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  #1   ^
Old Sun, Oct-21-18, 12:03
GRB5111's Avatar
GRB5111 GRB5111 is offline
Posts: 2,406
 
Plan: Ketogenic (LCHFKD)
Stats: 227/186/185 Male 6' 0"
BF:
Progress: 98%
Location: Herndon, VA
Default Feldman & Attia - Lipid Podcast - Some Uncomfortable Moments

Illustrating how much the idea of identifying blood lipids as health markers is far from settled, this podcast with Dave Feldman and Peter Attia encapsulates the discord and lack of scientific evidence with some ego flaunting and feather ruffling thrown in. I've followed each fairly consistently, and was surprised at the tone that developed during their first-ever exchange. In addition, the backwash from the follow ups is still churning. Feldman being transparent about all this only helps to push and force knowledge in this area. Lots to unravel here:

https://peterattiamd.com/davefeldman/

http://cholesterolcode.com/guesting...ause-mortality/

http://cholesterolcode.com/guesting...ters-prebuttal/

http://cholesterolcode.com/guesting...tured-thoughts/

http://cholesterolcode.com/dave-and...-attia-podcast/
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  #2   ^
Old Sun, Oct-21-18, 15:09
Grav Grav is offline
Senior Member
Posts: 891
 
Plan: Banting
Stats: 302/185/187 Male 175cm
BF:
Progress: 102%
Location: New Zealand
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I haven't followed Peter Attia for as long as I've followed Dave Feldman, and I've only read through the first of those links so far, but from what I have read so far, it seems to me like Dave's getting exactly what he's often been asking for: ideas that refute his own. As you say Rob, he's very open about being self-taught in all of this and not being qualified at all.

If there was any niggle between the two of them during the podcast itself (which I also haven't yet listened to) then that's unfortunate, but on the flipside, debates such as this where opposing points of view are directly discussed between the two sides can often be the most interesting, for the sake of advancing the overall discussion on the subject. The Swiss Re conference earlier this year was particularly interesting for this reason also.

This will definitely take a while to digest. Thanks for the links!
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  #3   ^
Old Sun, Oct-21-18, 23:22
GRB5111's Avatar
GRB5111 GRB5111 is offline
Posts: 2,406
 
Plan: Ketogenic (LCHFKD)
Stats: 227/186/185 Male 6' 0"
BF:
Progress: 98%
Location: Herndon, VA
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Quote:
Originally Posted by Grav
If there was any niggle between the two of them during the podcast itself (which I also haven't yet listened to) then that's unfortunate, but on the flipside, debates such as this where opposing points of view are directly discussed between the two sides can often be the most interesting, for the sake of advancing the overall discussion on the subject. The Swiss Re conference earlier this year was particularly interesting for this reason also.

That's exactly why I thought this exchange and subsequent posts in Feldman's blog about the podcast are so valuable. We are working to get answers to a topic that has had many certain yet debatable claims over the past 40+ years, and we should not be afraid to deeply explore all views on the matter for the purpose of finding the truth. Because we still have much to learn on the matter, opinions are going to be diverse and agreements will not come without the hard work to get to the facts. We are now starting to scratch the surface here.
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  #4   ^
Old Mon, Oct-22-18, 09:28
khrussva's Avatar
khrussva khrussva is offline
Posts: 6,878
 
Plan: My own - < 30 net carbs
Stats: 440/205/210 Male 5' 11"
BF:Energy Unleashed
Progress: 102%
Location: Central Virginia - USA
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I recently joined Dave Feldman's LMHR (Lean Mass Hyper Responder) FaceBook group. Dave's always in search of more data. He put this targeted group up for both information gathering and debate. It is an interesting mix of people with many of us posting lab data, CAC scores, etc. There are approximately 800 members. Most are LMHR -- or at least have very high LDL cholesterol. Some have LDL-C at 300+ or 400+ and don't seem to care -- or even seem proud of it. They've bought into Dave's theory or the generally accepted position that cholesterol doesn't matter for those doing LCHF/keto. However, most members have joined because they and their doctor's are freaking out about their crazy lipid panels after going keto and they are looking for answers. Some members are MDs & RDs just looking to better understand this phenomenon. Unlike here and other "weight loss" oriented groups, many - if not most of the LMHR in that group started Keto for reasons other than losing weight. Many are younger, athletic types. Some are just very lean. My being a 'big loser' makes me sort of an odd duck in that group. At the moment Dave's theory of what makes a LMHR is 1) Not IR (metabolically healthy) and 2) Keto + Lean, Keto + physically active, or both. I think that my activity level and diabetes reversal are the things that 'qualify' me as a hyper responder.

I'm glad to be part of this group. The debate goes on and given my LMHR status I do want to know how this plays out (and contribute if I can). The science is not 100% settled. It wasn't settled when they decided to make fat & cholesterol that bad guy decades ago and it is not settled now. When I do keto my LDL-C doubles. When I eat LCHF right at my keto carb limits my LDL-C falls into a reasonably doctor pleasing range.

My problem is that I do better when I keep my carbs well down into the keto range. As I have chased better LDL-C numbers I find that I'm walking the 'slippery slope' of my carb limits. When my target is 40 to 50 net carbs each day keeping the eating within reason is harder. Frankly, I don't feel as good when I'm eating more carbs. With the exception of that darn LDL-C number, my gut tells me that keto is where I belong. At the moment I'm working on returning to keto. Once the reins are let out it is work to tighten things up again. I want to feel better. I also want to take care of a few pounds that I put on over the summer. My LDL will shoot up again. That's a given. But I will be heating healthy, whole foods and staying active. And I'll keep my head in the game about the latest science regarding the 'associated risks' of high LDL-C. What else can I do? I'd rather error on the side of staying lean and healthy. The way I see it, if I'm going to check out of this life early I'd rather be living a vibrant life up to the day of a massive heart attack than return to the path that I was on. Slow death by obesity, diabetes & alzheimer's certainly looks less appealing. If something new comes up to make me change my mind about keto, I'll consider making changes. But until then I'm returning to a VLC diet - perhaps for good.

Link to Dave's LMHR FB Group

Last edited by khrussva : Mon, Oct-22-18 at 13:19.
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  #5   ^
Old Mon, Oct-22-18, 12:26
GRB5111's Avatar
GRB5111 GRB5111 is offline
Posts: 2,406
 
Plan: Ketogenic (LCHFKD)
Stats: 227/186/185 Male 6' 0"
BF:
Progress: 98%
Location: Herndon, VA
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Quote:
Originally Posted by khrussva
The debate goes on and given my LMHR status I do want to know how this plays out (and contribute if I can). The science is not 100% settled. It wasn't settled when they decided to make fat & cholesterol that bad guy decades ago and it is not settled now. When I do keto my LDL-C doubles. When I eat LCHF right at my keto carb limits my LDL-C falls into a reasonably doctor pleasing range.

My problem is that I do better when I keep my carbs well down into the keto range. As I have chased better LDL-C numbers I find that I'm walking the 'slippery slope' of my carb limits. When my target is 40 to 50 net carbs each day keeping the eating within reason is harder. Frankly, I don't feel as good when I'm eating more carbs. With the exception of that darn LDL-C number, my gut tells me that keto is where I belong.

Well stated, and this is exactly why I'm watching and listening to these discussions and new ideas on lipids. I do far better when I'm around or below 20-25 grams of carbs per day. That slippery slope is always potentially looming in the background, as I was a carb addict in the past, and I know it would be so easy to become one again. Attia, Dayspring, Feldman, Krauss, and others are deep into research; yet, we currently have no practical answers regarding accurate lipid health markers. Simple disagreements over the presence or not of LDL receptors in endothelial cells is a good example.

I'm taking the same approach, Ken. I'll keep my carbs low, eat healthy whole foods, and stay close or in the keto range, as that's where I do best and feel great. I'm hoping we can get something definitive on blood lipids as valid health markers and receive some guidance that adjusts for WOE. Until then, my simple N=1 adjusts for how I feel, and that's the best I can do. The good news? Much more to come as this dialog continues and more good minds contribute to it.
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  #6   ^
Old Mon, Oct-22-18, 13:38
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cotonpal cotonpal is online now
Senior Member
Posts: 4,174
 
Plan: very low carb real food
Stats: 245/128/135 Female 62
BF:
Progress: 106%
Location: Vermont
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I guess I'm just an ostrich. I eat my keto diet, my weight remains stable, I walk every day (now that it is not hot and humid) and easily get 4-6 miles in, my bg's are "normal", half a dozen "diseases" or more are gone, and I take no prescription drugs. In December I turn 70. It's been a decade since I had my cholesterol checked. I have no idea what my numbers are. I am curious but since I know I won't change the way I am eating I don't see the point in having the test. The fact that cholesterol numbers get prioritized over so many other possible measurements just doesn't make sense to me. I sure they mean something but I've just opted out of the game. I figure I"m doing really well all things considered. Perhaps I'm just a luddite as well as an ostrich.
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