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The Proof with Simon Hill
Is high cholesterol always a problem? | Nick Norwitz, PhD
Jul 23, 2024
Nick Norwitz, Oxford PhD graduate and Harvard Medical student, explores high cholesterol debates including Oreos vs statins, lean mass hyper-responders, and cholesterol management. Topics cover a self-experiment study with Oreos, managing statin discussions, debunking health claims, and personal health journeys like ulcerative colitis and the ketogenic diet.
05:00:59
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Quick takeaways
- Lean mass hyper-responders on a ketogenic diet challenge traditional cardiovascular risk models with high LDL but elevated HDL and low triglycerides.
- The study comparing Oreos and statins showcased a 71% reduction in LDL cholesterol, questioning common LDL-lowering methods.
- Misinformation hinders climate change solutions, emphasizing the need for informed discussions on agriculture's impact and dietary tribes' conflicting views.
- Innovations like black soldier flies can address protein malnutrition in developing countries and offer sustainable alternatives to traditional meat sources.
- Physiological adaptations like lean mass hyperresponsiveness challenge naturalistic fallacies in dietary choices, highlighting potential risks and benefits of carbohydrate restriction.
- Personalized health management is vital for complex conditions like ulcerative colitis, requiring informed decision-making regarding medication and dietary choices.
Deep dives
Challenging High Cholesterol Notions in Lean Mass Hyper-responders
Lean mass hyper-responders on a ketogenic diet exhibit high LDL cholesterol but also elevated HDL and low triglycerides, challenging traditional cardiovascular risk models. The need to assess their real risk and treatment strategies is emphasized.
The Oreo Experiment and its Impact on LDL Cholesterol
A study involving the consumption of Oreos led to a 71% reduction in LDL cholesterol, surpassing the effect of statins. This demonstration questions LDL-lowering methods and highlights a unique metabolic response in specific individuals.
Navigating Misinformation and Climate Change Intersections
The podcaster addresses the spread of misinformation exacerbating climate change issues, calling attention to conflicting views within dietary tribes, the impacts of agriculture on the environment, and the importance of informed discussions to combat climate change challenges.
Innovative Food Waste Solutions and Future Diets
Discovering innovative solutions like black soldier flies that upcycle food waste for generating nutrition not only for livestock but also for addressing protein malnutrition in developing countries. Organizations like Eat Lancet and Oxford University are exploring a future where traditional beef consumption is replaced by alternatives like insect-based food sources.
Challenging Assumptions on Dietary Adaptations
Addressing the naturalistic fallacy in dietary choices and discussing the physiological adaptations, like lean mass hyperresponsiveness, as potential survival strategies. Examining the potential benefits and risks of physiological states induced by carbohydrate restriction and questioning the assumption that all natural adaptations are beneficial in the long term.
Navigating Personal Health Decisions and Medications
Exploring personal health decisions in the context of complex health conditions like ulcerative colitis and the impact on dietary choices. Discussing the challenges and considerations around medication usage, including the decision-making process regarding lipid-lowering medications and the importance of personalized approaches to health management.
The Role of Fiber in Chronic Disease Risk
Fiber is not essential for human survival, but it may have beneficial effects, especially from whole foods. Studies show that fiber can have a net benefit for general populations, although individual responses may vary, as shown in studies on inflammatory responses based on baseline diversity.
Saturated Fatty Acids and Cardiovascular Disease Risk
There is weak evidence that consuming whole foods rich in saturated fats increases cardiovascular disease risk. The association between saturated fat intake and cardiovascular disease is nuanced and context-dependent. The type of saturated fats, food matrix, individual genetics, and substitution effects all play a role in determining the impact of saturated fats on cardiovascular health.
Clinical Trials and Microbiome Manipulation Studies
Rigorous randomized controlled trials that focus on dietary intervention, real-world protocols, and meaningful outcomes are essential for advancing our understanding of microbiome manipulation and its impact on health. Protocols that combine prebiotics, fermented foods, and fiber titration could have significant implications for microbiome health and individual responses.
APOB in Atherosclerotic Cardiovascular Disease
APOB is identified as a causal and necessary element for atherosclerotic cardiovascular disease, forming part of the pathway for coronary plaque progression. APOB acts within APOB-containing lipoprotein particles, representing the particle number in the bloodstream.
Necessity vs. Sufficiency of APOB for Atherosclerosis
While APOB is deemed necessary for atherosclerosis development, it is highlighted as not solely adequate, requiring additional factors to drive the disease fully. Discussions around the sufficiency aspect of APOB in atherosclerosis reveal differing views, pondering thresholds and the potential cross-over to being sufficient under certain conditions.
Importance of Understanding Unique Physiological Responses
Lean mass hyper-responders exhibit unique physiological causes of high APOB, which could impact absolute risk. While the absolute benefits of lowering APOB in this subgroup are unknown, further research is needed to tailor individual care.
Consideration of Trade-Offs in Interventions
Interventions to lower APOB come with potential trade-offs and risks that vary among individuals. It is crucial to assess individual metabolic contexts, genetic factors, and family histories to make informed decisions about therapy, highlighting the importance of personalized care.
7.
Navigating Controversial Conversations and Misinterpretations in Health Discourse
20min
8.
Exploring proper hydration, electrolyte replenishment, and a brief touch on climate change
2min
14.
Exploring Views on Lipid Lowering Medications and their Impact on Cardiovascular Health
2min
18.
Exploring the Effects of Fermented Foods and Fiber on the Microbiome and Inflammation
3min
27.
Exploring the Unknown Benefits of Lowering APOB and Engaging the Audience in Fun Challenges
1min
Episode #323. Oreo cookies or statins – which is more effective in reducing LDL cholesterol? The results from one study might surprise you. Join me as I sit down with Oxford PhD graduate and Harvard Medical student Dr Nick Norwitz to discuss the lipid energy model, what it has to do with Oreos, and how different diets affect your health.
You’ll learn about Dr Norwtiz’s health journey, including his experience with inflammatory bowel disease and the ketogenic diet. We discuss cholesterol management and cardiovascular disease risk, lean mass hyper-responders, and statins. This episode is an important and informative reflection on scientific curiosity and misinformation.
Specifically, we discuss:
- Introduction (00:00:00)
- The Importance of Curiosity in Scientific Progress (04:39)
- Exploring the Oreo vs. Statin Experiment on Lean Mass Hyper Responders (08:52)
- Scientific and Clinical Impact of the Oreo Study (25:03)
- Addressing Criticisms and Misinterpretations of the Study (34:47)
- Navigating Statin Discussions on Social Media (40:27)
- Debunking Claims About PCSK9 Inhibitors (53:18)
- Challenging Misinformation in Health Communities (59:15)
- The Lipid Energy Model and Lean Mass Hyper Responders Explained (01:06:59)
- Defining Lean Mass Hyper Responders: Key Terminology (01:14:19)
- Practical Advice for Lean Mass Hyper Responders (01:30:35)
- The Carnivore Kid: An Intriguing Case Study (01:41:48)
- Personal Struggles with Ulcerative Colitis and Starting Keto (01:45:24)
- Balancing Medication and Personal Health Choices (01:50:31)
- Debating Dietary Interventions for Inflammatory Bowel Disease (02:11:09)
- Challenges in Dietary Research and Medical Interventions (02:25:55)
- Introducing the Lipid Energy Model and Its Mechanisms (02:34:49)
- Debating the Validity of the Lipid Energy Model (02:44:29)
- Long-Term Effects of Ketosis and Carb Restriction (02:52:31)
- Critiques and Limitations of the Lipid Energy Model (02:57:17)
- ApoB-Containing Lipoproteins and Atherosclerosis (03:03:50)
- Current Research and Future Directions on LMHR (03:06:41)
- Exploring Inflammatory Responses to Fibre (03:16:12)
- The Link Between Saturated Fats and Heart Disease (03:20:49)
- Closing Thoughts on Effective Scientific Communication (03:25:29)
- The Lean Mass Hyper Responders Debate: Addressing Frustrations (03:32:32)
- Understanding Carbohydrate Reintroduction Physiology (03:46:58)
- Diet-Specific Strategies to Lower ApoB (03:55:16)
- Examining Claims About ApoB and Cardiovascular Disease (04:01:50)
- Trade-offs in Lowering ApoB Levels (04:12:54)
- Exploring the Link Between All-Cause Mortality and ApoB (04:22:42)
- Lean Mass Hyper Responders and ApoB: A Unique Profile (04:44:54)
- Concluding Thoughts and Future Discussion Topics (04:48:10)
Connect with Nick Norwitz, PhD on Twitter/X, Instagram, and YouTube. Make sure to check out the full show notes for additional resources and supporting studies.
This episode is brought to you by:
38TERA
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Eimele
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LMNT
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Simon Hill, MSc, BSc (Hons)
Creator of theproof.com and host of The Proof with Simon Hill
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