ng0rge
#829
Let’s do an experiment with @AnUser , somebody hold him down.
But really I think a lot of the chest beating here is just a tempest in a teapot…a lot of smoke and mirrors and misdirection. As I said above, lipidology does not say that if you have high LDL-C, you will get CVD. Period. Full-Stop. Lots of people have high LDL-C and don’t get heart disease. The biggest issue and the cause of most heart disease (as pointed out in the video) is when you combine high LDL-C, or the much better measure of actual particles, ApoB, with other metabolic problems - like obesity, high blood pressure and faulty blood glucose control(and I would add inflammation). Since these are so common, it’s easy for the medical establishment to say - Just reduce your cholesterol (ApoB/LDL-C) and you reduce your chance of getting CVD - and that’s true. However, it does not mean and lipidologists are not saying, that if you are perfectly lean, healthy, getting good sleep and regular exercise, that having high LDL-C makes you unhealthy (but you should be more careful and keep a close eye on your metabolic biomarkers).
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By the age of 40, around 50% of people have plaque buildup in their blood vessels.
Atherosclerosis: Your Arteries Age by Age (webmd.com)
And it only gets worse. Even people with no other risk factors can have plaque buildups.
There is good evidence that crushing LDL-C via diet and medication below certain thresholds (60-80) can lead to some plaque regression. Of course other risk factors should be addressed aswell because medications which reduce blood pressure, blood sugar and inflammation have proven themselves to help with reducing risks aswell.
Overall, moderate/high LDL-C/apoB’s needs to be addressed one way or another. If you have superhuman genetics (which you can’t know for sure) you can eat all you want (all the carbs and saturated fat), never exercise and still make it to the age of 120. But none of the people in this forum are likely to have those.
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ng0rge
#831
I don’t disagree with the first part of your post. But…
If all of your other health markers are great, high LDL-C does not have to be addressed and will only be a problem when something else goes wrong - of course that may be likely as we age. I don’t think you need superhuman genetics but you should always be careful with your diet, exercise and sleep (and stress). People on this forum are generally well positioned in terms of metabolic health so it’s not like talking to the general public. For the general public…absolutely “Lower your LDL-C!”.
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Oh it does. Even people at low risk have a good chance of developing plaque.
Progression of Early Subclinical Atherosclerosis (PESA) Study: JACC Focus Seminar 7/8 - ScienceDirect
I don’t think you need superhuman genetics but you should always be careful with your diet, exercise and sleep (and stress).
And then you still get a stroke or heart attack despite all the exercise and sleep you’re doing.
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ng0rge
#833
Again, let me be perfectly clear, most studies are based on a representative sampling of the general public so, of course, atherosclerosis is common. But if they rounded up a group with great metabolic health, no obesity, etc. and followed them for all cause mortality just based on LDL-C, my guess would be no statistical difference. Again, not the general public and not just average metabolic health but great.
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No such studies exist though so your best guess is just that. Artherosclerosis is such a common disease that even existed back in the stone age. Given that, it seems stupid not to crush your LDL-C/apoB. Also, most people here are over the age of 50 where their bodies naturally are not in perfect condition anymore regardless of how much they exercise.
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AnUser
#835
Which lipidologists are saying that high LDL-c doesn’t make you unhealthy, in case of no other risk factors? Do you understand what causality mean? What ‘independent risk factor’ mean?
ng0rge
#836
Your Daddy…Thomas Dayspring! And my guy William Cromwell. But I suspect that was a rhetorical question. Are you really going to make me round up and post a bunch of sources? Because they’re out there and not hard to find…a simple google search.
My point is simple…You can be perfectly healthy with a high LDL-C. LDL-C ALONE does not cause heart disease.
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AnUser
#837
Thomas Dayspring has said that? Show a quote, since you repeat this false point over and over.
ng0rge
#838
Yes, give me time to round up a bunch of links.
AnUser
#839
A single quote or link would be fine in which Thomas Dayspring says that high LDL-c is fine without any other risk factors.
mccoy
#840
Tom Dayspring says that there are cases with a high ApoB who do not suffer atherosclerosis and that is due to some unknown protective factor. I have been listening to hours of podcasts with him as a guest and he never hinted at the fact that in a healthy population high ApoB does not constitute a risk factor for atherosclerosis.
A few posts above I have cited a stemtalk podcast with Dom D’Agostino and Ken Ford, both staunch keto followers, both healthy guys as far as we know. D’Agostino clearly says, at 00:44, that there is a high atherogenic risk associated with an elevated cholesterol. They just accepted the trade-off with the perceived benefits. I clearly remember Ken Ford saying: “There is no free lunch!”
That part starts at [00:40:13]
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Did they disregard all intervention trials and just make up their minds with mechanistic studies that support their opinions?
AnUser
#842
The low carb cult believes that ‘unknown protective factor’ is whatever they do, and they are not like the rest.
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ng0rge
#843
Absolutely, it’s a risk factor, and the higher your ApoB, the more risk you have of CVD. My point, again, is…You can be perfectly healthy with a high LDL-C. LDL-C ALONE does not cause heart disease.
Exactly what I’m saying.
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AnUser
#844
LDL-c causes plenty of heart disease cases on its own…
Search up famillal hypercholestrolemia, or search up fatty streaks in young adults…
It’s not even logical since the cases of heart disease you see were developing plaque the previous decades, much of the time without any risk factors that is what the genetic studies have shown us.
There is no heart disease without cholesterol transported through apoB containing lipoproteins. Risk factors can mediate that risk but it is enough on its own to cause disease without any risk factors, if it is increased or not.
As well as in the case of no risk factors, atherosclerosis will still continue developing…
I’m waiting for that quote or link you were talking about …
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You can also be morbidly obese, eat 500g of carbs per day and still get over the age of 100.
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Yes, just about as likely as winning the lottery - but possible. Much more likely in those with a slightly different profile.
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mccoy
#847
The first sentence is true, but you are omitting the probabilities. In the whole population, or even a healthy subgroup, what is the probability that a high LDL-C is associated to CV health (meaning: no significant atherosclerosis)?
The 2nd sentence should be reformulated, citing LDL-C as a proxy for ApoB. Then high ApoB alone according to your thesis would not cause heart disease. But this is not what Tom DAyspring and the preponderance of evidence allude to. High ApoB alone according to this eminent lipidologist is a direct cause of heart disease, since the higher the ApoB, the higher the number of collisions of such particles with the artery walls and the potential initiation of the atherosclerotic process.
I remember that the ‘safe’ threshold according to Daysping depends on other factors like blood pressure, smoke, diabetes and so on. But these just shift the threshold downwards. The threshold remains even in healthy individuals.
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