Happy to see you again in a long time. You've not aged at all. You were one of the very few professional out there whom I followed during the start of my low carb journey about a decade ago. Thanks

I've been one of your patients, and I want to say thanks for reinforcing my decision to go off statins! I don't recall hearing they might contribute to dementia (but if I did hear about it - I'll blame the statins!) And if I forget our wedding anniversary, I'll blame the statins! Anyway, it was sad to hear you have problems with people complying with a low carb diet. It has done wonders for my wife and I! She is a 30 year type 2 diabetic with a pancreas that is about gone (thank you ADA). If they don't want to listen to you, there are a lot of other gurus to back you up! We've listened to: Dr. Richard K. Bernstein (an 88 year old type 1 diabetic and doctor - one of the last of his generation), Dennis Pollock (also on KZread), Dr. Jason Fung, Dr. Ahmet Argin (SugarMd on KZread), Dr. Sarah Hallberg (her 2015 TED talk on KZread was a classic), and Dr. Robert Lustig (the Foodgate video on KZread he did with others - also a classic). I look forward to seeing you at least at my next Medicare Wellness visit!

@lowcarbconferences

Жыл бұрын

Hi Chris. Glad you're doing well and thanks for the comments. Important for others to understand that treatment decisions are made between patients and providers and everyone is different. The info provided here is for educational purposes only. We again encourage everyone to discuss with their healthcare provider any decisions regarding diagnosis, treatment and medication. - Dr. Jeff

What a fascinating talk. The info towards the end regarding dementia & certain statins is scary but very important to know. I was put on statins (atorvastatin) 4 years ago age 60 due to high cholesterol but couldn’t tolerate them so stopped them after 6 months despite my GP trying to get me to try a different brand. With all I’ve learned since from people like Dr Aseem Malhotra (consultant cardiologist in UK), Malcolm Kendrick & others I would never go anywhere near them. It’s good that this information is getting out there but doctors need to have conversations with patients around relative risk reduction & absolute risk reduction so we can make informed decisions. I certainly had none of that. Just this fear factor that if you stop your statin you’re going to die. It’s great that people can empower themselves & maybe educate their doctors! Thanks.

Great discussion, as usual but I think there’s an important angle - the actual importance of statistics - which is insufficiently discussed in the literature except, significantly, by statisticians. They point out that statistics is a mathematical exercise and is important to understand the experiment, that is, the biology. So, a 1 % difference between experimental controls requires attention but the rejoinder of cholesterol people in the studies with those kinds of number is - reasonably - that if you scaled up 1 % differences to a whole population, you would save thousands of lives. That assumes, however, is that the data have very low error and that depends on knowledge of how salient the risks are, the variability of the subjects, and the error in measurement of outcome. This depends on the analysis of the experimenter. That’s why we make them go to medical or graduate school. There are experts. Of course, we expect little bias. So that is an important part. If the disease is unusual in its features and you are administering a vaccine, you have more inherent trust in scaling up low outcomes because you know that the disease does not have big variability and you know who got the vaccine and who didn’t. So, the scaling up argument is appropriate but that requires attention to the details of the biology. In cholesterol, a minimum is to understand that the doubt is great about traditional opinion but, as you show the burden is on them.

Two BRILLIANT people! The high HDL/ low trigs being important is nothing new. Dr Atkins was talking this in 1972. The medical establishment/BIG PHARMA thought he was a crackpot...

@jobrown8146

Жыл бұрын

There are some excellent videos on the internet explaining the cholesterol "life cycle".

I'm 65 yo F. I've now been low carb for almost 16 months. At the 1 year mark I had a blood test and my LDL has gone up but my trig/HDL ratio was good. All other blood test results were okay. I also got a CAC with a score of 0. My cardiologist, head of dept of major hospital, recommended a low dose of statin. I said no thank you and that I have made an informed decision about not taking it. I also told him that even if my CAC was not zero I would not take one. My low carb doctor has suggested getting an LDL particle size test down but it an out of pocket expense and from who I have seen on the internet, when the HDL is high and the trigs are low that the LDL particle pattern is generally the large fluffly ones. And even if I got the test, I wouldn't be changing my diet or taking a drug, so I cannot see any point in paying for something that I cannot afford. When I told my low carb doctor that the cardio has recommended a statin he threw his arms up in the air!

I'm in favour of using low carb diet instead of looking at LDLc as traditionally advocated to treat CVD, however the arguments put forward about relative risk of 50% being misleading and trivial is wrong. What the risk numbers used in the examples of 1% and 0.5% are saying is that out of a population of 1 billion, 1% (10 million) will die of CVD. And let's say this number is one of the leading causes of death in the world. By reducing the risk from 1% to 0.5% the number of people out of 1 billion that die drops from 10 million to 5 million. This is the same as saying we have halved the number of people that die from cancer, and I don't think anyone would argue that that is trivial and insignificant. Now, if we are going to say that a drop from 1% to 0.5% (in at risk patients in the study) is insignificant because it's such a small number then we might as well say that the chance of death of heart attack is small at 1%, so basically, if we fall into this group, we don't need to worry about paying attention to heart attack risk at all. To put it another way, the drop in risk rates that were being used in the examples in the video says something like this: assume you were forced to take part in a lottery where a hundred names are placed in the barrel and only one name gets drawn, and the one that gets drawn will be killed by an induced heart attack. If you were then given the option to choose a lottery where instead of there being 100 names in the barrel there are 200 names in the barrel, would you consider that a change worth going for...I say yes, and this is an absolute risk change if only 0.5% and a relative risk change if 50%. It all depends on how you look at it. I've made this comment because some if not many people will hear Dr Diamonds explanation and just run with the notion that a change from 0.7 to 0.35% is insignificant. Having said this, I'm still in favour of not following traditional convention when looking at how to treat heart disease, but I don't think this means overlooking critical thinking errors when a presenter makes them even if they are advocating an approach I agree with. I'd be happy to be corrected if I'm wrong.

@rogercastillo-beinglived1869

Жыл бұрын

Other points to make on the topic of risk (relative and absolute) as covered in this video are: - if risk factors of only 1% appear in a CVD study it's because of the length of time the study ran. That is, only 1 in every hundred died in the, let's say, 3 year period of the study. I say this because in real life in the US 1in 5 deaths are from heart disease. If the study were to run for 40 years the CVD risk in the study for the relevant groups (placebo vs statin intake) would be closer to the actual life time risk of that group profile, ie higher than 30% for participants profiled for CVD. Dr Diamond states, "...actually heart attacks are quite rare.....in most studies". Note that the study in question actually looked actual mortality and not just heart attacks. So I urge someone to not run with the numbers and think they say that one's lifetime risk will be reduced from 1% to 0.5% (as an average), it's saying in a let's say, 3 year period, it will make that difference (as an average).

@rogercastillo-beinglived1869

Жыл бұрын

So, going back to the lottery example. Using 1% (or reduceding it to 0.5%) chance of being drawn is only the risk for the first draw, however after the first draw you're told that actually the number of draws over the next 40 years is going to be 30 and not just 1. I'm sure that you'd rather have the two hundred names in the barrell rather than 100 names, right? I'm just discussing the topic of general mathematical risk here. Questions of side effects etc are a separate issue to consider when making further calculations to work out overall risk, but this can only happen properly once someone has gotten their head around how to work out the topic of basic risk as shown in the study.

Well. I exercise daily, have never had high glucose my A1c has alway been under 5, blood presseure is 100/70 yet I have extremely high Apo(a) the bad ldl. I have been under 20 carbs a day for 2 years and my HDL has actually dropped on low carb so you clearly don't know all the answers.

@lowcarbconferences

Жыл бұрын

Debbie, everyone's different and I don't think Dr Diamond said he has all the answers.

@debbiesue4287

Жыл бұрын

@@lowcarbconferences I wasn't inferring that either one of them did. Clearly they are seeking more answers, which is great! It does concern me however that absolutely everyone says HDL Goes up on a low carb diet when I am living proof that's not true. Not for everyone. And when you're HDL goes from an already low 40 down to a 26 because you changed your diet to low carb it does make you a little nervous.

@hardtruth2039

Жыл бұрын

What are you actually eating?

@debbiesue4287

Жыл бұрын

@@hardtruth2039 125 g of protien a day ( mostly ruminant animal meat, pasture raised eggs , sardines and other fish) 1 cup low carb veg, 3 tablespoons of fat either from olive oil, butter, coconut oil of bacon grease. 20 oz of black coffee, water. 4 oz of cheese or low carb homemade yogurt 2xs week max but often go 2 weeks without any dairy. 1 cup of berries a month. I also add a teaspoon of acacia gum for low carb extra fiber into meals a couple times a week. The supplements I take are Berberine, unsweetend electrolytes, D3K2, liposomal vitamin C, and I take 2 omega3 (1200EPA 900DHA )on days I don't eat any fish. No grains, no flours , no nuts, no refined seed oils, no pasta no potatoes no milk. I keep it as basic as possible I don't do any pre packaged processed Foods.. just cook it myself

@Malcolm-Achtman

Жыл бұрын

@@debbiesue4287 It would be interesting to see what an advanced lipoprotein panel would look like for you - i.e. your total LDL particle number, your small LDL particle number, etc. Also curious to know what your triglycerides are.