I find it baffling how you'll see guys trying to biohack their HDL levels up with things such as krill oil, citrus bergamot, Cardarine, high dose Niacin, and thinking it will outweigh their distorted lipid parameter.
This one has to be the best video I have seen about the subject...it is very illustrative, well made and entertaining, the metaphors you have chosen are funny and just perfection, thank you very much! You convey crucial information in a very professional and charismatic way.
That was very easy to understand. Thanks. The bells and metronomes and other loud noises were very disruptive, however, "undid" what I had just heard from you and made it necessary to repeat that portion.
thanks! i think keeping in mind the surrogates are imperfect (which is easy to forget...) explains many seeming discrepancies. role of HDL (the particle not the lipid) and lp(a) are interesting ongoing questions too
@@NutritionMadeSimple Of course, we're definitely coming at this from different perspectives. I'm one of those you're referring to who considers triglycerides to be substantially relevant and, for that matter, would love more data that combines low TG alongside high ApoB (and high HDL) to better test the association ApoB with CVD. Of course, we'll effectively get a direct testing of this with the #LMHRstudy anyway. If the hypothesis you present above proves accurate, then LMHRs should show rapid progression of atherosclerosis in the longitudinal CCTA scans given their very high ApoB in spite of high HDL and low TG (ofc, hoping that isn't what we see). Either way, it should be some extremely powerful data given its specificity.
@@realDaveFeldman 43 seconds in this video, why did the "buses" get stuck in the artery wall? please some on explain to me! once we can answer that question then we know the true cause of CVD right?
I knew very little until I watched this channel, the subject online IS confusing : this Doctor explains things I can grasp and use in my daily life. Thank you
The SAD thing is that my Doctor just told me that since my HDL is high, I am ok with my cholesterol. Thanks for providing this information Dr. Gil so that I can take a proactive measures to deal with my lipid profile.
thanks Gil! Could you also please make a video on the details of plaque development, what injures the endothelium, the metabolic activities affect that (as far as I know free radicals in the blood impairs the elasticity of the vessels) ?
Glad to discover your channel. Glad to discover I'm doing all the right things you've stated that scientific conclusions recommend to reduce the risk of arterial disease.
Excellent clarification, Gil. As promised, I followed your suggestion to watch this video in order to understand why apoB is a better indicator than simply focusing on the LDL or HDL number. It might explain why my total cholesterol is 212, despite the fact that I'm a vegetarian on a high fiber, plant-based diet who's a runner and works out regularly. What I gather from this video is that having a "high cholesterol" does not necessarily mean that one is at risk of having heart disease. The number of "passengers" on the bus might be high, but the number of "buses" might be low, which is a good thing. You did a better job explaining this than my doctor.
yes that's the gist. although bear in mind the population that shows 'discordance' (e.g. high LDL-cholesterol with normal apoB) is a minority (~25%). But yeah at least having more info empowers you to have the conversation with your doctors and ask their opinion re: measuring particle number
Thanks for the easy to understand analogy. Could you do a video on how Lupus affects cholesterol? Last year my Cholesterol levels skyrocketed off the charts and traditional medication is not lowering it. I’m suspected of having Lupus and wondering if that may have a bearing on how my body manages cholesterol.
But the real question is whether it's the number of buses that causes some to crash into the endothelium and break it. If it's not, then there's just a correlation between the number of buses and ruptures of the endothelium, not causality, i.e that the endothelium was already broken before the buses started to stack up and clot inside the breach.
At least it seems that we could be certain that reducing the number of busses reduces the hearth disease risk (there have been trials with drugs that reduce the apob), and that having a lot of buses is a red flag, so even without being sure of the mechanism, it seems pretty straight forward that we need to keep apob low.
So saturated fats are converted to cholesterol and packaged in ldl particles, but how are unsaturated fats carried around the body? Are they too converted into cholesterol?
Thanks for dumbing down this complex subject so a 5 year old can understand. Long story short make sure during you annual physical get a ApoB test. Be great if you now a lab proven diet. Exercise should also help.
True about HDL, my triglycerides, LDL and ApoB are really really low and my HDL is low, my calcium score is 0, my stress test is optimal and echocardiogram is optimal, I eat whole foods plant at 95% and 5% salmon
What about endothelial damage? And, as the body activates a repair process, and simultaneous ldl protein boats are shuffling past inflamed repair sites, might it be that the combination of ldl boat transport and endothelium repair are too much to bare simultaneously? I think it's an oversimplification to put out that more boat traffic induces more heart disease. I would suggest that chronic inflammation and suboptimal repairs contribute much more to artery disease than more boats traveling through the arteries. It would be the case that as the arteries degrade in structure and function, increased "boat" flow could also further contribute to the disfunctioning of the arteries. But, if the inflammation and repair corrects itself, does larger "boat" traffic still show traffic jambs and crashes?
Great presentation! Q: What about testing/measuring the arteries themselves like the thickness of the Carotid arteries, CT scan, echocardiogram etc. These tests seems to be seriously underrated too.
Problem with most tests is that they will only show you the issue once it's already progressed to the point of being a true problem. That's why ApoB and handling it way earlier is the way to go. Prevention > cure. Once you already have plaque, it's a self-propogating problem. Better to stop it from building up in the first place
@@laurasoftheart Yes there is a good chance it'll clean the arteries actually (and it can be measured). At least gradually for the better. It's definitely worth a try.
Great videos ... very informative and I really appreciate the linking to evidential studies. In many of your videos you mention how a person's risk of heart disease can be reduced through reduction of lipo-proteins etc. My question is, can the damage done to arteries and other blood vessel walls (plaque) be repaired. I am yet to find one of your video's that address this question.
we published a related one about a month or 2 ago, the gist is that I don't think there's very convincing evidence of *reversal* with any method but management does reduce risk effectively which is the bottom line and above all, prevention is king
Thank you for the info and the content, please could you make a video about TVP and generally soy? Or at least can you tell me If it s ok to eat it once a week? I'm confused whether it s considered unhealthy because of hexane for example, or for any other reason since it s not whole food. I'm trying to convert my diet slowly but steadily to completely plant based and TVP seems a useful tool for my goal until I find more recipes that I can actually eat with pleasure , but I must know at what cost. Thank you once again, appreciate your job, your videos educate many people and help them improve their health, thus their lives :)
hi! we do want to start releasing videos on soy soon. I haven't seen any concerns specifically with TVP, not sure what the industrial process to make it is, I'll keep it in mind for the series. I can't imagine it will cause much trouble once a week... the trick is to mix things up, maybe a TVP dish one time, edamame another, black beans another, tempeh another etc
My cholesterol went from 220 to 150 eating mostly plant based, with an LDL-c of 63 and my triglycerides from 700+ to 199. Since my trigs are still too high, should I ask for apob to be included in next blood work?
it's an idea. if your doc agrees it could tell you what's going on with particle number. we have a video in planning on high trigs on a plant-based diet. congrats on the amazing improvement!!
@@thedoc5848 really? Can you point me to studies showing negative health outcomes with that excellent level of LDL? All the dozens of studies I can find show lower CVD events when LDL was the lowest. You can find those studies referenced by research scientist Dr. Gil Carvalho and cardiologist Dr. Danielle Belardo. ruclips.net/video/Bjh9n2Cw0TY/видео.html
Is the long-term damage of high cholesterol lessened by other positive health markers? My total cholesterol is high, LDL borderline, Cholesterol/HDL ratio 3.2, triglycerides 89. I exercise vigorously 3x/week swimming, walk 1/2 mile daily, am not overweight, don’t eat much meat, avoid fried foods, enjoy many vegetables and low-fat dairy, 70 years old.
A topic that often come up when I discuss diet with people on high meat diets is the claim that non essential nutrients are in fact essential, and that a plant based diet only offer precursors for these nutrients and that it is insufficient. The claim is that we need meat to be sure to get these nutrients, and that getting them preformed is somehow better and more reliable than "just" from precursors. Some examples of these non essential nutrients are: Vitamin K2, carnitine, creatine, vitamin A, collagen among others. Some have even claimed that my blood work as a (whole foods) vegan of 5 years is unreliable and that I'm "probably deficient in a number of nutrients without knowing it"; even though my bloodwork is fine. I often ask for evidence from these people, but have yet to receive any; except for blogs or RUclips-clips that seem to be solely based on opinions or anecdotes. Care to weigh in on this topic, doc? ;)
You can eat a 100% animal foods diet with zero plants and you will be deficient in Vitamin A if you don't eat either organ meats or a lot of butter. I've never eaten organ meats or butter in my entire life. Whatever animal foods that I used to eat had very little or zero Vitamin A, so my entire life even as a non vegan I still got all my Vitamin A from beta carotene conversion. The belief that you have to eat organ meats to get enough Vitamin A is the stupidest of all of them. There are also many people who have been meat free since birth and easily make enough carnitine and creatine. Most people who supplement with those are also meat eaters.
@@dj-fe4ck Proof you do not make enough creatine pubmed.ncbi.nlm.nih.gov/21118604/ . They gave vegans creatine supplements and in short they became smarter.
Why is ApoB not made a routine test if it's so directly causal to heart disease? Is it just more expensive? It feels strange that for the #1 killer of people we're relying on such indirect/suggestive data. Even if it's only 25% of people who have this mismatch, that's a massive number, billions world-wide.
With a larger ‘bus’ full of ‘passengers’, while less likely to park itself inside of an arterial wall, isn’t it more likely to deliver more cholesterol if it does?
Hi again, Moved per your recommendation to watch this video and continuing my comments here. So - the never overstated issue of correlation vs causation is stated and humourously :) in this video for good reason. Where can I find definitive research that shows that coronary plaque is caused by LDL particle count (as opposed to the view that it is not the cause but rather part of healing process of coronary lessions and inflamation) ? On a personal note, I find it really hard to believe that a normal healthy body would clog its own arteries. Its just too simplistic IMO.
muito informativo! obrigado pelo conteúdo. One doubt that I have is if atherosclerosis is 'reversible' if you lower appB by drugs or diet. like, if you can have a cleaner or less restrictive blood vessel by reducing appB or if the damage done cannot be reversed
Btw Doc, Dr. Greger had an interesting set of videos come out about stents, the latest video came out today, the previous one a few days ago; worth checking out
Informative+Educational+Entertaining = Top-notch !! (...as usual) I definitely learned something here about the importance of keeping overall apoB low and the non-causal aspects of HDL (rendering the Chol/HDL ratio somewhat meaningless) Muito Obrigado!!
The best analogy for the correlation of HDL-C and health is youthful skin and health. People with youthful skin are generally healthy but you can not get healthy by facial masks or facial plastic surgery.
Is there a risk difference for the various ApoB carrying lipoproteins? Would it make sense to count the classes of ApoB tagged lipoproteins (LDL, IDL, VHDL, LpA, others?) separately to get a better measure of risk?
Why do the buses get stuck in the artery wall? What causes LDL carrying cholesterol to just randomly getting stuck in an artery wall. Why doesn’t the HDL bus get stuck in the artery wall? I would thing the answer to these questions might be more causal than the number of buses.
excellent questions. it's ApoB itself that sticks to proteoglycans in the wall. HDL-c doesn't have ApoB. some animals that have different ApoB sequences don't get plaque
Ahhhhhhh, the light just came on…So maybe the reason LDL has a main protein structure of ApoB is because those are the buses that take cholesterol where need for hormone making cell membrane repair etc….. and maybe the reason HDL doesn’t is because it’s the bus that transport back to the liver to be cleared…. IF THAT IS CORRECT….. then we would need to look at the function of these glycoproteins aka polysaccharides I’m assuming found throughout the tissue. So maybe these things are hydrophilic and enjoy nourishing cells with water….. maybe too they enjoy doing some biochemical signaling in case something goes wrong with anion covalent bonding to signal to the ApoB ( hey man, come here, we have a problem and I need cholesterol to fix these cells) or maybe come on in phagocytes we have a mess to clean up..maybe the cellular organelles have just the “right knowledge” of which glycosamineglycan to produce and which signal to send. I think our bodies are SUPER intelligent. To me it’s amazing how efficient it is to store fat for energy, to take a morsel of protein and know where to go to enlarge muscle tissue. Etc etc Bottom line I have reservations about things just happening. You know quiet well and easily there are so many stressors in the body and the body tries so hard to keep things in homeostasis. I enjoy these things. 🤓 lol
I wonder what I can do I'm 95 apob but my trigs are 28 and ldl is 138? My ldl is not low my hdl is 64 my apob is high...I don't know because not anyone I even work with knows...apob is new to me.
So after watching both videos again. I did watch them before just having the test done on Friday (the two videos low carb cardiologist and best human diet) ill take another apob test in 30 days and see if any good changes.. I'm waiting to hear from primary on Monday.
If a younger person who consumes a diet high in cholesterol and unhealthy fats have healthy blood cholesterol levels, is this simply due to their genetics, or will their blood cholesterol levels increase with age?
it could rise more with age esp. if body fat increases, but in all likelihood there is a level of genetic resistance there, because diet normally changes serum lipids very quickly, within days/weeks
@@NutritionMadeSimple So approximately, what would a healthy blood cholesterol level be? Im on a plant based diet now and havent done a checkup yet but previously my HDL was 0,92 mmol/L and LDL was 2,6 mmol/L. I've heard some claims that the general cholesterol guidelines have been altered due to people generally having higher cholester now?
As always very informative. THANK YOU. 2 questions: 1) Is ApoA an even better predictor than ApoB? 2) Does statins do anything in reducing the buses or ApoB?
the role of HDL particles (unlike HDL-c) is still being elucidated, it's possible it plays a protective role but kinda unclear yet. 2) Yes statins reduce ApoB, in fact all cholesterol-lowering drugs (Zetia, PCSK9 inhibitors etc) reduce ApoB, that's how they reduce risk. statins block cholesterol production which causes the liver to upregulate LDL receptor which removes LDL particles from circulation
To be very honest, if you know the history of lipoprotein particles the terms make sense. They were separated on, you guessed it, density. Just as why photosystem 2 is actually before photosystem 1 in photosynthesis: system 2 was discovered after system 1. For memes you'd have to look at the sonic hedgehog gene.
You’re saying that LDL and VLDL cause atherosclerosis yet most new sources I look at today say that they don’t. They’re a band aid over the damaged endothelium caused by sugar and other free radicals in the body. I think that’s really important to clarify?
are those peer-reviewed sources? that's key the strongest test is to lower those lipoproteins and see what happens. if they're problematic, lowering them will lower disease risk. if they're a band aid (helpful or neutral), lowering them will make things worse or make no difference. dozens of clinical trials show dose-dependent drops in risk when lipoprotein concentration is lowered. and people with genetically lower apoB also have lower risk eating an excess of refined carbohydrates chronically is not great and probably raises cardiovascular risk as well. heart disease is multifactorial, there's more than 1 risk factor. smoking is another one. also high blood pressure. etc.
Thank you so much for this video. Finally, I understand the basics of Cholesterol, LDL, HDL, and Triglycerides ❤️ I am curious though about low HDL. As per the video, I understand that high HDL levels do not mean that we are safe. What about low HDL levels. I was always curious to find out how I am doing with Cholesterol, LDL, HDL, etc. I did a test recently. Although I suspected that the results will be good, as I do not have any extra weight whatsoever and I follow a WFPB diet for more than 2 yrs now. The results were perfect except for the HDL, which was low. Could this indicate anything I should be aware of?
I know that is out of the scope of your excellent minilecture, but I must ask THE QUESTION. It is clear from your video what we need to do to prevent atherosclerosis; now, is there any way to cure the disease? Can an appropriate diet reverse plaque formation?
controversial. but even if some reversal is possible it's probably mild. the best course of action by far based on the evidence we have is to prevent it as early as we can. after plaque forms, it's damage control
Makes me think about my situation. Doing IF 16 hrs a day and weight training. HDL within normal range and Triglycerides are exceptional at 72 yet LdL is really high. Thoughts?
are you planning to make another video to explain how lipoproteins fit into the immune system? also, it feels a bit strange to state LDL as a "cause" when in reality, something else is "causing" the LDL to build up in the way that it does. otherwise, if that's all LDL did, they would continue to build plaque in your bloodstream regardless of how many you had. something else has to be responsible for corrupting the LDL into a state that it causes harm i guess my point is that LDL isn't the "root" cause and it almost sounds like blaming the victim of an accident for their own death
inflammation is the cause. Pro inflammatory foods cause inflammation. Look up the Dietary Inflammation Chart Basically. plants are anti inflammatory. Flesh is pro inflammatory
@@anarchy7741 i'm not sure what you mean by "the dietary inflammation chart", but i think you have that a bit backwards. the first result when i google "things that cause inflammation" is the healthline article and all the ingredients are derived from/related to plants.
@@LucasTigy2 I'm talking about whole foods. I'm not talking about oil, refined grains, vegan mock meats, added sugars, dried fruits, ect. I am talking about REAL FOOD Its called: DIETARY INFLAMMATION INDEX (sorry, I said chart instead of index, my bad)
Why does HDL go up with a change in diet? What is the boddy trying to do when HDL goes up from around 35 mg/dL to 50 mgdL. Just reaching normal values with nothing mechanisitic happening? In my case HDL went to from low to good normal values after going vegan. No processed foods.
Highly underrated channel! I’m such a fan! People want an escape from all the health confusion. Thanks for being open and for this information.
Agreed. Straightforward and he really does everything to avoid letting any personal bias get in the way.
My cardiologist has really appreciated my increased knowledge in cardiac disease and that is due to your presentations.
That analogy was class. Man this channel is CRIMINALLY underrated!
Thanks Gil! Your nutrition content is amongst the best on RUclips! I really appreciate all you do for us.
I find it baffling how you'll see guys trying to biohack their HDL levels up with things such as krill oil, citrus bergamot, Cardarine, high dose Niacin, and thinking it will outweigh their distorted lipid parameter.
This one has to be the best video I have seen about the subject...it is very illustrative, well made and entertaining, the metaphors you have chosen are funny and just perfection, thank you very much! You convey crucial information in a very professional and charismatic way.
It's incredible how easy you made this for me to understand using the bus analogy! Thank you so much for the info as always
It’s great to watch a video and come away feeling like I really learned something. Thank you!
Great resource. Thank you for posting, Gil!
That was very easy to understand. Thanks. The bells and metronomes and other loud noises were very disruptive, however, "undid" what I had just heard from you and made it necessary to repeat that portion.
I'm currently binge watching all your video's and this is the best one i've found so far. Great work!
Best channel ever. Never stop making videos
Enjoyed the video, Gil. I think this presents a very good, layperson-friendly summary of the lipid hypothesis as it stands today.
thanks! i think keeping in mind the surrogates are imperfect (which is easy to forget...) explains many seeming discrepancies. role of HDL (the particle not the lipid) and lp(a) are interesting ongoing questions too
@@NutritionMadeSimple Of course, we're definitely coming at this from different perspectives. I'm one of those you're referring to who considers triglycerides to be substantially relevant and, for that matter, would love more data that combines low TG alongside high ApoB (and high HDL) to better test the association ApoB with CVD.
Of course, we'll effectively get a direct testing of this with the #LMHRstudy anyway. If the hypothesis you present above proves accurate, then LMHRs should show rapid progression of atherosclerosis in the longitudinal CCTA scans given their very high ApoB in spite of high HDL and low TG (ofc, hoping that isn't what we see). Either way, it should be some extremely powerful data given its specificity.
@@realDaveFeldman 43 seconds in this video, why did the "buses" get stuck in the artery wall?
please some on explain to me!
once we can answer that question then we know the true cause of CVD right?
I knew very little until I watched this channel, the subject online IS confusing : this Doctor explains things I can grasp and use in my daily life. Thank you
This doctor make it fun to learn. Very clear too. thank you for this, subd :)
Excited! Favorite topic! Need this
The SAD thing is that my Doctor just told me that since my HDL is high, I am ok with my cholesterol. Thanks for providing this information Dr. Gil so that I can take a proactive measures to deal with my lipid profile.
thanks Gil!
Could you also please make a video on the details of plaque development, what injures the endothelium, the metabolic activities affect that (as far as I know free radicals in the blood impairs the elasticity of the vessels) ?
Glad to discover your channel.
Glad to discover I'm doing all the right things you've stated that scientific conclusions recommend to reduce the risk of arterial disease.
Good content! I've watched your other lipids videos but this was a good, big-picture refresher.
Excellent explanation!!
Wicked analogy! Makes sense now.
Important topic. Thanks for the explanation and the science. 🙏
The BEST explaination ever... well done ! Thanks for this .
Dr. Cavarlho could you kindly do a video on muscle hypertrophy, and protein requirements in relation to health?
we have one in the works :)
Excellent clarification, Gil. As promised, I followed your suggestion to watch this video in order to understand why apoB is a better indicator than simply focusing on the LDL or HDL number. It might explain why my total cholesterol is 212, despite the fact that I'm a vegetarian on a high fiber, plant-based diet who's a runner and works out regularly. What I gather from this video is that having a "high cholesterol" does not necessarily mean that one is at risk of having heart disease. The number of "passengers" on the bus might be high, but the number of "buses" might be low, which is a good thing. You did a better job explaining this than my doctor.
yes that's the gist. although bear in mind the population that shows 'discordance' (e.g. high LDL-cholesterol with normal apoB) is a minority (~25%). But yeah at least having more info empowers you to have the conversation with your doctors and ask their opinion re: measuring particle number
really great dude
My favourite nutrition channel on YT! Another homerun good sir
Get stuff! Love the short clips
can't appreciate you enough for ur efforts!
Another very informative video.... Thank you!
Thank you for all the details, which are crucial to understanding these things. Some graphics would be nice to aid comprehension, thanks
Thanks for the easy to understand analogy.
Could you do a video on how Lupus affects cholesterol? Last year my Cholesterol levels skyrocketed off the charts and traditional medication is not lowering it. I’m suspected of having Lupus and wondering if that may have a bearing on how my body manages cholesterol.
Good information presented in a pleasant style ☺👌
such a great video!! thank you for explaining so well!
But the real question is whether it's the number of buses that causes some to crash into the endothelium and break it. If it's not, then there's just a correlation between the number of buses and ruptures of the endothelium, not causality, i.e that the endothelium was already broken before the buses started to stack up and clot inside the breach.
At least it seems that we could be certain that reducing the number of busses reduces the hearth disease risk (there have been trials with drugs that reduce the apob), and that having a lot of buses is a red flag, so even without being sure of the mechanism, it seems pretty straight forward that we need to keep apob low.
Great content. Do you have an estimate for the optimal apo B range?
So saturated fats are converted to cholesterol and packaged in ldl particles, but how are unsaturated fats carried around the body? Are they too converted into cholesterol?
Keep watching/rewatching & recommending the channel! Happy to see it grow🙏🏼
I appreciate that
Thanks for dumbing down this complex subject so a 5 year old can understand. Long story short make sure during you annual physical get a ApoB test. Be great if you now a lab proven diet. Exercise should also help.
Solid analogy Gil.
what put the plaque on the artery wall?
43 seconds in the video, why did the "buses" get stuck in the artery wall?
@@LeonSKennedy.. they bind to proteoglycans within the intima, become oxidized, and eventually become retained.
@@ucchi9829 ok.... so what causes these important "buses" to bind to proteoglycans within the intima?
@@LeonSKennedy.. ionic bonding
Bravo! A clear explanation. Thank you.
Thanks so much for making this clear! Very helpful. Muito obrigado!
True about HDL, my triglycerides, LDL and ApoB are really really low and my HDL is low, my calcium score is 0, my stress test is optimal and echocardiogram is optimal, I eat whole foods plant at 95% and 5% salmon
can you please talk about gluten, different types of grains and which one's the healthiest? (whole grains, refined and gluten free)
Pausing to go get a sharpie to finally get my 6-pack 🤣
You're very informative and hilarious at the same time. Thank you
What about endothelial damage?
And, as the body activates a repair process, and simultaneous ldl protein boats are shuffling past inflamed repair sites, might it be that the combination of ldl boat transport and endothelium repair are too much to bare simultaneously?
I think it's an oversimplification to put out that more boat traffic induces more heart disease.
I would suggest that chronic inflammation and suboptimal repairs contribute much more to artery disease than more boats traveling through the arteries.
It would be the case that as the arteries degrade in structure and function, increased "boat" flow could also further contribute to the disfunctioning of the arteries.
But, if the inflammation and repair corrects itself, does larger "boat" traffic still show traffic jambs and crashes?
I completely agree with u
@6:29 Sometimes the acronyms are absolutely essential, so don't apologize for clarifications sake
Do you have a video about processed meats?
But what about H.Pylori being present in the arterial clogs of patients with cardiac disorders.
Super well explained, as always, amazing content :) Thank you!
Great presentation!
Q: What about testing/measuring the arteries themselves like the thickness of the Carotid arteries, CT scan, echocardiogram etc. These tests seems to be seriously underrated too.
Problem with most tests is that they will only show you the issue once it's already progressed to the point of being a true problem. That's why ApoB and handling it way earlier is the way to go. Prevention > cure.
Once you already have plaque, it's a self-propogating problem. Better to stop it from building up in the first place
If you already know you have arteriosclerosis and you change to a plant based/Mediterranean diet does the plague that’s already there stay?
@@laurasoftheart Yes there is a good chance it'll clean the arteries actually (and it can be measured). At least gradually for the better. It's definitely worth a try.
I really enjoyed and understood this! Thank you. Why are higher levels of HDL associated with better cardiovascular health ?
it's inversely correlated with apoB :)
Question. Can atherosclerosis be reverted by ingesting Vitamin K2 and D3? Can vitamin E prevent oxidation on LDL?
Great videos ... very informative and I really appreciate the linking to evidential studies. In many of your videos you mention how a person's risk of heart disease can be reduced through reduction of lipo-proteins etc. My question is, can the damage done to arteries and other blood vessel walls (plaque) be repaired. I am yet to find one of your video's that address this question.
we published a related one about a month or 2 ago, the gist is that I don't think there's very convincing evidence of *reversal* with any method but management does reduce risk effectively which is the bottom line and above all, prevention is king
Is muesli a good breakfast option?
How to lower Apo B? Please do a video on this.
ruclips.net/video/18FF4pYLxek/видео.html
Isn't it only an issue with the number of lipoproteins if they become oxidized? It is then that they can result in plaque build up?
Thank you for the info and the content, please could you make a video about TVP and generally soy? Or at least can you tell me If it s ok to eat it once a week? I'm confused whether it s considered unhealthy because of hexane for example, or for any other reason since it s not whole food. I'm trying to convert my diet slowly but steadily to completely plant based and TVP seems a useful tool for my goal until I find more recipes that I can actually eat with pleasure , but I must know at what cost. Thank you once again, appreciate your job, your videos educate many people and help them improve their health, thus their lives :)
hi! we do want to start releasing videos on soy soon. I haven't seen any concerns specifically with TVP, not sure what the industrial process to make it is, I'll keep it in mind for the series. I can't imagine it will cause much trouble once a week... the trick is to mix things up, maybe a TVP dish one time, edamame another, black beans another, tempeh another etc
~ TVP is textured vegetable protein ..❓
My cholesterol went from 220 to 150 eating mostly plant based, with an LDL-c of 63 and my triglycerides from 700+ to 199. Since my trigs are still too high, should I ask for apob to be included in next blood work?
it's an idea. if your doc agrees it could tell you what's going on with particle number. we have a video in planning on high trigs on a plant-based diet. congrats on the amazing improvement!!
That's very low LDL, very concerning
@@thedoc5848 really? Can you point me to studies showing negative health outcomes with that excellent level of LDL? All the dozens of studies I can find show lower CVD events when LDL was the lowest. You can find those studies referenced by research scientist Dr. Gil Carvalho and cardiologist Dr. Danielle Belardo.
ruclips.net/video/Bjh9n2Cw0TY/видео.html
Just a side note question : how good is the body's capacity at converting beta carotene to Vit a and k1 to k2?
not good at all
eat eggs, liver and cheese and you will never have to worry about conversion rates
@@LeonSKennedy.. LOL that's not the answer to my question.
@@markaguilera493 then listen to El Zee's response, there is your answer.
I was just giving you an alternative
@@LeonSKennedy.. Yeah sure...But it's actual data I'm looking for not birscience.
I would love to see you debate Dave Feldman or Dr. Nadir Ali and a few more who would strongly disagree with you.
those guys talk all day without any supporting evidence
Is the long-term damage of high cholesterol lessened by other positive health markers? My total cholesterol is high, LDL borderline, Cholesterol/HDL ratio 3.2, triglycerides 89. I exercise vigorously 3x/week swimming, walk 1/2 mile daily, am not overweight, don’t eat much meat, avoid fried foods, enjoy many vegetables and low-fat dairy, 70 years old.
A topic that often come up when I discuss diet with people on high meat diets is the claim that non essential nutrients are in fact essential, and that a plant based diet only offer precursors for these nutrients and that it is insufficient. The claim is that we need meat to be sure to get these nutrients, and that getting them preformed is somehow better and more reliable than "just" from precursors. Some examples of these non essential nutrients are: Vitamin K2, carnitine, creatine, vitamin A, collagen among others. Some have even claimed that my blood work as a (whole foods) vegan of 5 years is unreliable and that I'm "probably deficient in a number of nutrients without knowing it"; even though my bloodwork is fine.
I often ask for evidence from these people, but have yet to receive any; except for blogs or RUclips-clips that seem to be solely based on opinions or anecdotes.
Care to weigh in on this topic, doc? ;)
You can eat a 100% animal foods diet with zero plants and you will be deficient in Vitamin A if you don't eat either organ meats or a lot of butter. I've never eaten organ meats or butter in my entire life. Whatever animal foods that I used to eat had very little or zero Vitamin A, so my entire life even as a non vegan I still got all my Vitamin A from beta carotene conversion. The belief that you have to eat organ meats to get enough Vitamin A is the stupidest of all of them. There are also many people who have been meat free since birth and easily make enough carnitine and creatine. Most people who supplement with those are also meat eaters.
@@dj-fe4ck Proof you do not make enough creatine pubmed.ncbi.nlm.nih.gov/21118604/ . They gave vegans creatine supplements and in short they became smarter.
@@Alex-vi6iz One study is not proof. But thanks. :)
Why is ApoB not made a routine test if it's so directly causal to heart disease? Is it just more expensive? It feels strange that for the #1 killer of people we're relying on such indirect/suggestive data. Even if it's only 25% of people who have this mismatch, that's a massive number, billions world-wide.
some of the leading experts agree wholeheartedly and are pushing for the change :)
@@NutritionMadeSimple ahh I see, seems like a strange debate. Thanks!
So the only intressting hing is what happends
to the busses?
With a larger ‘bus’ full of ‘passengers’, while less likely to park itself inside of an arterial wall, isn’t it more likely to deliver more cholesterol if it does?
the foremost experts on lipids agree with you :) jamanetwork.com/journals/jamacardiology/article-abstract/2753612
SUPER great explanation! So when LDL apoB and LDL Colesterol are bad than the best way to dodge a heart attack is to go plantbased right?
diet rich in whole plants (whether it's exclusive or not depends on personal situation and preferences) and moderating saturated fat-rich foods
Hi again,
Moved per your recommendation to watch this video and continuing my comments here.
So - the never overstated issue of correlation vs causation is stated and humourously :) in this video for good reason.
Where can I find definitive research that shows that coronary plaque is caused by LDL particle count (as opposed to the view that it is not the cause but rather part of healing process of coronary lessions and inflamation) ?
On a personal note, I find it really hard to believe that a normal healthy body would clog its own arteries. Its just too simplistic IMO.
muito informativo! obrigado pelo conteúdo. One doubt that I have is if atherosclerosis is 'reversible' if you lower appB by drugs or diet. like, if you can have a cleaner or less restrictive blood vessel by reducing appB or if the damage done cannot be reversed
Btw Doc, Dr. Greger had an interesting set of videos come out about stents, the latest video came out today, the previous one a few days ago; worth checking out
I'll take a look tks!
~ Yes it points out how the vascular system is closing up _everywhere_ - not just where the stent is placed . 😥
@@NutritionMadeSimple 43 seconds in, why did the "buses" get stuck in the artery wall? you failed to explain this
Great explanation. But I'm missing lipoprotein (a) in your videos.
in the pipeline :)
Informative+Educational+Entertaining = Top-notch !! (...as usual)
I definitely learned something here about the importance of keeping overall apoB low and the non-causal aspects of HDL (rendering the Chol/HDL ratio somewhat meaningless)
Muito Obrigado!!
Any research on mental health and diet?
The best analogy for the correlation of HDL-C and health is youthful skin and health. People with youthful skin are generally healthy but you can not get healthy by facial masks or facial plastic surgery.
nice!
@@NutritionMadeSimple what caused that plaque on the artery wall at 0:41?
@@NutritionMadeSimple 43 seconds in the video, why did the "buses" get stuck in the artery wall?
you didn't give an explanation
Is there a risk difference for the various ApoB carrying lipoproteins? Would it make sense to count the classes of ApoB tagged lipoproteins (LDL, IDL, VHDL, LpA, others?) separately to get a better measure of risk?
I see you answered this question here: ruclips.net/video/-B8ybQ-L264/видео.htmlm25s
You imply but never say directly, but is it true that only one ApoB “tag” is present on each atherosclerotic lipoprotein (LDL, VLDL) particle?
How about associations between bone strength and diet?
veganism is associated with bone fractures.
pubmed.ncbi.nlm.nih.gov/30376075/
Why do the buses get stuck in the artery wall? What causes LDL carrying cholesterol to just randomly getting stuck in an artery wall. Why doesn’t the HDL bus get stuck in the artery wall?
I would thing the answer to these questions might be more causal than the number of buses.
excellent questions. it's ApoB itself that sticks to proteoglycans in the wall. HDL-c doesn't have ApoB. some animals that have different ApoB sequences don't get plaque
btw I´m trying to book some scientists that specialize on these mechanistic aspects to come on
Ahhhhhhh, the light just came on…So maybe the reason LDL has a main protein structure of ApoB is because those are the buses that take cholesterol where need for hormone making cell membrane repair etc….. and maybe the reason HDL doesn’t is because it’s the bus that transport back to the liver to be cleared….
IF THAT IS CORRECT…..
then we would need to look at the function of these glycoproteins aka polysaccharides I’m assuming found throughout the tissue. So maybe these things are hydrophilic and enjoy nourishing cells with water….. maybe too they enjoy doing some biochemical signaling in case something goes wrong with anion covalent bonding to signal to the ApoB ( hey man, come here, we have a problem and I need cholesterol to fix these cells) or maybe come on in phagocytes we have a mess to clean up..maybe the cellular organelles have just the “right knowledge” of which glycosamineglycan to produce and which signal to send.
I think our bodies are SUPER intelligent. To me it’s amazing how efficient it is to store fat for energy, to take a morsel of protein and know where to go to enlarge muscle tissue. Etc etc
Bottom line I have reservations about things just happening. You know quiet well and easily there are so many stressors in the body and the body tries so hard to keep things in homeostasis.
I enjoy these things. 🤓 lol
I wonder what I can do I'm 95 apob but my trigs are 28 and ldl is 138? My ldl is not low my hdl is 64 my apob is high...I don't know because not anyone I even work with knows...apob is new to me.
see the video with the low carb cardiologist we published 1-2 months ago
So after watching both videos again. I did watch them before just having the test done on Friday (the two videos low carb cardiologist and best human diet) ill take another apob test in 30 days and see if any good changes.. I'm waiting to hear from primary on Monday.
My Cardiologist will not test for ApOb but rather LpA. What is the science?
Is fasting recommended before testing for APOB?
If a younger person who consumes a diet high in cholesterol and unhealthy fats have healthy blood cholesterol levels, is this simply due to their genetics, or will their blood cholesterol levels increase with age?
it could rise more with age esp. if body fat increases, but in all likelihood there is a level of genetic resistance there, because diet normally changes serum lipids very quickly, within days/weeks
@@NutritionMadeSimple So approximately, what would a healthy blood cholesterol level be? Im on a plant based diet now and havent done a checkup yet but previously my HDL was 0,92 mmol/L and LDL was 2,6 mmol/L. I've heard some claims that the general cholesterol guidelines have been altered due to people generally having higher cholester now?
ApoB test vs Lipoprotein A test - what's the difference?
lp(a) is a (small) subset of ApoB lipoproteins, see ruclips.net/video/-WRRyG8il4g/видео.html
Excellent
Change your diet reduce the busses ?
As always very informative. THANK YOU. 2 questions:
1) Is ApoA an even better predictor than ApoB?
2) Does statins do anything in reducing the buses or ApoB?
the role of HDL particles (unlike HDL-c) is still being elucidated, it's possible it plays a protective role but kinda unclear yet. 2) Yes statins reduce ApoB, in fact all cholesterol-lowering drugs (Zetia, PCSK9 inhibitors etc) reduce ApoB, that's how they reduce risk. statins block cholesterol production which causes the liver to upregulate LDL receptor which removes LDL particles from circulation
@@NutritionMadeSimple Thanks!
@@NutritionMadeSimple in which case, if I reduce my apob to a good level with a statin I shouldn't have a heart attack. Is that correct?
To be very honest, if you know the history of lipoprotein particles the terms make sense. They were separated on, you guessed it, density.
Just as why photosystem 2 is actually before photosystem 1 in photosynthesis: system 2 was discovered after system 1.
For memes you'd have to look at the sonic hedgehog gene.
Does anyone know of a similar channel that focuses on medical science?
Mine does but as a cardiologist I focused more in heart disease our number 1 killer.
You’re saying that LDL and VLDL cause atherosclerosis yet most new sources I look at today say that they don’t. They’re a band aid over the damaged endothelium caused by sugar and other free radicals in the body. I think that’s really important to clarify?
are those peer-reviewed sources? that's key
the strongest test is to lower those lipoproteins and see what happens. if they're problematic, lowering them will lower disease risk. if they're a band aid (helpful or neutral), lowering them will make things worse or make no difference. dozens of clinical trials show dose-dependent drops in risk when lipoprotein concentration is lowered. and people with genetically lower apoB also have lower risk
eating an excess of refined carbohydrates chronically is not great and probably raises cardiovascular risk as well. heart disease is multifactorial, there's more than 1 risk factor. smoking is another one. also high blood pressure. etc.
Thank you so much for this video. Finally, I understand the basics of Cholesterol, LDL, HDL, and Triglycerides ❤️
I am curious though about low HDL. As per the video, I understand that high HDL levels do not mean that we are safe. What about low HDL levels. I was always curious to find out how I am doing with Cholesterol, LDL, HDL, etc. I did a test recently. Although I suspected that the results will be good, as I do not have any extra weight whatsoever and I follow a WFPB diet for more than 2 yrs now. The results were perfect except for the HDL, which was low. Could this indicate anything I should be aware of?
the same data indicate low HDL-c per se does not increase risk
I know that is out of the scope of your excellent minilecture, but I must ask THE QUESTION. It is clear from your video what we need to do to prevent atherosclerosis; now, is there any way to cure the disease? Can an appropriate diet reverse plaque formation?
controversial. but even if some reversal is possible it's probably mild. the best course of action by far based on the evidence we have is to prevent it as early as we can. after plaque forms, it's damage control
Makes me think about my situation. Doing IF 16 hrs a day and weight training. HDL within normal range and Triglycerides are exceptional at 72 yet LdL is really high. Thoughts?
check apoB and follow that. chances are it'll be higher than ideal (in which case the evidence recommends lowering) but some people are discordants...
@@NutritionMadeSimple how would you explain the really good Trig levels?
@@Proteinskidmark LDL gets high if either cholesterol or triglycerides get high. Your triglycerides are low but your cholesterol is not.
@@descai10 so essentially manage the cholesterol?
5 main Lipoproteins
HDL, LDL, VLDL, Chylomicron and IDL
Does the apoB test also pick up chylomicrons? Thanks.
most commercial ones dont, they detect apob 100 and chylomicrons carry apob 48. there are tests that detect it but usually used in research
@@NutritionMadeSimple OK; thank you.
No numbers?
are you planning to make another video to explain how lipoproteins fit into the immune system?
also, it feels a bit strange to state LDL as a "cause" when in reality, something else is "causing" the LDL to build up in the way that it does. otherwise, if that's all LDL did, they would continue to build plaque in your bloodstream regardless of how many you had. something else has to be responsible for corrupting the LDL into a state that it causes harm
i guess my point is that LDL isn't the "root" cause and it almost sounds like blaming the victim of an accident for their own death
inflammation is the cause.
Pro inflammatory foods cause inflammation. Look up the Dietary Inflammation Chart
Basically. plants are anti inflammatory.
Flesh is pro inflammatory
@@anarchy7741 i'm not sure what you mean by "the dietary inflammation chart", but i think you have that a bit backwards.
the first result when i google "things that cause inflammation" is the healthline article and all the ingredients are derived from/related to plants.
@@LucasTigy2
I'm talking about whole foods.
I'm not talking about oil, refined grains, vegan mock meats, added sugars, dried fruits, ect.
I am talking about REAL FOOD
Its called:
DIETARY INFLAMMATION INDEX (sorry, I said chart instead of index, my bad)
Joel fuhrman just had a debate with paul saladino, you should do a review of the debate, it would be really interesting to see your take on it.
can you post the link
What about LP(a)?
we have a whole video on it :) ruclips.net/video/-WRRyG8il4g/видео.html
@@NutritionMadeSimple Thanks! Mine is high. Cardiac event at 47yo w/ quad bypass. Watching for clinical trials. I’ll watch the video.
Why does HDL go up with a change in diet? What is the boddy trying to do when HDL goes up from around 35 mg/dL to 50 mgdL. Just reaching normal values with nothing mechanisitic happening? In my case HDL went to from low to good normal values after going vegan. No processed foods.