How about: let's discuss cholesterol

For decades, statins have been heralded as reliable heroes in the battle against heart disease, the leading cause of death in the United States and globally.
However, an expert review suggests that long-term use of statins may be aiding the enemy by accelerating coronary artery calcification instead of providing protection.

https://twitter.com/x/status/2019439103570247807
 
BBSA said:
For decades, statins have been heralded as reliable heroes in the battle against heart disease, the leading cause of death in the United States and globally.
However, an expert review suggests that long-term use of statins may be aiding the enemy by accelerating coronary artery calcification instead of providing protection.

https://twitter.com/x/status/2019439103570247807
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Part of the problem is:

Lifestyle factors contributing toward issues that result in a statin prescription.
Person takes statins and changes nothing about their lifestyle.
 
I have family in Europe in the village and city - that have had high cholesterol for years. They’re pushing between 88-95 and have not had heart issues. It confuses me completely lol.
 
In this episode, Ben challenges the long-standing belief that LDL cholesterol is the primary driver of heart disease. While LDL has dominated cardiovascular conversations for decades, large-scale data show that nearly half of people hospitalized with heart disease have “normal” LDL levels.

Instead, the strongest predictors of cardiovascular risk — especially premature heart disease — are markers of metabolic dysfunction, particularly insulin resistance. Measures like the lipoprotein insulin resistance (LP-IR) score, type 2 diabetes status, metabolic syndrome, and even the simple triglyceride-to-HDL ratio dramatically outperform LDL cholesterol in predicting who will develop heart disease.

One of the most practical tools discussed is the triglyceride-to-HDL ratio, which can be calculated from a standard lipid panel. This ratio reflects underlying insulin resistance and small, dense LDL particles far better than LDL levels alone.

 
BBSA said:
In this episode, Ben challenges the long-standing belief that LDL cholesterol is the primary driver of heart disease. While LDL has dominated cardiovascular conversations for decades, large-scale data show that nearly half of people hospitalized with heart disease have “normal” LDL levels.

Instead, the strongest predictors of cardiovascular risk — especially premature heart disease — are markers of metabolic dysfunction, particularly insulin resistance. Measures like the lipoprotein insulin resistance (LP-IR) score, type 2 diabetes status, metabolic syndrome, and even the simple triglyceride-to-HDL ratio dramatically outperform LDL cholesterol in predicting who will develop heart disease.

One of the most practical tools discussed is the triglyceride-to-HDL ratio, which can be calculated from a standard lipid panel. This ratio reflects underlying insulin resistance and small, dense LDL particles far better than LDL levels alone.

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It was only a matter of time until you started to pollute this thread again with your biased views.
 
JerryMungo said:
And this explains why that is and why you have to look more closely at that data rather than jump to conclusions.

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The professor says metabolic dysfunction is a key driver of heart disease. Improving your metabolic health may be more effective than taking statins for the rest of your life.
 
JerryMungo said:
Bikman starts his video with "What if I told you..." - already red flags, but hey, let's ignore that for now.. "half of heart attacks occur in people with normal LDL cholesterol levels"
No physicians claim that LDL levels at the time of death and heart attacks are connected, as Dr Alex points out, many elderly people die of heart attack with low LDL levels because at that point they have not eaten much at all because of general illness. Why would you use that data? What you want is long term studies, and the science is quite clear, particularly with those of us prone to high LDL - statins prevent death.

Your LDL cholesterol level is not a snapshot indicator of much at all other than at that point in time they're under control. My LDL cholesterol can be great today and for the next year, but if I've neglected things up to that point, it's not an indicator of the current situation in your arteries and heart. Some of us already start showing signs of elevated LDL in our 20s, and if you don't get things under control then already, by your 50s, when you're way more likely to have that heart attack, you already have problems and statins aren't going to reverse that damage.
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I get what you’re saying about LDL being just a snapshot, and it’s true that measuring LDL at the time of death isn’t meaningful. That’s why long-term studies matter. But the bigger picture is that LDL is only one piece of the puzzle. Metabolic health, things like insulin sensitivity, triglyceride/HDL ratio, blood pressure, inflammation, and even body composition, actually drives the development of atherosclerosis more strongly than LDL alone for most people.

High LDL in someone with poor metabolic health is more dangerous than high LDL in someone metabolically healthy. Conversely, someone with moderately high LDL but excellent metabolic markers often has a much lower risk of heart disease than their LDL number suggests. Statins can lower LDL, but they don’t fix the underlying metabolic dysfunction that’s actually causing arterial damage.

So the focus shouldn’t be just on “getting LDL under control,” but on improving the metabolic environment that causes plaque to form in the first place. That’s why lifestyle, diet, exercise, weight management, is so powerful, and why some experts argue that metabolic health matters more for preventing heart disease than LDL numbers alone.
 
JerryMungo said:
Well sure, but mostly because atherosclerosis is only one potential contributor of many to premature death.
There are many other ways to die :)
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Yes of course, but maintaining good metabolic health not only reduces the risk of heart disease but also helps prevent a wide range of other chronic conditions, including type 2 diabetes, fatty liver disease, certain cancers, and cognitive decline.
 
@BBSA you know of any labs in SA that do LDL-P (particle count) tests? Closest I've found is ApoB (Pathcare etc.) but afaik that counts everything rather than being LDL specific.
 
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saor said:
@BBSA you know of any labs in SA that do LDL-P (particle count) tests? Closest I've found is ApoB but afaik that counts everything rather than being LDL specific.
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Yeah, LDL-P is a tough one to get locally. As far as I know, none of the big labs here (Ampath, Lancet, PathCare) really offer it. ApoB is basically the closest you’ll get in SA, not identical, but a solid proxy since it counts all the atherogenic particles anyway. Otherwise you’re looking at sending samples overseas, which is a bit of a mission.
 
BBSA said:
While LDL has dominated cardiovascular conversations for decades, large-scale data show that nearly half of people hospitalized with heart disease have “normal” LDL levels.
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That's not because LDL does not cause disease. It's because LDL targets are set too high.

New 3 year study just came out that shows a 33% relative risk reduction going from 66mg/dl to 56mg/dl LDL.


This confirms previous studies that show plaque build up in healthy people with what is considered "normal" LDL levels.

1777053284884.png



So yeah, I expect LDL targets to be lowered to "50mg/dl or less" in the near future.
 
tetrasect said:
That's not because LDL does not cause disease. It's because LDL targets are set too high.

New 3 year study just came out that shows a 33% relative risk reduction going from 66mg/dl to 56mg/dl LDL.


This confirms previous studies that show plaque build up in healthy people with what is considered "normal" LDL levels.

View attachment 1903348



So yeah, I expect LDL targets to be lowered to "50mg/dl or less" in the near future.
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Who conducted and funded the new study?
 
BBSA said:
Who conducted and funded the new study?
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Supported by the Cardiovascular Research Center and Yuhan.
Disclosure forms provided by the authors are available with
the full text of this article at NEJM.org.
A data sharing statement provided by the authors is available
with the full text of this article at NEJM.org.

Author Information
1 Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea; 2 Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea; 3 Sanggye Paik Hospital, Inje University College of Medicine, Seoul, South Korea; 4 Korea University Anam Hospital, Korea University College of Medicine, Seoul, South Korea; 5 Kyung Hee University Hospital at Gangdong, Seoul, South Korea; 6 Gachon University Gil Medical Center, Incheon, South Korea; 7 Dongsan Hospital, Keimyung University, Daegu, South Korea; 8 Eulji University Hospital, Daejeon, South Korea; 9 Soonchunhyang University Hospital, Cheonan, South Korea; 10 Daegu Catholic University Hospital, Daegu, South Korea; 11 National Health Insurance Service Ilsan Hospital, Goyang, South Korea; 12 Ewha Womans Uni-versity Seoul Hospital, Seoul, South Korea; 13 Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea; 14 Inje University Ilsan Paik Hospital, Goyang, South Korea; 15 Korea University Ansan Hospital, Korea University College of Medicine, Ansan, South Korea.

 
What's recommended these days between skim milk, almond milk or oat milk, or does it depend on what added junk they put in the almond or oat milk?

e.g.

Pick n Pay Online Shopping

www.pnp.co.za www.pnp.co.za

ButtaNutt Original Oat Milk 1L​

Ingredients​

Water, Gluten-Free Oats (8%), Canola Oil (2%), Salt, Calcium Carbonate, Calcium Citrate, Acidity Regulator (Potassium Phosphate)
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Pick n Pay Online Shopping

www.pnp.co.za www.pnp.co.za

ButtaNutt Original Almond Milk 1L​

Ingredients​

Water, Gluten-Free Oats (6%), Almonds (3%), Salt, Calcium Carbonate, Tricalcium Citrate, Acidity Regulator (Potassium Citrate)
Click to expand...
 
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