Joe Rogan, he loved carnivore but kept bouncing off of it as he still craved pasta. There's just some things people won't give up regardless of the positive results they got when they did so. If we can free ourselves from all these vices we grew up with, nutrition is the solution, Truly, You Are What You Eat.. Great content let's keep these discussions going!! 🥩🧈🥓🍳✌️👍
If you can't fix lipids with nutrition, then you can't blame lipids on nutrition! That's totally stupid!
👍👍👏🖐🇷🇺
The idea that a metabolic characteristic (which is what serum lipid levels are) is not related to diet, is patently absurd.
Even in familial hypercholesterolemia, dietary changes will result in changes in serum lipids. The familial hypercholesterolemia just sets a different baseline.
Please explain in layman's terms the mendelian Randomization Peter Atilla is using on APOB
Peter Attia is just trying to hold on to the lipid hypothesis,.... no matter what.
It's just sad.
I do not beleive "the lipid problem" is a problem. High LDL is not a problem if TG is low and HDL is high.
I'm not sure I completely understand what Dr. Attia was saying there. Has he not previously recommended specific dietary patterns WRT lipids? I could have sworn I saw it...
Why are you so obsessed with Attila? Stop begging for his attention. You all are doing good work just keep moving forward and presenting the facts. The world is watching.
In my mind Peter's logic to is this. APOB is causal for ASCVD -> you crush APOB either with diet/genetics/medication -> you do not die from ACSVD.
So the two disagreements with Attia's statements would be nutrition in some cases is more important than he is making it sound and that in some cases we do not see as much plaque buildup as we would expect compared to the study that matched the 80 LMHR Keto subjects to the some general population. Am I getting that right?
I would still want to keep your APOB as low as possible assuming all other factors held constant. No? It seems risky to assume that I am somehow immune to the effects of APOB based on my diet/genetics given the current balance of evidence.
Also, maybe this is my lack of knowledge. But why do these studies always focus on LDL-C not APOB? Is the test for LDL-C that much cheaper? Why not do both?
Could it be that among people who eat a ketogenic diet, those who exhibit LMHR phenotype are at LESS risk of MI and stroke than those who don’t, ie, those who are not lean
Come on Nick, spill the beans (Oreos) on your outcome!
@4:59, i posted this on another video, hope you see it-
I would like to see people with genetically dramatically high LDL and in the context of otherwise good metabolic health be studied with the same fervor of LMHR.
The very few studies that are there do not look at people who would be equivalently fit to LMHRs, and the studies are not large enough in scope.
Even in your slide you mention HDL-C and TG as variable, then jump to high risk. No. I want a study on congenital high LDL with HDL-C above 80 and Triglycerides also below 70. Existing studies do not properly follow these people, and its not right to lump the two together when there's clearly lateral fields proving different understandings of cholesterol that will apply to these people.
Add genetically high LDLs to your future studies brotha.
Nicholas, I like your videos and the data you bring forth. However, your video angles make me feel like I’m laying on a couch looking up at you hovering over me (really close). 😄
Heres, the problem with that statement, atherosclerosis is an inflammatory disease, which is caused by an inflammatory diet! The inflammatory diet of the majority of people causes subendothelial accumulation of lipoproteins. The problem is the inflammation in the first place. Which, ya, is nutrition based, if nutrition and diet are in anyway related to the same thing in your view...
I wish you would dumb down your videos for us Non Scientific people. It would be helpful for us who are not understanding of half of what you say. I'm subscribed but half the time it just sounds like technical jargon us simple individuals who watch. Now if you want to talk about Automotive Electronics I'm good with that. lol
Peter doesn’t even respond to comments on his own TH-cam page lol
I'll make the same comment here that I did on that video:
I think Peter is right about so many things, but I think he's wrong about this. He is still too focused on pharmaceuticals. Nutrition should be first and foremost. No one has a statin deficiency.
I would love to have him analyze my hormones though.
If you listen to Attia’s recent Special Episode podcast where he talks about supplements and his personal medications, he reveals for the first time (I believe) that he no longer takes statins. This is down from an earlier high dose regimen. I believe he is slowly backing away from some of his claims about statins though in obscurist fashion to protect his franchise. I would love to see an exchange between him and Nick.
I like Peter Attia, but I think he is highly influenced by his own fear of cardiac issues due to his familial history of cardiac death at a young age. And that's fine for him, but it doesn't make his assumptions about statins right.
Peter Attia has cognitive dissonance.
Is it just me or has Peter flipped yet again and now focused on the pharmaceutical bandwagon as his new “magic pill”. Sure people should be able to change their mind, especially with new data. His jump feels to me to be pronounced, recent and not driven by new data.
Nutrition and exercise first, meds second.
you two dont even agree on the pronounciation of apob
Mycotoxins are nutrition?
I am currently doing my own N=1 experiment variation of your Oreo cookie thing. I'm a possible LMHR with very high LDL over 300, but with HDL in the high 80s to 100, and trigs lower than that, after several years on low carb/keto/carnivore, though last year I did get a 70 on first and only CAC score at the age of 61, so no telling if that was the result of this diet, or the high carb diet I did most of the rest of my life before going low carb. About a week ago I started eating high carb, including stuff like Claxton fruit cake, which I actually like a lot, and is my choice in place of Oero cookies. I have some blood tests scheduled for this coming Wednesday, so it will be interesting to see how they compare to the past.
I agree with you.
I agree with you on this
@NicknorwitzPhD - Hey Nick, the biggest mistake one can make in scientific research isn't it to have preconceived notions.
Isn't it wrong to assume that lean people are healthy as you seems to do when it comes to LMHR "patients" including yourself.
It's well known in the clinical work that there's a small patient group that are lean and are at high risk of CVD.
These lean patients are very often fit and with impressive muscle mass. All cardiologists have stumbled over these patients perplexed to see them having a heart attack and the progression of CVD.
@nicknorwitzPhD - What's your take on the elevated LDL in these patients?
Should they increase their carbohydrate intake to lower their LDL?
Share if you agree
I follow you both, and would 100% watch that conversation!
Has there ever been a case study of an individual with total cholesterol under 150 (earned with lifestyle not meds) with low homocysteine that had a heart attack?
If not, that is very likely a safe neighborhood to reside. Framingham study data supports this.
Both CHOL and HCY are just symptoms. I wouldn't bother about these. I am concerned about the REAL cause which is 1) endothelian damage, 2) immune system dysregulation by high insulin.
My husband had very low cholesterol, 120 and died of heart disease at the age of 60.
Sure…they probably die from falling and breaking their hips due to lack of muscle
@@prunelle19 "My husband had very low cholesterol, 120 and died of heart disease at the age of 60."
I'm sorry for that.
But my question: Was he eating sugar?
I look forward to hearing that discussion. Thank you Nick.
Absolutely loving your channel and insights!
I like what you're doing Nick! Young buck going after the old lion lol Peter all respect to him but he is a pretty stubborn guy
'roar'
I think i fall into the lean mass hyper responder group i recently started a ketogenic diet 2 months ago my hdl went up to 1.56mmol/Ll my triglycerides are 0.6mmol/L my LDL skyrocketed to 6.55mmol/L my fasting insulin is 15pmol/L and hemoglobin A1C is 5.2% with a body fat under 10% is there anywhere i can go to partake in any of your studies?
wait.......oreo vs. statin??
th-cam.com/video/GHALacs44I8/w-d-xo.html
Why don't you assess FH risk with the same metabolic lens as you do LMHR? Elevated LDL with low TG, high HDL, low inflammation, low HbA1C, etc should confer the same risk (or lack thereof) regardless of whether those lipids are elevated due to genetics or lifestyle (e.g. low carb). Correct?
Attia’s statement doesn’t even make logical sense. If you are eating lipids, you cannot separate the nutrition problem from the lipid problem. They are necessarily two sides of the same coin.
I suspect there may be an even more attention grabbing 3rd arm of your experiment you could try. Sum the total calories of oreos that you added to your regular diet,. So that is what? Around 650 kCal. Add 650 kCal of butter evenly spread out during the day between meals About 6 table spoons worth, right? Every 2 hours between meals - have a tablespoon of butter. All that saturated fat should raise your LDL, right? If you really want to be obnoxious about it, I'd use excellent French demi-sel (salted) butter. But that's just for style points.
The purpose being to add a supplement of fuel not from adipose buffers. and not from apo B-100 particles, but from apo B-48 particles instead. I suspect after 2 weeks of that your liver will not feel the need to package so many triglycerides to supplement the shortfall in the amount you are rate limited from generating from adipose buffers.
Context is key. The human body is an incredibly complex machine. I just wrote a letter page long comment in Dave Feldman’s latest upload on this regard.
How arrogant of us to think we can single point answers to questions about the human body?. I suppose We can, for each single context. The moment another marker in the body changes and or the context changes, the outcome changes. The single biggest limitation in science. It’s a never ending q&a process of this fascinating subject : the human body.
The LMHR study and the lipid energy model flies in the face of Peters beliefs of apoB being “causal”. And, with some of his book on the subject(which I did enjoy reading as it does have other gold nuggets in it). It will be interesting to see if his take on this changes being how heavily invested he is in his ideology.
Well said! "Food" for thought. ;)
these thumbnails are something else lol
I may fall into a 3rd group. I am not a LMHR and would be closer to FH, but my total cholesterol is normally in the 260-280 range. With an healthy diet and vigorous exercise, I have gotten as low as about 220. For the last 5 years, I have generally been on a low carb diet. In July, I increased protein intake and my total cholesterol jumped to the high end of my range at 285. TRIG 86/HDL 62. Around October, I added low carb apples and berries to my low diet. November readings were much different. Lowest ever (non statin) total cholesterol level of 206. TRIG 59/HDL 66. Not sure what to make of these readings, but my current plan is to keep the apples/berries in my diet.
Remember the “apple a day keeps the doctor away” advice? You may have discovered the technical basis for this!
You increased your fiber intake and fiber lowers cholesterol (look it up). That's my guess.
Normally just a half apple or a 4oz strawberries/blackberries per day. Not a lot of fiber. I have consumed far more fiber in the past without these dramatic results. I wasn't concerned about my cholesterol level, but I was pleased with the TRIG/HDL ratio improvement. My ratio had been that good in the past, but only after a concerned effort to restrict carbs and a lot of exercise.
@@RonniiV
@@wdc1040 I guess it’s some unknown mechanism. Maybe it changed your gut biome and now you process cholesterol differently, lol. Your comment inspired me to experiment and measure my readings every 3 months as well.
👏👏