@SamaHoole I always struggle with processing/handling the fat in the early stages (nausea+loss of appetite=carb cravings down the line). What helps: eating the meat cold, not eating warm liquid fats, taking Lipase tabs. Anything else you suggest? Or is the answer simply going slower?
The answer is to place a moratorium on the publication of all non experimental works. This POS junk science nonsense is no worse than the voluminous antithetical papers 'suggesting' that lipids are in any way causal to ASCVD. If you're not a fucking hypocrite, you have to concur.
@HRH_Ted@raveryn Watched. Liked. And appreciated. Infuriating that it gives the RD/PhD crowd so much fuel. They’re way over their skis re the data too—claiming massive risk and certain doom for the cohort. 1/2
@ethanjweiss Every critique still seems rooted in the belief that we have an "extraordinary amount" of "settled science" proving that LDL/ApoB-lowering meds mean a meaningful reduction in all-cause mortality. TMK, we don't - just tons of % thrown around that mean little in reality.
@nicknorwitz Appreciate this
@nicknorwitz
- the frantic WTFs spewing from The Usual Suspects (and some unusuals like Diet Doctor et al) has been painful at best. As an LMHR myself, I'm super-interested in all the ins and outs here. Keep going!
I realize there has been a tremendous amount of excitement and confusion about our new data. Let me concisely (re)clarify some matters.
1 - We reported the primary outcome in Figure 1 of the paper. We are also happy to update the current manuscript for additional clarity and are in the process of doing so. This does not change any of the conclusions. Additional data were provided in the supplement with more data forthcoming in the next paper.
2 - Based on absolute measures of plaque progression, most LMHR were not rapid plaque progressors.
As an added not because there are multiple plaque metrics, there are multiple definitions for rapid and slow progression, which is also why we reported more than one and emphasized the one with better consensus (PAV). If we wanted to "make the data look good for LMHRs" we would've focused on TPS or CAC (which didn't change in almost anyone) but are not ideal because they change slowly.
3 – High levels of relative progression can result from low levels of baseline plaque. Here’s simple math: 150/100 = 1/5. 0.0015/0.0010 = 1.5 But 50 does not equal 0.0005. High relative progression values can result from low baseline and data heterogeneity
4 – On heterogeneity, we’ve been consistent in the message that the #LMHR phenotype does not make one immune to heart disease, and that risk profiles among LMHR are heterogenous. We’ve been stating this for years. The question is then how do we risk-stratify? Bringing us to the main finding and point 5…
5 - Neither LDL nor ApoB predicted plaque change. This has not been seriously contended. That is the main novel finding of the paper.
We tested multiple times if high ApoB or LDL-exposure or saturated fat or any of the “usual suspects” made things worse for those with high risk. The answer was always no.
*As an aside on this, some have suggested a ‘saturation’ effect, such that an LDL of ~200 would be equal to an LDL of ~600. Were this to be the case, it would directly oppose the concept of mg/dl-year exposure.
*Additionally, I’ve heard that someone was analogizing ApoB to smoking such that smoking 1 pack/d is “bad” and smoking 3 packs/d is also “bad.” Let’s be clear, in a study we would absolutely expect to see a dose-response effect with respect to lung cancer risk comparing 1 pack/d vs 3 pack/d. Some analogies are useful. Some are off base and unhelpful.
6 – This final point is personal, and something about which I’m fiercely passionate and will defend to the day I die. #LMHR are a fascinating, unique population that have a tremendous amount to teach us. It would be irresponsible NOT to study them. I give an unmeasurable amount of credit to my colleagues, and especially Dave, for asking the hard questions when so many seem insistent to ignore the hard questions to defend status quo.
The science isn’t settled… and it will never be.
Cc @realDaveFeldman@AdrianSotoMota
@Rob_ThaBuilder You’re missing that the Spa is now being investigated by the SF HRC for contravening trans rights - you can’t make this shit up … cc @salltweets https://t.co/jibViirFjs
@CaryKelly11@EstieMaddie Learning to bake legit sourdough derailed me from keto first time, and carnivore the second. One slice leads to three which leads to weeks of eating it - no off switch. I WISH I could bake it, eat a few slices, and forget about it. But not so.
We've been telling everyone this for years Chamath and been endlessly ridiculed for it and gaslit with garbage epidemiological studies to defend their safety. It shouldn't be surprising to hear in 2025.
There is not a single study in existence on the safety of injected aluminum into infants (FOIA Case Number 50882, and HHS Appeal No.; 19-0083-AA). This singular fact alone should make everyone on earth stop vaccinating their kids immediately and cause a massive revolution with people in streets screaming for justice with nooses and pitchforks.
Every single person who has ever received a vaccine has aluminum in a place it shouldn't be, especially the brain. Now try to understand the broader implications of that and what it's done to the collective intelligence and health of humanity.
How much autism, depression, anxiety, autoimmune disease, cancer, multiple sclerosis, Alzheimer's, and dozens and dozens of other diseases have been elicited through the injection of toxins in vaccines? A lot....
It's incomprehensible and we want the vaccine database unlocked so we can see the full true scale of horror and finally end this insanity once and for all. Then we want the bastards responsible to pay in the most brutal and savage way possible. We're far past fines and jail time at this point.