cholesterol management

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In this special episode of The Drive, Peter discusses a variety of topics, breaking away from the typical deep-dive format to explore a wide range of common questions submitted by listeners. Peter tackles subjects like the viability of living to 120 and beyond, addressing some of the optimistic theories regarding achievement of this remarkable feat. Peter then shares his drug and supplement regimen while emphasizing how individualized these protocols need to be. The conversation also touches on lowering apoB, the long-term use of statins, the myth of good vs. bad cholesterol, the complexities of nutrition research, the quest for the ideal diet, and Peter's strategies for hitting daily protein goals. Peter finishes with a discussion about his favorite health-tracking wearables, the role of CGM in non-diabetics, and more.

We discuss:

• Overview of topics and previous episodes of a similar format [2:45];
• The viability of living to 120 and beyond: some optimistic theories [4:45];
• The potential of mTOR inhibition as a mid-life intervention, and longevity potential for the next generation [13:30];
• A framework for thinking about geroprotective drugs and supplements in the context of a lack of aging biomarkers [17:00];
• Supplements Peter takes and how his regimen has changed in the last year [26:15];
• Pharmacologic strategies to lower ASCVD risk, the limitations of statins, nutritional interventions, and more [36:15];
• Misnomers about cholesterol [48:00];
• Why nutritional research is so challenging, some general principles of nutrition, and why Peter stopped doing prolonged fasts [50:45];
• Optimizing protein intake [59:45];
• Wearables for sleep and exercise, continuous glucose monitors (CGM), and a continuous blood pressure monitor on the horizon [1:04:45]; and
• More.

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More than half of us have high cholesterol — and new research suggests that having even slightly raised levels in our 30s could significantly increase our chances of developing heart disease.

Medication is a common fix, but it comes with side effects. So, today we’re looking at how much changing our diets can help. 

In this short (ish) episode of ZOE Science & Nutrition, Jonathan and Sarah ask: Can we lower our cholesterol by changing our diets? 

Follow ZOE on Instagram: https://www.instagram.com/zoe/

Download our FREE guide — Top 10 Tips to Live Healthier: https://zoe.com/freeguide

Studies referenced in the episode:

• ‘Association between Carbohydrate Intake and Serum Lipids’ from the Journal of the American Nutrition Association here
• ‘The Mediterranean Diet And Cardioprotection: Historical Overview And Current Research from the Journal of Multidisciplinary Healthcare here
• ‘Direct comparison of dietary portfolio vs statin on C-reactive protein’ from the European Journal of Clinical Nutrition here

This podcast was produced by Fascinate Productions.

In this five-part series, Thomas Dayspring, M.D., FACP, FNLA, a world-renowned expert in lipidology, and one of Peter's most important clinical mentors, shares his wealth of knowledge on the subject of lipids. In Part IV, Peter and Tom review the history and current use of drugs to prevent cardiovascular disease. They also discuss why some drugs appear to be more effective than others, an in-depth conversation about niacin, cholesterol and brain health, and the futility of using CKs (creatinine kinase) and liver function tests to identify adverse effects in statins, to name a few topics in this episode.

We discuss:

• Bile acid sequestrants and statins [2:00];
• Ezetimibe (Zetia) [15:00];
• PCSK9 inhibitors [27:30];
• Fibrates [41:00];
• Fish oil, DHA, and EPA [1:01:00];
• Niacin [1:05:15];
• PCSK9 inhibitors [1:23:45];
• Cholesterol, statins, and the brain [1:30:00];
• Elevated creatine kinase (CK) and liver function tests (LFTs) on statins [1:50:30]; and
• More.

Learn more at www.PeterAttiaMD.com

Connect with Peter on Facebook | Twitter | Instagram.

In this episode, Dave Feldman, discusses his journey from software engineer to n=1 experimenter, his experience with low-carbohydrate diets, and his hypothesis that cholesterol levels are influenced by energy metabolism.

We discuss:

• Peter’s synthesis of Dave’s energy model [5:00];
• Dave’s journey from software engineer to cholesterol enthusiast [15:00];
• Standard blood panels, sterol panels, and what moves the needle when it comes to particle numbers [18:30];
• Hyper-responders [20:00];
• Lipoprotein transport [33:45];
• The lean mass hyper-responder phenotype [47:30];
• The progression of atherosclerosis, CAC, and CIMT [52:30];
• Testing for oxidized LDL [55:30];
• All-cause mortality and clinical endpoints [1:01:15];
• What does “LDL as causal” mean? [1:05:15];
• Dave’s low carb cholesterol challenge and drug & genetic study qualifications [1:13:15];
• If all other markers are in an healthy range, but LDL-P is high, is the patient at risk? A couple of case studies, and a self-experiment [1:27:30];
• Peter’s three-day exercise and ketosis experiment [1:41:00];
• What are remnant lipoproteins? [1:45:00];
• What might cause lean mass hyper-responders to have higher LDL particle numbers? [1:53:30];
• A case study from Dave of a lean mass hyper-responder [1:56:30];
• Mass balance and cholesterol flux [2:05:30];
• Can a higher degree of cholesterol explain the lean mass hyper-responder phenotype? [2:10:00];
• Peter’s LDL during his keto-fast-keto experiment [2:13:30];
• Does substituting saturated fats with monounsaturated fats lower LDL-P and LDL-C? [2:15:45];
• Dave’s carb-swap experiments [2:22:15];
• Dave’s carotid intima-media thickness tests [2:41:15];
• Looking for studies that stratify for high HDL-C and low TG alongside low and high LDL-C [2:53:00]; and
• More

Learn more at www.PeterAttiaMD.com

Connect with Peter on Facebook | Twitter | Instagram.