What does a mainstream cardiologist think of my cholesterol? With Nadir Ali, MD

PS

Paul Saladino1h 40m · 2020-10-20

Claims Made

155

Claims Supported

110

Support Rate

71%

Support rate

110 of 155 claims supported

110 supported45 partial / not

Claims from this content

119

Well SupportedIncreasing saturated fat and decreasing polyunsaturated fat intake is associated with lower plasma concentrations of lipoprotein(a) and oxLDL-EO6.Well SupportedAtherosclerosis is caused by the inflammatory response to oxidized cholesterol accumulation in macrophages within the artery wall.Well SupportedOxidized LDL, where omega-6 fatty acids have oxidized into MDA and HNE, is essential for the initiation of atherosclerosis in humans.Well SupportedAs insulin resistance increases, LDL particle number rises disproportionately to LDL cholesterol, with VLDL contributing.Well Supported

Discussion

Native comments, Twitter mentions, and Reddit threads about this content — surfaced together so the conversation isn't fragmented across platforms.

M

Share your read of this content…

Posting publicly as you · linked to your social profiles

Sort by:

AV

A. Volkovreader

4h

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

NP

N. Park

2d

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

Most individuals can obtain sufficient omega-3 fatty acids from grass-fed animal fats like suet or tallow, negating the need for excessive omega-3 consumption.

Not SupportedFish oil supplements often contain high levels of peroxides and oxidative products.

Partially SupportedPCSK9 inhibitors lower serum cholesterol by increasing the expression of LDL receptors on the liver and cells, leading to greater uptake of cholesterol from circulation.

Well SupportedIncreased linoleic acid consumption leads to accumulation in adipose tissue and LDL particles, making LDL more susceptible to oxidation.

Well SupportedLDL particles perform beneficial functions such as immunological function and cell membrane formation.

Well SupportedLDL particle size is a more predictive marker of cardiovascular risk than LDL cholesterol number alone.

Partially SupportedWhen ldl increases, particle size typically increases, and particle number may not be as critical as metabolic health.

Well SupportedIf an individual is healthy with high LDL and normal metabolic markers, their cardiovascular risk is likely not significantly elevated.

Well SupportedPaul Saladino maintains low hs-CRP, fibrinogen, and fasting insulin, suggesting no excess glycation or endothelial damage despite high carbohydrate intake.

Not SupportedNative LDL cholesterol alone is not sufficient to cause atherosclerosis.

Well SupportedDecreasing saturated fat intake and increasing polyunsaturated fat intake may lead to a decrease in LDL cholesterol but an increase in oxidized LDL and Lp(a).

Partially SupportedPolyunsaturated fats may increase oxidized LDL and Lp(a), while saturated fat and animal foods are often blamed for raising LDL.

Well SupportedAn LDL particle number to HDL particle number ratio less than 35 may carry increased risk.

Well SupportedForce of Nature Meats sources regenerative meat from the US and New Zealand, offering ground elk, venison, lamb, bison, and beef.

Well SupportedThe ox LDL assay measures the burden of oxidation within LDL particles.

Not SupportedExcessive omega-3 supplementation can lead to the formation of detrimental alkenals, alpha-beta unsaturated ketones, and hydroperoxides.

Well SupportedIndividuals with genetic variants affecting PCSK9 have an increased risk of type 2 diabetes.

Well SupportedThe LDL molecule transports cholesterol and triglycerides and consists of a lipid monolayer with apolipoprotein B-100, CoQ10, and other components.

Well SupportedLow HDL cholesterol is often associated with metabolic syndrome.

Well SupportedHumans were biologically intended to consume real foods, including meat.

Well SupportedWhen HDL cholesterol levels are high (e.g., 65-85 mg/dL), there is minimal increase in the risk of coronary artery disease as LDL cholesterol rises from 100 to 220 mg/dL.

Well SupportedPolyunsaturated fats, particularly linoleic acid, may increase oxidized LDL by enriching LDL particles with linoleic acid.

Well SupportedThe speaker's LDL cholesterol is lower now than when on a ketogenic diet or earlier in their carnivore journey due to the addition of carbohydrates.

Partially SupportedOrgan meats like liver, kidney, and heart are essential for completing the human nutritional picture.

Partially SupportedCholesterol supplementation with egg yolks and bile acids can improve growth, reduce photosensitivity, and ameliorate severe infections in individuals with Smith-Lemli-Opitz syndrome without harmful side effects.

Not SupportedThe PCSK9 inhibitor evolocumab increased the risk of all-cause mortality in the FOURIER trial when followed for 3.4 years.

Well SupportedThere is a clear biological mechanism and animal model evidence supporting a dose-dependent effect of LDL on cardiovascular disease.

Partially SupportedPaul Saladino's LDL has been around 100-128 mg/dL, attributed to dietary fat composition rather than familial hypercholesterolemia.

Partially SupportedAtherosclerosis may be a normal repair process for arteries, and problems arise when the repair process is too great or too slow.

Partially SupportedIn a study of individuals with very high LDL-C levels, there was no observed correlation between LDL-C values and plaque formation or CAC scores.

Partially SupportedLDL may serve as a repository for oxidized phospholipids and potentially acts as a sacrificial lamb to protect the body.

Partially SupportedRed meat is an important source of iron, complete protein, and fat, which are essential for human health and brain function.

Partially SupportedFocus on preventing oxidative injury rather than solely reducing LDL levels, as more LDL might aid in preventing and helping oxidative injury.

Partially SupportedHighly oxidized LDL particles are removed by scavenger receptors on endothelial cells like CD36, LOX1, and Sortilin.

Partially SupportedThe body downregulates the LDL receptor and upregulates scavenger receptors like LOX-1 on macrophages to clear oxidized LDL when LDL is injured.

Partially SupportedHumans require omega-3 fatty acids, and occasional fish consumption is sufficient for adequate intake.

Partially SupportedA coronary artery calcium (CAC) scan of zero is consistent with a very high LDL cholesterol level of 536 mg/dL.

Partially SupportedElevated LDL cholesterol may be normal and potentially beneficial in metabolically healthy individuals.

Partially SupportedFocusing on inflammation is more relevant to cardiovascular disease than solely aiming to lower LDL levels.

Partially SupportedA large number of LDL particles can lead to flags for increased small dense LDL, regardless of actual particle size distribution.

Partially SupportedThe benefits of lifestyle interventions such as nutrition, fasting, and exercise are significantly more powerful than medications for treating chronic diseases.

Partially SupportedElevated oxidized LDL may be a protective mechanism, sacrificing itself to shield important cells from oxidative injury, rather than being a primary cause of harm.

Partially SupportedLDL particles contain antioxidants like CoQ10 and Vitamin E and are designed to protect the body from injury.

Partially SupportedHumans are designed to eat predominantly animal-sourced food.

Partially SupportedSmith-Lemli-Opitz syndrome is a genetic condition caused by a mutation in the 7-dehydrocholesterol reductase enzyme.

Partially SupportedEssential nutrients like calories, minerals, vitamins, essential fatty acids, taurine, and Vitamin B12 are found in animal sources, not plants.

Partially SupportedMetabolic health is the most significant factor influencing health and disease.

Partially SupportedPCSK9 is an acute phase reactant that increases in infection and inflammation to keep LDL in circulation and signal the body to increase receptors that clear injured LDL.

Partially SupportedCaffeine mobilizes fat from fat tissue, but only increases fat oxidation by a small percentage and the fat is recycled.

Partially SupportedPaul Saladino uses his blood work to corroborate his beliefs about a good human diet and to educate others on interpreting their own blood work.

Partially SupportedOptimizing the ratio of stearic acid to omega-6 fatty acids and avoiding seed oils is recommended for human health.

Partially SupportedIncreased saturated fat intake and decreased polyunsaturated fat intake may lead to lower levels of oxidized LDL and Lp(a).

Partially SupportedNutriSense's app and dietitian service make CGM data digestible, actionable, and accessible for users seeking to improve their health.

Partially SupportedHuman biology and biochemistry are fundamentally adapted for animal foods as the primary fuel source.

Well SupportedStatins inhibit HMG-CoA reductase, an enzyme in the mevalonate pathway crucial for cholesterol synthesis.

Partially SupportedMost cardiologists are unaware of lean mass hyper-responders and cannot assess cholesterol quality or LDL particle size.

Not SupportedA meta-analysis of clinical trials found that PCSK9 inhibitors did not improve cardiovascular health and that evolocumab increased the risk of all-cause mortality.

Partially SupportedLDL particle number can be very high even with an LDL of 70 mg/dL.

Partially SupportedHigh LDL levels are normal and beneficial for insulin-sensitive individuals consuming a diet aligned with human design.

Partially SupportedThere may be a significant difference between native low-density lipoprotein and damaged low-density lipoprotein.

Partially SupportedLDL is designed as a host defense mechanism to protect the body from infections and inflammation.

Not SupportedPharmaceutical interventions like PCSK9 inhibitors may disrupt complex homeostatic mechanisms, leading to unrecognized negative results.

Partially SupportedMacrophages act as scavenger cells, picking up oxidized LDL to modulate and improve the body's response to injury.

Partially SupportedThere is a discrepancy between data published in journals and data reported to the FDA for multiple drug trials.

Partially SupportedA very high LDL cholesterol level (533 mg/dL) in a 43-year-old man with a family history of early heart disease is concerning to cardiologists.

Partially SupportedIndividuals of Indian background at age 43 with a zero CAC score who subsequently have a heart attack may have soft plaques and exhibit metabolic dysfunction.

Partially SupportedCaffeine may play a role in modulating paracrinology for fat burning and fasting optimization.

Partially SupportedExercising in a fasted state and delaying meals for at least five hours after exercise can improve health, particularly for individuals with pre-existing diabetes or metabolic dysfunction.

Partially SupportedExercising in a fasted state and not eating for five hours afterward has tremendously improved health.

Partially SupportedReducing meal frequency is important for individuals with metabolic unhealth to improve metabolic syndrome and insulin/glucon signaling.

Partially SupportedUnderstanding paracrinology can help optimize fat burning and fasting.

Partially SupportedPracticing intermittent fasting is recommended because the human body and biology are designed for it.

Not SupportedReducing LDL significantly with PCSK9 inhibitors may be detrimental because LDL plays a role in dampening infection and reducing inflammation.

Not SupportedTraditional mainstream medicine advice to eat low-fat, carb-heavy diets and exercise has not worked for 60 years and should be abandoned.

Partially SupportedLimiting LDL cholesterol can lead to mood and behavioral problems, similar to Smith-Lemli-Opitz syndrome.

Not SupportedMainstream cardiologists often assess health from a monovariate perspective rather than a contextual one.

Partially SupportedHuman plasma low-density lipoprotein (LDL) binds and partially inactivates Staphylococcus aureus alpha toxin.

Partially SupportedMetabolic dysfunction, rather than LDL cholesterol itself, is the primary driver of cardiovascular risk.

Partially SupportedNadir Ali eats nose-to-tail, including organs like liver, brain, and kidneys.

Partially SupportedInsulin is essential for muscle building and brain signaling, and insulin resistance is problematic.

Not SupportedMany cardiologists cannot define insulin resistance or identify a HOMA-IR.

Not SupportedLipid hypotheses may have been based on incorrect information for 70 years, potentially leading to millions of deaths.

Partially SupportedHigh oxidized LDL levels are treated with statins and PCSK9 inhibitors to lower total LDL, but the primary question should be whether LDL is sacrificing itself to protect against oxidative injury.

Partially SupportedIn the last 50 years, overall human health in Americans has declined, with increased obesity, diabetes, and heart disease.

Not SupportedHigh LDL cholesterol may not be a problem, and individuals should use critical thinking when deciding on statin or PCSK9 inhibitor treatments.

Partially SupportedNadir Ali offers online one-on-one consultations for health improvement.

Partially SupportedB-Kampo offers organic, grass-fed, grass-finished meat products, including organs, with a 20% discount for podcast listeners using code CARNIVOREMD.

Partially SupportedEfficient insulin signaling in the brain enhances synaptic plasticity and cognitive function.

Not SupportedThe premise that fat and cholesterol are culprits in human vascular disease is incorrect.

Partially SupportedIndividuals with genetically reduced PCSK9 levels have lower LDL but exhibit higher rates of visceral obesity, fatty heart, fatty liver, fatty pancreas, and diabetes.

Partially SupportedThe development of the 1500-gram human brain is a result of consuming high-quality animal-based nutrition.

Partially SupportedConsuming a diet of mostly animal-sourced food, low-carb, and being physically active can lead to very high LDL cholesterol levels.

Partially SupportedElevated PCSK9 leads to more LDL in circulation, which enhances immunologic activity.

Partially SupportedLow cholesterol and LDL levels can cause significant problems in human biology, potentially due to impaired cell membrane function.

Partially SupportedLean mass hyperresponders are typically lean, athletic individuals who eat relatively low-carb diets and have very high LDL cholesterol.

Partially SupportedRecommending vegetable oils may contribute to heart disease by increasing oxidized LDL.

Partially SupportedTransitioning to a predominantly animal-sourced food diet is foundational for achieving optimal health.

Partially SupportedConsuming animal-based foods often increases LDL and serum lipoproteins.

Partially SupportedUnderstanding high triglycerides, even on an animal-sourced food diet, is important for optimizing health.

Partially SupportedAn ancestral diet promotes better insulin function and is beneficial for health.

Partially SupportedConsuming lamb and goat tongue, slow-cooked with hooves, provides excellent gelatin.

Partially SupportedInsulin resistance is a bi-hormonal disorder involving both insulin and glucagon.

Partially SupportedMetabolic dysfunction, characterized by insulin resistance, is a primary driver of dyslipidemia, including low HDL and altered LDL particle characteristics.

Partially SupportedAn animal-sourced food diet, intermittent fasting, and avoidance of refined foods and processed carbohydrates are recommended for optimizing health.

Partially SupportedExercising in a fasted state can increase fat mobilization and oxidation, especially for the obese and insulin resistant.

Partially SupportedGenetic deletion of PCSK9 is associated with changes in lipoprotein metabolism, diabetes, increased fatty liver, and increased VLDL uptake.

Partially SupportedEfficient insulin signaling requires less insulin to facilitate dietary fat uptake and protein conversion to lean mass.

Partially SupportedRecommending diets rich in linoleic acid may contribute to heart disease.

Not SupportedMost cardiologists (95%) lack understanding of lean mass hyperresponders, high LDL, low triglycerides, high HDL, and large LDL particle size.

Partially SupportedThe next generation of Americans is projected to live a shorter lifespan than the current generation, a reversal of historical trends.

Partially SupportedNadir Ali's LDL cholesterol level was 533 mg/dL.

Partially SupportedRuminant animal meat provides sufficient omega-6 fatty acids, and linoleic acid intake should be limited to 1.8-3% of total calories.

Not SupportedStatins, which inhibit HMG-CoA reductase, are associated with mood, personality, and behavioral changes.

Partially SupportedAn individual consuming an animal-sourced food diet with LDL over 300 mg/dL experienced optimal health markers despite high LDL.

Partially SupportedHumans have a smaller colon size, making them less capable of processing large amounts of plant food compared to ruminants or horses.