Dave Feldman kills the LDL Hypothesis

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Dave Feldman kills the LDL Hypothesis — Clip 1/2 from Low Carb Breck / Low Carb Down Under

00. I put this out question for those in
the know. Аre there any studies that show
00:05
high LDL with high cardiovascular
00:08
disease in spite of having low
00:10
triglycerides? Аnd in doing so I managed
00:14
to get one response from dr. T (hats off
00:17
to dr. T for this one from our friends
00:19
at Framingham) and actually I really
00:22
liked this sample size because it was
00:24
people who didn’t already have
00:25
cardiovascular disease and after
00:27
excluding users for lipid-lowering
00:28
therapy that’s a big deal to me I don’t
00:30
like gene or drug studies that’s a
00:32
that’s a talk I could do all by itself.
00:34
well sure enough I get into the chart
00:37
I’m like okay so their baseline here
00:39
they have it at an odds ratio is zeroed
00:41
out at triglycerides below 100 LDL below
00:43
100 low HDL, which by the way was below
00:46
40 for men, below 50 for women . and
00:51
naturally as we would expect if you have
00:53
a high HDL see odds ratio being lower is
00:56
better you have the best version if your
00:58
triglycerides are below 100 and your LDL

Я задал этот вопрос, a кто знает, а есть ли какие-либо исследования, которые показывают, что высокий ЛПНП ассоциируется с высоким уровнем сердечно-сосудистых заболеваний НЕСМОТРЯ на низкий уровень триглицеридов? Мне удалось  получить ответ от dr. T ( снимаем шляпу ) одного из моих  друзей в Фремингеме.  На самом деле мне действительно понравился этот размер выборки, потому что это были люди, у которые еще не было сердечно-сосудистых заболеваний и после, исключили пользователей терапии для снижения уровня липидов. Для меня это очень важно, не как исследование генов или лекарств, это разговор, который я мог бы сделать   достаточно с уверенностью, что я попадаю в график. Конечно, так что их исходные данные здесь, они имеют значение с равным коэффициентом обнуления при триглицеридах ниже 100 ЛПНП ниже 100 низкий HDL, который, кстати, был ниже  40 для мужчин, ниже 50 для женщин естественно, как и ожидалось, если у вас есть  высокий показатель HDL показывает, что отношение шансов ниже лучше ,у вас лучшая ситуация, если  триглицериды ниже 100, а ваш LDL ниже 100,

01:00
is below 100 you have high HDL it’s like
01:02
the ideal profile right so we would
01:04
expect if LDL got flipped and we started
01:06
looking at a hundred and above the odds
01:08
ratio would probably also flip right go
01:10
to like one point three and one point
01:12
four ,no actually, it’s next to the it’s
01:17
the next best risk marker and it’s right
01:19
next to it at 0.7 well okay maybe this
01:23
was including a lot of people that an
01:24
LDL of like 105 and 110, fortunately
01:28
though they also had a category for
01:29
people who had an LDL of a hundred and
01:31
thirty and above how many people get
01:32
prescribe statins for 130 in above
01:35
that’s the high-risk category right?
01:37
actually it’s identical to 0.7 as you
01:42
can see on the confidence interval on
01:43
the right side this isn’t a
01:44
fantastically large study but
01:46
unfortunately I wasn’t able to find any
01:48
fantastically large studies so I got
01:50
really honore and I built this graphic
01:53
and I pushed it around on social media
01:55
and I really genuinely and not in a
01:58
trolli way truly trying to peeing all of

1:00  у вас высокий уровень HDL, это похоже на 1:02 идеальный профиль чтобы мы 1:04 ожидайте, если LDL перевернется, и мы начали 1:06 глядя на сто и выше шансов 1:08 отношение, вероятно, также перевернется вправо 1:10 как одна точка три и одна точка 1:12 четыре нет, на самом деле это рядом с 1:17 следующий лучший маркер риска, и он прав 1:19 рядом с ним на 0,7 хорошо, может быть, это 1:23 в том числе много людей, 1:24 LDL вроде 105 и 110, к счастью 1:28 хотя у них также была категория для 1:29 людей, у которых был ЛПНП из ста и 1:31 тридцать и выше, сколько людей получают 1:32 назначение статинов для 130 в вышеуказанных 1:35 это  категории высокого риска 1:37 на самом деле он идентичен 0,7, поскольку вы 1:42 можно увидеть на доверительном интервале на 1:43 с правой стороны. Это не 1:44 фантастически большое исследование, но 1:46 к сожалению, я не смог найти 1:48 фантастически большие исследования, поэтому я получил 1:50 действительно чествовал, и я построил этот график 1:53 и я толкнул его в социальные сети 1:55 и я действительно искренне  1:58 действительно пытаюсь разобраться в этом

02:01
the biggest Pro LDL lowering experts
02:03
that I know and you can if you if you
02:05
ever get bored look through my Twitter
02:06
feed you can see me doing this they said
02:08
look look look you guys are saying we
02:09
shouldn’t take comfort in having low
02:11
triglycerides and high
02:13
HDL cholesterol when our LDL cholesterol
02:15
is high so can you just bring me one
02:18
study, just one study the best study that
02:21
you can so long is it’s not a drug or a
02:24
gene study that shows that we have
02:27
higher rates of cardiovascular disease.
02:28
anyone want to guess how many studies I
02:30
got? zero ! I’m actually hoping I’m
02:34
genuinely hoping that this feed in this
02:36
video will help inspire some people to
02:37
bring more into comments I’m sure
02:39
there’s a chance there’s some out there
02:40
but I still haven’t seen it yet and what
02:44
I am thankful for is it brought me
02:45
around to something most people don’t
02:47
know about even in the low carb
02:49
community it’s called remnant
02:50

cholesterol

Dave Feldman kills the LDL Hypothesis — Clip 2/2 from Low Carb Breck / Low Carb Down Under

00:00
and what I am thankful for is it brought
00:02
me around to something most people don’t
00:03
know about even in the low-cut community
00:05
it’s called remnant cholesterol and I
00:08
think when I think Wikipedia actually
00:10
summarizes this really well they say
00:11
look remnant cholesterol also known as
00:14
remnant lipoprotein is a very a thorough
00:16
genic lipoprotein composed primarily of
00:19
very low-density lipoproteins that’s
00:22
these guys and intermediate density
00:24
lipoproteins that’s these guys stated
00:28
another way remnant cholesterol is all
00:30
plasma cholesterol that is not LDL
00:32
cholesterol or HDL cholesterol and this
00:36
was a big moment for me because before I
00:38
read any further studies I said this is
00:40
actually a perfect match for what it is
00:42
that I believe is ultimately the root
00:44
cause of the disease the remnant
00:46
cholesterol people are saying that it’s
00:48
a more atherogenic particle I don’t
00:50
think so I think it’s a failure of the V
00:54
L deals from being able to drop off
00:56
energy fat based energy version of
00:59
triglycerides so what do you suppose
01:01
remnant cholesterol is highly correlated
01:03
with sure enough it correlates closely
01:07
to insulin resistance in fact Remnick
01:09
cholesterol correlates much closer to
01:11
insulin resistance than what I’ve seen
01:13
with LDL as I ever brought up same thing
01:16
with the scheme ik heart disease notice
01:18
by the way as HDL is going down remnant
01:21
cholesterol is going up even with LDL
01:23
hardly moving at all
01:25
myocardial infarction remnant
01:27
cholesterol was the lipid fraction most
01:30
associated with premature mariokart
01:33
myocardial infarction and my favorite of
01:37
all all cause mortality
01:39
now which graph do you think you would
01:41
want to be in on the LDL moving up or on
01:43
the remnant cholesterol moving up I want
01:45
to talk about Craig Moffatt who by the
01:47
way contributes a lot to our website
01:49
Thank You Craig and he also have some
01:51
data that I’ll show you in a second but
01:52
would you guess that he has a lean mass
01:54
hyper responder yeah he’s actually very
01:57
thin and he’s very athletic
01:59
his total cholesterol is 457 milligrams
02:02
per deciliter and I hope you’ve had your
02:05
beta blocker as ldlc is 335
02:11
his hdl-c is 109 and his triglycerides
02:15
are 67 he is the picture of a far end
02:18
lean mass hype responder so you would at
02:20
least expect remnant cholesterol to
02:22
probably go with scale right like
02:23
probably it’s just a bit higher anyway
02:25
well you could probably do the math
02:27
right now actually it’s 13 milligrams
02:31
per deciliter hits it’s actually just
02:33
one pip I heard in mind on my last test
02:37
so how do you calculate remnant
02:39
cholesterol well there is a caveat to
02:41
that which I’ll say in a second but yes
02:42
you just take your total cholesterol you
02:43
subtract your LDL you subtract your HDL
02:45
you can be forgiven if you thought that
02:47
actually this whole time total
02:49
cholesterol was those two added together
02:51
know that remainder is those VLDL boats
02:55
those ideal boats and specifically the
02:57
cargo cholesterol that’s not inside them
02:59
this is what’s neat
03:00
I literally calculated this just this
03:03
morning cholesterol code data from our
03:06
site for remnant cholesterol we have a
03:08
whole bunch of submitted labs that
03:09
people have and I create the criteria of
03:11
an LDL cholesterol of 200 milligrams a
03:14
deciliter or above right that by the way
03:17
is well into range of hyper cholesterol
03:19
sorry familial hypercholesterolemia
03:21
which means your doctor will almost
03:23
certainly give you two medications
03:24
before you can leave the office right
03:27
there’s probably statin police around
03:29
the corner and you just cause the minute
03:31
or something but with triglycerides of
03:34
at least a hundred milligrams per
03:35
deciliter or lower and what’s neat is we
03:37
now have a lot of entries just on the
03:40
site of 456 total of that I found 138
03:45
that met this criteria how many of those
03:48
hyper responders who are typically on a
03:51
low-carb high-fat diet for the highest
03:54
medium highest and medium risk
03:56
categories combined we ended up with a
03:58
total of nine out of the hundred
04:00
thirty-eight for the medium lowest
04:02
quintile 44 for the lowest quintile of
04:07
remnant cholesterol 84 so over 90
04:12
percent of those that have submitted in
04:14
concern to our site about their high
04:17
levels of LDL cholesterol and in
04:18
particular I’m picking them out for
04:20
those who have 200 and above over 90% of
04:23
them had very
04:24
low remnant cholesterol
04:33
you

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