Dr. Paul brings on Dr. Mohammad Alo, a cardiologist and personal trainer, to discuss the cholesterol debate. They explore topics such as cardiovascular risk, insulin resistance, metabolic health of Americans, LDL and atherosclerosis, fasting insulin, arteries and veins, genes and lifestyles, seed oils versus saturated fat, and the problems with totality of evidence.
Insulin resistance should be considered when assessing the correlation between LDL cholesterol and cardiovascular disease.
Alternative risk factors like LP little A and oxidized LDL should be considered in addition to LDL cholesterol in assessing cardiovascular disease risk.
Greater emphasis should be placed on metabolic health and insulin resistance as crucial factors in determining cardiovascular disease risk, rather than solely focusing on LDL cholesterol.
The distinction between atherosclerosis in veins and arteries is an area that requires further exploration in relation to LDL cholesterol and cardiovascular disease.
Linoleic acid consumption, primarily found in seed oils, may be associated with markers of inflammation and increased cardiovascular risk.
Deep dives
Insulin resistance and correlation with LDL and cardiovascular disease
The podcast discusses the correlation between insulin resistance and LDL cholesterol, suggesting that in people with insulin resistance, there is a consistent correlation between high LDL and cardiovascular disease. It argues that focusing on LDL as a risk factor for cardiovascular disease may be misguided if not considering insulin resistance. It highlights studies that show the attenuation of correlation between LDL and cardiovascular disease in people without insulin resistance. The importance of insulin sensitivity and metabolic health is emphasized as crucial factors in determining cardiovascular disease risk.
Challenging the mainstream view on LDL
The podcast presents an alternative perspective on LDL cholesterol's role in cardiovascular disease. It questions the mainstream idea that LDL cholesterol causes atherosclerosis and discusses the importance of considering alternative risk factors like LP little A and oxidized LDL. It suggests that metrics of insulin resistance, such as fasting insulin, should be incorporated for a more comprehensive understanding of cardiovascular disease risk. The importance of understanding the correlation between LDL and cardiovascular disease in people with and without insulin resistance is highlighted.
The need to broaden the understanding of metabolic health
The podcast emphasizes the need to address the overall metabolic health of the population, pointing out that a large percentage of people in the United States are metabolically unhealthy. It argues that the emphasis should be placed on insulin resistance and markers of metabolic health rather than solely focusing on LDL cholesterol. The podcast challenges the traditional approach of treating LDL as the primary risk factor for cardiovascular disease and suggests considering other factors like LP little A and insulin sensitivity.
Atherosclerosis in veins versus arteries
The podcast briefly touches on the distinction between atherosclerosis in veins and arteries. It suggests that veins and arteries react differently to LDL and proposes discussing this distinction further. However, the topic is not expanded upon in detail.
Increased linoleic acid linked to oxidized LDL and LP-L(a)
Studies have shown that increased linoleic acid consumption is associated with higher levels of oxidized LDL and LP-L(a), which are markers of inflammation and cardiovascular risk.
Linoleic acid impact on child development and hormone levels
Higher levels of linoleic acid in maternal colostrum have been linked to poorer child development and decreased male sex hormones in humans, highlighting potential concerns with excessive linoleic acid consumption.
Adipose tissue linoleic acid as a more accurate measure
Adipose tissue linoleic acid levels are considered a more accurate measure of linoleic acid consumption. Studies that examined adipose tissue linoleic acid levels did not find a protective benefit for linoleic acid in relation to cardiovascular disease.
Mixed evidence on the effects of seed oils and linoleic acid
While there is evidence suggesting possible negative health effects of excessive linoleic acid consumption, it's important to note that more research is needed to fully understand the complex relationship between seed oils, linoleic acid, and cardiovascular health. Current studies provide mixed results, and the debate continues among experts.
Importance of Educating Patients and Doing Personal Research
The guests stress the importance of patients being proactive and well-informed about their health. They encourage individuals to do thorough research, follow different perspectives, and engage in discussions with healthcare professionals to gain a better understanding of complex topics. They believe that educated patients ultimately lead to more productive and nuanced conversations about health and treatment options.
Different perspectives on LDL and Cardiovascular Disease
The guests highlight their differing viewpoints on the relationship between LDL cholesterol and cardiovascular disease. One guest argues that LDL plays a significant role in the disease, while the other guest emphasizes the need to consider insulin resistance as the primary driver. They discuss the inconsistencies in the data, the importance of personalizing treatment plans, and the need for further research to better understand the complexities of LDL and its impact on cardiovascular health.
This week’s episode is a collaborative conversation between Dr. Paul and Dr. Mohammad Alo, board-certified cardiologist and Personal Trainer. They both offer their differing perspectives about lipids, LDL, cardiovascular disease, and seed oils.
00:00:00 Podcast begins
00:08:08 Dr. Alo’s thoughts on cardiovascular risk
00:15:18 Dr. Paul’s thoughts on cardiovascular risk & insulin resistance
00:31:38 Metabolic health of Americans
00:37:53 LDL, APOEB & atherosclerosis
00:43:53 How fasting insulin & insulin resistance relate to atherosclerosis
00:52:48 Arteries vs. veins & atherosclerosis
01:12:38 Genes vs. lifestyles & insulin resistance
