Controversial thoughts: When High Cholesterol is GOOD!

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Paul Saladino27m · 2020-10-22

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49

Claims Supported

44

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90%

Support rate

44 of 49 claims supported

44 supported5 partial / not

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41

Well SupportedIncreasing saturated fat and decreasing polyunsaturated fat intake is associated with lower plasma concentrations of lipoprotein(a) and oxLDL-EO6.Well SupportedThe majority of the US population has suboptimal metabolic health, often indicated by hypertension, obesity, or a combination of factors.Well SupportedElevated Lp(a) and elevated oxidized phospholipids on apoB is of greater concern than elevated Lp(a) with normal oxidized phospholipids on apoB.Well SupportedPaul Saladino's hemoglobin A1c has remained between 5.2 and 5.4.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.

Paul Saladino has a coronary artery calcium scan of zero.

Well SupportedIndividuals with the APOE4 genotype had a lower risk of developing dementia, particularly Alzheimer's, in a metabolically healthy Nigerian population.

Well SupportedMetabolic health determines the atherogenicity of one's lipid profile.

Well SupportedNative LDL does not initiate atherosclerosis and will not be taken up by macrophages in the sub-endothelial space.

Well SupportedTo establish LDL as causal, one must ensure atherogenic dyslipidemia does not affect LDL levels and no other factor causes both LDL and the outcome.

Well SupportedLDL cholesterol may be less significant for atherosclerosis in metabolically healthy individuals compared to those with diabetes or metabolic dyslipidemia.

Well SupportedThe APOE4 gene variant may have conferred benefits under certain environmental conditions.

Well SupportedIn the Semai population, APOE4 is associated with improved cognitive function in metabolically healthy individuals facing high parasite and pathogen load.

Well SupportedIn metabolically healthy individuals, LDL levels are not consistently related to incident cardiovascular disease.

Well SupportedMetabolic unhealth in Americans is defined by criteria including elevated waist circumference, fasting glucose, HbA1c, blood pressure, triglycerides, or low HDL.

Well SupportedMetabolic health, not just high cholesterol, is the primary determinant of heart disease risk.

Partially SupportedThe 'homeobiscus model' suggests that increased dietary saturated fat may necessitate higher LDL levels to maintain cell membrane fluidity.

Well SupportedThe context of lipid profiles, including HDL, Lp(a), ApoE4, and uric acid, is crucial for interpreting LDL's role in cardiovascular disease.

Well SupportedHigh HDL and low triglycerides are not strongly associated with atherosclerosis.

Partially SupportedPaul Saladino's LDL cholesterol was 130 and ApoB under 100 in December.

Well SupportedLow HDL cholesterol is often associated with metabolic syndrome.

Partially SupportedHyperinsulinemia is an independent risk factor for ischemic heart disease, predicting it better than LDL cholesterol.

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

Well SupportedIn the Framingham study, individuals with the highest HDL levels showed no significant relationship between LDL cholesterol and cardiovascular risk.

Partially SupportedConsuming healthy animal fats like butter or red meat is unlikely to increase cardiovascular risk if they do not worsen metabolic dysfunction.

Partially SupportedAn ancestrally consistent diet, such as a carnivore diet, should not increase heart disease risk if other metabolic markers are optimal and the individual feels well.

Not SupportedHigh LDL levels in well individuals on a carnivore or ketogenic diet should not automatically lead to stopping the diet.

Partially SupportedPaul Saladino's lipid profile includes HDL between 80-110 mg/dL, triglycerides usually below 70 mg/dL, and LDL much higher than 200 mg/dL.

Partially SupportedIncreasing cholesterol levels are associated with increasing risk of Alzheimer's disease in individuals without the APOE4 allele.

Partially SupportedThe risk associated with the APOE4 genotype is modulated by the individual's underlying metabolic health.

Partially SupportedLow HDL is indicative of underlying metabolic dysfunction, which increases the relative risk of ischemic heart disease.

Partially SupportedThe APOE4 genotype is problematic primarily in metabolically unhealthy individuals.

Partially SupportedHigh LDL cholesterol may not be a significant problem for metabolically healthy individuals on ketogenic or carnivore diets.

Partially SupportedInsulin resistance predicts the severity of coronary atherosclerosis in non-diabetic patients.

Partially SupportedLean mass hyper-responders typically follow relatively low-carb diets, have low body fat, and high activity levels.

Partially SupportedMetabolic health is critical for interpreting lipid profiles, uric acid, and ApoE4 status.

Partially SupportedThe 'lean mass hyper-responder' phenotype is characterized by very high HDL, very high LDL, and low triglycerides.

Partially SupportedIndividuals following ancestral diets are often metabolically healthy.

Partially SupportedLow HDL cholesterol concentration is often associated with hypertriglyceridemia and has a greater impact on the atherogenic index than raised LDL cholesterol for predicting ischemic heart disease events.

Partially SupportedFamilial hypercholesterolemia is associated with xanthomas and xanthelasmas, which may indicate a different risk profile for elevated LDL on an animal-based diet.

Partially SupportedIsolated low HDL cholesterol is associated with higher insulin levels during an oral glucose tolerance test, indicating insulin resistance.

Partially SupportedUric acid is not problematic unless an individual is metabolically unwell.