undeather

The lipid hypothesis of atherosclerosis is one of the most coherent and consistent theories in all medical science. Denying the causal role of apolipoproteins in plaque formation is a bit like denying germ theory or the globe earth. There is over 100 years of bullet proof research behind it. Will there be adaptions of this theory in the future? Sure! Just like Einstein adapted newtonian gravity, the same thing could happen to lipids. However, analogous to this physics example, the core axiom of lipoproteins & atherogenesis will remain true nontheless. The problem with Ox-LDL as a marker for cardiovascular disease (CVD), and we have talked about this Jason, is that it foods on a limited understanding of the atherogenic mechanism. When you measure your Ox-LDL in a lab, you ONLY get a picture of the minimally oxidized version that was in your bloodstream when the blood was drawn. However, we have known for at least 30-40 years now, that lipoprotein-oxidation happens for the most part IN the sub-endothelium (IN the walls of the artery), right after the lipoprotein entered the wall and reacted with the proteoglycan/lipoxygenase. You can NOT measure the ox-LDL in your endothelium. In fact, the assays used in most laboratories can only measure minimally oxidized LDL. You also can not infer that lower ox-LDL in blood equlas lower oxidation-rates in the sub-endothelium. And guess what, we do not have a single good study that shows substantially higher CVD-risk with ox-LDL WHILE sufficiently controlling for ApoB (+ good primaryendpoints). There is no reason to believe this would be true. Lean mass hyper responders (LMHR) are a poorly studied subject-group. Saying that those individuals don't develop early-life heart disease is problematic for many reasons. It takes years for atherogeneic plaques to show up on screening tools like CTA's. There are NO long term studies (I am aware of) that compare LMHR's with "normal LDL". There are case reports, subgroup analyses and one study including a web survey (lol) for data collection - which is horribly confounded & low quality in general of course. Look, I am open that we might learn something new about LMHR-phenotypes in the future - but you just can't make that point at the moment. Maybe the higher HDL often seen in those individuals actually protects some of them from ASCVD - who knows! But at the moment, there really is no good reason to believe that.

Nutrition is way overrated in individuals who already have a decent diet & general healthy lifestyle. Nutrition is way underrated in everyone else.

Health is more than LDL-C and even though it's proapbly the most important risk factor when it comes to cardiovascular disease progression, there is a lot to say about individual approaches and bio-phentypical proclivities. That said, it's pretty much a undeniable fact that a reduction in saturated fat and dietary cholesterol goes hand in hand with benificial effects on blood lipids and insulin-sensitivity - in MOST individuals. Since >90% of those ingredients are found in animal products, the results of the study make a lot of sense. I am not advocating for a vegan diet because of many reasons. There are downsides, especially if you don't know what you are doing - and since most people fall into that category, a healthy omivorous diet is the way to go. However, if you want to max out on potential longevity, then one should consider giving it a try and compare health parameters before/after. Since cardiovascular risk factors are cumulative, the potentially benificial effect will increase over time. There is some evidence looking at lifetime vegans vs meat eaters but those studies are usually heavily biased & confounded. If you would ask me personally, I would argue that it will propably give you 2-4 years of additional lifetime if you start early.

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LDL-C down by 10%+ is an incredibly meaningfuly difference, especially if you take into account that the average LDL-C in the inverntion group was 114mg/dl. There is an about 20% reduction of cardiovascular disease risk per mmol/L(=38mg/dL) LDL-C lowering. Now, notice that the difference we observer is between two healthy diets - imagine the difference between the standard american diet and veganism. As I alerady mentioned multiple times, I don't care about the ethical reasons of a vegan diet - I personally love meat and cheese, but this is just a result we can't/shouold not ignore. When it comes to CVD-risk, the more plants - the better! If you would run that trial for 8+ years, you would propably see shocking differnces.

Might be the higher fiber content, but it's an intersting finding! I don't buy the TMAO - heart disease connection either! But Bart Kay, really?

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Not the kind of information I would usually share here since integral medicine requires quite an extended case history to begin with - but here are some things that might help you with yoru symptoms. Most of it is very benign and easy to purchase - I left out dosages by design. Supplements: -Vit D3, Very high dose initially if well tolerated -Zinc lozenges until symptoms gone -10,000mg vit c per day (split up) - Melatonin before bed, lots of sleep - Quercetin - Green tea extract, polyphenols - Lysine - SPM’s - Selenium - Collustrum, transfer factor, betaglucans - Glutathione, NAC - Manuka honey - BHT (Betahydroxytoulene) Herbs: - Licorice - Black cumin seed oil - Neem - Artemisia, Lomatium, St Johns Wort, Echinacea, Propolis, Olive Leaf, Garlic, etc.

While animal protein sources tend to have a more benificial amino acid profile and great bioavailability, it also has been consistently associated with increased all cause mortality, esepecially at higher intake. That said, I think you need to take that research with a grain of salt since the effect sizes are usually small if you start to control for confounders. My personal view is that it's more likely a trade-off function than anything else. Plant-protein sources like beans, legumes or quinoa are among the healthiest foods out there, whcih not only come with a good quality protein, but also a wide array of complex carbohydrates, fiber and secondary plant compounds. Again and again, those foods have shown a significant risk reduction over a wide array of diseases (cardiovascular, cancer, autoimmune..). It's just a no-brainer to center your diet around those kind of foods. Fish is like the best of both worlds - but the problem with fish nowadays is pollution. That said, it still seems that fish intake is assocuiated with lower risk of dying!

Very roughly ... - Start resistance training, increase lean muscle mass! - In general, move more! Take stairs instead of elevators, walk around a bit after work, implement an active lifestyle. - Center your meals around a wide variety of real, unprocessed & good quality ingredients - Learn about caloric metabolism - caloric deficit and the approximate energy density of everyday food products - Preperation of meals at home > Take away or delivery - focus on adequate protein intake - 1,5-2g/kg/day - Plants as the main source of protein - Protein intake should include fish and can include eggs, dairy & lean cuts of meat - Shift to a more complex carbohydrate profile - minimize short chain carbs and increase intake of whole wheat products & especially vegetables - Focus on plant-fats like nuts, seeds, avocados, extra virgin olive oil - go easy on saturated fat-sources - Minimize or cut out empty calories like soft drinks - sugar alternatives (zero products) are fine in moderation - Healthy snacking (fruits, dates, nuts...) - The best diet is the one you can follow for the rest of your life - so don't try to be "perfect". Good enough is good enough. There is flexibility in all this - the most important thing is to get into a calorie deficit and be physically active.

When there are 300 studies on a certain topic and you pick out the ones which fit your your inherent bias, than that's bullshit. And sadly, this is what most of these health influeccers tend to do nowadays. They play under the cover of being scientifically sound, but once you actually take a closer look at their claims, it becomes psychotic. Nobody is absolutely right und the scientific method is not perfect - but I hope we can agree that in order to get the the closest picture of how reality actually works is to incorporate as much high quality information as possible. And not leave out the stuff we don't agree with! I would not care if everything we know about nutrition is wrong and low-carb is actually the holy grail. In fact, that would be kinda cool because meat and cheese are freaking delicious. But I can assure you that Dr, Fung has a vested interest admitting the opposite. His whole business model is about denying and that alone should make you suspicious. I trust the people servicing the plane because there is an extreme, both personal and market driven incentive to not crash it.

And that right there is kind of the problem. How would you know if what Dr. Fung is saying isn't, at least to some degree, complete nonsense? At some point, you have two possitibilites - you either spend hundreds of hours learning about scientific epistemiology, the current state of resarch and his particular claims about nutrition & physiology - or you kind of have to BELIEVE him. It's really easy to shape someones worldview with a MD and some flashy diagrams - even if it's based on no substance at all. Fung is a cholesterol/sat.fat-denialist and this makes me particularly fuming, because it's one of my main areas of research.

I particularly recommend whole wheat as a health food because it is. There is a very solid mechanistical basis, we have tons of epidemiological reserach and the randomized controlled data also looks extremely positive. Is it maybe possible, and please don't take this as a shot because it isn't, that you fell for those anti-wheat/carb authors and their pop-sci books? Anyone can sell you their idea of things, which doesn't automatically make it true. The link between autoimmune disease and wheat consumption is complicated and not a black or white issue. That wheat and particularly whole grain prodcuts "act" like sugar in the body is wrong - diabetics can improve in their peripheral insulin sensitivity and glucose kinetics by increasing their whole grain consumption. The most addicting foods are based on high glycaemic load AND high fat/salt content. I doubt your girlfriend eats plain spaghetti when she gets depressed.

This sounds like telogen effluvium (TE), a form of diffuse, non-scarring alopecia with a sudden onset, characterized by increased hair loss or thinning hair. It's not uncommon to see this after a viral infection and recent studies have shown that it's even more common after Covid-19. I have never seen someone getting covid 15+ times (?), but if this is true - then TE could be a very logical explanation for your symptoms. The good news is that your hair is not lost and will regrow after a couple of months. After that, androgenic alopecia (genetic hair loss) is another possible explanation. You have said that you have always had thin hair, which could be a sign of DHT (Dihydrotestosterone) fucking up your hair roots. Genetic hair loss can take many different forms, depending on the underlying genotype you have inherited. Some people rapidly lose their hair, others consistently thin out over a long period of time before actually losing ground. You have mentioned that you think you are good genetic wise. While looking at your families scalp is usually a good indicator, genetics can be much more complex than that. I doubt it has anything to do with your lifestyle-habits. Anyway, this is just pure conjecture. There are questions which just can not get answered over the internet. Go visit a dermatologist and do some basic blood-work (especially thyroid function). Then you know what's up for sure.

Relative Risk of weight gain

Again, obesity and diabetes are complex phenomena and wheat products play a role in it. People usually don't get fat because they overeat on pasta or white-bread. They get fat because they overconsume meals which are combinations of simple carbohydrates, high fat, high salt and some form of modified protein (Burger, Kepab, Fried meats, Lasagna, Soft drinks, Pizza...) Whole grain wheat products actually lower obesity rates.

The complex pathogenesis of diabetes and obesity can not be boiled down to "eating bread and occasionally sugar". The increasing rates of obesity are mostly the product of a hypercaloric food environment that promotes overeating on low-quality, undersatiating & hyponutritious foods while living a mostly sedentary lifestyle. The increasing rates of diabetes and other metabolic diseases (i.e hyperlipoproteinemia, high blood pressure) are for a big part due to this energy-dysbalance.

I recently had a quite hefty dispute with Huberman on Twitter - it was on his episode about hormones, especially DHT, hairloss and the indications/risks of DHT-conversion-blocking agents like Finasteride. It became increasingly clear to me that Huberman, besides being the head of a neurosceince-department in Stanford, often operates on a pretty low level of scientific epistemiology. I have seen him completely misunderstanding simple implications of the research he is citing, referencing dogshit studies with underpowered design and no explanatory power and even get basic things about medicine/physiology completeöy wrong. This does not mean that the information he presents on his podcast is necessarily wrong or bad - in fact, I would even argue that in the great scheme of health infleuncers, he is one of the more sane and trustful voices (the bar is extremely low to begin with). I have made the same observations with Dr. Sincalir and his research about longevity - he became quite the laughing stock on med-twitter because of his opinions about Reservatol recently. He also was terribly wrong about Metformin as longevity agent. Here is a pretty decent episode about Huberman's failures: https://decoding-the-gurus.captivate.fm/episode/andrew-huberman-forest-bathing-in-negative-ions

The average person in Japan consumes over 200 fewer calories per day than the average American. Food prices are substantially higher in Japan, but the traditional Japanese dietary habits, although changing, are also healthier. The Japanese are also far more physically active than Americans, but not because they do more planned physical exercise. They walk more as part of their daily lives. They walk more because the cost of driving an automobile is far higher in Japan, whereas public transportation is typically very convenient, but normally requires more walking than the use of a car. Despite the obesity rate being low, data is showing that the prevalence of overweight (BMI > or = 25) was 30.4% in males and 21.1% in females, of which overweight in males has increased in recent 35 years almost twice from 15% to 30%. In general Japanese people get fatter now because they adapt western eating habits.

Yeah, to be clear - I dont blame anyone following these health influencers. In fact, I get it! It sounds legit, most of them have credentials, it's motivational, it's non-conformist, it's cool, there is a community around it - and after all, some people clearly imrpove their health in the process. The thing is, once you actually start reading into the source material and become somewhat of a professional as well, you realise how absurd most of their claims are. They speak under this smokescreen of scientific rigor, but once you actually start to examine each claim with the evidence provided, you quickly realise how much of a bullshit fiesta it actually is. Claims for or against a specific diet are either built on an extremely fragile line of evidence or made up completely. What to do and what to avoid is stated with such a delusional level of confidence but no real substance at all. Some even sell their overpriced and usually completely shitty supplements to their clueless customers. It makes me angry, because people don't realise the real extent of the shitshow. Not everything is bad, you obviously need to look at each claim on it's own. And hey, if this is what it needs for someone on a standard american/ultraprocessed junk diet to switch to a more healthy option - then that's great. The problem is that there is so much dishonesty and bulshittery involved - it muddies the information landscape so nobody really can think straight anymore. Just look on all the social media platforms - it's diet wars - vegans vs. carnivores vs. keto vs. paleo....of course people get confused. And those influencers you mentioned are at the epicenter of this sensemaking crisis. Just look at this forum for example - the majority of posts about nutrition & health are regurgitated phrases/videos or podcasts from famous health influencers. "Oatmeal bad" - "Cholesterol good" - "Insulin spikes scary" - "Carbs kill you". This is not truth - this is a NPC mindset of uncritically repeating catchphrases you heard in a 10 minute Dr. Berg video. I would not care as much if this wasn't such a crucial topic. People will die earlier beacuse of this and that's terrible. Enough ranting!

Both Asprey and Perlmutter are terrible sources for reliable health information. Their interest is in selling books and supplements. At least you can make the Argument that Johnson is doing this out of integrity and at least hast some bulletproof science behind (some of) his claims.

The internet somehow managed to rot our brains to the extent that people are now afraid of carbs. And the ones to blame are all the "health experts" spouting absolute garbage without providing any solid evidence for it. The sheer amount of conflicting information dumbing just confuses people. If I find some time, I will write down a no bullshit guide to nutrition. This community needs it more than anything.

Does your appetite get better after you slept well? I would not play around with drugs that will increase your appetite - that's beyond unnecessary in your case. If you are really struggling with maintaining calorie intake, you could always substitute with energy gels or other means of high energy density foods (shots of super high quality olive oil for example).

That's nothing - if you want to know about one of the most horrifying diseases ever, google "fatal familial insomnia".