Match Analysis of High LDL on Keto - Matthew Budoff -

CoSci (Collaborative Science Conference) is a charity fundraising event to raise money for the Citizen Science Foundation. Please consider making a tax-deductible donation to CitizenScienceFoundation.org/... - and thank you for your support.
Dr. Matthew Budoff presented the #CoSci keynote on the use of CT angiography to measure atherosclerotic plaque and evaluate the effects of a ketogenic diet on cardiovascular health. He introduced a study involving 100 metabolically healthy participants on a ketogenic diet with extraordinary high levels of LDL. 80 of the participants, both Lean Mass Hyper-Responders (LMHR) and borderline LMHR, exhibited increases in LDL but no corresponding increase in atherosclerotic plaque compared to a matched control group (n=80, Miami Heart) with much lower LDL levels. The study aimed to determine if a high LDL level induced by a ketogenic diet is associated with an increased risk of atherosclerosis. Preliminary results showed no significant differences in plaque levels between the ketogenic group and the control group, suggesting that high LDL levels induced by diet may not pose the same risk as high LDL levels in those of poor metabolic health or genetic abnormalities. These findings are preliminary and research is ongoing.
0:00 - Introduction of Keynote Speaker Dr. Matt Budoff
0:21 - Overview of the Presentation Topic
0:28 - Introduction of CT Angiography Tool
1:19 - Details on the Study and its Participants
2:15 - Exploration of LDL Changes and Keto Diet Impacts
4:00 - Comparisons with Population-Based Study
5:27 - Initial Results on Plaque Levels
6:54 - Discussion on LDL Levels and Plaque Correlation
8:12 - Theoretical Insights and Previous Research References
10:27 - Conclusions Drawn from the Study
11:06 - Invitation for Questions and Answers
19:13 - Additional Discussion on CAC Scores and Their Implications
24:28 - Personal Insights and Experiences with Low-Carb Diets and Patient Treatment
30:19 - Closing Remarks and Audience Appreciation

[@markleblanc451]

I think that was Nadir Ali asking one of the questions. He’s right, we need to consider completely dismissing the Lipid/Heart hypothesis. It was wrong and doomed from the beginning.

[@dave29339]

However, it is very effective at getting statins prescribed and making money for big pharma.

[@werquantum]

I appreciate Dr. Budoff’s explanation for why he prescribes statins. I suspect his comment is at odds with a few watching this video, but to me it demonstrates clear, honest, and measured thinking. Thank you for posting this, Dave.

[@KMCarnivore]

I have been on carnivore for 14 months. Went from insulin resistant to LMHR in 9 months. I am 54 with a CAC score of 121. Would love to be in the next study. Thanks Dave, Nick, and Dr. Budoff for everything you guys are doing. You guys are a blessing to humanity!

[@thehoteldeveloper]

That's awesome. They need to include folks new to carnivore like yourself to see if CAC results improve or at least stay the same.

[@OisteinThomassenMScPharm]

CAC scores never improve due to the irreversibility of the condition.

[@jenjabba6210]

​@@OisteinThomassenMScPharm never say never! I've seen some post that they have improved!

[@kenadams5504]

​@@OisteinThomassenMScPharmIt was thought that plaque was irreversible until ppl doing ketogenic diet showed less plaque on scans ,cac and CT Angiogram.

[@dave29339]

I've been doing intermittent fasting and very low carb diet for years. My doctor was horrified at my very high LDL (and overall cholesterol) and tried very hard to get me on a statin, which I politely refused. We agreed that I would do a CAC scan instead to make sure I wasn't doing too much damage to my arteries. Fast forward a few weeks... I have a CAC score of *zero*. My arteries are perfectly clear, yet my LDL is well over 200. Something is very wrong with traditional medicine's accepted understanding of cholesterol.

[@suzannehodgkins7197]

CAC doesn't tell you if you have arteriosclerosis. It only tells you have calcium attaching to it.

[@mompo1900]

Ditto story for me

[@RBzee112]

​@@suzannehodgkins7197 In other words, no calcification.

[@kenadams5504]

Its worth noting one thing about a zero cac score on keto, (I'm a lmhr and also got zero cac score ). A Cac scan only measures calcified plaque and not soft plaque (more dangerous plaque ) .A keto diet , over time develops a healthier metabolism ,which is then better able to calcify any existing soft plaque that would not show on a cac scan . Hence , a future cac scan may then show some calcified plaque .Don't panic if that happens . As long as the cac score isn't very high , this may just be pre-existent soft plaque that eventually calcified because of the ketogenic improved metabolism. .

[@cyndimanka]

Same here!!! My triglycerides went down to 90 but after a two month illness in the inability to cook I had to eat what my husband gave me. When I had my blood work done for my annual check up my triglycerides had gone up over 130. He wanted to put me on a statin and I said no it’s because I have been down for two months with my back and I am unable to cook and I have to basically eat. What’s put before me. My Husband and Retired and I’m not gonna make him work all day and then figure out what the heck I can eat and not eat. When I finally get up and walk and shop and I got back into it. I’m not 100% perfect but in my home, we do not have carbohydrate foods.

[@laurengianna9944]

I’ve had high cholesterol my entire life. My father was a butcher and we always had meat on the table. I used to smoke and was around second hand smoke my whole life as well. I am 56 years young and started ketovore this past December. Had my first cac scan in February and it was a score of 7. Feel amazing 🙌🏼. I can’t wait to get my blood work again and see what it’s gonna show me. My A1C said 5.8 so I’m hoping it went down.

[@thehoteldeveloper]

Dave. Please do a study next on newer carnivores with a CAC to see what happens. Thank you for all of your hard work. What you're doing for humanity is very important.

[@KarenMacLeod-zn4rc]

Yes!

[@btudrus]

My respect to Dr. Budoff who - as probably every cardiologist - have had his biases but was willing to actually look at the real data. Many other scientists just stay in their own dogmas which is very sad to see them being so closed-minded...

[@daveramser647]

I was KETO for 6 years and fell naturally into carnivore this past year due to simplicity and my new found craving for fatty beef. Best I've felt in my life! My doctor's mind is blown, but I refuse to take a statin. Never had it, never will. My LDL is routinely 250+

[@vondabell7600]

Me too

[@docgl8301]

It is encouraging to witness this new science reporting evolve. Unfortunately (my) doctors still use very old "recommendations" and feel with absolute necessity to refer to book-worn old pages, to assure themselves, in prescribing statins for high LDL rather than what is in the best interest for the individual patient. Thank you for producing a quality video of this rich caliber about an old topic that needs modern day adjustment.

[@yoso585]

Zero CAC at 58 and just now at 62 yo. I’m probably done with all the testing: keeping my Zeros on file.

[@rahvastepaabel]

On long term ketosis?

[@yoso585]

@@rahvastepaabel Nope. Actually some terrible behavior for most of my life. Father had cvd and I was a heavy smoker and drunk for 35 years.

[@terryolay4613]

That's excellent but zero CAC doesn't mean you have no CAD. You could still have soft plaques. A better test than CAC is CCTA.

[@laurengianna9944]

@@terryolay4613 or an ultrasound of the carotid arteries. Less radiation with a sonogram. The less we are radiated the better.

[@yoso585]

@@terryolay4613 Yes, but what I was sharing is that one can get tired of looking for trouble after a while. So that’s why I’m banking the good news and over looking for trouble. Just gets old.

[@danielmccarthyy]

Statins help patients become diabetic which increases heart disease risk by 10x. I applaud DF and everyone participating is reconstructing the ASCVD paradigm.

[@WFPBFORLIFE]

BS

[@stellasternchen]

2 times. But it decreases small LDL particles, the most dangerous part of being diabetic. The risk of becoming diabetic on a statin is very low. The people that did become diabetic in the studies were already pre - diabetic.

[@WFPBFORLIFE]

@@stellasternchen meat and dairy contribute greatly to diabetes.

[@danielmccarthyy]

@@WFPBFORLIFE eat your statins and enjoy thinning of the cardiac muscle and CHF!

[@WFPBFORLIFE]

@@danielmccarthyy If you live a WFPB Lifestyle statins are never needed and cholesterol is not an issue. High cholesterol comes from one basic dietary plan. no meat 39 years!

[@nocarbsnation]

Since going low carb over 6 years ago, HDL remained steady, Triglycerides went from 260's to 80's, Total and LDL skyrocketed (321 and 253 respectively on last labs). I also dropped my A1C from 10.1 to 5.3 (highest to lowest). Doctor has been pushing me to go on statin. I have politely declined so far.

[@bradfordsimms715]

Not on KETO long enough to get in the study so was not selected , all other numbers in line with LMHR. Thank you Dave and DR B, keep the info coming.

[@WFPBFORLIFE]

lol

[@TheAnimalBasedCure]

Im 42 year old, had a CAC done 3 years ago and i scored a 9. Ive been keto for about a year and carnivore for the last 4 months. My LDL is now 193, HDL is 70 and Triglycerides are 57. My doctor freaked out when he saw my LDL so now i am having another cac done on tuesday. So shall see how this turns out..

[@wmn8344]

Keep us informed ! Ty

[@evelynda5235]

How did it gooooo???

[@laurengianna9944]

I read that the drugs would only extend your life a few days. Compared to the side effects I don’t think I would go on the medication 🤷🏼‍♀️.

[@Frostbiker]

What I recall is that, on average, statins extend your life by a day or two for every year you take them. This is for people who have not had a heart attack previously (primary prevention).

[@CashMoneyMoore]

​@@Frostbikeryes which is why they are not recommended for primary prevention. NNT is too high

[@JMK-vo8pv]

In a 2016 BMJ review performed by Ravnskov, et al, it was demonstrated that if you were over 60 years old, LDL-C was NOT associated with cardiovascular disease and was INVERSELY associated with all-cause mortality. So if a person is over 60 years old, then the level of LDL-C was absolutely worthless in predicting development/progression of arterial plaque AND the lower your LDL-C, the earlier you are going to die!!!!!!!

[@Cyberrjey001]

Dr. Sara Pugh has a presentation about LDL, and in one of her slides, the text states that statins extend life by 5 minutes. 🤣🤣

[@stellasternchen]

@@CashMoneyMooreThey are if there is a high or very high 10 year risk.

[@bezoar21]

Thank you for posting these sessions

[@jimw6659]

I wish these papers and presentations would also detail mmol. Not everyone is American. That said, all power to you all for your crucial work.

[@forester057]

You should be though 😜

[@jobrown8146]

I've convert my numbers from mmol to dl whatever it is so that I can compare the more easily.

[@Malcolm-Achtman]

It's an easy conversion. Whenever they give you a cholesterol value in mg/dL, simply divide it by 38.6 to convert it to mmol/L. With triglycerides, you divide the U.S. number by 88.5. That's all there is to it.

[@beautifulgirl219]

Another great video Dave and Dr. Budoff, thanks for all the very important work you and your organization does. Cheers. :)

[@jima7925]

70 yo lost 70 lbs over the last year. (Keto) Cholesterol shot up to 294 LDL 221 HDL shot up to 66 TG way down from 300+ to 74. BMI from 33 to 24. Waist from 44 to 36. LDL particle size now type A (large), IR Reduced to now normal. CAC very low 30 but not zero (from 5 years ago). I work out at the gym 5 days a week followed by 20 min sauna. All markers big improvement except cholesterol. I abused my body for 69 years so I expect it will take more time to reduce the ill affects. I wonder if I have become a LMHR via my weight loss and lifestyle change. Keep up the great work.

[@mompo1900]

Thanks Dave and Nick and Dr Budoff for this incredible work, God bless you all! This is SO exciting! Dr Budoff you are a rare MD that thinks of the individual, not the rote, standard treatment path. I have high cholesterol level, like the LMHR. My cardiologist had me get a CAC and cardiac ultrasound, all normal. She stopped bugging me to take a statin, which I’ve refused from several other MD’s. My dad took one, had a cholesterol level in the 170’s got dementia, had a debilitating stroke. I don ‘t want that path for myself.

[@kathya1956]

Cholesterol does not determine plaques. Blood pressure, stress, do. See Malcom Kendrick.

[@laurengianna9944]

My BP is always perfect 🙌🏼.

[@CashMoneyMoore]

I agree, I think blood pressure is a biggger factor. I saw a study in pigs that high ldl had no effect on their coronary plaque until they raised their blood pressure

[@pmccord9]

I'm reducing plaques with no statins. My inflammatory markers are quite low, lowered insulin, lowered BP, reduced resting HR from 65-70 BPM to 55-60. HDL/Trigs 78/58. Two years keto then 3 years carnivore.

[@stellasternchen]

@@pmccord9The only diet proven to reduce plaques was a vegetarian one. Sorry. That‘s why I can‘t stand people online selling specific diets, diet books, coachings promising a mirical healing. Because people do just think they should ignore medical advice.

[@pmccord9]

@@stellasternchen when I was plant based, I was anemic, obese, B12 deficient, prediabetic, and grotesquely flatulent, with acid reflux. All that resolved with carnivore along with disappearing calcium plaques. N of one.

[@AmberPhlameDeB]

Fantastic! thank you for all you've done getting this out there.

[@stanswarts1939]

The answer is that the higher your triglycerides are the lower the HDL is !

[@robyn3349]

Thank you!

[@gstlynx]

Great video, heartwarming and ....

[@patrice2288]

Fantastic Q&A, thanks!!

[@susanbeever5708]

Statins stimulate TRPV1 that stimulates insulin secretion and hyperinsulinemia causes insulin resistance!

[@scottw2317]

there is a strong association with diabetes and statin usage and diabetes has the strongest association to CVD of all the factors we generally understand. Statins in general interfere with clotting and inflammation it certainly doesn't seem to be the LDL aspect. Seehausen et al (2024) has an interesting graph showing high LDL with the lowest incidence of progression based of VLDL but even high levels of VLDL and high LDL matches the best results from the low LDL group. In other words this whole lowering LDL specifically looks bunk.

[@stellasternchen]

@@scottw2317👏I bet this study is a RCT? Or a randomized Mendelian study? Because those show the opposite.

[@scottw2317]

@@stellasternchen why the hell would mendelian bias bs be a strong study? only vegans push that bs.

[@stellasternchen]

Lol, no. Again, a recent study sowed a strong insulin response is protective against type2 diabetes. Insulin is not the enemy. Insulin would have to be chronically too high to induce insulin resistance, not as a response to food. The people that developed diabetes in those studies where prediabetic. We know that statins can slightly rise blood sugar. Why? Because they decrease insulin secretion. But statins also get rid of those small LDL and the high triglycerides that do come with metabolic syndrom/diabetes.

[@susanbeever5708]

@@stellasternchen lol, yes ;) Chronic stimulation of TRPV1-> chronic stimulation and the risk of hyper secretion of insulin and then insulin resistance happens. Cells already resistant become more resistant. Why? Because insulin stimulates more TRPV1 including on cell membranes that forces glucose into cells ~independent ~ of the insulin receptor. This leads to too much glucose metabolism and ultimately reactive oxygen species production in ~excess~ of the cell’s antioxidant supply and this leads to lipid oxidation, mitochondrial and cell damage. TRPV1 on mitochondria with excess activation leads to mitochondrial destruction and ultimately cellular apoptosis. Do you know how glp-1 and TRPV1 function? Check out the 2020 Berkeley study that describes the neurolymphocrine system.

[@Malcolm-Achtman]

Let me tell you a new story. I've been low carb, more animal based, since 2018. I ate terribly all my life and in 2016 I needed a triple bypass. My goal with a low carb diet was to prevent a reoccurrence, although my cholesterol did skyrocket. I always refused a statin. In April 2024, I did experience some new, albeit fairly minor, angina. I got a new 64-slice CT angiogram. It detected the calcium and plaque in my old (i.e. native) arteries, but guess what it found in my 3 bypass grafts? Nothing. Nada. All those bypasses were "patent." Do you know what patent means? It means normal, open, clear. This aligns well with the LMHR study on people like me who go low carb. The big difference being now I'm talking about bypass grafted arteries, not original arteries.

[@ellieb2914]

I feel like there should be more comments here or an entire video about just this... wow. I went to your channel and watched your speech for background and context. So eating high fat low carb for the last 8 years deposited nothing, no soft plaque nor calcified plaque, in the new artery grafts that have been carrying the full load for the arteries found to be blocked in 2016?

[@Malcolm-Achtman]

@@ellieb2914 Yes. The bypass grafts are clear despite eating high fat low carb and seeing my LDL rise more and more the stricter I got with my diet. And thanks for checking out my speech at CoSci in Las Vegas.

[@ellieb2914]

@@Malcolm-Achtman That's amazing! If I may ask, are you following any supplement protocols that may prevent further plaque creation/calcification? For example K2 (MK-7).

[@Malcolm-Achtman]

@@ellieb2914 I've been taking K2 since 2013, after reading about it in Dr. Kate Rheaume-Bleue's book entitled "Vitamin K2 and the Calcium Paradox." I still K2 but I don't believe it's a magical solution for plaque. It can't hurt, though, so I take it. I take other heart supporting supplements, most of which are recommended by cardiologist Dr. William Davis (who I follow). He especially says to take vitamin D3 and magnesium, which I've done for years. I take a kelp supplement that provides iodine, which supports the thyroid, which is important for heart health too. I've been taking CoQ10 for about 15 years (although that one is not on Dr. Davis's list). Dr. Davis likes fish oil and I would sometimes take it, but I've moved away from that as I feel it is not necessarily helpful. I prefer getting my omega-3 from eating real fish (e.g. wild caught salmon). I take some methylated B supplements as well. And some vitamin C (whole food Camu Camu vitamin C capsules).

[@chateaurico413]

Super interesting, and demonstrates that the new diet resulted in no new calcium in (probably) in any of the arteries after. So why would Budoff prescribe statins for someone like you to lower the high LDL that is a consequence of the diet/ lifestyle that resulted in such a positive effect? Meantime those drugs will be majorly manipulating your metabolism, for the rest of your life. Wow!

[@DJdavefromlondon]

22 min: statin used to lower ldl if existing heart disease but ldl is not a cause. Surely this strategy avoids the root cause .... carbs. In other words let's treat root cause, not symptoms

[@twhip2002]

Thank you for sharing this video.

[@davidgifford8112]

Budoff plays both sides of the argument, in a Medscape discussion recently he was extolling the ventures (lack of risk) of driving LDL down to below 50mg (

[@HEARTANDSOULOFMINE]

Typical nonsense expressed by the ADA. Must keep exploding the growth of the diabetic population to support the salaries and expensive lifestyles of their executives and those executives of the food industry and pharmaceutical companies who financially support the ADA.

[@stellasternchen]

You have to understand that diabetics have mostly small LDL particles with little cholesterol. The LDL-C value measures the cholesterol inside to estimate LDL particle quantity. This measure was developed when diabetes was a rare disease in the elderly and people had mostly larger particles, and so the normal range is adapted to those. High small particles can lead to a LDL-C in normal or even below normal range, as they carry very little cholesterol. So the LDL-C goals for diabetics need to be adapted to that.

[@shelleygower9843]

Did you include subjects with High LPa. ???

[@DJdavefromlondon]

But yes..appreciate Dr Budoff

[@sjaron23]

Dr. Budoff really shines - he has all the facts right at his fingertips, and he is willing to state clear conclusions.

[@fredsmit3481]

Dave, great video. Can you please provide a link to the paper in the show notes? Also, he talks a lot about "keto" diets. Most scientists only call a diet "keto" when the person is in a ketogenic state defined by producing ketones greater than or equal to .5mmol/L. In order to determine ketosis, ketones must be measured and ketosis cannot be assumed by the food that is eaten. As you know, everyone reacts differently to a particular diet. Many internet influencers including Dr. Westman incorrectly label low-carb diets as "keto". I would like to know if the diet was a real keto diet where people were verified to be in ketosis or not a keto diet where it was just a very low carb diet. There is a huge difference in metabolism between people in a ketogenic state and people who are not in ketosis and just eat a low-carb diet.

[@stellasternchen]

The study is not out yet, it has not passed peer review as well.

[@fredsmit3481]

@@stellasternchen Thanks!

[@CashMoneyMoore]

Amazing stuff. My question would have been, is there or will there be a followup to look at progression in Miami Heart to see what "normal" progression looks like. And 2) why do we think there was no association between ldl and coronary plaque in Miami Heart? Is it because they were pretty darn metabolically healthy already and their ldl was just lower? IE the metabolic health is the larger factor than just ldl

[@stellasternchen]

Miami heart is just a dataset from a different study they picked to compare with that had people with statins, existing plaques, did not fit in BMI with LMHR participants, do not know if they are metabolically healthy or not etc… This is comparing apples to oranges. You can‘t do a follow up if you take data from somebody else instead of collecting your own. Yes metabolic health does play a part. It also has time and time again been shown that LDL-C does not depict cardiovascular risk accurately in those that are not metabolically healthy. Framingham heart study for example. And? People with poor metabolic health have 3 other risk factors on top of that, being overweight/obesity, high blood pressure, having an sedentary lifestyle. We know that tose individuals have lower LDL-C due to their predominantly small particles full of triglycerides low in cholesterol. So we look at the trigs. Other markers that better depict risk are ApoB or LDL particle measures.

[@Koolaukoa]

Been low carb since 2018, last blood panel 2017 (I don’t think going to the doctor in the US is worth the time) until a few weeks ago. Dirty keto with lots of veggies for years, switched to ketovore since 2022. Now high fat ketovore trying to heal some inflammation issues. Now my cholesterol: LDL 505,HDL 118, Trig 62, total 635. My doctor freaked out, but I’m not overly concerned and refuse to take a statin. LMHR is real, I’ll look into getting a CAC scan if LDL is still crazy high in 6 months.

[@Margaret2494]

Jim Fixx was a runner which also may have contributed to his untimely death. There’s research linking endurance athletes and heart disease.

[@CashMoneyMoore]

Probably running away from bad diet and trying to fix themselves, the running helps

[@RebekahBavryCPHC]

@@CashMoneyMooreit has to do with the increased cardiac demand of endurance athletes for longer periods of time.

[@aboutsupplies]

Dr Sean O'Mara has tested visceral fat on long distance runners, not uncommon for them to have it. Visceral fat secretes toxins which inhibit normal gene functions that prevent arteries from calcification.

[@trail.blazer]

@@CashMoneyMoore There are some studies that show a correlation between ongoing high cardio and atherosclerosis. Possibly increased turbulence in blood vessels over longer periods; effectively a continuous physical assault. Some high cardio people also have high carb diets and maybe that causes an additional glycation assault on blood vessels.

[@binhmai1]

​@@trail.blazer YES YES YES Glycation from carbs and ROS spilled out from overworked mitochondria and super oxidative stress from long distance running.

[@diablominero]

A number of medications shouldn't work by their alleged mechanism, but seem to work anyway, and it's likely because of anti-inflammatory side effects. Two that spring to mind are SSRIs for depression and doxycycline for several non-bacterial illnesses. Statins are known to have an anti-inflammatory side effect, so they have all the makings of a medication that works better than it should.

[@hannahviviers3066]

This video was now really just the answer I needed. Because my LDL is so high, HDL low and Trigltcerides very low as well as very low blood pressure. I am a female, 66 yrs old and a carnivore. Two days ago my doctor says I am a nightmare happening and I must!!!!!!!! use statins.😢

[@barblacy619]

Hope you have a doctor like mine. He charts “Patient refused” and shuts up. Of course I keep sharing these videos with him so he doesn’t want me to start up again…LOL

[@Malcolm-Achtman]

I don't know why Dr. Budoff would use statins on a person who is now low carb but has proven heart disease. He would likely agree that the heart disease is the result of years and years eating a crappy diet. If the person now eats a low carb/keto diet, and their LDL spikes upwards, the 4.7-year LMHR study shows it does not provoke plaque formation. So, I repeat. What's the statin for?

[@mariecampos6923]

Hi Dave, you asked about getting my brownie recipe at the Keto Chow meetup in Feb. How can I get that to you?

[@TMB-B10M]

My ldl-p was so high they didn’t even give me a number. They just said over 3500 - but I don’t fit the LMHR profile. My hdl is low and my triglycerides are high. I am still a bit overweight but have lost almost 100 pounds in the last year on keto. It could be my thyroid causing my high ldl-p, but not sure. Just got a CAC score but they are so far behind in reading it that I won’t get the results yet for over a month. But a bad CAC score won’t deter me from my carnivore diet

[@rtay0311]

Is ldl the best target or is it the only target

[@FactsDontCare1]

What I don’t understand is if this study challenges the conclusions and interpretations of past evidence where they felt that lowering the LDL was a positive because it would lower lower plaque is now being ignored because of “ the data” when someone already has heart disease. I understand we don’t have a study on it yet. It would indicate that this new information and insight from this study would also have us question the conclusion that LDL is a risk factor and people with heart disease already. LDL is not causing heart disease then the fact that they already have heart disease would also mean the LDL is not contributing to heart disease in this case. Not sure what I’m missing. It is a contributing factor or it isn’t.

[@dakotalynn4773]

I'm lmhr ❤ 🎉 trig to hdl is 0.6 with high ldl

[@jj900]

Does anyone know the rationale to report the median rather than the mean? If there are outliers on the data at either extreme its good to know

[@laurengianna9944]

My LDL was 245.1

[@forester057]

Perfect. Keep up the good work!

[@karen96978]

Okay, I didn't know that LMHR is not equal to FH. That's an important distinction to know.

[@masucci61]

I hope they measure Lp(a)

[@shelchicago8997]

Would taking niacin help? 250 mg x 4 to 6 times a day

[@user-vk5yr9cy1i]

Being in full ketosis and taking a statin or pcsk9 inhibitors should work against the lipid energy model. Destroying the fuel needed that is transported by the ldl. Is that correct an assumption?

[@stellasternchen]

Lipids are transported by chylomicrons to the liver from your gut. Liver cells are the only ones capable making ketones. If stored lipids are recruited for energy production, they travel as a free fatty acids bound to albumin, not in LDL particles. It does not make any sense to me, what the lipid energy is proposing.

[@virojchittchang655]

On low carb diet, you have low insulin thus excess fat in chylomicron is taken up and repackaged by the liver as VLDL . Excess free fatty acid is also taken up by the liver as well as by the muscles. In low insulin environment there is a lot of excess fat that cannot go to storage (due to low insulin) in fat cells, and it is not possible to float around in free fatty acid form only ,so the liver makes more VLDL. After fat in VLDL is used by the body, VLDL becomes LDL. Statin does not halt the production of VLDL but increases liver uptake of LDL.

[@stellasternchen]

@@virojchittchang655 What you are writing here contradict itself. You are perfectly describing a state of insulin resistance. Fat droplets on muscles, on fat cells, blood stream full of free fatty acids. Those fat deposits have been demonstrated to block insulin receptors. Fat infusions cause insulin resistance in rats. Proposed mechanisms are that this protects the mitochondria from lipid overload, as lipids are high energy, take long to burn and cause lots of free radicals that need to be neutralized before causing major damage. The other proposed reason is a mechanism preserving glucose supply to vital cells that can not exist without it in the liver, blood and brain when there is not enough. I‘ve read a study of the phenomenon of insulin resistance and reduced glucose tolerance in endurance athletes, but not in other kinds of athletes. This seems to be an effect of them being in fat metabolism for a prolonged time. Hyperinsulenemia has been shown to precede insulin resistance in the obese. What does hyperinsulenemia in the insulin sensitive cause? Low blood glucose. Anyway in both the keto diet and the prolonged endurance exercise insulin is low. We know this is reversible at least in keto by eating carbs. Glucose cures insulin resistance. Funny. Illogical. But glucose seems to get rid of the fat overload. Back to keto and the lipids. Where is the high cholesterol coming from? There is everything but. Let’s look at your text. You say we have high VLDL particles, high LDL particles, high free fatty acids and high triglycerides from diet, as they fail to be stored. If there are lots of triglycerides - we also have HDL particles picking them up by exchanging their cholesterol for TG from LDL. LDL and HDL particles, that carry many TG, are small, have less cholesterol. This model describes insulin resistance perfectly, but also explains the lipid transport during it very well. But it would result in high VLDL-C, normal or low total cholesterol, normal to low LDL-C, high to very high triglycerides and low HDL-C. Remember: LDL = particles LDL-C = cholesterol inside LDL particles. This can‘t be it. The LMHR phenotype has the opposite lipid profile: LMHR have very low VLDL-C very high TC, very high LDL-C, very high HDL-C and very low TG. 1. Why would the liver send the fatty acids from diet coming from the chylomicron anywhere during ketosis? They are needed in the liver to produce ketones and even can be stored there if not needed right away. If at all I would expect lower VLDL production and low TG send to be stored somewhere. But what I would see is tons of free fatty acids. Fat from fat cell storage is needed for ketosis and so the lipid droplets with TG‘s from fat cells are dissolved. Free fatty acids travel to the liver. But there is cholesterol in those droplets now no longer needed. And I think that is the cholesterol in our particles. It is picked up by HDL, given to LDL in exchange for some TG and brought to the liver to be excreted via bile. And the rate this is happening is overwhelming the LDL receptors of the liver, no longer able to keep it up. This results in lots of LDL full of cholesterol floating around.

[@davidzip8841]

One extremely important fact that was surprisingly left out of this presentation. Anyone with existing cardiovascular disease was excluded from the study. This was defined, in part, as having a CAC score above the 75th percentile. A number of people were excluded based on this criteria alone. Had they been included there would have been a different starting result. This is beyond misleading. This study, when concluded, will prove if it is successful that if you are on a diet that elevates your lipid numbers, you are unlikely to suffer any negative affects over the next two years. That is the maximum one can learn from a study such as this one. They were told at the outset that they needed at least a five year study to have meaningful results. For a one-year study, they needed progression of plaque rather than incidence of plaque.

[@megandurnford6043]

Completely agree. Do LMHR with a starting CAC score improve! That would be great to know.

[@stellasternchen]

They are also comparing metabolically healthy people with ones that are not, are on statins.

[@tomunderwood4283]

The study will show high LDL does not increase CVD if one fits the LMHR definition. It’s funded independently. Please donate to the next study so they can test more.

[@jeffrey4577]

20:...Dr Nadir Ali ❤

[@tonyprice1526]

Hdl will not increase in anyone unless the structure of the phospholipids in the HDL membrane can accommodate the curvature geometry required. HDL is small and dense, and the surface curvature is tight compared with larger LDL and VLDL. To accommodate this tighter curvature, a person has to either eat small chain fatty acids in their food or make them via the gut mirobiology through a higher fibre diet. Someone really should start studying interfacial colloidal science related to surfactant curvature of membranes and effects on packing at the interface.

[@lindapestridge3073]

Hi Tony I've just had my blood work back and I have very high hdl and very high ldl If I try to lower my ldl I'm worried my hdl Will be lowered as well do you think I should not Take a statin incase my hdl goes down as well I Live in the UK And when they are talking about Numbers I can't convert the US to the UK I find it so hard to understand Any help would be appreciated.

[@tonyprice1526]

@lindapestridge3073 hi Linda. Sorry for the late reply. Firstly I recommend you talk to your doctor about your concerns. I have a background in science and research, but I am not medical. I take a very high dose statin, which I would like to either lower or get off. My approach has been to reduce the dose and alter my diet at the same time. I eat a lowish carb diet, i.e., no sugar, bread, pasta, rice, potatoes, cake, snacks etc. I eat meat and lots of green veg. I have stopped using dairy but still eat cheese. I also eat as healthy as I can, so there is no processed food and only eat out about once a month. My HDL is good, and my LDL is low, but I am also very happy my triglycerides are low as well. I had my bloods done last week, and they look good. I supplement with combined D3 and K2, magnesium, and I use low salt. I restrict my eating window five days a week from 12am to 7pm. I only drink a couple of beers on a Friday and have a lowish alcohol bottle of wine over the weekend. I exercise and keep active. I live in the UK also and get my blood test results directly to my NHS account. They are all displayed in an easy to read form, placing them within or outside the required bands. You should be able to do the same. Hope this helps. But if your confused your doctor will help.

[@szghasem]

There is something about Dr. Budoff that makes you stop and listen to what he has to say. He makes a lot of sense.

[@tomedwards1879]

That's great news. Pity about all the other problems associated with an animal based saturated fat diet, like colon cancer.

[@ronaldlenz5745]

Pity there is no evidence to support that hypothesis.

[@tomedwards1879]

@@ronaldlenz5745 I suggest you go and do some proper research. If you have any doubts, go and get yourself an angiogram of your heart to see all the plaque buildup you have, Afterwards, you can thank me for saving your life.

[@lumay333]

LDL 750 here.

[@forester057]

Wow nice! Lean?

[@lancerebo952]

Wtf

[@chadfitch3293]

Darn you got my 550 LDL beat!

[@saintjulien9707]

​@@chadfitch3293Are you on keto diet ?

[@chadfitch3293]

@@saintjulien9707 yes

[@barblacy619]

If statins increase risk of diabetes why? Does he prescribe them?

[@jj900]

Shouldnt the LMHRs be compared to people with the same BMI and body composition? The BMI of 22 is in someone lean. The control group with a bmi of 25 will no doubt have more subcutaneous and visceral fat, and likely lower muscle mass

[@danwvsukh]

I hear a lot of negativity about statins here, however, I heard they make your CAC bigger

[@primalspirit1]

It can't be either LDL is 100% the problem or LDL is zero percent of the problem. I'm coming back in 2 years and hopefully AI will have figured it out.

[@WFPBFORLIFE]

plaque build up happens over time. High00 Choesterol issues are caused by one particular food group.

[@vohh7401]

Don’t statins increase CAC?

[@markopolo8845]

Indeed they do…

[@barblacy619]

So why statins?? To me it’s pretty obvious

[@davidwinebrennerjr4196]

More clown show. Apob should be lower not higher and the data is clear. Eventually higher apob will result in higher plaque.

[@Raktan1]

Dr Budoff has been a waste of my time. He's not a keto guy. He'd treat high LDL with a statin. He is confusing himself & the keto science.

[@Jean-yn6ef]

💚🏜️💚