undeather

What you are looking for is not a particular diet, but healthy & sustainable diet patterns. Judging by your replies, you seem to be almost anxious about this stuff - but this is exactly the first pitfall when it comes to eating healthy. Don't stress yourself out about reaching some "ideal" - sustainability takes root in slow progress & thoughtful interaction. You don't want to force yourself on a diet which isn't palatable to your specific needs - you need to find out what works for you and not copy someone's else diet plan. When it comes to "what to eat" - there is an easy rule to follow: Eat real food, mostly plants & not too much. Notice that this is not a particular diet, but a pattern - from a health perspective, most of your diet should be focused around plant-products but could and in my opinion should involve some amount of animal products. Use extra virgin olive oil instead of butter. Prefer healthy snacking (nuts, berries, dates...) over that Mars-bar. Focus on eating real food - meaning cut out all the processed garbage - most people suck at cooking and therefore have to rely on precooked stuff or fast-food suppliers. Not too much - meaning that you eat according to your specific caloric needs. The one goal you should try to hit every day from a macronutrient point of view is around 1-1,5mg/kg of protein intake. If you are physically active/lift weights, then try to get closer to the 1,5mg/kg point. If you just follow this simple but effective pattern, you will be fine health wise. You don't need to be perfect when it comes to dieting - I personally follow a 80/20 approach, where I eat a mediterranian style diet for 80+% of the time and induldge in garbage food once or twice a week. It works because it's sustainable - sometimes I just crave a pizza or a fatty burger with fries - and there is nothing wrong with it. Don't let perfect be the enemy of good.

Okay - very interesting! Thanks for sharing! Here is what I would recommend: - Don't stress out about this! You are young, live an above average lifestyle and your previous blood test (2022) shows that you propably do not suffer from an inherited lipid-disorder (hypercholesterinemia). - From a medical perspective, I want you to do a checkup at an internal medicine doctor (if that is possible under your current circumstances). He should do an ultrasound of your carotid arteries and the heart. - I also want you keep an eye on your LDL! Defintitely do another screening in 3-6 months and see if it changed! There are plenty of potential reasons why your LDL almost went up 100 points in the span of that short period of time. While stress plays a role in LDL-synthesis, I agree with your doctor that this is unlikely only due to increased stress. I would put my money on a mixture of causes (increased stress, circadian changes, foods that screw with fasting mechanisms and lipids in the short term..) - As for your diet, you hinted that you don't enough vegetables. This immediatly makes me think about you not getting not enough fiber, which is important because you might be a so called "cholesterol/fat hyperabsorber" and fiber blocks this absorption process to some degree! You don't have to go crazy on this, you can still enjoy your meats - but I recommend adding some fiber-containing foods to your diet (vegetables, beans, lentils, fruit, nuts..). You could also start adding "Psyllium Husk" to your protein shakes if you take them. - If you eat a lot of saturated fat (butter, ghee, fatty meats..), you could start experimenting with replacing it with better fats like olive oil or leaner cuts! Again, don't go crazy on it! - The big red flag is your stress level & sleep though! Stress, especially long term stressors and through activating the cortisol axis, can definitely elevate your LDL-C. Poor sleep quality is also known for scewing with your lipid-metabolism! Often, as well I think in your case, bad sleep is triggered by a stressful life. You should think about implementing some sort of techniques that help you dealing with the work-stress. This is a complex topic and might contain anything from a simple meditation-technique to breathwork you regularly do during worktime (alternate-nose breathing) or some form of active recovery like Yoga/Tai Chi or Qigong. There are also some supplements you can look into, which could improve your sleep (Melatonin 300mcg, Magnesium Threonate (300–400 mg), Apigenin (50 mg)) - Medications: I personally would not perscribe you a drug right now. This could be a temporary increase that will get better with time! Cheers

"one of the worst" - Some parts of Croatia show one of the worst cardiovascular risk outcomes across the whole european continent. One big factor is an increased consupmtion of high claoric, high saturated fat, high salt food plus a good amount of alcohol intake (especially beer!). This made Croatia the most overweight country in the european union. The healthcare system is also lacking in many different regards. It's really a shame, because the traditional croatian cuisine also involves many classic mediterranian influences (fish, olive oil, beans..), which is among the healthiest diet patterns you can find. That said, croatia is insanely beautiful and the people are pretty chill- I visit as often as possible because I also live only a few hours drive away. Enjoy your trip!

A LDL-Cholestrol of above 200 puts you in the 99th percentile - meaning that you are in the top 1% of people with high "bad"-cholesterol. This directly translates to an high amount of Apo-B particles in your blood, which are the atherogenic (atherosclerosis causing) parts of the LDL-molecule. This is a significant risk factor you should deal with, but it's not a cause for concern in the short run. Cardiovascular risk factors like cholesterol are functions of time and magnitude - meaning that they increase your risk of a stroke/heart attack to the extent of how long and strong (higher/lower numbers) they exert influence on your body. Also very important to consider is that there are many risk factors that go into that equation. If your blood pressure is normal, you don't have diabetes, are not obese, don't smoke - then your risk of getting into serious problems in the next 10 or 20 years is very low (I am assuming you are in your 20s/30s). That said, I am sure that it is in your interest to live a long and healthy life - therefore it's important to start working on this right now! The first and most important step towards better blood lipids/cholesterol is lifestyle modification! How does your diet look like? Are you overweight? Are you sedentary or is there some form of exercise routine in your life? I have seen that you are from Croatia, which is known for having one of the worst cardiovascular dietary patterns in central Europe. Also, are there any early age heart attacks/strokes in yoru family history? Especially before the age of 60?

The pernicious anemia is a specific form of a vitamin B12 deficiency anemia, triggered by a lack of intrinsic factor (a protein your body needs to absorp B12) within the context of atrophic autoimmune gastritis. I highly doubt you suffer from this condition. Even though you are on the lower end of the recommended B12-range, there is no way you get anemia from that. I am sure the doctor you visited did a blood-test? A manifested B12-deficiecny anemia is easy to diagnose through a normal blood-lab with high MCV (mean cell volume) & MCH (mean corpuscular hemoglobin), high LDH, high Bilirubin & low hemoglobin. Now something important: Serum B12 is not the best measurement in that case. A significant portion of Vitamin B12 is bound to haptocorrin and therefore biochemically inactive. A better indicator is Holo-Transcobalamin (Holo-TC), also referred to as "active B12". You would also want to measure your methylmalonic acid (MMA) & homocysteine-levels - which indicate a so called functional B12-deficiency. If you really want to evaluate your B12- metabolism, then you need to go that extra mile. _____________________ That said, now let's talk about your symptoms. There are dozens of pontential explanations for your complaints. This could range from micro or macronutrient deficiencies, some more or less serious medical conditions or simply a psychosomatic maladaptation. I know how dismissive most doctors can get when it comes to "weird and complex" symptoms which aren't easily explained through cookie-cutter diagnoses. It's crucual for you to find someone who takes you seriously and wants to work with you through that. This could be another doctor or a knowledegeable health-coach like @Michael569. It's really difficult to give you an over the internet perscription of what to do next because I don't know you, nor your medical history. Maybe the best thing you can do on your own is to change up your lifestyle habits a bit. Maybe change your dietary patterns, see how your body reacts if you put some form of animal product back into your diet. Maybe try eating some salmon for example. Observe what happens and maybe you can resolve it on your own.

At some point you just gotta respond with memes because the arguments made are stupid to the degree it hurts. I also work a shitload, you know, like with real people and also their diets - so I just can't respond to everything in detail. But hey, if you want to debate this one day on Discord, than I would happily do that. You are smart but young and caught up in some terminally online epistemology. I will guarantee you that in 10 years, you will think differently about those topics.

Please post your total blood report. Ferritin is a strongly fluctuating value and the considered safe-range is pretty large. If you want me to take interpret your lab, I need more than that.

A well balanced, whole food vegan diet does not have a problem with any of these nutrients. That's nonsense. You can make the argument that you need to be more concious about that sort of staff, but that's it. The exact same strawman can be made about eating meat. Shitty dietary patterns exist everywhere but are not defined by leaving out animal products. If you found a diet that works for you, than that's great. But let's stop generalizing anecdotes and personal preferences to the point of total absurdity. The vegan propaganda machine has those stories as well and you know that.

The phenomenon that some individuals on a vegan diet go back to eating meat due to perceived health issues is well known. And in almost all cases it boils down to either inadequate calorie/macronutrient intake, weird dietary patterns (frutarians, paleo-vegan...) or an insufficient supplementation protocol. I also believe that we tend look for associations when new, often transient and psychophysically triggered health symptoms show up - and diet being one of the primary go to's in that case - despite there being no clear causation under the guise. But then, and this is often left out, you definitely have people like Peterson who for whatever reason just come along well with plant-based diets. That said, in my 10+ years working in the medical field and taking care of many vegan patients in my private practice, I have seen many more cases of drastic health improvements than people getting worse after switching to vegan (which they did in their own interest because I don't advice people to go vegan!).

Do you consume seed oils?

Show me one diet that meets all nutritional requirements and I will kiss your feet. It doesnt exist. I am not even advocating for veganism because it's a boring as fuck elimination diet - but the premise is the case. If I take yours or Jasons's blood - I am going to find deficiancies! From an integral health perspective, supplementation is part of the game! Outside of internet echochambers, most nutrient-concious vegans who supplement B12 will just do fine in the long run. But thats very hard to accept for most people. Also, the reason vegans have to supplement B12 are well understood and has nothing to do with an "inherent" lack of nutrients. Stop making people afraid of going vegan! It really is a nonsense argument based on gibberish. And you guys are smart enough to know that!

That's very reasonable -I do the same!

Look, skin cleansing is not an exact science. There have been more than enough suggestions in this thread already - go pick one and try it out for yourself - experiment a bit, see how your skin responds. If you are worried about potentially harmful chemicals, then Princess Arabia & Jason have provided reasonable alternatives. The reason why I use Cerave products is because I use them and it greatly improved my skin. While I also think that we need to be cautious in the face of ubiquitous, potentially harmful & endocrine disrubting compound exposure - the dosages and pharmakokinetics used in skin care products like Cerave (especially those you wash of instantly like a cleanser) seem to be pretty benign. People fear about miniscule compound exposure in beauty-products, which for the most part can't even penetrate the skin barrier - but then go out and eat their beef or salmon which provably contain a mixture of dozens contaminations in much, much higher concentrations. When it comes to sunscreen - don't fuck around. Oils and other, alternative sun protectors show inadequate proteaction. Skin cancer has become the most frequent neoplastic disease among the Caucasian population in Europe, North America and Australia, and its incidence has reached epidemic proportions. I advice sun screens containing mineral compounds like zinc or titanium oxide - everything we know so far is that those compounds don't seem to get absorbed systemically and show very good UV-protection.

While it's true that the skincare industry is a billion dollar, profit maximizing enterprise we better do not throw the baby out with the bathwater. I think most people would agree that a small selection of high quality products, build into a regular skincare-routine, definitely improves skin health & general appearance. We also have some interesting scientifc studies of supplements that evidently improve your skin. When my patient ask me about which products they should use, I usually point them towards Cerave. It's usually affordable, high quality stuff and most importantly just the ingredients you want without the nonsense. It usually goes well for individuals with sensible skin. Cleansing: CeraVe Gel/Foam Moisture: CeraVe Moisturising Cream Sunscreen: I would also advice to regularly apply suncreen! Supplements that improve skin-appearence: - Collagen (15g/d) - Hyaluronic Acid (200mg/d) - Creatine (5g/d) The most potent skin-care product we know of are retinoids (Trentinoin) -> It's a perscription only product (for treating acne), and might come with side effects (excssively dry skin among others) -> If people want to try it, I usually reccommend starting with 0,025% and slowly increasing towards 0,1% As @Jason Actualization already mentioned - A skin care routine should act as an add-on - on top of an already healthy lifestyle. Your nutrition-patterns and exercise routines are by far the biggest influence on how your skin looks. Sun exposure and avoiding any type of smoke are up there as well.

Yes - in fact, every thursday after a full moon, me and the other doctors meet up and discuss how we can keep people as sick as possible, while indulging on adrenochrome Martinis and pledging allegiance to Moloch the owl-god.

I mean, it's a great lipid panel from a metabolically very healthy, young man. What more can I say? No signs of any genetic lipid disorders, propably a good draw of ApoE4 alleles, low cardiovascular risk across the board.. I dont really get the point of this post

I have neither watched the recent Professor Dave video, nor the exchange with Cronin at Harvard. But I did watch the initial debate and the videos that led up to it in the first place. It remains a highly frustrating topic. On the one hand you have "Professor" Dave, a guy clearly trapped by a stage orange/oversecularized paradigm and who lacks the epistemological framework/self-reflectory modalities to see beyond it. He is obviously smart and well educated, but his videos on the origin of conciousness, religion and most of his philosophy takes are cringeworthingly bad. He is basically the secret love child of Christopher Hichens and Patricia Churchland. On the other hand - James Tour. A boomer-christian chemistry professor who asserts that his bis believe in god does not influence his scientifc heuristic - despite the obvious fact that this happens all the time. The debate was a shitshow. Dave being really aggressive and going for ad hominens all the time. Tour putting up difficult to understand arguments that require deeper understanding of chemistry to validate the signficance. Personally, despite having a background in medicine which makes me familiar with the scientific concepts at hand, I have not taken out the time to look at the evidence myself. From what I understand is that we make strong progress in the field of biogenesis, but we still lack the certain puzzle piece that makes it all click together. I think Dave's argument boils down to that we kind of do have a trail of evidence worth following because it looks promising - and Tour's argument is that since we haven't found that piece yet, it's all a big scam. I think this was a fair analysis of the debate:

There are dozens of influences that impact stool consistency. If you want us to help you properly, you need do provide more information! What's your weight/height, how does your diet genreally look like, has it always been this way?, when did the problems start?, Do you experience a lot of stress in your personal life?, do you take medications or supplements?, how many bowel movements per day?, What does your stool look like (color, consistency, any smells?)

Dr. P.L. Acebo had an amazing experience with it

Hey, I wanted to share a super interesting study which just got published today in JAMA. They took 22 healthy, adult twin-pairs (share the exact same genes) and randomized them into following one of two diets: One twin would go on a healthy vegan and the other on a healthy omnivorous diet - both emphasized minimally processed foods, vegetables, fruits, meats (omnivorous diets) and whole grains while limiting added sugars and refined grains. Participants were told to eat until they were satiated throughout the study. Here is what blood-markers & weight looked like after 8 weeks of following the diet: LDL-C = LDL-Cholesterol: Lower is better (statistically significant) HDL-C = HDL- Cholesterol: Higher is better Tryclycerides: Lower is better Glucose: Lower is better Fasting Insulin: Lower is better (statistically significant) Vitamin B12: Higher is better -> Would become statistically significant in longer follow-up period! Weight: (statistically significant) -> Depends if lost mass is fat or lean muscle! TMAO: Is associated with cardiovascular disease - so lower is better! (based on weak evidence!) Precursors of TMAO are found in meat products - however, the difference came out as not significant and only showed up as that after controlling for outliers! Dietary satisfaction: Vegan diet had a significantly lower dietary satisfaction!

This study was sponsered by the Jeffrey Dahmer foundation.

Legumes, lentils, beans, seeds & oats are beyond the most health promoting foods out there. I dont know the context of the Leo-quote, but it's nonsense.

Those are very kind words! Thank you! I apprechiate your honesty and good faith nature - I also kind of get why you think what you think! Going through a personal health crisis and seeing how the current medical paradigm fails to adress the underlying cause while healing oneself through alternative approaches ignored by the orthodoxy, changes the way one thinks about this whole situation. And boy... am I jealous of that hairline! Cheers mate!

I saw this posted on twitter few weeks ago and reading through the comments brought me close to a stroke. It's the ultimate litmus test for being a gullible fool.

Yes - They need to get trapped in the subendothelium AND go through oxidation processes. That's true. The vast majority of lipoprotein oxidation happens IN the wall though! There is no credible evidence that ox-LDL is a strong predictor for CVD after controlling for total Apo-B. I know of one study who did that, and it was a highly flawed paper to begin with. If you have evidence for that claim (human data), please provide it! Having higher levels of circulating lipoproteins absolutely does cause heart disease. I would again, advice you to take the mendelian randomization papers into account. We find a dose-dependent relationship between ApoB and CHD across approximately two dozen genetic variants across many independent pathways (Graph below!). The study design of mendelian randomization does take oxidation status into account and we see the effect nontheless. Also, what you are describing here is the so called oxidative hypothesis of atherosclerosis. There is clear and convincing evidence that oxidation is involved in the pathogenesis of atherosclerosis and this alone provides a compelling argument that antioxidants should decrease the risk of atherothrombotic cardiovascular diseases. Yet, after 20+ years of clinical trials that studied the effect of supplemental antioxidants on incident cardiovascular disease, there is no overarching data to indicate that this intervention works. This is old science my friend! Increasing antioxidants and therefore lowering oxidation in your plasma does not protect you from heart disease. It's much, much, much mor ecomplex than that. Oxidation has it's part in the equation, but all the evidence suggests that there are more important targets than that. The reason why fruit and vegetables intake tracks favorably with heart disease outcomes is not (only) due to their antioxidative effect. There are many potential health effects due to secondary plant compounds, vitamins, minerals etc. - people who consume a lot of plants also tend to decrease total calorie consumption. But the #1 compound which is consistently associated with incredible health outcomes ...is: FIBER! Yes, and how do we know that? We see that effect REGARDLESS of fiber source and there are a variety of mechanisms that explain this change - foremost a change in total lipoprotein load! Ok the Budoff study - which has exactly the problem I mentioned in my previous post. You won't see many changes in someone's CTA after 1-2 years of high LDL, especially in young adults. The sensitivity of CTA-procedure is just not high enough to give you that data. If he shows me the same result after 10 years, I would be impressed. However, we do have longer term data from the Framingham trial, showing phenotypes involving high LDL, low TG, and high HDL are associated with poorer CHD outcomes compared to low LDL, low TG, and high HDL. The healthy user bias has been systematically ruled out by mendelian randomization studies. You can be very health concious ("living a low oxidation lifestyle") while still getting your arteries cloged up by genetrically high ApoB. The only thing that consistently stops atheroma-progression is lowering total lipoprotein load. And this has been shown again and again and again.... The pro-atherogenic effect of cigarette smoking is complex, not yet well understood and does not boil down to simply increased oxidative stress. Seed oils, which are chemically more prone to oxidation than saturated fat sources, consistently show a LOWER risk of cardiovascular disease - especially if you switch to them from saturated fat sources. We have had that discussion before Jason, and I have linked you at least 10 different studies (Epidemiology, RCT's & mechanisms, mendelian...) which consistently show this effect across all-age groups. We have decades of human data showing this effect - but all I hear from the other side are some rough mechanistical arguments, correlations where no causality can be inferred (seed oil consumption in the US vs. heart disease) and of course, anecdotes.