BREAKING - New Analysis of Heart Scan Data (CCTA) for Extremely high LDL vs Average LDL Cholesterol

BREAKING: Dr Matt Budoff has now presented the matched analysis for:
KETO (#LMHRstudy) vs Control (#MiHeart)
METHODS - 80 Participants of #LMHRstudy fell within #MiHeart age range and were then matched 1:1 for age, gender, race, diabetes mellitus, hyperlipidemia, hypertension, and past smoking to asymptomatic subjects from the #MiHeart cohort.
PRIMARY ANALYSIS - High resolution heart scans (#CCTA) allowing for primary analysis of Total Plaque Score (TPS), Total Stenosis Score (TSS) and Segment Involvement Score (SIS)
RESULTS
The matched mean age was 55.5 years, with mean #LDL cholesterol of 272 mg/dL (max LDL-C 591) mg/dl and mean 4.7 years duration on a ketogenic diet.
🚨 There was no significant difference in coronary plaque burden of #LMHRstudy (mean LDL-C 272) cohort as compared to #MiHeart controls (mean LDL 123 mg/dl); nb: pre-KETO LDL-C in KETO group was 122 mg/dl
🚨 There was no significant difference in CAC (median and IQR) [0 (0,56)] versus [1 (0, 49)], p = 0.520
🚨 No relationship of LDL-C elevations and plaque
⚠️ is still ongoing for second CCTA completion in our cohort by February of 2024. And as always, please continue to work with your doctor.
- I will have my own video reaction and thoughts in the coming hours.
🙏🙏🙏 to everyone -- and I mean everyone -- who helped us get to this pivotal milestone. 🙏🙏🙏

[@KenDBerryMD]

Excellent! The cognitive dissonance in the questioners at the end of the video is a great example of why your doctor says certain things...

[@davidcottrell1308]

yup. They have "Doc ears" ie: they only hear what they want to.

[@AKMcF]

Need to spread the word of these findings far and wide before a counter epidemiological strawman is erected in the public space to mask and bury this study.

[@AleksandarIvanov69]

We shouldn't be too hard on them. Re-learning knowledge contradicting prior experience, especially established by a large body that you deem with reverence, is a very difficult process.

[@davidcottrell1308]

That said, relearning is what plastic brains can do. And considering their profession, this intransigence has damaging effects. @@AleksandarIvanov69

[@JumpstylA78]

Give that one some reach, Sir !

[@tomunderwood4283]

I nominate Dave for the Nobel Prize for medicine.

[@forester057]

Nobel was a scammer.

[@carnivorewisdom]

#nobelprize is not immune to the BIg Industries corruption. It's the human outcomes these heroes work for. #seektruth #carnivorewisdom

[@plflaherty1]

I think Dave may well deserve it, but that will be in 30 years or so.

[@jimw6659]

I still find it incredible that late middle-aged people, on Keto for an average of 4 to 5 years (i.e., non-Keto for about 50 years beforehand and, therefore, you might expect to be accumulating arterial plaque, in many cases), have CAC scores of zero. This blows everything we have been told by the medical establishment out of the water. Please keep up the great work!

[@JennifertxCarnivore]

This is true data to show proof that cholesterol has nothing to do with plaque build up! Visceral fat from a heavy plant based diet is what causes it.

[@kroop5427]

Finally...a study to hand to my Doctor! Yay!!

[@user-ch1mq2fr7c]

The results of the 1st & co ing 2nd CCTA scans with clear arteries (hopefully) will blow the diet/heart hypothesis and maybe lay it to a final rest. The dictatorial, somewhat dogmatic and terroristic doctors & AHA may have to eat humble pie.

[@JennifertxCarnivore]

@@kroop5427 exactly!

[@forester057]

That’s because fat is not bad and is actually beneficial for all of us. I feel amazing eating Ribeyes and Chuck Eye steak daily. Much much better than my previous diet of salad and lots of nuts. The nuts out of my diet helped my brain fog and mood more than anything I’ve tried. Of course I had to replace that with more meat. My CTA/CAC showed a small amount of old calcified from my previous diet but no soft plaque showing my current diet is not causing damage despite high LDL. LDL does not cause anything. Chronically high glucose does.

[@coffeemachtspass]

I was one of the participants, although I have no idea if I was subsequently matched across to the Miami Heart Study. I was essentially a carnivore for the duration of the study and took daily ketone readings to confirm that I hadn’t fallen off the wagon. At the second meeting with Dr. Budoff’s team, my total cholesterol was a bit over 400, LDL around 335. I’ve followed a ketogenic diet for about eight years and feel great every day. The only time I feel ill is when I eat ‘normal’ food at a birthday party or a holiday. I don’t plan on ever returning to the SAD diet that made me fat, cranky, pre-diabetic, and exhausted.

[@juanramondelacruz]

Tank you

[@TehLiquid]

Doing gods work right there bud, thanks for your participation.

[@kyozaki9838]

I'm the same. Drs losing their shit and wanting me to take statins cus my ldl total cholesterol are high, but the only time I feel bad is when I eat normal food. I feel good on carnivore.

[@therealbenyu]

Could it be that the reason why LMHR phenotype is "rare" is because in modern world, "leanness" itself is rare, so are low-carb diets? Before agriculture, this phenotype would probably been the norm, when everyone was lean and ate animal based diets

[@eatanelkberger6416]

Qualifying as a person who is LMHR, this is what I expected. If you go through this diet transformation and see what it does for your health, you are far less surprised by this than the average MD.

[@laural1543]

Brilliant Dave!! You are THE Citizen Scientist; your work is groundbreaking!

[@dannysmith2466]

This is great news!! Coming from a guy that had an MI at a young age of 39 Y/O and was told I had FH. But after education myself on nutrition by great dr’s on YT I’m off all medication and don’t have any numbers on my labs that would suggest that I have FH. Been on the carnivore diet for 3 years now. These mainstream dr’s need to concentrate on metabolic health if they truly want to help their patients.

[@billsemenoff]

curious about that it seems you're conflating keto and carnivore...do you eat beef or pork? is your iron status normal ? are you actually high fat or just high lean meat ? Not picking on you for any reason, lots of comments on this video like this and I dont get it, did i miss something ?

[@dannysmith2466]

@@billsemenoff I my journey to get healthy I when from vegan to keto to carnivore in a 5 year span. Carnivore by far has gotten my health back. I eat mainly beef but will eat pork, eggs and fish.

[@apocalypze83]

​@@dannysmith2466 Did you have a MI on a vegan diet? That would be very interesting to hear the details on that?

[@gcdelrosario]

Stay woke people! I remembered what my cardiologist told me "im against keto/low carb diet". That was the reason i went deep down the rabbit hole. God bless you all!

[@susanvanheel4382]

I have never been overweight, have been on low carb, carnivore diet for 7 years. I had a normal cholesterol while on the SAD diet, while on Carnivore, had a large increase in LDL, OVER 250, previous LDL, was 140. No change in weight over the past 50 years, I am 68 now.

[@forester057]

Sounds like perfect LDL to me for a lean healthy carnivore. Get a CAC - likely clear but you never know.

[@dmcfence]

Hi lipids are very common with centenarians... this info is suppressed and discredited 100% by an empire built for sick obese sheep fed by bigpharma... No fire no damage. Blaming lipids are like blaming the fire on the firefighters!! Stay well.

[@nicholaspostlethwaite9554]

Likewise never fat. But Chl high, GP is all, take statins. Never saw a GP at all till late 50s. Also late onset supposed typ1, though they seem less than certain may be typ2, 1.5? lol. Did high sat fat diet for a bit, and got rid of a little weight to my school leaving weight making bmi 19 and next Chl numbers were double normal, usual panic by GP to take statins. 'Possible' FH sister sent for testing for it. No known family history commonly dying from heart problems. Just sick of all the on line total confusion and variances with 'official' guidelines. Mind you, as a 'fussy' eater I will only alter foods I eat inside a tiny tiny range I will eat. Regardless of anything else. No point living longer eating horrible food every day. Never fell for low fat con, kept proper milk in tea and coffee.

[@ElizabethMillerTX]

Thanks, Dave! Thanks, Dr. Budoff, for keeping an open mind! Thanks everyone who worked on this! We may be a 'small' subset, but I suspect that we're only that we're only that small because everyone else is so fat.

[@YVM3311]

Agreed

[@sarahb.6475]

If you look at the old sewing patterns from the 50s + 60s you can see the normal waist size for women was 24 or 25 inches. But most women these days have waists over 30 inches! Or even 40+ inches.

[@sobu105y]

U agreed

[@sobu105y]

I agreed!!!

[@CashMoneyMoore]

This is incredibly exciting. At first to be honest I was disappointed that the lmhr wasn't significantly better off than control, but then in the presentation I saw how closely matched the controls are - right down to their blood pressure and, hscrp, and a healthy hdl to trig ratio. The biggest difference I was was BMI, it looked like it barely put the Miami cohort into the overweight category. Also, so many of the Miami heart group were on lipid meds, you would think that would be quite helpful for their cac and ct scores!? and yet there was no statistical difference. LMHR's rejoice! And get your cac scans people

[@dilettanter]

Yes exactly my thoughts too! I was interested to see that ldl also didn’t seem to correlate with plaque score (it was a jagged horizontal line for ldl, while plaque score increased) in either group, if I looked at it correctly ?

[@Calvinxx1]

Thanks to Dave, Nick and all of the Citizen group for doing what the medical establishment will not in looking for the truth.

[@Paulsaladinomd]

Thanks for sharing this work, Dave. Appreciate all of your efforts in this space.

[@roshinvarghese6879]

You’re not doing keto. This study doesn’t explain your high ldl.

[@MartoDriftz]

​@@roshinvarghese6879😂😂😂

[@marthah7431]

I guess you can take a narrow approach to the study unless you are in the very small percentage of those who have good metabolic health, get 1 yr older and are once again having to calm down a GP who wants to push a statin because you have high LDL, high HDL and very low triglycerides on an animal based diet low in carbohydrates. That was my situation so yes, I’m following the work and thankful for it. At 70 heart disease is not on my radar but potential diabetes, muscle pain and dementia, all side effects of statins, are. I don’t have FH. I postulate that my LDL originally went up due to low weight (18 BMI), stress, and a low grade undiagnosed infection which turned out to be c diff and possibly a root canal. The cholesterol discussion is not black or white, one size fits all, which is what this study underscores. Thanks Dave!

[@marthah7431]

Thanks, Paul, for all of your work! A life saver for sure!! 👍👍

[@tomunderwood4283]

There is a lot of cognitive dissonance in the audience. It will take a generation for the medical profession to embrace the ground breaking information here which goes against what has been taught in medical school and reinforced by the very profitable statin industry. Going forward if anyone has a high LDL, the standard of care should be to get a CAC test. Also the key blood marker for cardiovascular disease should now be HDL/Triglycerides ideally >2 or at least >1; not LDL.

[@shellderp]

This is one very specific cohort. It will take a lot more data to figure out the truth here. But, this is great evidence that we don't know the full picture and have a lot to learn about metabolism, and need to study this much more. Previously it would have been unethical to run an RCT where you put people into a 200+ LDL level, now there is an argument that it is ethical.

[@nicholaspostlethwaite9554]

Just shows the picture is complicated NOT that there is a one diet for all. Basically still none of them actually know one way or the other who should eat what or is ldl is any problem at all even. Let alone if mere food makes any difference. Utterly chaotic and a seedbed for Snake Oil KZbinrs selling fake hopes for personal gains. I don't care who is 'right' just sort it all out before preaching to the non expert public! We are sick of the pick any answer you want to believe in nonsense.

[@tonyk6815]

Funny how the initial Pfizer data was considered robust, but this, after 4 years, seems suspicious.

[@vcosino]

This is super cool, I was one of the participants or study subjects that was in the cohorts 2022-2023 LMHR at UCLA 😎😎😎. Thanks Dave for taking care of the individuals that was part of the study. Also the staff at Lundquist were very nice

[@jy4893]

Did they test ApoB in the study? All my markers are good except LDL and ApoB…both very high

[@clyde9803]

I got a 0.0 score at age 51, after nearly 20 years of pretty consistent LCHF. My doc at the time shrugged it off without comment (test was her idea), no doubt disappointed she wouldn't be getting any statin $ off of me.

[@sunnyBLR]

Explain how your Doc makes off off statin? You get a prescription and you are feee to fill generics anywhere you want. Not sure why people say they make money prescribing metformin statin etc. they prescribe it because they are following guidelines, whether the guidelines are correct or not and save their ass getting sued for not following hospital protocols

[@gif24gt60]

They adore the medication kickbacks. It fuels their mansion mortgage payments

[@clyde9803]

@@gif24gt60 Correct. I'm not joking, you should have seen how her face fell when she showed me my score. She genuinely looked disappointed. If there's an reasonable alternate explanation for her reaction, I can't think of it.

[@clyde9803]

@@sunnyBLR Why else would she look slightly disappointed when she showed me my perfect score?

[@PR-wt3qf]

Thank you to everyone involved, this is really important work. Looking forward to further results and more research from this team.

[@Mar.Lop.]

This is great news, I am very happy with these results. I want to continue my Keto diet without fear of harming myself.

[@biodivers5294]

Very nice that you can show this! A small step for men, …

[@thestrongcarnivoress]

At age 40 I was obese BMI 35, with lots of metabolic health issues, took matters in my own hands and lost a lot of weight going on a Keto style animal based high saturated fat way of eating lifestyle. BMI now 21 As a side note I have a congenital heart condition I had major surgery age 12. I discovered that I am a LMHR too. Refusing statins and had a CAC scan recently waiting for results. Age 43 and feeling better today than in my 20’s

[@vladyslav743]

Share your score please.

[@thestrongcarnivoress]

@@vladyslav743 will do when I get it. Just waiting for my next appointment

[@vladyslav743]

@@thestrongcarnivoress thanks!

[@Nonie_Jay]

Have you received your result yet?

[@thestrongcarnivoress]

@@Nonie_Jay not yet, I expect it to be in January ad the NHS is so incredibly busy.

[@ecwestman]

Great initial presentation. Can’t wait for the final results! I understand that this was a gofundme type of study. Amazing. How can someone help to fund further studies like this? At the Citizen Science Foundation?

[@DanEngell]

I started ordering my own lab work without a doctor's help back in 2018. A great way to help Dave Feldman and this team is to use their website when ordering your lab work from LabCorp. I don't think I can put a website in a comment on KZbin but try a search of Own Your Labs. The prices are lower than the site I was previously using and any profit goes towards this project.

[@LucasTigy2]

they should have a website if you wanted to contribute

[@YVM3311]

Yes. Go to citizen science foundation website

[@shellderp]

yes, donate there for future studies

[@AnneMB955]

I’d be in that Dr Westman. Show me where I can donate.

[@jamesdellaneve9005]

Malcolm Kendrick has been saying that plaques are due to inflammation. He says that cross sections of plaques shows the plaques are incorporated into the arterial walls. David Diamond shows studies that people with FH with Factor 8 clotting factors are susceptible to coronary issues and those without F8 don’t have cardiac issues.

[@janisansbergs2441]

High carb diet promote systemic inflammation. Should we be worried about cholesterol fractions if our glucose levels are low and we are lean? I don't think so.

[@jamesdellaneve9005]

@@janisansbergs2441 If Malcolm is correct, then inflammation is the culprit. CRP tests seems to be in order.

[@apocalypze83]

​@@janisansbergs2441 but there are people out there who are high carb but low in inflammation markers? So how is it just the high carb? And I've seen high carb people reverse disease with their diet and carnivore reverse disease with diet? Is there something I'm missing?

[@janisansbergs2441]

@@apocalypze83 you are missing the main idea of "elimination". The low carbohydrate, like carnivore both are "eliminnation" diets. High carbohydrate can also be elimination diet for šomēnes else.

[@AKMcF]

Brilliant !! Well done !! Loved the question on selection bias... the current literature could never be accused of that, most of the raw data has definately not been carefully selected and adjusted 🙄

[@plflaherty1]

Ya, and the old fashioned discredit Atkins diet. LOL Over the last 50 yrs modern medicine has proven time and again how beneficial a HCLF diet is for the general population. And, the profit margins are amazing!

[@OldFArt-gx9fh]

I have LDL above 460, 57 yo and on ketogenic diet for 4 years. Calcium score of 5. LDL went up in sharply during Low carb phase, all other blood markers are excellent and improved during keto phase. BMI around 22. This video makes all sense to me. Thank you and happy to participate in any studies.

[@acke26]

I've corrected my own comment that was wrong. I wrote: "I hope you know that if you've lost weight due to ketogenic diet then you're not considered to be a LMHR" The concept LMHR does not take into account how one became lean. The criteria only include low BMI, high LDL, high HDL and low triglyceride value. Sorry if I've mislead someone Cheers!

[@OldFArt-gx9fh]

@@acke26 Agree and thanks, however I was never fat or even considered overweight and have always been naturally lean but always with high cholesterol. Going on keto made me lose weight I didn’t really needed to lose, I am way too skinny now and most people like the way I looked before. And yes, my ldl skyrocketed on keto, but trigs went the other way.

[@acke26]

@@OldFArt-gx9fh - ok, I see. I'm also very lean. No subcutaneous fat at all in arms and legs. Having and have always had a hard time putting on weight as subcutaneous fat. When I've gained the slightest weight it's all concentrated around the abdomen. I've also always had high cholesterol. I don't think I meet the criteria for LMHR because of that. We should get a full evam to see if we have some kind of genetic disturbance. Lp(a) is tge first test we should take. Then check the genes for ABC-G5 and G8 and off course FH. My LDL skyrocketed on keto and my trigs went down, but my HDL has stayed low (too low) I've heard this can be a sign of Insulin resistance . Have you heard of prof. Roy Taylor's multi year research scanning peoples visceral fat. He means that everybody has different ability to store fat in the subcutaneous tissue, which is a good protection against diabetes. He calls it "The personal fat threshold " In that respect lean people are much more unprotected against insulin resistance and diabetes 2. Lean people that can't store excessive energy fat subcutaneously store it as visceral fat. It is here it starts to get dangerous and creates insulin resistance.

[@eugeniebreida1583]

Well, I am very skeptical of going to Ketogenic level of low carb for this very reason. I do not think it wise to head beyond my years (65) as a 'way too skinny' person. Add a crazy infection/illness/hospitalization and one quickly fades away entirely. If you have ideas of how to gain healthy weight via diet (yes I know about weights/training etc) I am ALL ears. An idea i toy with is adding a TBSP of MCT oil and/or freshly ground flaxseeds to every meal, but my knowledge of 'best ways to get fat' is - experientially - pizza/ice cream/breads and etc 'all day long'. Sorry this is rambling, but as a healthy eater who SHOULD avoid dairy (inflammation) and flours. etc, I really wonder how to gain weight on my organic green leafies, alliums of all varieties, flax seeds/oil, lamb, beef and eggs, fermented veg, salads, etc etc. Ideas???@@OldFArt-gx9fh

[@acke26]

@@eugeniebreida1583 - wow, that diet with coconut oil to every meal must elevate your cholesterol levels massively. Or? I wouldn't bother gaining weight. Just keep eating healthy.

[@clyde9803]

This is going to piss off the vegetarians, mightily.

[@chuckleezodiac24]

they'll just wave it off as cholesterol-denier nonsense.

[@gon7155]

They've got bigger problems

[@picking4profit]

excellent!. Thank-you so much for your ground breaking work on cholesterol

[@ogeoge6000]

Fantastic, thank you Dave and everyone involved.

[@TteokbokkiNari]

So exciting to see this!!

[@josephvacquier6968]

Nice one Dave, well predicted!

[@sarahb.6475]

Thank you Dave!

[@gailpaul5274]

Great presentation. Thank you.

[@kathrynzusmanis6076]

What about previous studies reporting those with higher total cholesterol live longest? Regardless of lifestyle. Cholesterol is essential, critical to life support. Inflammation of arterial walls from poor lifestyle creates the plaque cascade not LDL my friends.

[@YVM3311]

Agree we need more studies and information about all the things that cholesterol Does in our bodies to counter and really provide a full picture of cholesterol . Most people think cholesterol is evil . Most general doctors won’t be able to tell me 3 things cholesterol does in our body. All they remember is that ldl raises cac. It’s time cholesterol is shown and remembered for all the good it does in the body. And explain the masses and doctors why cholesterol is important. And why at heart, pun intended, the diet heart hypothesis never made sense. We also need more studies specifically looking at the what isles causes advancement of cac in arteries .

[@rrrlasse2]

That's actually because cholesterol goes down when you are very ill. It's the same paradox with weight because you also lose lots of weight when you are about to die.

[@lolerie]

​​@@YVM3311Vitamin D is produced from cholesterol

[@YVM3311]

@@lolerie dr Nadir Ali and Dr Natasha Campbell are the only two that come to mind with presentation on many things cholesterol does. I just feel like we need to be talking way more about it . Also seems like higher cholesterol Is supportive for other diseases eu ch as cancer ? And in general to fighting disease we need cholesterol, isn’t it?

[@jillengland3277]

That is good news for me. Thanks for doing this.

[@mikeg329]

This is absolutely amazing.

[@alanlierz3745]

I found the questions to be typical drip from a medical group sold out on the idea that high LDL is bad. The reason these people are lean is because of the ketogenic diet.

[@PardieDiem]

Lol, I've been lean my whole life not being on low carb and also being hypothyroid which they say causes weight gain. Not me.

[@orion9k]

​@@PardieDiemyou are a smoker? 🤷‍♂️

[@PardieDiem]

@@orion9k No nor do I drink.

[@tomgoff7887]

Notice that Budoff himself says that he is a believer in the LDL hypothesis and stresses that the LMHR group are unique.

[@orion9k]

@@tomgoff7887 you mean LCHF?

[@rosebailey6623]

Thank you thank you for your persistence and careful scientific approach.

[@tktkwei]

Congratulations! 🎉 Thank you very much to everyone involved in making this happen. I can certainly feel the headwinds that’s gonna come just from the audiences’ questions. Keep it up Dave! I am not LMHR. I am 90% sure I have FH(LDL-C 200 ish) but I am on higher protein Keto diet for 3 years. I really wish there will be study with FH who’s on ketogenic diet and risks regarding to following the diet. I was pre-diabetes and obese, but after 3 years of keto, I am BMI 22 and almost LMHR lipid profile with very low TG, HDL almost 80, LdL190-220 (LDL always around 200 no matter what diet). I am up for your future study if it happens.

[@kathya1956]

I'm a type 2 diabetic with hypothyroid and Addison's disease. After starting low carb 5 years ago, I lost 25lbs slowly to BMI of 22.0, LDL skyrocketed, HDL went very high, and Trigs are low.

[@Michael-4]

Are you still a T2D?

[@markbeiser]

@@Michael-4Not sure it is ever completely reversible. After 4 years of keeping my A1C at around 5.0 without medication, I still respond poorly to a glucose tolerance test, thought it has improved some.

[@judyhein3737]

Great presentation! Thank you

[@mark11145]

As a LMHR I am following this closely. Since I am also running my own LMHR study of one. After 6 mths of carnivore my Doc freaked at my LDL just over 300 and ignored my HDL over 90 and low triglycerides. So he ordered a CAC and at 53 yrs I have a score of 400. 😬 I am at roughly a year since my CAC score test and have stayed on the Carnivore diet and added sauna as well as some supplements to try to help the CAC score but, I have refused statins and changing my diet. So while I watch this study closely and it continues to validate my opinion that the calcium deposits I have were causes by a high carb high stress period of my life before carnivore, my next CAC score will tell the tale for me.

[@brianshockley8161]

Please do update us on your follow up CAC.

[@YVM3311]

Please keep us posted! When’s the next cac scan ?

[@ApoBeef]

CACs don’t show soft plaque. If you develop soft plaque, you won’t detect it on a CAC until it calcifies.

[@greensmoothieparty]

CAC shows calcified plaques that are stable and can eventually cause symptoms but they are not as deadly as the soft plaques that can rupture. Good luck.

[@johnzinckgraf3831]

Regarding soft plaques, most people don't get scans to measure that and often use CAC for calcified plaque. Are you suggesting that CAC scans for calcified plaques are useless since the pre-requisite to calcified plaque is soft plaque. @@greensmoothieparty

[@250txc]

I'd say Mr. Budoff kicked butt with his answers at the end of his presentation.

[@ccamire]

Excellent. I also liked the questions form amazed doctors.

[@DrKarlGoldkamp-KetoNaturopath]

It would have been great to see a fasting glucose and insulin with these. Since it issue is around "Keto" defining the HOMA IR statis to coinside this would have been great to have. The added cost would have been negligible to add them. Love the CCTA correlations. Nice.

[@jcat5150]

Encouraging information in the presentation; scary questions at the end - how do a couple of those folks have medical licenses if they can't listen any better than they did?!?!?!?

[@YVM3311]

Quite interesting the set of questions at the end.. this will cause a lot more asking and hopefully inquiring in doctors brains and hopefully further investigation in an entire new field the medical system has not been paying attention to

[@Gionei1000]

Fascinating!

[@CashMoneyMoore]

Excellent!!!!

[@robyn3349]

Thank you!!!

[@Nick-gg6tg]

Excellent.

[@Frostbiker]

Dave, where was this recorded? And thank you for sharing this with us.

[@mikewagenbach5585]

World Congress on Insulin Resistance, etc in LA yesterday

[@wyadvd]

@realdavefeldman , where was this presentation and who were the audience ? Many thanks for getting this research done by a credible scientists and cardiology professor . Amazing .

[@AKMcF]

WCIRCD 2023 - $750 tickets so i'd think mainly MD's and researchers attending (and ofcourse pharma interests who likely havd a double take moment on this presentation).

[@DS-vu5yo]

Omg. The ignorance of the poor audience. I just felt sorry for them. But enlightenment has to start somewhere. Great work.

[@jenjabba6210]

Now, you need to go deeper and do keto diet and non LMHR hyper responders. To potentiality show that inflammation is the cause of plaque. ?? Also. I'm not lean mass and my cholesterol is normal on SAD diet but on carnivore/keto I'm a hyper responder. I think there are more subsets that aren't FH. Much more needs to be researched. Great study.

[@AKMcF]

Glucose - Inflamation - LDL Damage - Plaque ? Love the engagement on this video so far, so many inqisitive minds !!

[@250txc]

Great video ..

[@Epona52]

The fact that those with high blood calcium were at greater risk suggests that this might be a better indicator of risk than the cholesterol numbers, although I think the ratio of HDL to triglycerides is also important. I suspect that even "normal" people with lower levels of cholesterol would show an increased risk if their blood calcium is elevated - particularly on a standard American diet.

[@michaelpadula2943]

Awesome!

[@juanvideofotos]

This video is bad news for big pharma. YES!!

[@mjoh090]

It would be very interesting to see an analysis of the the variability of KIV2 units in the apo(a) molecules attached to Lp(a) through ApoB, and a standardised concentration measurement of Lp(a), across all participants, especially in those with zero plaque formation that have high LDL levels. It increasing seems that that the size and concentration of the Lp(a) isoform may be the main factor in determining plaque formation.

[@jrennickemd]

Super intriguing. Thanks for sharing this. I remain open to the possibility that there may be a subset of people where LDL doesn’t seem to be as causal for atherosclerosis and looking forward to more data. I also really liked how the presenter mentioned that this doesn’t “disprove” the LDL hypothesis in that LDL + Inflammation +/- insulin resistance is really what gets us into trouble. Also will be interesting to see what the apoB breakdown was of these patients and whether or not that had a better predictor on those who developed atherosclerosis. Although I personally don’t follow a low carb diet, it’s cool to think that we may have additional tools in our tool belts for patients who prefer a certain dietary pattern but may have some atypical lab values.

[@pergamX]

I do respect your willingness to engage with this study as an MD, but if you really think about it - it really does disprove the LDL hypothesis as a causal factor for atherosclerosis. This subset of people is not exceptional for their health status, these are just normal genotypical metabolically healthy people. The subset is exceptional because of their extremely high LDL numbers, so why would you think that another subset of the population consisting of normal genotypical metabolically healthy people that DO NOT have these astronomical LDL concentrations would be any worse off? The study is testing the literal worst case scenario if we assume LDL hypothesis is true. If inflammation and/or insulin resistance are necessary for plaque build-up, then these are causal, since without them there would be no effect. LDL alone as this study shows is insufficient to cause an effect, thus not causal.

[@jrennickemd]

Very interesting point of view. Thanks for the input. I guess my idea of the LDL hypothesis is that LDL is necessary but not necessarily sufficient for atherosclerosis. Meaning without adequate apoB particles, there can't be atherosclerosis, in the same way that there may not be heart disease without the apoB getting oxidized by inflammation. So in my opinion, both are causal, so this doesn't disprove the theory, rather might shift it a bit. Also, for the majority of the patients I see, LDL or apoB is still very pertinent as they are not as metabolically healthy as these individuals. Thanks for the dialogue. Excited to see more data as it comes out. @@pergamX

[@pergamX]

@@jrennickemd Thank you for the response. We should keep in mind that LDL and ApoB values are never zero (nor should they be), so there is always some available to be oxidized and formed into plaque (in the right conditions). I understand that mechanistically LDL/ApoB is necessary for plaque build-up, but it is also necessary for many other processes in the body, such as nutrient transport, proper immune function etc. In that regard, saying that LDL is causal is like saying driving is causal in deaths from traffic accidents. Sure, it is necessary to drive in order to be in an accident, but it is not the actual cause of deaths from traffic accidents, and driving is also necessary for our society to function properly. The data here shifts the LDL hypothesis way more than a bit, as the hypothesis would suggest that LMHR people with no plaque shouldn't even exist, thus, in order to help your average metabolically damaged patient - data here suggests that the focus needs to be shifted from fixing the LDL count, to fixing the actual metabolic damage. To go back to the traffic example, the solution to deaths from car accidents is not to ban driving or reduce driving to the least possible amount, but rather to make people drive safely, i.e. without drinking and speeding, without using their phones etc.

[@SongbirdRanch2005]

It’ll be interesting to see the relationship between BMI and CAC scores

[@adri180674]

I am very into understanding really well. My case I had great cholesterol numbers until I started low carb…my cholesterol LDL started to raise from 160, to 190, to 220, 287, to 316…I started strictly Keto and my ldl cholesterol now is 350 and total cholesterol 580. I feel magnificent, I have been very lean my whole life and even I gain a bit of weight…I really want to keep my Keto diet and don’t have to take meds but the doctor (he is non-traditional as well) wants me to take medication..

[@jdrobison1967]

Sounds like you’re doing well. How is your TG and plaque? If all good, nothing to be concerned with.

[@boutthere3374]

Same here......Chart your own course and own it.

[@linneasimchah1621]

What's your HDL and triglycerides?

[@irmabenavides6287]

Great information!!! Where I can found the study!!!

[@russellgallman7566]

Interesting.

[@ContradictionKid007]

Amazing

[@ElizabethMillerTX]

Please update the description with the occasion, location, audience, etc. Thanks!

[@williamlitsch5506]

I did think about ascertainment bias too, but even should that be the case it also must be the case that "some individuals do not develop pathologies with high LDL and high HDL and low triglycerides" That appears to be proven.

[@Gengh13]

Peter Attia isn't going to be happy, of course this is just one piece of evidence, not enough to convince the masses, but at least it's a start.

[@gon7155]

Petey boy is exercise addicted and requires the carb loading to feed his habit, plain and simple.

[@kristaG73]

How do you figure he is exercise addicted and requires carb loading to feed his habit?@@gon7155 He only reintroduced some carbs into his diet after being very strict for 3 years because there were some foods he missed. He is a tinkerer with exercise and longevity, not an addict.

[@CashMoneyMoore]

"I don't believe that all LDL is necessarily pathological".

[@user-fm7dj9tr3z]

Thanks Dave, et al. Just wonder what MiHeart cohort eat to have such an ideal blood pressure range despite overweight BMI.

[@DrKarlGoldkamp-KetoNaturopath]

with the data that is referenced here (min 5:30) the average triglyceride/HDL ratio is .71 Nice. What would be interesting as well would be to do a scatter plot of LDL verses that ratio and you could do that as a before an after as well. Even better do that with the Miami study and the Danish study if you access to the data. I would believe what one will see consistently with all three study but mostly yours is that as the trig/HDL ratio increased the LDL would drop. To add a layer to that with the same data, would be to divide the groups into two catagories, one with a trig/HDL ratio below 1.5 and the other group with their ratio above that. In essence dividing the groups into insulin resistance and not-IR. Their scatter plot are not the same.

[@ketolomics]

Patients can present with low TAG/HDL ratios but have very different underlying metabolic dynamics. This highlights one of the inherent challenges of ratios. Consider two patients, both with a TAG/HDL ratio of 1.4. Patient A has TAG=126 and HDL=90, ratio = 1.4. Patient B has TAG=80 and HDL=57, ratio = 1.4. These are two quite different scenarios. Patient A presents with lovely HDL but elevated TAG. This is one of the reasons why analyses of TAG/HDL ratio have failed to reach statistical significance when used as a predictor of CVD or all-cause mortality. Another way of putting it is that ratios are inherently compensatory in nature. If you do poorly on one of the two measures, you can compensate by doing extra well on the second measure. This hopelessly confounds the signal. One of the things Budoff's study emphasized in the selection criteria was the importance of setting separate cut-scores for TAG and HDL.

[@DrKarlGoldkamp-KetoNaturopath]

I apprecate that. As a general rule I never bank on only 1 method of determining IR. Homa IR, Trig/HDL (which parallel's the NMA) and The TryG. the Trig/HDL also fails with fatty liver pts as well. @@ketolomics

[@KirstiCheetahh]

Fantastic! It does not surprise me. LDL and cholesterol do not cause CVD. This idea was based on Ancel Keys' lies, paid for by the sugar industrie. I love my high LDL, high HDL and low TG! I believe being LMHR is the normal state for all humans. I wonder if other carnivorous animals have this phenotype too. I beleive high LDL and high cholesterol is protective and good for longevity. When you say "normal" LDL, I wonder, is it really normal? Or is it too low for humans? Is it low because of an unproper diet (carbs)? Maybe humans are not supposed to eat carbs? I think it is not LDL that causes CVD, but the inflammation caused by carbs, seed oils, anti-nutrients in plants (cereals and legumes), stress and processed food. BMI of 22 is not very lean, it is normal for humans!

[@davidcottrell1308]

EXACTLY.

[@YVM3311]

I’d agree we should refrain from using descriptions such as “normal ldl”. Who knows what that is. Always reference numbers. People with lead above x, versus if individuals with ldl below y.

[@jonathanberry1111]

🎯 Key Takeaways for quick navigation: 00:20 🍎 *Carbohydrate restriction and atherosclerosis analysis* - Discussion about the keto trial presented by Professor Matt Budoff focusing on carbohydrate restriction, elevated LDL cholesterol, and its effects on atherosclerosis. - CT angiography as a robust method for examining atherosclerosis. - Study initiation to observe patients on a carbohydrate-restricted ketogenic diet with elevated LDL levels. - Comparison of lean mass hyperresponders and matched Miami Heart study participants. 03:49 💡 *Lean mass hyperresponders versus Familial Hypercholesterolemia (FH)* - Highlighting the distinction between lean mass hyperresponders (LMHR) and those with Familial Hypercholesterolemia (FH) in terms of high LDL cholesterol. - LMHR experience a significant increase in LDL levels due to ketogenic diet, contrasting FH who have chronically elevated LDL irrespective of diet. - Genetic testing confirms the normal LDL baseline for LMHR, distinguishing them from FH. - The study matches 80 participants with high LDL from the keto trial against a Miami Heart cohort for comparison. 06:31 📊 *Comparison of atherosclerotic burden* - Evaluation of atherosclerotic plaque progression in lean mass hyperresponders (high LDL due to diet) versus the Miami Heart study participants (normal LDL levels). - No significant difference observed in coronary plaque burden between the two groups over a 5-year period. - Detailed comparison includes calcium scores, total plaque scores, and other indicators showing consistent findings. - Area under the curve was identical, signifying no increased risk of atherosclerosis in the LMHR group despite elevated LDL levels. Made with HARPA AI

[@jfangio9260]

Wonderful findings and a great presentation however I feel the answers to the questions missed an opportunity to encourage these doctors to be open the ketogenic diet as a health lifestyle/diet.

[@TomKatsiroubas]

Dr. Paul R Mason's research on atherosclerosis due to damaged LDL (caused by oxidation) might explain how some with high LDL have a higher calcium score than others with high LDL. I feel like both research works are converging here. All of this is so fascinating. Have you had a chance to discuss/share with Dr Paul Mason?

[@Stuart.Branson.]

So the question they are asking is - "why does peoples health improve when they stop eating poison and start to actually eat the correct food for humans ?"

[@BrainOverBingeCoachJulie]

Woooohoooo!

[@gif24gt60]

Is the cimt the best compared to the calcium score for detecting soft and hard plaque?

[@akirafujiwara9390]

excellent presentation and QA.the questioners should read LMHR paper first then ask questions.😅

[@AnneMB955]

This is wonderful news. Let’s hope the naysayers begin to step back and let the truth prevail. Doctors out there, you’re allowed to change your mind. It shows you’re up to date with current studies. 👏

[@iss8504]

The questions reveal a lack of belief in what they heard. The last question about these people being atypical completely misses the point: right now, we treat high ldl regardless of the patient's weight. Now Budoff is saying wait, there could well be a difference between lean and fat people with the same ldl. Why is this so hard to understand? You can see they are different groups. Will be interesting to see the msm spin on this.

[@christineellengalbraith2215]

So still remaining cautiously optimistic about high LDL on a ketogenic diet. Just wondering what Clay would be saying Dave. I’m not so optimistic about the live audiences grasp of the topic or research process. The questions asked were revealing.

[@AllyCegally]

I got onto the keto diet last year with the encouragement of my functional doctor. She also strongly encouraged me to stop my statin meds. It scared me bc I do have FH which was confirmed by a genetic test years ago and every doctor I've gone to in decades has insisted I be on a statin. Anyway, I got off the statin and on keto - my Total cholesterol is now 462, LDL 357, Trigs 81, HDL 95. What I'm hearing is the this theory doesn't apply to FH.

[@Michael-4]

Dave needs to do a rerun of his 2018 Podcast with Peter Attia. Also, will this actually get accepted for publication by a respected journal?

[@LVQ-so5th]

Is there a target journal for this research?

[@russbrown6453]

Dave Feldman and Dr Norwitz are genius' I think I'm a LMHR. 1. My vldl averages between 3 and 8. Why is my LDL 221? I'm 52. Before I was a LMHR My calcium score was 24.5 with an average LDL of 82...

[@eatanelkberger6416]

VLDL is calculated from Trigs, so you must have low Trigs. Your LDL is 221 because you are using a lot of fat for fuel, instead of glucose.

[@russbrown6453]

@@eatanelkberger6416 That makes sense. My Trigs are 58

[@jgeph2.4]

What about those with FHc on a ketogenic diet with high ldl?

[@lchangc]

Anyone who is otherwise a LMHR was removed from the study if they had any of the genetic markers for familial hyperglycemia, the vast majority of whom do not exhibit CVD. Wondering if there is a hypothesis about whether such subjects would exhibit similar results.

[@jondeppp]

Was body composition of each participant measured? I think body fat % + muscle mass % combination would be a better metric for leanness than BMI.

[@scottsanders5327]

You can hear the disdain these providers have about data that likely disproves something they have been so biased towards for so long. Its truly sad our medical system is so rigid in beliefs and not as open as it should be towards new possibilities especially in the face of new science.

[@bruceberry1111]

I think its normal to be skeptical about a very disruptive narrative. We probably don't want doctors that immediately adopt a new modailty based on a single presentation. But the cholesterol-heart hypothesis reveals decades of ignoring data, not just a healthy skepticism.

[@scottsanders5327]

I think something that is even more telling is the data from the denmark study in regard to FH patients. If anything it excludes causality for LDL and ASCVD.

[@ballgms308]

Health is not number on a chart. So many doctors think they are here to give us medicine to balance out bloodwork numbers. Instead of all of the skepticism, I think it would be most reasonable for the Physicians to take a step back and realize “the more we intervene as time goes on, population health and even life expectancy is going down drastically” showing there is seriously something wrong with our current system. Someone comes in that has lost 100 lbs, reversed type 2 diabetes and heart damage, feeling better at 50 than they did at 25 will currently be told the diet will kill them since the number next to LDL cholesterol is high. People are realizing doctors stuck in this simple-minded way of thinking are not helping anyone. The same ones that will never ask what you eat, if you exercise, how well you sleep, do you have a daily routine, do you drink caffeine at night leading to your issue of insomnia? Nope, here’s a pill come back next month, if it doesn’t help we’ll increase the dosage. Now we’re in the most “medically advanced” period but over half the population is obese. Everyone feels like hell and chronic preventable diseases are running rampant

[@timlowery7156]

It's almost like the questioners were not even present for the presentation. If I were Budoff I would have gotten irritated.

[@JimSiverts]

Were the Denmark subjects keto too? If not, was it really elevated LDL that increased the risk or was it something else?

[@LowCarbHealthMD]

Hi Dave. In which conference did Budoff present this? Was this at the IR conference in Universal LA?

[@FoodPornNetwork]

Well now our meat prices will be going up soon

[@stefansmith920]

Dr put me in a statin for cholesterol after only 8 weeks of ketogenic diet. I'm also lmhr

[@williambuckley6128]

In other words, LMHR burn more fat for fuel than anybody else.

[@5446moto]

To be clear unlike FH anyone following a low carbohydrate eating method for long enough will eventually become a LMHR or at least very close according to lipid profile. Yes for some (many) this may take years while others not so long.

[@jy4893]

How did the High LDL levels affect their APO B? Thanks

[@cocosilkworm]

Were any of these LMHR in the study previously diabetic or insulin resistant or overweight and became lean and LMHR on keto?