Cholesterol & Heart Health: Insights from LDL Research on Keto with Dave Feldman & Nick Norwitz, PhD
Sep 16, 2024
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Join citizen scientist Dave Feldman, founder of the Citizen Science Foundation, and Nick Norwitz, an Oxford PhD and Harvard medical student, as they challenge traditional views on LDL cholesterol and heart health. They discuss their research on lean mass hyper-responders, revealing that LDL levels might not correlate with plaque buildup in keto dieters. The duo also highlights how advanced imaging techniques could redefine cardiovascular risk assessment, pushing for a fresh perspective on cholesterol management and dietary impacts on long-term health.
The study reveals that high LDL cholesterol levels in lean mass hyper responders do not correlate with increased plaque development in coronary arteries.
Coronary CT angiography is advocated as a superior diagnostic tool for assessing cardiovascular risk over traditional calcium scoring methods.
Deep dives
Impact of LDL Cholesterol on Plaque Development
The study reveals intriguing findings regarding LDL cholesterol levels and their relationship to coronary plaque. Despite a significant difference in average LDL levels—272 mg/dL for the lean mass hyper responders compared to 123 mg/dL for the Miami Heart cohort—there was no statistically significant difference in plaque development as measured by CT angiograms. This suggests that higher LDL levels may not correlate with increased plaque in individuals who maintain good metabolic health. The study's authors emphasize that, after almost five years in ketosis, these individuals show no signs that high LDL is causing plaque accumulation.
Rethinking the Lipid Hypothesis
The discussion challenges the simplistic lipid hypothesis, which posits that higher LDL is a direct driver of coronary plaque development regardless of individual health factors. The researchers highlight that many previous studies linking LDL to atherosclerosis involved populations with confounding variables like insulin resistance or genetic abnormalities. In place of the traditional view, this research suggests that metabolic health and individual patient background must be considered when assessing LDL's impact on cardiovascular risks. This nuanced understanding opens the door to further research on how different populations respond to high LDL levels.
Importance of Advanced Imaging Techniques
The research also advocates the use of coronary CT angiography as a critical diagnostic tool over traditional approaches like coronary calcium scoring. CT angiograms provide a more nuanced view of coronary plaque, potentially enabling better risk stratification for patients with high LDL. This method allows for the detection of plaque at earlier stages compared to calcium scoring, which typically indicates late-stage disease. The study's findings suggest that incorporating CT angiography into routine evaluations could enhance understanding of cardiovascular health in patients with elevated LDL but good metabolic profiles.
Future Directions and Research Implications
As discussions continue, the researchers express a desire for more in-depth studies on lean mass hyper responders and their unique lipid profiles. They highlight the necessity of quantifying data through advanced imaging and analysis techniques for better understanding the relationship between lipids and cardiovascular disease. Future research aims to explore the composition of lipid particles in those with high LDL yet stable plaque scores, thereby addressing the underlying causes of lipid variations. The hope is that this research will foster further investigation into metabolic health and improve individualized treatment strategies.
In this interview, Dave Feldman, citizen scientist and founder of the Citizen Science Foundation, and Nick Norwitz, Oxford PhD and Harvard medical student, discuss their latest study, which challenges the traditional view of LDL cholesterol and its relationship to heart disease risk and metabolic health. Their research focuses on lean mass hyper-responders (LMHRs)—lean, metabolically healthy individuals on a low-carb, high-fat diet, also known as a ketogenic diet. Their findings suggest that LDL cholesterol levels may not contribute to plaque buildup in these individuals as is commonly believed in the general population.
They also delve into the role of coronary CT angiograms as a powerful tool for more accurately diagnosing heart health and evaluating cardiovascular risk. This study provides new insights into the intersection of cholesterol, heart disease, and metabolic health, offering fresh perspectives on how we should rethink diet, cholesterol management, and long-term health outcomes.
Watch as they break down the intersection of cholesterol levels, heart disease, and metabolic health, offering fresh perspectives on assessing cardiovascular risk in modern medicine and calling for further research.
Don't miss this enlightening discussion that could change how we view diet, cholesterol, and long-term health outcomes!
*Featured In This Video*
Dave Feldman
X: @realDaveFeldman
LinkedIn: https://www.linkedin.com/in/dave-feldman/
https://citizensciencefoundation.org/
Nick Norwitz, PhD
X: @nicknorwitz
https://www.linkedin.com/in/nicknorwitz/
*Related Papers*
_Elevated LDL Cholesterol with a Carbohydrate-Restricted Diet: Evidence for a "Lean Mass Hyper-Responder" Phenotype_
https://pubmed.ncbi.nlm.nih.gov/35106434/
_Carbohydrate Restriction-Induced Elevations in LDL-Cholesterol and Atherosclerosis: The KETO Trial_
https://www.jacc.org/doi/10.1016/j.jacadv.2024.101109
_Carbohydrate restriction-induced elevations in LDL-cholesterol and atherosclerosis: The KETO Trial_
https://www.metabolismjournal.com/article/S0026-0495(24)00080-5/abstract
*Related Videos*
https://youtu.be/cXwpYDWS0RE
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