Is high cholesterol on a keto diet always a problem? | Dave Feldman and William Cromwell, Md

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Apr 29, 2024

Guest

William Cromwell, MD

Guest

Dave Feldman

Join experts Dave Feldman and Dr. William Cromwell as they debate high cholesterol risks on a ketogenic diet. Unpack lipid hypotheses, ApoB's role, mortality factors, and metabolic vulnerability. Explore cholesterol levels' impacts on atherosclerosis and the complexities of statin therapy for managing high LDL cholesterol.

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Introduction

00:00 • 3min

Optimizing Plant-Based Diet with Supplements

03:07 • 2min

Exploring the Evolution of Lipid Understanding in Heart Disease

04:48 • 4min

Transition from Software Engineer to Citizen Scientist

08:22 • 17min

Decoding Cholesterol and Apo B: A Complex Relationship

25:41 • 19min

Exploring Health Biomarkers and Gut Health Optimization with Inside Tracker and 38 Terra

44:29 • 3min

Genetic Data, Macrophages, and Trans-cytosis in Lipid Circulation and Atherosclerosis

47:22 • 5min

Understanding Lipoprotein Movement in Arteries and Atherosclerosis Risk

52:03 • 18min

Exploring Metabolic Vulnerability and Mortality Factors

01:10:05 • 3min

Analyzing Cholesterol Levels and Mortality Risk in Relation to Metabolic Vulnerability

01:13:21 • 3min

Exploring Transitosis and APOB Particles in Atherosclerosis Progression

01:16:16 • 21min

Exploring Resilience through Sauna and Cold Water Immersion

01:37:25 • 2min

Exploring the Living Proof Long Jevity Challenge and Lean Mass Hyper Responders

01:39:04 • 3min

Exploring High Cholesterol Response in Individuals on a Ketogenic Diet

01:41:45 • 10min

Exploring the Impact of High Cholesterol on Metabolic Health in Lean Mass Hyperresponders

01:52:04 • 18min

Managing High LDL Cholesterol and Statin Therapy Discussion

02:10:11 • 23min

Analyzing Biomarkers and Plaque Progression

02:32:57 • 21min

Navigating Complexities of Cholesterol Studies

02:54:07 • 19min

Exploring Nuanced Approaches to Cardiovascular Risk Assessment and Informed Patient Discussions

03:13:34 • 3min

Some people follow a ketogenic diet seeking to lose weight, feel more energised, or gain control over their eating habits. Others may turn to this diet in an effort to treat conditions such as epilepsy, bipolar disorder, diabetes and inflammatory diseases. Regardless of their reasoning for adopting this eating pattern, a key question remains: is there ever an instance where having high LDL cholesterol levels on a ketogenic diet can be safe? In Episode #311, I’m joined by Dr William Cromwell, MD and Dave Feldman to explore this question.

In this discussion, Dr William Cromwell and Dave Feldman share their professional opinions on whether high cholesterol on a keto diet is a problem. We investigate where their opinions align and where they differ, where Dave’s hypotheses diverge from the norm, and what we do and don’t know with the available evidence. We also explore the significance of ApoB, lifespan and healthspan considerations, research Dave is currently conducting, and much more.

Specifically, we discuss:

Intro (00:00)
Dr. William Cromwell: Background as a Lipidologist and LDL Research (01:54)
Dave Feldman's Ketogenic Diet and Elevated LDL Experience (05:34)
Unpacking the Lipid Hypothesis and Cardiovascular Risk (12:30)
The history and evolution of the lipid hypothesis (20:40)
The role of apoB lipoproteins in atherosclerosis (23:39)
Factors beyond apoB involved in atherosclerosis and mortality risk (31:59)
The complexity of interpreting mortality data in the context of apoB (41:40)
Macrophages and the process of atherosclerosis (44:00)
Beyond ApoB: Metabolic Vulnerability, Inflammation and Mortality Risk (52:57)
Transcytosis: A New Perspective on LDL Movement and Atherosclerosis (1:10:36)
Exploring Low Cholesterol Impacts and Genetic Disorders (1:17:30)
Macrophage function and phenotype in the context of different drivers of high apoB (1:22:30)
Defining Lean Mass Hyper-responders in the Context of a Ketogenic Diet (1:31:40)
Investigating PCSK9 and Its Effects on Healthspan (1:38:00)
Assessing cardiovascular risk in lean mass hyper-responders (1:43:50)
Statin safety, adverse effects, and patient reluctance (2:01:54)
Ketogenic Diets and Elevated LDL: Balancing Individual Risks and Benefits in the Absence of Long-term Data (2:10:40)
Insulin Resistance, ApoB, and Cardiovascular Risk: Navigating the Challenges in Assessment and Imaging (2:18:12)
Lean Mass Hyper-responder Study: Design, Recruitment, and Eligibility Criteria (2:32:45)
Closing Perspectives on Research and Dietary Options (3:04:47)
Outro (3:06:42)

Connect with Dr William Cromwell: Twitter/X, LinkedIn, and https://www.mylipid.com/. Discover more of his work with Precision Health Reports: Twitter/X, LinkedIn, Facebook, Instagram, and at https://precisionhealthreports.com/.

Connect with Dave Feldman: Twitter/X, YouTube, and Instagram, and discover more of his work at https://citizensciencefoundation.org/, https://ownyourlabs.com/, and https://cholesterolcode.com/.

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