Paul Saladino· MD
the whole paradigm of lowering LDL makes no sense to me there has to be something else going on this spark to light the fire which people who listen to my podcast will know that I believe is insulin resistance
We can't find evidence that holds up here. Proponents are reasoning from mechanism or analogy rather than direct human data, and the most credible skeptics raise objections we can't dismiss.
the whole paradigm of lowering LDL makes no sense to me there has to be something else going on this spark to light the fire which people who listen to my podcast will know that I believe is insulin resistance
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i have real issue with all of these this continued focus on ldl as the main driver of atherosclerosis independent of insulin sensitivity context
but doctors insist on getting hung up on ldl and they ignore all the other indicators of insulin sensitivity and that to me is tragic
this is a failure of our medical system in my opinion this is the problem with repeating an incomplete paradigm which we might consider a lie over and over to the point that it becomes a truth
the more ldl you have the more ldl delivers that cholesterol to your arterial walls but that is false and we've seen that over and over and over there are all these studies that those people are missing that show context that in people that have low triglycerides and high hdl and who are not hyperinsulinic who are insulin sensitive the amount of ldl you have is not geometrically or connected with the amount of atherosclerosis that you have in any way shape or form
I'm not convinced that quote unquote healthy blood cholesterol levels that is a lower level of LDL can be any sort of metric for cardiovascular disease prevention or prediction in the absence of a metric that gives us a sense of insulin sensitivity
just lowering your LDL independent of knowing what your triglycerides HDL and fasting insulin are doing is very dangerous metric to have
if any physician looks at your LDL and tells you it's too high without looking at your insulin sensitivity they are missing the boat
this is a philosophical it's an error of judgment this is a logical fallacy and this is what I'm saying is that I think we're missing the Target and not doing as well for people as we should be I think there's a more important Target to focus on and the best thing that I've ever seen throughout all of this is insulin resistance