Understand Your CHOLESTEROL PANEL & Metabolic Health Tests - The ULTIMATE Guide | Dr. Robert Lustig

A metabolic blood test and cholesterol panel can be confusing, so in this ultimate guide, our Chief Medical Officer and Co-Founder Dr. Casey Means talks with Levels advisor and author of Metabolical, Dr. Robert Lustig, to give you advice on how to interpret your panels to better understand the status of your metabolic health.
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Dr. Robert Lustig walks through what HDL, LDL, triglycerides, and total cholesterol mean, how fasting insulin tests relate to your cholesterol panel, how to improve your cholesterol numbers, and how to interpret ratios of your cholesterol numbers like the triglyceride-to-HDL ratio.
#metabolicHealth #cholesterolPanel #LDL #triglycerides #bloodPanel
📍 What Dr. Robert Lustig and Levels’ Dr. Casey Means discuss:
00:00 - Intro
02:17 - Understanding cholesterol
02:44 - The correlation between LDL and heart disease
05:12 - The connection between LDL and triglycerides
07:14 - Good cholesterol
16:48 - Measuring LDL
30:04 - Portal systems in the body
44:51 - The importance of liver function tests
54:05 - How to reduce liver fat
👋 WHO WE ARE:
Levels helps you see how food affects your health. With real-time, personalized data gathered through biosensors like continuous glucose monitors (CGM), you learn which diet and lifestyle choices improve your metabolic health so you can live a longer, fuller, healthier life.
🔗 LINKS:
Watch the conversation: • Understand Your CHOLES...
The ultimate guide to understanding your cholesterol panel and metabolic blood tests: levels.link/youtube/blog/the-...
Show notes: levels.link/youtube/podcasts/...
Subscribe here on KZbin: kzbin.info?sub_...
Connect with Casey on Twitter: / drcaseyskitchen
Connect with Casey on Instagram: / drcaseyskitchen Connect with Rob on Twitter: / robertlustigmd
Connect with Rob on Instagram: / robertlustigmd

[@georgeyoung1810]

Chapter 9 of Metabolical taught me what I needed to know about my lipid panel. Total cholesterol 288, HDL 62, triglycerides 52. So I knew how to interpret the results. Dr told me I was a candidate for a statin and I told her I was a candidate for a new doctor

[@robm2707]

Hi George I’m in the same category. Can I ask what was your LDL please?

[@georgeyoung1810]

@@robm2707 LDL 217. The worst part is I asked for an LDL-P test and she said it wasn't available. My wife was in the next office with same system and got the test!! Needless to say I will be looking for a new doctor!!

[@walterski8377]

Still be sure to get the inexpensive CIMT test done as well per Dr Ford Brewer. Cardio Risk is best place I just had my first one, they were great their test is accurate and thorough.

[@slay2525]

I had Afib, high blood pressure, some thickening of my left atrium and the septum, high blood pressure, some plaque in Coronary Arteries, eczema, 34 BMI, high triglycerides, sleep apnea, acid reflux, etc…. I was a vegan eating a ton of fruit, grains, …. Always hungry and getting fatter and sicker every day. Cardio wanted to put me on 5 scripts including 2 statins. I took the statins for a month incorrectly, then took at night correctly. On the third day, I woke up at 2 in the morning with horrible headache. I jumped online, found about statins and the bs and how the doctors will disregard the adverse side effects …. Next appointment my cardio yelled at me straight out of the playbook that the adverse headache wasn't caused by the statins (I never get headaches) when I told him about the headache and that I wasn't going to take statins. Anyway, I gave up on vegan, went hardcore keto meaning zero carb and HIGH fat (keto is not a meat diet … too much protein), started 3 day fasting regularly, supplementing w d k2 c potassium chloride and magnesium, I lost 80 pounds, my triglycerides went down to 75, hdl went up to 55, ldl went to 100, heart shrunk, CAC went to zero for all 4 coronary arteries. My cardio had to discharge me as a patient because all my risk factors went below what my insurance required for cardiac care. He said I was the only patient he ever discharged and that I was the only one that ever lost the weight and lowered all the risk factors and had a zero CAC. His final words were “what did you do again?” I told him, he wrote it down, I never saw him again.

[@libbycollins9349]

How do you find a doctor who actually knows about this stuff!!?

[@e.a.miller6503]

Holy cow. What a brilliant educator. I’ve been in medicine 30 years and I’ve never had cholesterol explained like this. Thanks, this was the highlight of my day.

[@kicknadeadcat]

Doctors need to think outside the box to make medical progress.

[@surapongpukdee5911]

So enlightening. So important. Thank you so much. Now I feel better with my high LDL and low Triglyceride.

[@jujuapple6706]

Huh? Oh Gawd, I hope you are not a doctor!

[@yuurishibuya4797]

That’s sad to hear, I understand that the general public may not have access to such educational videos (prior to KZbin, which provides sparse information and often not correlated), but ppl in speciality fields aren’t taught well; that’s very scary. This applies to other fields like engineering, accounting, law etc as well.

[@TheMrprez]

@@jujuapple6706 I hope YOU are not a doctor.

[@rgbcolor6450]

Dr. Lustig saved my life ten years ago when I found his lecture "Sugar, the bitter truth". We downloaded the youtube video and played it on the big screen in the living room. After cutting out the sugar (all of it) my cholesterol fell by half, and while I didn't lose any weight, my blood pressure came down with the cholesterol. Back in November 2023 (three months ago), I read his book Metabolical, and since using the information in that book, I have EFFORTLESSLY lost 40 lbs in three months. I capitalize "effortlessly" because that's important. I'm not using super-human willpower to fight cravings or hunger. I don't count calories, I don't restrict my food intake, I just cut out the processed food and let the chips fall where they may to see what happens. What I learned from my experience is that the processed foods are why I was always hungry. Before following his information, I would get so hungry I couldn't concentrate on anything but the hunger. It was a physical hunger pain that wouldn't go away until I ate something. After his book, I don't even get hungry for at least 10 to 12 hours, and if I get even a little distracted by something, I'm likely to forget I was hungry for a few more hours. For the first time in my life a few days ago, I forgot (FORGOT!) to eat dinner. I was shocked in the morning when my wife asked why I didn't reheat what she left for me in the fridge. I have lost 40 lbs in three months and just had a blood test.. my liver tests AST and ALT are back in the green and falling, and my triglycerides dropped 40%. My knees no longer hurt, and I don't wake up every morning feeling like I'm hung over. Thank you Dr. Lustig. If I had the opportunity I would shake your hand and thank you personally.

[@colinobriant6895]

Would you mind breaking down what you tend to eat on a daily basis? I was doing keto but then I realized it was driving my LDL up in a way that scared me. I'm curious what you've been doing.

[@rgbcolor6450]

@@colinobriant6895 Breakfast is usually 3 or 4 scrambled eggs with kale and oat bran fiber mixed in. I will almost always have a cup of Kimchi on the side with the eggs. I usually skip lunch, but if I don't, or if the psychology of needing to shove something in my mouth comes up, its usually a small piece of hard white cheese with a handful of pecans or walnuts. Dinner is whatever my wife makes, but never anything processed. If you're loosing weight, your cholesterol and LDL is going to go up.. that's what happens when your body harvests fat stores and burns them. I also add a lot of flax seed to my meals whenever I can, like mixing into the soups my wife makes. We purchase whole flax, then grind in coffee grinder as we need. Chia seed as well. (Keep your flax in the freezer or fridge) Dinners that are not soups, will always be a some dead animal or another with lots of vegetables like roasted brussels sprouts or steamed asparagus or something else. And lots of butter on them. I also make sure to eat one fruit a day.. Usually a couple small tangerines or an apple or banana. Snacks are things like Kifer and flax seed, or blueberries. When you stop losing weight, your LDL and total cholesterol will fall.. Your triglycerides are far more important. Read the book "METABOLIC" by lustig.. they have an audio book version.. it was fascinating and stunned me.

[@ginaqc78]

@@rgbcolor6450 Congratulations!!!! Totally different from the standard American diet!!!!

[@balajisrinivasan6861]

What were your HDL,LDL,TRIG numbers before and after the diet change please. Cheers

[@balajisrinivasan6861]

I had a similar diet in March but HDL shot up to crazy values (75 to 96) LDL stayed same (100) altho TRIG came down from (79 to 59). Been reading that 90+ HDL is as bad as below 40 HDL. But no easy way to reduce it. Appreciate any feedback. Cheers

[@AA-nl5bl]

Dr. Lustig is phenomenal. His ability to break down complex information is a gift to humanity.

[@liliancalo3518]

Sure, a gifted brain, and I imagine, hours and hours of studying and reading and keeping up with medical literature and everything else that makes the difference from being a doctor and being “the” doctor. Thank you Dr Lustig, for dedicating your time to educate us all.

[@kklau4715]

As a medical doctor myself who had worked for twenty years, I honestly confess that a lot of what is mentioned in this video is not taught in medical school, and yes I gain so much new insight from this and surely I will read the book to learn more indepth in this topic. Thanks so much for all the valuable information.

[@draselee6131]

Thank you for being an open minded MD willing to learn. Your patients are fortunate to have someone like you looking out for their health and well being.

[@thesixsidedbox]

@@draselee6131 can I pay for you to read my blog work panel?

[@SamFreedom]

Thanks for stepping up and confirming things we intuitively knew.

[@bobtosi9346]

Good for you.

[@jacksoneglise1657]

About time you took on the responsibility to learn your trade. We lay people have been reading medical literature for years and knew this info. However, our hubris was not killing anyone. Food for you in reading med literature you should have read and kept current with starting the day you exited the med school.

[@kaynenbrown5102]

You guys have no idea how much posting videos is helping people in the world. Thank you.

[@user-oo1wi6de3v]

Robert Lustig should be US Surgeon General

[@brucehutch5419]

Robert Lustig MD should be a senior adviser on the presidential cabinets of the President elected 2024. And every President 2028 and Beyond as long as he wishes to serve. He needs to be in there to have the power influence and disseminate his knowledge to the politicians to change the FDA CDC NIH American Heart Association American Diabetes Association so they quit being influenced by Big Food Big Pharma. So the federal government organizations make policy and approve medications and diets based on real up to date functional medicine knowledge. So these government organizations quit being influenced by and Pawns of industry whos lobbyists write the laws and pass them on to Congress for Congress to write into law.

[@paulseverson2307]

At the very least, he should be the head of the AMA instead of the USELESS people there now.

[@Milkman4279]

OMG!!! Can you imagine?

[@markbeiser]

Unfortunately the people who we NEED in those kinds of positions don't want anything to do with them, and the people who WANT those kinds of positions shouldn't be allowed anywhere near them!

[@hopehenley3002]

Dr. Robert Lustig rocks!

[@sincocuerdas]

I got Fatty Liver last year. I immediately went to KZbin, found Dr. Ken Berry, immediately cut out ALL sugars and most carbs, went on Keto and felt better in the first week. 2 months later I had reversed my NAFLD. This podcast is on a different level of being informative, very thorough and detailed. I'm glad I found Dr. Casey and Dr. Lustig.

[@sincocuerdas]

@Nine Bun Bun I eat at least 2 eggs a day and my triglyceride to HDL ratio is optimal.

[@tamikessler7600]

What is NAFLD?

[@sincocuerdas]

@@tamikessler7600 Non Alcoholic Fatty Liver disease

[@defeqel6537]

@@tamikessler7600 non-alcoholic fatty liver disease

[@ocpersonofinterest]

@@tamikessler7600 Non Alcoholic Fatty Liver Disease

[@fdbassociatesllc7889]

This is one of the most important 57 minutes of content in all of the internet! High substance questions and answers that were all understandable to non-medical professionals. Congratulations for knocking it out of the park!! Thank you both!!

[@jobrown8146]

Yes, I agree. I am very impressed with this presentation.

[@erastvandoren]

It's a lie

[@jobrown8146]

@@erastvandoren May I ask what makes you state this please? I'd be interested to hear about your own experience/s.

[@erastvandoren]

@@jobrown8146 it's not about my own experience, I'm somewhat of an expert on the subject. 80% of his statements here are made up.

[@jobrown8146]

@@erastvandoren You made the statement "it's a lie" without providing anything to back it up or say why it is a lie. I have no idea who you are or what your credentials are. It makes it very difficult for me to make an informed decision about your statement.

[@ohanaomar77]

Dr. Rob is from another planet. The way he explains what metabolic health is all about, is phenomenal. I must admit that medical school doctors should listen to what he advises on metabolic health. One of the most eye-opening interviews I have ever come across. Thank you Dr. Rob. You are the real doctor!

[@jimmason8502]

He's so animated and explains things so well I'm almost applauding him when he makes a point. Can only imagine having him for a prof, best teacher ever.

[@barbbq9963]

This ER nurse of 35 years thinks you are brilliant! Thank you!

[@johnryden2921]

I’m a 58-year-old male, 5’ 11”. I weigh 175 pounds I’ve been eating 42 eggs per week or six per day for years. Every month I donate platelets at a local blood clinic they use for burn victims. (Not to be confused with plasma donation). This is a personal sacrifice of two hours I’m on this machine each month. (I feel like I’m doing something positive). The process is where they take blood, separate out the platelets and return the red blood cells and Plasma. Hanging above the machine is the bag that holds the collected platelets. My technician says you can tell a lot about someone’s diet by the color of their platelets. You can tell a lot about your blood chemistry by the color of your platelets. They are yellow in color. My technician loves my platelets, she says, mine are the most perfect she has ever seen. Mine are a clear golden yellow. Everyone else theirs are a milky yellow due to the triglycerides or suspended fats in their blood. (Platelets only have a 5 day shelf life and have to be constantly moving to prevent them from clotting). I’m in great shape for my age. I can do 100 push-ups. My dad lived to 90 on a similar diet.

[@DjSiN71]

100 push ups straight or broken into a few sets ? Curios cos I’m similar to u, height and weight but I’m only 53. I have been super slack with fitness lately and I’m hoping to get the motivation going again. I have always trained weights etc. what else are u eating mostly ?

[@alann2430]

What was your dad cause of death?

[@BadHorsie1]

​@@alann2430too many eggs

[@BadHorsie1]

6 eggs per day every day. Jesus, I'd get sick of that quite quickly

[@sharkbait1958]

You are a hero, for real.❤

[@Paolo_De_Leva]

_"Oh my gosh, this is so good. That was such a beautiful description of the pathways in the liver"_ (Dr. Casey Means @33:08) You are right. Lustig's explanation was impressively magnificent. He is at the same time a top researcher and a top teacher. One of the best in the world. He deserves the Nobel prize.

[@stnln2180]

Guy is truly a national treasure❤

[@intothenight9256]

I agree!!!!! Dr Lustig is a brilliant man and a caring man!!! Thank you to both drs for an epic interview! Eternally gratefully! 🙏🏼

[@bbyng7316]

International treasure! ​@@stnln2180

[@jefcalomarde3288]

hi. im a filipino. i have eliminated sugar in my diet and super low carb in my diet. and im doing intermitent fasting for more than a year now. my diabetic has reverse and my triglycerides is 100. it really worked. i do exercise too. JUST DO IT.

[@bobo-si3kw]

Watch the rice intake, while in the Philippines, I noticed people eating Rice 3 times a day.

[@drsaravananr]

This is just too good. Dr. Robert Lustig, Dr. Pradip Jamnadas, Dr. Jason Fung and the likes are real geniuses. I have been a doctor for more than 2 decades now and never knew this side of medical science. Great brains sharing great info. Thank you so much.

[@slay2525]

You need to add Ivor Cummins (heart disease stuff, not that conspiracy theory stuff that he got into since the Covid pandemic) and Cole Robinson/Snake Diet (if you are not afraid to push tough love on your patients). Also I made Dr. Jamnadas my cardio after I found out that he was in Orlando. I might add that in connection to his practice when he is working with patients, not giving lectures on line, his medical recommendations is more aligned with the standard treatment model.

[@baguaboy11]

Wow ! As a heart disease patient ( 3 heart attacks , 5 stents) who is now self educating as to causation .. and pursuing low carb , intermittent fasting , exercise lifestyle changes ( kudos to Dr Ford Brewer at Prevmed) .. this video has been a total eye opener.. giving the missing pieces … thank you so much!!

[@obrotcho8289]

This Doctor has superhuman intelligence of the human body and a superb teaching ability.

[@tralalabonbon8294]

Couldn't click any faster when Dr Lustig pops up in my feed

[@LevelsHealth]

We feel the same way

[@karencollisson8421]

4 months on keto, no sugars, low carbs, and I no longer had non alcoholic fatty liver disease and no type two diabetes! 8 years later and I’m still healthy with triglycerides at 39, HDL at 69.

[@jfinca]

Holy F#$% that is awesome...My triglycerides are 142 and HDL 27 ration 5.2...I'm on meds and have had 2 heart attacks Yikes

[@MrPcphn1]

Very few people know this knowledge. Doctors are train by drug companies to give drugs. I can testify because I on low carb diet , loose 20 lbs in 7 weeks and bring my liver enzymes and high blood pressure to normal.

[@arifaahamed7239]

Great ! What’s your LDL number ( just for curiosity)

[@TheAnimalBasedCure]

I went on keto+IF earlier this year and went from LDL 140, HDL 50, TRI 69 and did bloodwork this week and my results were LDL 168, HDL 66 and TRI went down to 35 Cut out seed oils and alcohol in June I started doing carnivore/animal based diet about 2 months ago. Lost 73lbs in 7 months My testosterone also went from 361 to 588 I feel pretty good

[@aprilgabutina6970]

I wish we could have more doctors like him. Doctors that continue to do research and updates themselves not depending on pharma company-base studies. God bless you more Doc!

[@jenadamsuk]

Don’t need to be a doctor to know this stuff!

[@jimmason8502]

@@jenadamsuk Literally the dumbest comment on KZbin. You're shoving aside this brilliant man's insight and decades of research as if it's something you read on the back of a cereal box.

[@ph0ib0s1]

Literally my life saver. His lectures about sugar saved my life. Several family members, some of them MD's died from diabetes 2 after experiencing the worst possible outcomes. After learning the truth from his amazing lectures, I found the way to fasting and low carb diets.

[@lisaa8795]

Agreed. I had cut my soda consumption down to 0 for a couple of years due to one of Dr Lustig's talks - I wish I hadn't started up again. But once again have limited soda consumption to about once a month. Now that I've heard what the norms have done to the liver measurements in the bloodwork, I realize I have a lot of work still to do!!

[@wellnesspathforme6236]

Look up Dr. Chris Palmer, Morley Robbins, and Dr. Thomas Seyfried.

[@wellnesspathforme6236]

@Times Past Television Excellent. Don’t miss out on Morley Robbins and Dr. Chris Palmer, though. They have key insights on mitochondria, too.

[@defeqel6537]

@@lisaa8795 it's really easy to fall back into eating / drinking sugar with it being present in all events and gatherings, and it's always a bit of an effort to wean yourself off it. Also need to work on better stress relief than food...

[@joycebrewer4150]

​​​@@defeqel6537Amen! My sis-in-law wanted me to go the "moderation" route, but I told her it wasn't in me to do that. I either eat much sugar, or none. And I am very much a stress eater.

[@ViktorHristovvv]

This was mind-blowing. Having someone actually explain this in very simple terms helps so much more than having a dozen of meaningless lab results. Thank you both so much for this!

[@Doudoustein]

Dr Lustig is such an incredible teacher!

[@mystatinfreelife]

I had a Trigs/HDL ratio of 7.45 years ago when I was on statins. I changed my diet. Most recent calculation was 1.47 (not on statins.)

[@4406bbldb]

Wow, I’m on the right track. I’m a healthy 75 year but 5 years ago I was all the sicknesses you two talked about. No sugar matters. I’m actually 1 day into my normal 1-3 days fast I eat if I don’t feel great. My Visceral fat is completely gone, my mid section felt like a well inflated basketball and now it soft and I’m working on muscle. Thanks for this video it is really important And I’m so happy I understand it. 😊

[@mariabyrne1954]

What do u do for muscle loss and growth

[@tonygosbee3390]

@@mariabyrne1954 u can only get back yr muscle loss thru resistance wt lifting. A dumb bell will do the jb. Goggle search yrself.

[@Isaac5123]

​@@mariabyrne1954 what muscle loss are you talking about ?

[@movievaudeville]

I just had a lipid panel done. Using some heart-disease-risk calculation my primary care doc wanted to put me on a statin. I refused. My TG/HDL ratio is 1.8. I remembered watching this several months ago, returned to refresh the knowledge. Now, I would love to drop that ratio even more and will do some diet tweaks to accomplish that. All my other stats like BP (109/69)are great, particularly for my age (64) although I'm considered well over-weight. I take no medications. Last year, another doctor spent the entire session talking about putting me on Ozempic. Why? Because the intake nurse had miss-typed my height, off by nearly a foot. So, rather than actually LOOK at me and realize my BMI was NOT 42, the doc proceeded to advise me based on a complete error. I didn't take her "advice" either. Today, listening to this again, I had a cold chill wondering what I would've done had this type of information NOT been available to me. Thanks to Dr Means, Dr Lustig, and all the brilliant minds out there spreading knowledge to empower us.

[@stephsmith3857]

Retired 40 yr veteran registered nurse still fascinated with the human anatomy, most interesting lecture. Still learning !

[@chanwalobhagwandin1477]

I am over 60 and hady gall bladder removed approx 6 years ago.now my cholesterol is high now and I am on statin,and had to do stress test.Is this concern I should know?

[@anticom]

As a retired physician I really appreciate this total explanation of the cholesterol issue. This should be in the medical teaching program in evert medical school. Definitely it has not been so nicely presented in all teaching programs or seminars that I have ever ran through.

[@annemccarron2281]

This is new formation. The scientific world did not understand this when you went to medical school.

[@SuperLuckao]

​@@annemccarron2281it isn't new info.vthis doc knows about it and he is a professor. It is deliberately not taught and is suppressed so thy can sell the drugs. Medicine is now a business. No longer care for us health. Thyll keep u alive but sick yo fund pharmaceutical industry. If u r well thy have no customer or $$. Follow the money.

[@cletusamlung5122]

Wonderful.. I did all three suggestions.. Got rid of processed sugar, Added intermittent fasting and exercise daily. Lost over 20 pounds in 6 weeks. Looking forward to getting my cholesterol tested.

[@marcuswillett8236]

Llomkl

[@marcuswillett8236]

L mmk 9

[@slay2525]

Me too. Add some 3 day fasts and you will be a teenager with washboard abs in no time.

[@dineshbeto]

What is your test result

[@herbertlong3981]

note: your doctor is going to try to push statins on you. As you achieve fitness, and achieve getting rid of sugar and other simple carbs your LDL will rise. Like this doctor says, the important one is your TG/ HDL. (Dont you love the way that in a space of 100 years out of the million we have been here, that we have decides that heart disease is caused by LDL? It is not. LDL is a necessity for basically all life) I am 71 now, basically the epitome of physical fitness. Always have been, because of the work i did since childhood. In 2005 a doctor tries to push statins on me. I laughed at him and said "never". In 2017, my total cholesterol panel was 272, the HDL 75, the TG 43. My doctor tries to push the statins at me. I grinned at him, derisively. IF ONLY THE AVERAGE PERSON IN THIS COUNTRY COULD HAVE THESE RESULTS! And weigh 157 at 5'11 inches But I need statins, by golly! Yes indeed I do!!! I have friends and relatives who fell for the hype back then, and many of then are dead, or are not really lookin too great! Jus sayin! In our modern society, we are INCREDIBLY able to lie to ourselves. We believe things like this: --- That heart disease is caused by lack of Lipitor in your body. (Your doctor actually believes this rubbish) --- Another fine example would be that tooth decay and obesity is caused by lack of aspartame in your diet!!! Wow! How gullible can we be???! --I could go on and on with the hilarious lies we apparently believe. In the western world we are involved in a pandemic, the proportions of which diminish this so called covid pandemic to a proportional nothing. (And btw, most of the people who died of covid, died because of the real metabolic syndrome pandemic!) And the remedy for all this is so very simple: Stop eating more food than you need. (This is really the most important one -- if you burn off all those calories you consume, on a daily basis, these things will not cause you so many problems, even if your food is not so good). Specifically, stop eating sugar, and the other simple carbs. Start, by not bringing this shit home from the store! FI, a "great sale" on Pepsi, is not a great sale, by any stretch of the imagination -- this should be your attitude. (And no, it does absolutely no good to replace it with diet pop, so dont go there!) Somehow we must start to eat to live, rather that living to eat! Your supermarket is literally stocked with "food" that is little more than sugars Literally 80% of the floor space. It is not food. It is candy, and convince ourselves, and then teach or children that this stuff is food Your doctor is going to try to push Lipitor at you. That Lipitor is for lazy people who have capitulated and realized that they do not have the self discipline to stop shoveling shit down their pie holes. In my country, 70% are overweight, half of those obese. They all have metabolic syndrome to some degree, and it is all done by personal choice. (It isnt something inherited, it isnt your doctors fault). This is really the only pandemic in America that matters today

[@williamhenry3337]

I am 75 years old and on Medicare. My last physical was in 1969. I have a 29" waist line. Never had a prescription. I just had my FIRST blood test of my life. A week later I get a call from the RECEPTIONIST and she says "your cholesterol, LDL and PSA are slightly high" click, she hangs up. I go down and request a PAPER COPY of the results. My triglycerides are 76, my glucose is 84 and my ketone are high (I fasted for 48 hours prior). My cholesterol 201 and LDL 139. THANK YOU for explaining what the doctor didn't.

[@Ivailolondon]

this interview is blowing my mind. I have to stop every minute or so and rewind to re-listen, incredible stuff

[@stitchknit72]

Exceptionally good info. Thank you Dr Lustig. And Kudos also to Dr Means for her interview style. I really appreciated that she asked questions and allowed Dr Lustig to answer without interruptions.

[@erastvandoren]

Exceptionally bad and wrong info

[@jobrown8146]

@@erastvandoren Please explain why it is bad and wrong info.

[@erastvandoren]

@@jobrown8146 I'll do a video later

[@jobrown8146]

@@erastvandoren I look forward to it.

[@clownbackpainrick6581]

@@erastvandoren Hi, which markers do you recommend to look at?

[@Malcolm-Achtman]

Dr. Lustig mentioned that we should check our WBC (white blood cell) count and thyroid health before evaluating cholesterol, as those variables could affect our cholesterol results. Another important factor that Dr. William Davis reminds his tribe about is that you should never get your lipids evaluated while undergoing weight loss. He says the mobilization of fats during weight loss (even just a pound) could affect all the values and mislead the patient and/or their doctor. He says a person should wait at least a month after achieving a stable weight before getting tested.

[@SamFreedom]

What about BEFORE dieting? I had a physical jan 30, 2023, not dieting. I can use those as the before, correct.

[@Malcolm-Achtman]

@@SamFreedom If you had blood work done and weight has been stable then your test results should serve as a good "baseline" or starting point. I trust you fasted 12 hours prior to your blood draw.

[@SiriusStarGazer]

This happened to me. Only a few days ago i did a lipid profile and my ldl was high 150. I was on a low carb , no sugar , no processed food diet and lost 20 lbs in 3.5 months of diet.! my trg was 50 hdl 56, lowest and highest testing respectively since I have been doing lipid profiles.

[@claudettesechler149]

Such a great episode, great guest! My HDL is 122 and my doc wanted to put me on a statin and my triglyceride level has gone up to 40. He did ask me if I was “one of those!” Yep, 71 year old fit Girl!!

[@TheFeelyourself]

How did u get HDL so high?

[@clintcarter]

Bless this man and thanks for hosting. ❤💪🔥

[@chrisrobison1352]

Everybody should watch this video before going in for your annual checkup. Outstanding content thank you so much for posting this!

[@libbycollins9349]

I’ve relistened to this several times. Very clear and helpful. I’m old. I’ve read some NIH and PubMed stuff that high LDL can be protective and correlate to lower mortality in older people. I’m banking on it as, at age 75 with a zero CAC, I have increasing LDL but with HDL over 100 and triglycerides of 59. My doctor wants me to take a statin and I’ve declined, but she acts like I’m a moron. I wish doctors would listen to this discussion and read more articles the NIH publishes. Thanks for this.

[@mnp870]

It’s difficult to talk to a doctor about cholesterol. They consider only the total number as the only GOLDEN rule to follow. If you don’t do what they want they feel they can’t help you and to find another dr. because you won’t take the drugs they prescribe.

[@JohnDoe-et8th]

As Dr. Lustig says, you'll probably be a centenarian. My doctor is the same way and I can only shake my head at how programmed these people are. I have to put it down to the fact that they have to waste nearly all their time typing stuff into computers and fighting the insurance companies rather than doing good medicine--which means keeping up with basic research at the minimal level available on KZbin!

[@lindawick455]

Dr Ken Berry has an exceptional video on the detrements of lowered ldl. Check him out. His ldl is like 209. Mine is 160. I shall live forever like you. Without the dementia that comes with statins, especially us septugenarians

[@josephboronka1734]

​@@lindawick455 ? Whats a " septugenarians ❤?🧐🤔😉🤚👍

[@gette4439]

@@josephboronka1734 someone in their seventies. 😊

[@sup375]

Thank you so much for posting this interview.

[@watcherworld5873]

I can see the passion in the face of Dr. Lustig. I am glad that someone is looking out for us. Thank you Dr. Lustig.

[@angelheart408]

Thank you Dr Lustig for explaining the cholesterol panel. I now understand it! You are such a clear and concise teacher. I really appreciate you ❤️

[@alexsaptetrei]

I’m a mechanical engineer and I fully understood what dr. Listing said. This is an awesome explanation. Thank you to both of you.

[@lisalong9140]

What an informative, understandable explanation of cholesterol!! Doctors have been scaring me with my 290 cholesterol panel for years. Last one sent me to a heart clinic where they tried to talk me into a statin. I've always been fit and healthy and rarely ill. I'm 64 and all my other biomarkers are excellent. My triglyceride (65) to HDL (72) ratio is .90! In your words, if my ratio is less than 150 I'm "gonna live forever." I'm passing this episode to some of my cholesterol-worried family and friends. THANK YOU!

[@jespestana]

I guess you meant "less than 1.50". Congrats on your good health :-).

[@lauracurta3709]

Hi Could please let me know your LDL level? Thank you

[@msmacmac1000]

Same with me! I’m 73. My tri: 69 Hdl:77. Doc tried to put me on a statin and I did the research and refused. I’m looking for another doc, but they are harder to find these days- a good one, that is. I am fit, and work out regularly, still practicing law, healthy! Doc is a complete downer and doesn’t seem to care what the reality is. Oh- my CAC is zero! I took the test because she kept pressuring me. Still: lightbulb doesn’t go on.

[@michellejf777]

Can someone explain how you measure this plz?

[@williamdennis1256]

@@michellejf777 Hi, the triglyceride to HDL ratio is determined by dividing the HDL into the triglycerides. For example, if your HDL value has been determined to be, say 75, divide that number into your triglyceride value, eg., 68, which will give a ratio of .91. And, according to Dr Lustig, the interpretation of this value is very strongly associated with good health. Best regards- hopefully this is what you were asking.

[@Aperto8]

IMPORTANT POINTS 04:00 Not ONE but TWO LDLs 14:38 Large vs. small LDLs 19:44 Triglycerides and sugar metabolism

[@d0nj03]

One minor point where the host doesn't get it quite right is where she says cut out all white flour along with all sugar. You can have pasta done in ways that aren't that damaging, for example if you refrigerate it overnight and crystallize some of the starch to resistant starch and serve it cold the next day or reheat it to body-temp but not higher (also, pro tip: keep bread in the fridge if you're going to eat bread). And it also helps somewhat if you shorten the boiling time and leave it with more of a chewy core, in the traditional Italian style of "al dente".

[@tonygosbee3390]

@@d0nj03 good insight however, I rather be safe....... cut dn on flour and sugar.

[@d0nj03]

@@tonygosbee3390 I mean there's also whole-grain before you get to full anti-flour policies. :) Foods can reduce eachother's detrimental effects by being eaten together in various ways - once you're going whole-grain and eating it with other stuff that's not insulinogenic you should be fine. There's a reason the pasta-friendly Mediterranean diet isn't known to be a great destroyer of health. :)

[@Definitely_Someone]

@@d0nj03 that only cuts carbs by half but that doesnt mean its healthy, it means its much better choice if you want to eat some pasta or rice once in a while.

[@d0nj03]

@@Definitely_Someone You seem to be pushing extreme interpretations of "sugar is bad" and going into "all carbs are bad". If you're not doing the high-discipline near-zero carb ketogenic diet, dr. Lustig said you shouldn't be half-assing it and eating a randomly high-fat diet because it's one of the worst possible options. If you're not going for true keto, a recommendable balanced diet has quite a lot of carbs in it (I personally aim for 50% by weight, which is less than 50% by calories). The problem are insulin spikes, most easily caused by blood sugar spikes. As long as you're eating "slow carbs" and keeping the quantities sane, you're fine, there will be no spikes. Pasta can be OK in that equation, with certain precautions. Whole-grain pasta has fiber, protein, vitamins, minerals, it's a nutritious food, it's not the devil. It has no fructose, the liver-toxic part of sugar. Sugar is the devil. Unjustified insulin secretion is the devil.

[@elsonck2523]

Note at 50:40: good summary about what to check for before jumping on stats... first look at your total cholesterol levels, then your LDL, and if high look at your HDL vs. triglycerides ratio... should be below 2.5:1 for Caucasians or 1.5:1 for African Americans, lower is better. HDL should be above 60... higher is better. When checking LDL, if triglycerides (small density LDLs) are less than 100 that is good.

[@michaelatreacher7088]

Excellent!!!!!! I've been in practice for more than 20years and finally I have a complete understanding for it. Thank you!!❤

[@rockstar7907]

Omgosh thannnnk you for this video!!! This doctor has saved my life! The doctors didn't even care I have a fatty liver and my triglycerides are 359!!!! I've been researching for years to find out what I have and I'm finally seeing I'm on sugar overload too just like the doctor is describing. Im skinny fat and unhealthy just like he said! I love this doctor!!!! Ive been trying to figure it out for 5 years now!! I hope its not too late to heal my liver. This doctor actually cares!!!! Hes not masking the problems and open up ppl minds to the food industry and I applaud you and THANK YOU, THANK YOU FOR SAVING ME! His new book is EVERYTHING! And its all FACTS and makes soo much sense now!!!!! ! All I can say is thank you SOOOO MUCH FOR PUTTING THIS OUT THERE!!👏🏾👏🏾👏🏾👏🏾Let hope ppl wake up and see what's clearly going on in the medical field!!! There killing us really!!! How can I get insulin test because my pcp doesn't believe me when I talk to him about stuff like this! Going to the doctor is truly a waste of time and money! We have to be our own doctors nowadays! And that's sad cause there getting paid big bucks to do nothing smdh!!!

[@Jessica-ld4bs]

Checking in! How is your health doing?

[@eddserrano6967]

Great lesson for life. Thank you both!!!

[@margiewinslow872]

Im so impressed and encouraged. My cardiologist keeps increasing my Crestor even though my LDL is 96. She wants 70. My Tri/HDL IS 1.08!! Hdl is 81. Sode effects from Crestor have slowed me down so exercise is harder to do. Getting a handle on this!!! Thank you!

[@boblatkey7160]

Dump that crap!

[@SET12DSP]

​@@boblatkey7160 no kidding.....

[@TheFeelyourself]

My TGL/ HDL was above 5, got it down to about 2.25, now with some bad diet, got back to 3.75.

[@slay2525]

I am not a doctor, this is not medical advise, stop the statin!

[@MJ-gg3zq]

Hi is this number he said should be at 1.5? If so how did you lower it?@@TheFeelyourself

[@MT-sq3jo]

Fascinating interview! At my last yearly wellness physical check, I asked my doctor if there was a way to measure my level of insulin resistance and he told me that he was not aware of any testing to do so! I need to show him this KZbin video and give him some post graduate education!

[@bobtosi9346]

Tell him to take a true fasting insulin level. Research what the levels are to indicate well, pre diabetes, and full type two diabetes .

[@kirstinstrand6292]

@@bobtosi9346 I'd find a new doctor! 🙄💣💣

[@njsongwriter]

HOMA-IR

[@Once_in_a_Lifetime]

They just play dumb, making it look like your the dumb one. They know no one can call them out on it because they have medical knowledge that can be spewed out and can’t be readily fact checked without knowing if what their telling you is from a corrupted study. Your not going to change them anymore than you trying to get someone to change their religion or politics!

[@NG-iy5rq]

Rob you will win the Nobel prize... you deserve this. God bless you Dr. Rob...

[@calvinkalmon6746]

So appreciative of this conversation!

[@yevazargaryan4236]

Thank you very much dr.Robert Lustig

[@dasikakn]

I always thought the American Diabetes Association is a group of esteemed altruistic doctors until I went over to their website and saw their top 2 board members are a lawyer and guy in finance/business. Their 3rd guy is a physician but mostly focused on the aftermath of diabetes complications. How or why on earth would this group care about prevention 😢. Our lives are being saved by these bold counter-culture docs from Stanford and UCSF. Thank you.

[@bobtosi9346]

It’s a money making group tied to big pharma and govt grants

[@erastvandoren]

Look up Khambatta's Mastering Diabetes

[@sarahg1077]

I like to watch all sorts of videos out there about health and nutrition. I watch them all… and wow. I am shocked with what is still out there. Dr. Lustig is brilliant. I loved this convo with Dr. Means. So a shocking video I watched earlier today was an older lady who was a dietician at a hospital talking about cholesterol and encouraging people to eat margarine and to stay away from saturated fats. That info was bad enough but never once was SUGAR mentioned. It’s like the old way of thinking never takes sugar into account. So now my next thought… when does Honey Nut Cheerios (processed, high carb, sugar) lose the “heart healthy” seal of approval?

[@tangulo8869]

If people follow the new food guidelines everyone will get sick and everyone’s going to be on meds. The food industry spends millions to promote their fake foods as healthy.

[@lisaa8795]

Back when they only measured total cholesterol with no breakdown, my Grandpa was told he should eat margarine instead of butter and limit his consumption of eggs. Seems as though that advice hasn't changed in 50 years for many people. (Sugary drinks weren't really as ever-present in the 60s and early 70s, especially for the older population)

[@youuuuuuuuuuutube]

Absolutely brilliant video! So much real information, and for free.

[@dakotalynn4773]

Amazing interview. Thank you ❤

[@y.g.1313]

19:25 - if you are fasting .. your triglycerides = VLDL = your sugar consumption. Thank you dr Lustig, that was golden!

[@jurajplavcan]

This part was confusing to me. When you are fasting , isn't your sugar consumption zero? What am I missing here? What exactly is "sugar" in this context?

[@salemdesigns65]

@@jurajplavcan All sugar - no sodas, no processed food, no extra added sugar. I personally go deeper; no grains, no pasta, no fruit, no dairy and no bakery products.

[@studentaccount4354]

I think glucose is stored in your liver and that is how they get it while fasting. It takes a while of fasting, sometimes days to deplete them and go into fat burning keto.

[@studentaccount4354]

@@salemdesigns65I eat whole grains. It is the refined grains you need to avoid. Also, avoid cholesterol and added oils. There is oil naturally in plants and grains. You can get omega 3 from algae, ground flax, chia seeds. Even black beans have omega in it.

[@21550spurs]

What he is saying is absolutely correct. I was a normal weight but had a lot of midsection fat. I went on a keto diet and quickly lost that fat . My cholesterol went up, and my internist wanted to put me on a statin, which I refused to take. A year later, my cholesterol was still mildly elevated, but hdl levels were good,and triglycerides were 69. Statins are way overprescribed and have a lot of bad side effects. MDs need to be educated on reading these results correctly. Thank you for this video

[@craigcrawford6749]

Dude, there's no such thing as "elevated" or "too high" those numbers are artificial, they're set so the doctors can sell statins. If you're a lean mass hyper responder or an athlete, you may need cholesterol levels in the 300s -400. Your body sets what your body needs.

[@directajith]

Can someone give a solution: I have high triglycerides. when I reduced it through excercise, ldl sky rockets. So as per the video, i understand that triglycerides converted to small dense ldl. But is there any proof for this? my current ldl is 208, triglycerides is 276. Before excercise it was 160 and 321 respectively. Hdl increased from 31 to 39. What is your recommendation?

[@virtual007bond]

@@craigcrawford6749 this is true, as i also doing keto diet (no sugar, no fruit, no carb) loss a lot of weight and doing routine exercises but the cholesterol get even higher? if the video said correct (sugar got turn into fat by the liver into cholesterol) then why mine is getting higher, with no sugar? it does not make sense

[@craigcrawford6749]

@@virtual007bond stop thinking high cholesterol is bad!! This is a random number determined by the drug companies. Your body produces cholesterol as it's needed. The longest living people have cholesterol between 240-260. Your body is now finding it's natural balance. Remember every single cell in your body makes cholesterol. That's because it's absolutely vital for life.why do people become morons when they take statins? Because the cholesterol is being sucked out of their brains. Japan is the longest living country in the world and they eat more eggs than any other population. And meat for every meal. Think about that

[@craigcrawford6749]

"lean mass hyper responder". Google that. As you get leaner and are eating more complex foods, not just fruit, which is shit sugar, and simple carbs, your body needs more cholesterol to carry all the goodness around. Dont worry, if you are eating healthy, and exercising, your body is doing exactly what it needs to do. You are finally getting healthy. @@virtual007bond

[@thomasforsythdesign]

So so impressed with both of you! This is truly incredible and priceless content! So grateful for this

[@jimstoops5792]

This is so informative. I love DR Lustig.

[@mattolsson8816]

Great interview that explains cholesterol in an easy way for anyone to understand.

[@Malcolm-Achtman]

Dr. Lustig said lots of doctors won't run an advanced lipoprotein profile because the insurance is unwilling to cough up the $500.00 fee. Well, there are lots of places that will run a full lipoprotein panel for much less than $500.00, and almost anyone could order it themselves and not even involve a doctor. My preference is to use a lab called SpectraCell (in Houston, TX). I've done it at least 6 times on my own and never needed my doctor's consent. I believe the current cost is about $150.00 US. And there are many other labs that offer a basic NMR lipoprotein panel for less than that.

[@pvenkatraghuram8840]

Such a great Dr. I ever see with systematic explanation

[@benfromaustria]

Great job Dr.Lustig - Great content ! Best regards from Austria

[@200Nora]

This video gives me peace of mind. It validates my refusal to the statins offered. With my last result of HDL of almost 100 and tri of 47, I can sleep better and go about enjoying my life.

[@j24601valjean]

As a layperson with the results of a recent blood test in front of me this was incredibly useful in helping me make sense of the results. Thank you for the great work that you guys are doing.

[@samirgawde]

Thanks you both for this upload. This is so informative.

[@stephanieegorova7819]

Dr. Rob Lusting you are amazing doctor.God bless you.

[@rosalagamba2434]

Thanks to this brilliant Dr Robert Lustig I gave up all sugar and alcohol out my diet. I am 70 years old never been on medication, but softer from inflammation, and I was 35 pound over weight. Six month without sugar or any carb I lost 28 pounds and all the pain disappear. Let’s hope Dr Robert Lustig receive the Nobel Prize for his hard work. Seen him receiving the Nobel Prize would be the better than finding a new habitable planet 🌎

[@dcnike820]

Exceptional interview! I have Metabolical (the book) but the summary (end explanation) of reading lipid panels in this interview is priceless.

[@user-nh9hd2zi1e]

The most helpful medical conversation I have heard in a very long time

[@lisalau2452]

This program gave me so much clarity on this subject and a piece of mind. Thanks!

[@swanee9414]

Lustig and Bikman are two of the very best in this field. BTW, the test for small dense pattern B -"B" for bad in my book, LDL particles is the NMR (nuclear magnetic resonance test) and it costs $119 through Request-A-Test.

[@mannyradzky493]

FABULOUS VID. Thank you both. By far top 3 vids I have watched on health. I have watched over 700 vids. Dr Lustig, 2 things please, 1. Keep on fighting 2. Live to 180, we need you around. Thanks again.

[@Gary-ns1zm]

This should be watched!!!! Dr. Lustig is wonderful.

[@raylares]

I love watching Lustwig interviews. He is awesome.

[@christophercoupe5006]

Huge thanks to both doctors for educating us!!!

[@selenekranz4061]

One of the best discussions I’ve ever listened to. Thank you so much!

[@shanti888]

You’re a terrific respectful interviewer. This is packed with useful info. Thank u

[@dinaliflowers]

Amazing. What a great teacher. As a layperson I finally understand and am so thankful.

[@Malcolm-Achtman]

I was curious to hear what Dr. Lustig feels a good HDL level is. I'm happy he mentioned (near the end of this video) that we should be moving above the typical recommendations of 40 mg/dL for men and 50 mg/dL for women. Cardiologist Dr. William Davis sets his baseline at 60 mg/dL. Dr. Robert Cywes recently suggested 75 mg/dL or higher for HDL. Dr. Lustig said the problem for some people is they are genetically predisposed to having low HDL. That might be true, but I'm thinking it might apply to a very small number of people. The reason low HDL seems to run in a family and seems to be genetic probably has more to do with the fact that the children typically eat what the parents ate, and if they're all eating a high sugar & carb diet it will naturally lead to everyone having low HDL. Before changing to a low-carb diet, my HDL values were in the 30-range. Now (on low-carb) I'm closer to 60 and I've even reached 70 mg/dL. Meanwhile, my identical twin brother, who continues to eat a higher carb diet, still has HDL hovering close to 30 mg/dL. Dr. William Davis tells a story about his HDL going from the 30's up into the 90's after getting off carbs. Note: This won't happen overnight. The increase is gradual over a period of time. And many people can achieve success raising their HDL with a proper diet low in sugar and carbs.

[@thoushaltnotlie3487]

Great observation and I can tell you are doing your homework. On the same path

[@slay2525]

Throw in some HIIT sprints 2X a week and doing some weighted squats so you get out of breath will push up the HDL as well.

[@user-zq3qd8ui5o]

Apparently, high quality extra virgin olive oil, specifically eaten with vegetables helps to raise HDL levels. I saw a lecture by a PhD nutritional scientist here on KZbin who espoused on the great benefits of high quality extra virgin olive oil & that ingesting it as part of a heart healthy diet high in vegetables helps to raise the good HDL levels.

[@Mimi-vegi2go]

Fantastic program thank you for your life long hard work looking for more of your episodes

[@LABIWorld]

Thank you for the good and detailed explanations

[@jtanagho]

Very very informative, thank you very much, God bless you both.

[@angelaasadi9283]

This was GREAT information. Thank you.

[@denisespencer395]

Excellent discussion. You made it sooo clear… thank you!

[@kathryns5122]

Most information discussion of lab tests ever!!! Thank you,!

[@robertwilliams2609]

Great interview!!! Thank you for this.

[@chaz6399]

The situation with liver function tests is even worse than you describe. Prior to educating myself my ALT was _above_ the upper limit of normal on multiple occasions (46 to 60, as I recall). I had two different doctors tell me exactly the same thing: "It's nothing to worry about. It's probably just a little bit of fat in your liver". Asking them to recognize that a value over 25 is unhealthy seems like a stretch when a value explicitly noted as "HIGH" doesn't phase them. PS: Thanks for the awesome video!

[@cathylapierre2383]

Because they have no time for people just the Dollar signs !one question at a time THEY DONT CARE !! SAD WHEN YEARS AGO (AND I MEAN YEARS LIKE 60) THEY DID HOUSE CALLS ,NPW YOUR 95 AND CANT GO TO THE DRS YOUR SCREWED !!VERY SAD .

[@michellemusillami3701]

This was one of the best you tube interviews I have ever listened too!!! Fantastic!

[@DeirdreRawlings]

Excellent discussion, thank you both very much. Enormously helpful.

[@neilshillito7726]

Superb content and brilliantly presented - thank you.

[@ttocselbag5054]

Thank you Casey and thank you Rob. Listening to you two passionate and intelligent medical minds speak and demystify metabolic health was so damn inspirational! 🙏❤️

[@newphaseofme8223]

Thanks for the summary at the end Dr. Casey

[@lanrupf9750]

I just stumbled on this interview. Thank you so much for your detailed explanation about the ratio of Triglyceride/HDL and ALT. Both of my readings are good, at your recommendation. Still the info you gave us is so valuable. Thank you so much again.

[@cathyellis767]

THANK YOU FOR CLARIFYING ALL OF THIS!

[@betsydurham9067]

Awesome interview. Very understandable 👏🏽👏🏽👏🏽

[@benjaminbecker8508]

Dr. Lustig is pure genius!

[@papaduck2443]

This is the video I needed and the information I needed! Thank you so much for this info! Dr. Lustig, you did such a great job explaining this! Again, I really appreciate this video! And Dr. Means did an excellent job of asking questions that we needed to know the answers to and then the recap at the end was perfect! Great interview!!!!

[@12Pearls12]

Special thanks for this great information! ❤