Audio: The ULTIMATE lipid podcast with Dave Feldman and Siobhan Huggins

PS

Paul Saladino2h 0m · 2019-08-27

Claims Made

216

Claims Supported

163

Support Rate

75%

Support rate

163 of 216 claims supported

163 supported53 partial / not

Claims from this content

172

Well SupportedContinuous Glucose Monitors (CGMs) provide valuable insights into how various foods and lifestyle factors affect glucose levels, and can lead to behavioral modification.Well SupportedThe enzyme FMO3, which converts TMA to TMAO, is under the control of insulin and its activity increases in insulin-resistant individuals.Well SupportedIndividuals with LDL levels of 200 mg/dL or higher demonstrated the greatest survival rate, even when excluding those who died within ten years of their lipid panel test.Well SupportedFasting can increase serum LDL, potentially indicating LDL's role in substance transport.Well Supported

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A. Volkovreader

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Bookmarking — the dossier-vs-overview split is the right call. Most of the time I want overview; sometimes I want receipts.

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Would love a "what would change this verdict" RSS feed. Sign me up if it exists.

High ferritin levels can occur with infection or chronic inflammation even if iron is deficient.

Well SupportedThe ketogenic diet has been associated with severe lipid perturbations, including elevated total cholesterol and LDL-C.

Well SupportedChylomicrons and VLDL deliver triglycerides to tissues, not cholesterol.

Well SupportedWhile the correlation between elevated LDL and improved outcomes in infection is not causal, LDL is beneficial to the immune system.

Well SupportedFasting insulin levels are often very high in patients with early hyperinsulinemia.

Well SupportedLDL particles can bind to and neutralize lipopolysaccharide, lipotichoic acid, and viruses, playing an essential role in the innate immune system.

Not SupportedPaul Saladino believes coffee polyphenols are not beneficial and suggests coffee may contain mold toxins, acrylamide, and pesticides.

Well SupportedDistance running, such as marathons, causes inflammation reflected in elevated Hs-CRP levels.

Well SupportedInflammation can trigger insulin resistance as an evolutionary mechanism to shift resources to the immune system.

Partially SupportedLipoprotein(a) [Lp(a)] includes an additional protein, apo(a), which enables it to assist in wound repair and clotting.

Partially SupportedIn a state of abundance after a high-fat meal, the body may reduce VLDL release due to sufficient energy intake.

Partially SupportedHigh free fatty acids and high insulin can occur in pathological states like sickness, injury, or inflammation, inducing insulin resistance.

Partially SupportedTriglyceride levels can decrease from 240 mg/dL to under 100 mg/dL within 12 hours of fasting.

Partially SupportedDietary fat is packaged into triglycerides in the gut and then into chylomicron particles for transport in the bloodstream.

Partially SupportedThe risk associated with a marker like TMAO or Lp(a) may stem from its underlying cause, such as insulin resistance or inflammation.

Well SupportedReactive oxygen species are utilized by the body for intentional processes like fighting infections and promoting cell growth after exercise.

Partially SupportedClinical data from carnivore diet followers does not show a tendency toward inflammation.

Well SupportedFor individuals in a challenged health state, quarterly blood tests are recommended to track progress and monitor ongoing changes.

Partially SupportedFor individuals with insulin resistance or elevated fasting insulin (above 5 or 8 micro IU/mL), a ketogenic diet can be very helpful in the short term.

Partially SupportedCardiovascular risk associated with Lp(a) may disappear in metabolically healthy individuals.

Partially SupportedAcrylamide from roasting, potential mycotoxins, and pesticides are concerns associated with coffee consumption.

Partially SupportedA high ferritin level with low inflammatory markers may warrant further investigation for hemochromatosis.

Well SupportedConsuming a steak alone does not result in the same blood triglyceride profile as a meal containing both fat and carbohydrates.

Well SupportedObtaining multiple sets of blood work data provides a more accurate assessment of health indices.

Partially SupportedStopping coffee consumption leads to improved sleep quality, including deeper sleep and more REM sleep, and overall feeling better for the vast majority of patients.

Not SupportedLDL has potential immunologic functions.

Partially SupportedNo single test result should be interpreted in isolation; context from prior tests and trends is crucial for accurate assessment.

Partially SupportedFree fatty acids in the bloodstream can bind to albumin or are released from fat cells via lipolysis.

Partially SupportedSome individuals may experience an increase in triglycerides when drinking coffee.

Partially SupportedHigh-calorie, high-fat ketogenic diets can significantly lower LP(a) levels.

Partially SupportedFor a minority of habitual coffee drinkers, coffee consumption can cause elevated triglycerides, even with decaffeinated coffee.

Partially SupportedTwo weeks after a fever, the speaker's Lp(a) was recorded at its highest at 180, while hs-CRP and ferritin had dropped significantly.

Partially SupportedDuring illness, HS-CRP can drop significantly below 1 or 3, and ferritin can also decrease within two weeks.

Partially SupportedDuring sepsis, individuals may exhibit high insulin, insulin resistance, and high glucagon, a pattern also seen in some diabetics.

Partially SupportedFasting insulin over 10 IU/mL warrants lifestyle review, with an ideal target below 5 IU/mL.

Partially SupportedAll-cause mortality is a more comprehensive endpoint than cardiovascular disease mortality for evaluating interventions like LDL lowering.

Well SupportedA triglyceride level over 100 mg/dL is considered abnormal, and levels more than 2x HDL cholesterol are a significant concern.

Partially SupportedIt is recommended to measure both insulin and C-peptide together, especially if insulin levels are at the high end of normal.

Partially SupportedLower fasting insulin levels are associated with higher free fatty acid levels, suggesting the body is mobilizing free fatty acids.

Well SupportedInsulin is the most important marker to track for metabolic health, especially in a fasted state.

Partially SupportedHigh fasting insulin or C-peptide levels after 12 hours of water-only fasting are a serious concern for metabolic derangement.

Partially SupportedBovine tracheal cartilage from grass-fed New Zealand animals may have unique effects on wound healing, immune conditions, and joint health.

Partially SupportedHigh LDL levels in mice directly block the ability of Salmonella to invade organs, contributing to better survival rates.

Partially SupportedSwitching from a pork-based to a beef-based diet can affect LP(a) levels, potentially due to differences in L-carnitine.

Partially SupportedThe carnivore diet can be powerful for many people.

Partially SupportedWhen indigenous populations adopt Western diets and lifestyles, they develop previously unencountered health problems.

Well SupportedC-peptide has a longer half-life than insulin and may offer more reliable correlation with insulin levels.

Partially SupportedWestern medical physicians require more training to understand the physiological differences in individuals on ketogenic diets compared to carbohydrate-based diets.

Partially SupportedHigh LDL cholesterol, with high HDL and low triglycerides, is associated with a 1% per year reduction in all-cause mortality.

Well SupportedIndividuals on low-carb diets typically have Lp(a)-PLA2 levels around 200-250, which is not associated with significant increased risk of high Lp(a).

Partially SupportedChanges in LDL can be related to diet or inflammation.

Partially SupportedObservational data showing centenarians are predominantly two-pack-a-day smokers would challenge established understanding of smoking's risks.

Not SupportedPlant molecules like caffeic acid and chlorogenic acid in coffee may be harmful to humans.

Partially SupportedFocusing solely on LDL for cardiovascular disease neglects its potential benefits in other areas of health, such as immunologic function.

Partially SupportedHabitual coffee drinkers on low-carb, keto, or carnivore diets may experience high triglycerides paired with normal HDL levels after fasting for 12-14 hours.

Partially SupportedHigh Lp(a) is associated with increased cardiovascular disease risk only when Lp(a)-PLA2 levels are above 700.

Not SupportedLinear regression in studies can be misleading by implying causation and causing fear of higher values.

Not SupportedThe assumption that LDL particles are pathogenic may be incorrect.

Partially SupportedKetogenic physiology requires more carrier proteins to transport triglycerides compared to carbohydrate-powered metabolism.

Partially SupportedCooking meats, beans, coffee beans, and seeds may create compounds that affect satiety and are addictive.

Partially SupportedMany components in nose-to-tail animal eating have not been studied and their contents are unknown.

Partially SupportedReducing dietary fat intake in the Feldman protocol led to an increase in cholesterol levels.

Partially SupportedKetogenic diets may show suggestions of improvement for Multiple Sclerosis (MS).

Partially SupportedThe speaker found no strong correlation between glucagon levels and non-esterified or free fatty acids in their data.

Partially SupportedGlucagon activates lipolysis and signals for the release of free fatty acids from fat cells, especially during fasting.

Partially SupportedThe speaker is considering an experiment to induce a hyperinsulinemic state for 3-4 days.

Partially SupportedHigh HDL levels may mitigate the cardiovascular risk associated with high LP(a) in individuals with coronary artery disease.

Partially SupportedHigher triglyceride levels are associated with increased risk of all-cause mortality and cardiovascular disease.

Partially SupportedNon-fasted lipid panels can still have utility when interpreted in the context of recent food intake.

Partially SupportedSunburn can elevate Hs-CRP, ferritin, and lipoprotein(a) levels.

Not SupportedSmoking is associated with significantly greater all-cause mortality, with hazard ratios exceeding 1.3 and increases of 200-400% or even 2000-4000%.

Partially SupportedHemochromatosis is associated with excess iron storage and can lead to oxidative stress.

Partially SupportedFree fatty acids are important to measure, especially in individuals on low-carb diets.

Partially SupportedIndividuals following a low-carb, high-fat diet may experience a decrease in LP PLA2 levels.

Partially SupportedPostprandial lipid panels, especially in individuals on a low-carb diet, can show very high triglycerides and may include chylomicrons.

Partially SupportedPatients on low-carb or carnivorous diets should educate themselves about their physiology to better inform healthcare professionals.

Partially SupportedThe immune system responds to infection, injury, sunburn, and other damage or repair needs with a specific biomarker profile.

Partially SupportedFerritin can decrease from 900 to 200 without phlebotomy, potentially influenced by factors like blood draws or electrolyte balance.

Partially SupportedInflammatory markers, insulin, glucagon, and C-peptide can be abnormal in asymptomatic individuals.

Partially SupportedElevated C-peptide levels, particularly in the context of a diet high in white bread and processed meat, indicate a significant metabolic issue.

Partially SupportedOxidative stress may not always be detrimental, as the imbalance of oxygen and antioxidants can serve purposes like promoting cell growth or healing.

Partially SupportedHigh triglycerides that cannot be stored in adipocytes can be deposited as ectopic fat in organs like the liver, pancreas, and heart.

Partially SupportedWhen an immune response is active, LDL, triglycerides, and inflammatory markers tend to be high, while HDL is low.

Partially SupportedDave Feldman found that LDL alone, independent of triglycerides and HDL, was associated with lower all-cause mortality in age-parity cohorts.

Partially SupportedHigh LDL may be upregulated in response to inflammatory signaling during challenge events, acting as an acute phase reactant.

Partially SupportedPersonal lab results show that during illness, LDL particle count, triglycerides, and hs-CRP tend to increase, while HDL decreases.

Partially SupportedThe association of lower LDL with lower all-cause mortality may be an artifact of age rather than a direct causal relationship.

Partially SupportedLowering LDL may lead to increased mortality from causes other than cardiovascular disease.

Partially SupportedMedical decisions should not be based on Hemoglobin A1c values within the test's error rate or before its potential change is understood.

Partially SupportedHemoglobin A1c levels can change by 0.2-0.3 points within a few days.

Limited ResearchHs-CRP can remain elevated for at least two days after intense exercise, as seen with a level of 13.4 after a half marathon.

Partially SupportedSmoking meets the Bradford Hill criteria for causation of increased all-cause mortality.

Partially SupportedCardiac and skeletal muscle tissue preferentially utilize fatty acids as a substrate over other energy sources.

Partially SupportedAfter adopting a high-fat carnivore diet (2:1 fat to protein ratio), triglycerides were elevated at 11 hours fasted but dropped below 100 at 12 hours fasted.

Partially SupportedChecking triglycerides at 14 hours fasted is recommended for patients and clients to identify potential triglyceride-elevating factors.

Partially SupportedWhile many people thrive on ketogenic diets, some individuals report even better outcomes on carnivore diets.

Partially SupportedTriglycerides are the storage form of fat, consisting of three fatty acids bound to a glycerol backbone, and are broken down by lipoprotein lipase to release fatty acids for cellular uptake.

Partially SupportedLP(a) levels can be substantially reduced through dietary interventions such as prolonged fasting and high-calorie, high-fat ketogenic diets.

Partially SupportedAs people age, their LDL levels tend to increase.

Partially SupportedBeing ketogenic or fat-adapted before undertaking a fast can avoid significant discomfort.

Partially SupportedLP PLA2 levels track with LDL-P during fasting and ketogenic protocols.

Partially SupportedFasting can be a powerful tool for identifying dietary triggers for illness.

Partially SupportedA multi-day fast (2.5 days) can elevate ferritin levels into the 900s.

Partially SupportedThe author takes bovine tracheal cartilage for connective tissue, immuno-regulators, cartilage building blocks, and potentially unknown trophic factors.

Partially SupportedChylomicrons are approximately 1200 nanometers in size.

Partially SupportedIn the INHANES data, people with lower LDL levels have lower all-cause mortality.

Partially SupportedCorrecting electrolyte issues, including consuming more salt and occasionally supplementing with sports salts, may lead to a decrease in ferritin levels.

Partially SupportedLDL can neutralize reactive oxygen species during infection, protecting host cells from damage caused by immune cells' oxidative barrages.

Partially SupportedHbA1c is an indicator for type 2 diabetes and pre-diabetes.

Partially SupportedLp(a) levels can be influenced by diet, lifestyle, or genetics, and elevations due to inflammation are distinct from those caused by diet or lifestyle.

Partially SupportedIn humans experiencing infectious burden, VLDL and LDL can be upregulated, similar to an increase in white blood cell count.

Partially SupportedLipoprotein(a) [Lp(a)] collects and breaks down oxidized parts of lipoproteins or cells, passing byproducts to albumin for excretion.

Partially SupportedA high-carbohydrate, low-fat diet is expected to lower LDL levels.

Partially SupportedA basic lipid panel measures lipids and Lp(a).

Partially SupportedL-carnitine may contribute to a drop in Lp(a) levels, potentially explaining diet-related Lp(a) changes.

Partially SupportedCertain diseases can lower LDL cholesterol, potentially creating reverse causality in studies associating low LDL with higher mortality.

Partially SupportedA high-carbohydrate, low-fat diet may lower LDL and Lp(a) levels.

Partially SupportedLP PLA2 levels correlate with LDL particle number (LDL-P).

Partially SupportedHs-CRP, ferritin, and lipoprotein(a) are considered an inflammatory triad because they increase in response to inflammation.

Partially SupportedMany people adopt the carnivore diet out of necessity after other interventions fail.

Partially SupportedImprovements seen on carnivore diets, potentially on top of ketogenic diets, suggest factors beyond just ketones are at play, possibly related to food removal or addition of quality protein and fat.

Partially SupportedHemoglobin A1c provides a 90-day average of blood sugar levels.

Partially SupportedComprehensive metabolic panels and complete blood counts are broad-based tests for assessing health.

Partially SupportedConsuming a lot of fat can drive down lipoproteins that remodel into LDL cholesterol.

Partially SupportedInfection or other challenge events can cause insulin resistance, and monitoring insulin sensitivity, HDL, triglycerides, and inflammatory markers is important for context.

Partially SupportedChanging diet from high-carb to keto cleared the speaker's depression.

Partially SupportedHaving multiple markers for the same physiological state, like inflammatory markers or insulin sensitivity markers, is valuable for accurate assessment.

Partially SupportedThe body has an orchestrated system involving inflammatory markers, fasting insulin, HDL, LDL, triglycerides, hs-CRP, and ferritin that normally deals with infections.

Limited ResearchThe effect of coffee on triglycerides in some individuals may be due to factors beyond caffeine.

Partially SupportedConsuming a high amount of dietary fat before a blood test can temporarily lower LDL and total cholesterol.

Partially SupportedChronic inflammation and hyperinsulinemia lasting for months or years are pathological situations not previously seen ancestrally.

Partially SupportedIndividuals with the lowest LDL levels (0-79 mg/dL) had a higher mortality rate compared to those with higher LDL levels.

Partially SupportedA carnivorous diet may lead to elevated triglycerides, with levels of 240 mg/dL observed 7-8 hours post-meal.

Partially SupportedGlucagon is a hormone that counterbalances insulin and can be elevated for negative reasons.

Partially SupportedFerritin levels can vary significantly between labs, with some having very low cutoffs.

Partially SupportedBlood donation does not appear to appreciably affect ferritin levels.

Partially SupportedHigh triglyceride levels indicate an abundance of triglyceride-carrying lipoprotein particles due to a metabolically deranged state where energy cannot be effectively redistributed to adipocytes.

Partially SupportedVery high triglycerides are often associated with very low LDL cholesterol and may indicate a metabolically deranged state.

Partially SupportedLDL can bind to endotoxins, neutralizing them and preventing immune system overactivation that can lead to sepsis.

Partially SupportedConsuming a steak on a carnivore diet can result in postprandial triglycerides of 230-240 mg/dL two hours afterwards, which can persist until sleep and carry over into the next morning.

Partially SupportedCoffee is potentially addictive due to compounds created during roasting.

Partially SupportedGamma-glutamyl transferase (GGT) may correlate with liver damage, oxidative stress, and glutathione production.

Partially SupportedThe carnivore diet is less prone to 'miss-hits' compared to ketogenic diets due to its definitive low-carbohydrate nature.

Partially SupportedEpidemiological data is effective at refuting claims of causation, though it does not prove causation.

Partially SupportedThe Feldman protocol initially observed a significant drop in LDL-C by eating a low-carb diet.

Not SupportedStudies on cholesterol often use opaque adjustments in their methodology, potentially affecting the accuracy of the final outcome.

Partially SupportedA diabetic individual on a carnivorous high-fat diet for one month saw glucagon levels decrease from ~100 to 56 while insulin remained high.

Partially SupportedChronic disease can arise from insulin resistance and inappropriate inflammation.

Partially SupportedCitizen scientists may be at the forefront of discovering the root causes of insulin resistance compared to the medical community.

Partially SupportedFollowing a ketogenic diet resulted in Dave Feldman's longest stretch without sickness, suggesting reduced immune response-related illnesses.

Partially SupportedThe ultimate question is what causes insulin resistance, not whether insulin resistance is the direct cause of toxicity.

Partially SupportedPostprandial triglycerides are expected to be higher in individuals following a high-fat ketogenic diet compared to those on a carbohydrate-based diet.

Partially SupportedA ketogenic diet can improve diabetes and non-alcoholic fatty liver disease.

Not SupportedTesting blood work only once a year or every six months provides insufficient feedback for patients like those with diabetes.

Not SupportedAntioxidant supplements like vitamin C and vitamin E have failed to prevent cardiovascular disease or improve mortality and have sometimes been associated with higher mortality.

Partially SupportedFatty acids released from adipocytes can be re-esterified into other adipocytes or taken up by non-adipose cells like muscle tissue.

Partially SupportedKetogenic diet may increase ferritin levels, potentially to over 500-700, which is above typical lab reference ranges.

Partially SupportedA comprehensive assessment of multiple health markers is necessary because individual markers can be misleading.

Partially SupportedThe NHANES dataset contains approximately 40,444 individuals with complete lipid data for analysis.

Partially SupportedBlood tests for inflammatory markers, insulin, glucagon, and C-peptide should be taken when not experiencing acute inflammation from illness, intense exercise, or injury.

Partially SupportedMultiple data points and trend analysis are essential for predicting health outcomes, similar to financial market analysis.

Partially SupportedC-reactive protein (CRP) is a valuable inflammatory marker.

Partially SupportedFerritin levels can be in the 500s before starting a ketogenic diet, indicating a potentially high baseline.

Partially SupportedThe National Health and Nutrition Examination Survey (NHANES) dataset includes a comprehensive set of blood panels.

Partially SupportedFerritin levels can double or triple from a baseline of 30-40 to above 70-120 due to factors like sunburn.

Partially SupportedHS-CRP levels above 3 are significantly elevated for individuals with a usual baseline around 0.4.

Partially SupportedSimple linear regression was used for the NHANES data analysis, with adjustments made one at a time.

Partially SupportedAcute inflammation can make blood test results unrepresentative.