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Dr. Paul Saladino's claims on the Joe Rogan podcast. Part II of the fact-check. Yet another Joe Rogan podcast touching on nutrition...
109:38 as long as you have high HDL, increasing LDL has very little risk. very little cardiac risk.
common idea that HDL-c makes up for high LDL-c. this idea of the protective HDL-C comes from correlation studies. bag 2. when it was tested directly, in randomized clinical trials, bag 3, raising HDL-C did not improve cv risk. meta-analysis of 39 clinical trials:
“observational studies suggest a simplistic hypothesis for HDL-cholesterol, that increasing it would reduce cardiovascular events, but substantial trials do not support this concept”
genetic studies confirm that higher or lower HDL-C determined genetically didn’t change cv risk
bottomline, for heart disease, raising HDL-C probably does nothing and certainly does not make up for high LDL-C
LDL-cholesterol and triglycerides are helpful markers but it's well understood that the real cause of heart disease is the number of lipoproteins, the vehicles that carry cholesterol and triglycerides. In most people, high LDL-C and high triglycerides indicates high concentration of lipoproteins, but some people are exceptions and may have high lipoproteins but normal LDL-C or vice versa.
111:21 insufficient evidence to say high LDL in someone who is metabolically healthy is the same as in someone who is metabolically unhealthy.
we’re acknowledging high LDL-cholesterol is a problem, but maybe if I’m metabolically healthy, if the high cholesterol is the only issue, maybe I'm an exception? meta-analysis: lowering LDL-cholesterol in different contexts.
‘there was a reduction in cardiovascular events (heart attacks, strokes) in people with diabetes which was similar to the effect observed in those without diabetes” and “There was a reduction in mortality with lower LDL cholesterol in people with diabetes, which was similar to the reduction in those without diabetes”. they conclude “Among all trials, the effects of cholesterol-lowering were similar with or without diabetes”
So whether they had diabetes or not, they benefited by bringing ldl-c down to normal levels.
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References:
HDL-C: www.ncbi.nlm.nih.gov/pmc/arti...
LDL-C and context:
www.thelancet.com/journals/la...
www.ncbi.nlm.nih.gov/pmc/arti...
jamanetwork.com/journals/jama...
www.sciencedirect.com/science/article/abs/pii/S0140673605673941
search.proquest.com/openview/...
www.sciencedirect.com/science...
www.kidney-international.org/...
www.sciencedirect.com/science...
jamanetwork.com/journals/jama...
Minnesota and Sydney:
www.ahajournals.org/doi/full/...
www.ahajournals.org/doi/abs/1...
CAC: academic.oup.com/jcem/article...
RCTs on plants:
pubmed.ncbi.nlm.nih.gov/15867...
academic.oup.com/jn/article/1...
www.ahajournals.org/doi/full/...
www.nejm.org/doi/full/10.1056...
pubmed.ncbi.nlm.nih.gov/29215...
www.nejm.org/doi/full/10.1056...
academic.oup.com/ajcn/article...
academic.oup.com/ajcn/article...
academic.oup.com/ajcn/article...
www.ncbi.nlm.nih.gov/pmc/arti...
science.sciencemag.org/conten...
jamanetwork.com/journals/jama...
www.thelancet.com/journals/la...
link.springer.com/article/10....
www.ahajournals.org/doi/10.11...
jandonline.org/article/S2212-...
link.springer.com/article/10....
academic.oup.com/ajcn/article...
www.nature.com/articles/ejcn2...
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