Search the Community

After having read Peter attia's strategy on lipids in his books, I wanted to listened directly to one of the sources, Tom Dayspring being one of the most respected lipidologists who teaches credit courses to medical professionals. His explanations are exceptionally clear and surely leave much less confusion than the 7-hours total podcast with Peter Attia. Maybe this material should be listened before Attia's ultra-marathon. The main aspect is that the lipids regulating system is of course much more complex than we can believe. He also dispels some myths about cholesterol. For example, the brain does not need dietary cholesterol since it's the main producing plant of cholesterol in the body, ditto the gonads, testosterone does not need dietary cholesterol to be produced nor high amounts of dietary cholesterol for optimal T concentrations. He also offers some guidelines on threshold levels. Main aspect, such levels are not stationary, but are a function of the general health of the subject, when various risk factors are present (smoke, T2D), the threshold is lower. When a CV event has occurred, the threshold goes further down, close to the very low levels suggested by Peter Attia. In the following brief but info-packed video he suggests the following values for Trigs and Non-hdl, whereas in the following longer podcast with Simon hill he suggests values for ApoB (1:06 hours). Triglycerides: the guidelines suggest physiological levels < 150, but he as a lipidologist suggests <100 values, optimal range being <80 Non-HDL cholesterol: it may constitute a proxy for ApoB. Ideal range < 130 if no CV risk factors are present. IF CV risk factors are present (insulin resistance, smoke, high blood pressure, atherosclerosis), ideal range is << 100 (well below 100), if you had a heart attack, ideal is << 70 (well below 70). If borderline values of Non-HDL chol are observed (130 mg/dL in individuals with no CV risks), then an ApoB analysis should be carried out to obtain a more precise risk indicator. ApoB: best is to be in the lower quintile (20%) of the population, that is in the range 0-80 mg/dL. 80 mg/dL is good if no other risk factors are present. Values >>80 are never good and values pertaining to the upper quintile, > 115-120 mg/dL are definitely to be avoided, harbingers of CV risk. He also comments of people with very high ApoB values who do not exhibit atherosclerosis. Such cases have been observed and the hypothetical explanation is that they enjoy some other unknown protective factors. The rule is that high ApoB statistically constitutes high (additional) risk for Atherosclerosis. And we know that when speaking statistics we also include outliers or extreme values.