0:00 Intro and Ethan’s background

3:33 Cholesterol Skeptics and Concerned Medical Professionals – meeting in the middle.

8:20 How many patients does Ethan feel reach a decent level of knowledge about lipidology and cardiology?

10:15 Navigating the discussion on the benefits/risks of lipid changes from diet

17:15 When cholesterol is elevated for a metabolic reason alone – does it pose a greater risk?

23:00 Giving doctors the benefit of the doubt – are doctors just trying to help?

27:10 Dave’s disappointment with perceived lack of curiosity from the medicalsphere.

30:15 The difficulty in discussing possible benefits from lipoproteins and potential influence on all-cause mortality

36:50 Nuances of data collection and statin trials

Study mentioned: MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20 536 high-risk individuals: a randomised placebo controlled trial

Note from producer:

In the efficacy and safety statement for the trial mentioned it lists Merck Sharp & Dohme (manufacturers of simvastatin) as well as Hoffmann-La Roche (manufacturers of the vitamins used) as providing partial funding for the study:

The study is being funded by the UK Medical Research Council, the British Heart Foundation, Merck Sharp & Dohme (manufacturers of simvastatin[…]) and Hoffmann-La Roche (manufacturers of the vitamins[…]) doi: 10.1053/euhj.1998.1350

However in the published paper of the results it states the following:

The Clinical Trial Service Unit has a staff policy of not accepting honoraria or other payments from the pharmaceutical industry, except for the reimbursement of costs to participate in scientific meetings. doi: 10.1016/S0140-6736(02)09327-3

44:56 If there were a trial that showed that people with high HDL, high LDL, and low triglycerides didn’t benefit from statins would [Ethan] want to know that information?

I would love to hear comments about statin use for those with ⬆️LDL ⬆️HDL⬇️TG while eating KETO. You both have seen this paper I’m sure. https://t.co/if52OhO5bW pic.twitter.com/MIjpVJBZcQ — Eric Rodgers (@erreyedoc) August 15, 2019

Study mentioned: Influence of Low High-Density Lipoprotein Cholesterol and Elevated Triglyceride on Coronary Heart Disease Events and Response to Simvastatin Therapy in 4S

52:40 Open data, machine learning, and possibilities moving forward

56:20 Non-HDL and mortality from the NHANES dataset

Twitter exchange mentioned:

1/ So here's some "realtime science" for you… @ethanjweiss pinged me in another thread regarding non-HDL regarding risk here: https://t.co/brFpCiXDpa

I realized I hadn't actually checked out non-HDL in NHANES to this point. The raw results are pretty interesting… — Dave Feldman (@DaveKeto) May 28, 2019

58:30 Changes in ability to connect with researchers and scientists

1:00:05 What does Dave mean by risk?

1:04:10 Modifications to low carb to achieve lower LDL

1:08:55 What Dave has learned about the importance of rigorousness in self-experimentation

1:13:29 Can self-experiments have benefits applicable to people beyond the person doing them?

1:17:29 Cholesterol biosynthesis

1:18:40 Reverse causality – is there a possibility that the lipoproteins are reflecting a problem and not causing it?

Note from producer: I attempted a follow-up to see if I could find any studies looking at the impact of infusion of native mouse lipoproteins on atherosclerosis development, but I have not found any thus far.

1:24:33 Clotting, vascular injury, and engineering

1:29:55 The impact of placebo

Podcast mentioned: The Hidden Brain: The Untapped Potential of Placebos to Heal (transcript available)

1:33:23 The impact of seeing lipids change – could this impact the results of the study?

1:35:56 If it were dose dependency would all drugs that lower LDL have a likewise decrease in cardiovascular disease mortality?

1:38:46 Drug trials – ideals, replication, and funding

1:42:35 Wrap up and outro

Ethan Weiss Contact:

Twitter: @ethanjweiss