Is MVX the New Frontier in Predicting All Cause Mortality? - Dr. William Cromwell -

Dr. William Cromwell discusses the complex interaction of metabolic and inflammatory factors in determining mortality risks, beyond traditional cardiovascular risk factors. He introduces the concept of the Metabolic Vulnerability Index (MVX), which combines six biomarkers to better predict mortality risks in various populations. His studies illustrate that mortality can be significantly predicted by metabolic and inflammatory vulnerabilities, suggesting a need to shift focus towards managing these broader health markers rather than solely traditional factors like cholesterol and blood pressure. Dr. Cromwell emphasizes the importance of a comprehensive, patient-centered approach in healthcare, advocating for continuous learning and adaptation in medical practice to better understand and manage individual health risks.
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0:00 - Introduction to Dr. William Cromwell's Expertise
1:22 - Early Morning Challenges and Arrival Anecdotes
2:47 - Overview of the Day's Discussion on Mortality and Lipidology
4:12 - Addressing the Complexity of Disease Outcomes
5:38 - The Historical Evolution of Lipidology
7:04 - How Lipoproteins Influence Cardiovascular Health
8:29 - Distinguishing Between Modifiable and Non-Modifiable Risk Factors
10:15 - Exploring the Dynamics of Risk Factors Over Time
11:43 - Understanding Biomarkers in the Context of Mortality
13:09 - Analyzing Conflicting Opinions in Lipidology Research
14:35 - The Importance of Lifelong Learning in Medicine
16:01 - Introduction to Metabolic Vulnerability Index (MVX)
17:27 - How MVX Predicts Mortality Risks in Different Populations
18:52 - Statistical Insights from Recent MVX Studies
20:18 - Implications of MVX Findings for Disease Treatment
21:44 - Adjusting Models of Disease Based on Emerging Data
23:10 - Patient-Centric Approaches in Clinical Settings
24:36 - Discussing the Role of Malnutrition and Inflammation in Mortality
26:02 - MVX in Cardiovascular Disease and Low-Risk Populations
27:28 - Detailed Analysis of MVX Components and Their Clinical Relevance
28:53 - Evaluating the Impact of Biomarkers Beyond Traditional Risk Factors
30:19 - Applying MVX Insights to Broader Population Studies
31:45 - Gender and Age Analysis in MVX Application
33:11 - Q&A: Addressing Audience Questions on Lipidology and MVX
34:37 - Concluding Remarks on the Future of Lipidology and Patient Care
36:03 - Personal Reflections: The Motivation Behind Dr. Cromwell's Research
37:29 - The Broader Impact of MVX on Global Health Practices
38:55 - Discussing Potential Changes in Clinical Guidelines
40:21 - Final Thoughts: The Need for Holistic Approaches in Healthcare
41:47 - Thanking the Audience and Closing the Session

[@kenadams5504]

24:07 Dr Cromwell shouldn't feel the way he described about his former patient (Sue) . If the probability of Cardiac Arrest from a small plaque blockage was minimal ,then he had no way of expecting what happened .It shows the calibre of him as a person of immense Sincerity , that he felt as if he had let her down, despite not being at fault .In 2,021 my own Mother got very ill and tests were done to diagnose her .Eventually ,she was found to have advanced lymphoma cancer that didn't show up on tests until it was too late to treat . She passed away from a high dose of chemo that was a last ditch attempt to save her .I sensed her Doctor , just like Bill, felt that he let us down ....He didn't because he had done everything that he was expected to do , and no-one could have done any more . I felt sorry for her medical team , then ,and so I understand how sometimes these heroes feel responsible when its not their fault .

[@sabine8419]

I like that Dr. Cromwell addresses the complexity of these issues.

[@DrJK-wm9ec]

I had my blood work analyzed by Precision Health Reports and it showed on a scale of 1 to 100, 1 being the most metabolically fit and 100 being the most metabolically unfit….I was a 1. However because my APOB was high (90) and I had a positive CAC score (low number), I was at the highest risk for ASCVD. I don’t believe lipids are causal in ASCVD. Rather they are potentially part of an immune response to endothelial damage. What damages the endothelial lining of arteries leading to the formation of atherosclerotic plaque? Many things… Smoking Pollution Smoke from fires Glyphosate Other pesticides and herbicides sprayed on our food High levels of sugar are know to damage the glycocalyx which protects the endothelial lining. Seed oils Ultra processed food Poor sleep And more…. So while Big Pharma has us focused on lipids….heart disease remains the number one cause of death in the US. We need to focus on building Teflon arteries! Then we can really bring down the number of heart attacks and strokes.

[@susanbeever5708]

What is your lipid fraction score?

[@thomass5169]

Under "And more...", I think we need to add a particular kind of vaccines as well.

[@DrJK-wm9ec]

@@susanbeever5708LP IR was 20

[@jp7357]

Funny … biology doesn’t care what you believe … neither does ASCVD … whatever your belief system so far .. your non zero CAC score suggests you find new belief systems … ones that may keep you alive.

[@scottw2317]

@@jp7357 According to the creator of the CAC (Dr Agaston) score a rate of change around 10% per year has never led to a serious event, the common increase in plaque is about 40% per year so it isn't the increase itself but the rate of increase.

[@kirkwolak6735]

Dave Feldman, NOW I know why you invited this "contrarian", and what you like about him. I am always impressed by your ability to reach out and treat people and their arguments fairly. As someone with CIRS, Inflammation, and Metabolic issues that are NOT completely resolved with being carnivore. This lecture SPOKE TO ME. (of course my take away is NOT: I am good because my Hypertension and higher BMI mean I am protected... I saw it in his slide. He said it!) Integrity means... Changing your mind when the data/context changes!

[@realfoodcures]

At 14:00, He’s talking about lactic acidosis (cachexia), well known in the 1930’s as clinically relevant but dismissed after 1961. I have 40 videos about this in my YT channel.

[@realfoodcures]

I don't know if people understand the importance of the MVX lab test. All of medicine should be focused on fixing the cause and mechanism of chronic disease. This information upends most of medicine.

[@PardieDiem]

@@realfoodcures All I could find on Google about the MVX score was related to heart failure. Where can I find the study associating all cause morality to the MVX score?

[@CipovPeter]

what an awesome example of how biological systems are complex. How hard it is to figure out causality, showing that opposite facts can be true at the same time in different contexts. I will read MVX study, thanks for sharing.

[@mkrig]

Great presentation. Hoping for a Part 2 describing how to lower MVX.

[@veryaware]

Very interesting talk, a mature look at available information.

[@kahearne5361]

Excellence is critical. I remember so vividly when the hospital I worked at in Canada took the word EXCELLENCE out of their mission statement! A slow decline in care ever since and less trust in care overall with endless examples across the board. Clearly this physician should be heard. Another Dr Eric Westman. Intelligent, humble, open to continuous learning and human first. Thank you for this!

[@jobrown8146]

Wonderful presentation and I loved what you said at the end. Thank you very much.

[@lucillkryger8268]

Brilliant love “ there is a person at the end of the day “ 👏👏👏👏👏👏👏👏👏♥️♥️♥️🙏🙏🥰🇨🇦

[@robyn3349]

Thank you, Dr. Cromwell!

[@sjaron23]

Very impressive scientist and human being.

[@robbyvillabona]

Thank you for this! Been looking for one since your and his appearances on The Proof.

[@DrJK-wm9ec]

Dr Cromwell is an American 🇺🇸 hero! The story of Sue is so powerful. I highly recommend you get your Precision Health Report! MVX.

[@mattbmartin]

The story of Sue had a lot of people in the room choking back tears.

[@getalonghome]

Well, I didn't expect to cry by the end of it.

[@jimstone6570]

When will the latest scans of the LMHR cohort be revealed??

[@kathym6603]

Dr. Cromwell, Have you gotten back to Dr. Darren Schmidt yet? After all he knows your methods and is raising awareness about them and possibly even contributing to them. See his youtube channel and his June 7th video. Title of the video is = The Most Important Lab Test For Measuring Health! | Not Yet Available?

[@jamesgordon8867]

When more are like this, maybe outcomes will improve

[@PardieDiem]

All I could find on Google about the MVX score was related to heart failure. Where can I find the study associating all cause morality to the MVX score?

[@scottw2317]

None of this indicates 'causal' in the classic sense, especially given this is based off population surveys then a game of pick the factors to fit. It might be an interesting thought experiment but putting 'risk' to this is a bit much. Incidence, association etc is the best it can do.

[@jacobgise2479]

Wow. That is quite stunning how came to that conclusion after this presentation.

[@scottw2317]

@@jacobgise2479 'causal' and 'causal language' is something in a clinical sense you should avoid in demonstrating association. If we were to look at epidemiology and population studies (the later was the case), they can not demonstrate causality unless the association is so strong as to demonstrate a essential proof is replicated in a RCT. Prof John Ionidis indicated that even at 200% association with something an RCT will at best prove the association as true just 20% of the time. What this shows is that to make a causal claim on those types of numbers are generally false and would in fact be misleading. So what numbers are epidemiologists happy to start looking at using causal language? this is generally starting at about +500% above the baseline. This is just how unreliable using population data is, regardless if you want to mendelian bias the results in whatever favour etc or not, shrink the error bars despite the increase in inputs with their own errors etc. This is not to be confused with necessary or sufficient causal which confuses the topic further but rather the idea to use Incidence and Association instead of cause.

[@peterfaber7124]

This is such a great talk. He sees the world like I do. But I'm wondering about adjusting data for confounders.... The ApoB vs ACM graphs he showed in the end. It shows a pretty much linear relationship between ApoB and ACM,... But I'm wondering,... It's a completely theoretical relationship. In the real world there are almost no people who fit in that adjusted for confounders group. How many people who are completely healthy have sky high ApoB in isolation? Wait,.. they do exist,.. (don't they, Dave? 🙂). These are the LMHRs. And what do we see in these people? They hardly have atherosclerosis and they are metabolically very healthy. So the theoretical relationship between ApoB and ACM doesn't apply to them. (as far as I can tell now, it doesn't) That's where I am now,... I still haven't figured it all out. But the issue I see is that treating people's ApoB based on that theoretical relationship between ApoB and ACM,... may not be as effective as you would hope for. And complimenting people with untreated low ApoB,... may also be a dumb thing to do. Low ApoB seems to be a marker for, as far as I can tell,.. T2D + obesity + mitochondrial dysfunction will drop your ApoB levels like a stone.

[@descai10]

"And what do we see in these people? They hardly have atherosclerosis and they are metabolically very healthy. " As far as I know we have no large studies on this phenotype yet.

[@descai10]

"And complimenting people with untreated low ApoB,... may also be a dumb thing to do." There are many populations we have done studies on that have low ApoB levels but have long lifespans. Vegans and vegetarians, when eating carefully to not become malnourished, have average ApoB levels under 70 and are one of the longest living groups measured. Look into studies on seventh day adventists.

[@peterfaber7124]

@@descai10 I'm talking about obese T2D people with hypertension who have under 70 ApoB levels.

[@peterfaber7124]

@@descai10 From the LMHR study we do know that after almost 5 years of astronomically high ApoB levels, they do not have more plaque than people of similar health and age, and indeed similar lipid values (except for the ApoB of course). So that's not what happens in the standard views of atherosclerosis.

[@descai10]

​@@peterfaber7124 Type 2 diabetes, hypertension, and obesity are all correlated with higher ApoB, not lower.

[@diablominero]

I'd be interested in seeing research on whether anabolic steroids can affect MVX. Tissue selective anabolic steroids (such as oxandrolone) have historically been used to preserve muscle in various disease states that cause cachexia (AIDS, severe burns, etc), and I'd love to know how that relates to this research.

[@ptbwinland146]

So if you add in other variables with LDL, like hair color you could get a different result ?

[@realfoodcures]

yes. but hair color is a bad example.

[@freecat1278]

If you were caught in the rain, you were exposed to glyphosate.

[@richardbray8004]

He said LDL is causal, where's the proof.

[@jillengland3277]

Everybody knows LDL causes ACVD. That is an axiom. We don’t dare question it since it is the basis of modern medicine since the 1960s. 😈 Fat clogs arteries just like it clogs drains.

[@susanbeever5708]

Exactly.

[@chris-nj3vg]

Genetic studies

[@SydneyCollin]

At the end of the day, he's a pharma shill gatekeeping the lipid hypothesis. See pro publica's dollars for docs. Dr. Cromwell has garnered hundreds of thousands of dollars in fees from pharmaceutical companies.

[@CashMoneyMoore]

So many domains of evidence