#21

If there were a way to make cigarette smoke “less oxidizable”, should one take supplements and have faith that they are having such an effect (given no way to measure), or rather just get rid of the cigarette smoke in the first place?

The mistake, in my view, is if one were to take a stance such as “it doesn’t matter if my ApoB is high because I’m taking aged garlic extract (or pycnogenol, or whatever) and it’s keeping my LDL from being oxidized, therefore I’m fully protected”. That’s like being obese, out of shape, high blood pressure, smoker and saying any/all are ok because I’m taking x,y,z supplement(s), rapamycin, etc.

Since we have no way of measuring how oxidizable one’s LDL is, we’d have to take it on faith that whatever combo of meds/supplements is making it better and not worse (or how much better or how much worse). There is such a thing as reductive stress with too many antioxidants. At least we can directly measure ApoB.

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#22

I think the better view is that we can do both. Lower apo b, and look to reduce oxidation.
Especially if someone can’t take statins for example (side effects), and diet and exercise and ezetimibe aren’t getting their apo b down towards 60 mg/dl, then improving oxidation risk could be make a big difference.

But for everyone, given we don’t know for sure how low to target apo b, why not look to reduce oxidation as well?

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#23

I cut it in half and take it every other day alternating with rosuvastatin 2.5mg. No muscle pain so far.

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#24

Agreed. I take Pycnogenol/gotu kola in addition to maximally lowering ApoB, since the Pycnogenol /GC combo has shown plaque reversal and incident reduction in a few human clinical trials. I used to take aged garlic extract as well, but I don’t want to overdo the antioxidants.

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#25

Do you have a link to the pyncogenol study

#26

why Canola oil? which is considered bad?

#27

Here’s one of them. You should be able to find the other ones on PubMed. Specifically it’s combo of Pycnogenol and Centellicum (branded extract of Gotu Kola)

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#28

Decreases LDL more than olive oil, although apoB differences wasn’t detected doesn’t mean it doesn’t decrease apoB too. ApoB is highly correlated with LDL so it’s likely it will decrease apoB too.

Personal experience that canola decreases apoB as well, as expected. If I don’t get a reduction in apoB I will try olive oil again.

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#29

From the literature I have read, I don’t think there is much difference in the benefits.
I use both, EVOO on salads and my morning shot, canola oil for cooking.
Since both oils have slightly different benefits there is no reason not to use both.

Here is what Dr.Oracle Ai had to say about it:

Which is healthier, olive oil or canola oil?
Overview
Both olive oil and canola oil can be part of a healthy diet. Here is a comparison of the key differences between these two oils:

Fatty Acid Profile
Olive oil is higher in monounsaturated fats (65% vs 55% in canola oil)
Canola oil is higher in polyunsaturated fats (26% vs 8% in olive oil)
Manufacturing Process
Olive oil is extracted by crushing olives
Canola oil is extracted from rapeseed using chemical solvents
Smoke Point
Canola oil has a higher smoke point (400-450°F) compared to olive oil (374-410°F)
This makes canola oil better for high heat cooking
Nutrients
Olive oil contains more vitamin E than canola oil
Canola oil contains more vitamin K than olive oil
Potential Downsides
Olive oil is more likely to be adulterated with cheaper oils
Some forms of canola oil use GMO crops
Recommendations
Both can be part of a balanced diet and have health benefits
Olive oil is better for low-medium heat cooking, canola for high heat
Choose high quality, pure versions of either oil
Limit overall oil intake and get more fats from whole foods

Follow-up question:
Me: Which is more likely to lower LDL

Dr.Oracle: Both olive oil and canola oil can help lower LDL (bad) cholesterol when used in place of saturated fats. However, olive oil appears to be more effective. In studies comparing the effects of olive oil and canola oil on cholesterol levels, olive oil resulted in greater reductions in total and LDL cholesterol compared to canola oil. The higher monounsaturated fat content of olive oil is believed to contribute to its greater LDL lowering effects. So olive oil gets a slight edge over canola oil when it comes to improving cholesterol levels. But both are healthier choices than butter, lard or tropical oils. Replacing saturated fats with either olive oil or canola oil can help lower LDL cholesterol.

Conclusion
Overall, there is evidence that both olive oil and canola oil have health benefits compared to saturated fats. Canola oil may have greater benefits for improving cholesterol and insulin sensitivity, while olive oil may reduce inflammation. However, the evidence is limited by the small size and number of trials directly comparing the two oils. More research is needed to determine if one oil is definitively healthier, especially for different health conditions and populations. Current guidelines recommend both as healthy choices as part of an overall healthy diet.

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#30

AI’s are currently very limited, see it even lacks internal consistency. There is 1 study showing canola lowering LDL more than olive oil, and that along with personal experience is good enough for me to try it.

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#31

My ApoB is down to 49 from 5mg Rosuvastain + 10mg Ezetimibe in addition to smart lifestyle choices. It was 87 before the meds.

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#32

Great, thank you. I take pyncogenol anyway for my eyes. Just need to add some gc

#33

I haven’t read the whole thread but I just wanted to chime in and say this. Peter Attia has a very high personal risk of heart disease as he has explained in various interviews. And I do think that’s coloring his perspective on this and biasing him toward over aggressiveness. I get the need to put a damper on the factors leading to ASCVD sooner rather than later and harder rather than lackadaisically. But there might be marginal diminishing returns after some point in going after that single metric and if so, aiming for 20-30 apob probably hits them.

He has never shown anywhere any evidence that the linear relationship to apob and risk hold all the way down to the lowest extreme. His cardiologist interview subjects that I’ve listened to do not propose such a thing even though they obviously agree that going after it is a good thing.

All in all I think he overestimates its importance due to his own risk factors.

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#34

There’s plenty of evidence showing the risk holds all the way down, and the risk decrease is similar from low to very low. Look for statin studies to ultra low ldl and pcsk9 inhibitor trials.

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#35

I was watching the 4 hour Attia and Rhonda Patrick interview. Attia is claiming that blood circulated cholesterol and ApoB aren’t really needed anymore. They were an artifact from our evolution to help us cope with famine. Famine just doesn’t affect most of us anymore.

In order to eliminate ASCVD completely, he said to target an ApoB of 30 or below. Once you hit 30, you don’t really get much benefit going lower. That said, 30 is damn hard to hit. You need pharmaceuticals to do it.

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#36

I don’t think all pharmaceuticals. Probably have to target PCSK9 or CETP.

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#37

Perhaps if your goal is to live a healthy life into your 70s. If you want to aim for 90s and +100s, or even give longevity escape velocity a chance, I think you want to consider things fundamentally differently - one need’s a paradigm change vs conventional, historical, med guidelines.

Btw, Peter separates what he does himself for what he does for his patients - and the “get down into 30-60 Apo B” is for people in general, not just people with his health history.

Btw2, here is an example of the view from a world leader, at a world leading (and often conservative) institution:

*“The lower the LDL, the better,” says Professor Eugene Braunwald, MD, distinguished Hersey Professor of Medicine at Harvard Medical School, faculty dean for academic programs at Mass General Brigham and cardiovascular medicine specialist at Brigham and Women’s Hospital. “You can’t have too low an LDL."

(quote from recent feature in* MIT Technology Review )

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#38

I don’t know. My grandad died at 93 after a fall because he couldn’t stand being bed ridden to let the fracture heal and got internal bleeding after getting active too soon. My grandma passed at 99 with just a year of VERY mild cognitive decline. She was also an apoe4 carrier (I know because my husband insisted on doing her 23andme way back). She never exercised and ate sugar like it was going out of style. Need I even say no statins or other fancy meds? Essentially died of late onset diabetes because her caretakers didn’t want to hurt her feelings and take away her sweets.

I think the obsession with the apob / ldl to Attia’s extent is insane in the absence of familial risk factors.

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#39

Most people die from a heart attack.
So it is perfectly good advice based on the base rate.

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#40

Well I don’t base my interventions based on what the situation is for “most people.” I’m not most people and need to do what’s best for me. My ldl looks great by the way and I don’t even try. Haven’t measured my apob yet but I’m not worried about it. Tons of other areas I can improve faster and would make a much bigger difference to my health than lowering my already low cholesterol when it didn’t kill anyone in my family tree.

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