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0:00 Intro and Greetings
0:35 Ivor’s backstory
2:40 Cholesterol Conundrum – What’s changed since Ivor gave the presentation in 2014?
Video mentioned: Cholesterol Conundrum
3:55 Dave’s thoughts on Ivor’s Cholesterol Conundrum video
4:43 Do LDL particles drive inflammation in-and-of themselves?
5:43 Do LDL particles “BB gun” into the arteries and damage the endothelium (arterial wall)?
7:35 Devil’s Advocate Intro
7:50 Considering the majority of top lipidologists are in general agreement over lowering LDL cholesterol and particle count, shouldn’t Ivor (and other non-experts) concede to this point?
9:55 Even if one were to find a few outlier studies, doesn’t the bulk of the data on LDL cholesterol and particle count more than cover any skepticism of the lipid hypothesis?
12:30 Whether CAC is zero or not shouldn’t everyone take steps to prevent heart disease anyway? Wouldn’t you want to discourage a false sense of security from a zero score?
19:14 Discussion on no benefit from statins for 0 CAC results
21:37 Concerns over adjustments in the study
22:55 Submitted Questions from Social Media Intro
23:37 What tweaks to keto would Ivor suggest for people with genetically high cholesterol (Familial Hypercholesterolemia)?
26:18 ApoE4 and keto – does anything change if they’re already, in some way, metabolically deranged?
28:52 What is your opinion on keto and saturated fat for people with apoE4? And what is your ApoE status?
30:32 How soon after receiving a CAC Result above 0 should you re-test?
32:00 Is there any strong mechanistic evidence that real world changes in human serum LDL can alter the rate of active or passive movement across the arterial glycocalyx or endothelium without pre-existing damage to the area?
35:31 What is LOX-1 and what is it for?
36:48 Could aspects of atherosclerosis be serving a purpose?
37:50 Differences in LDL types in healthy and diabetic people and its effects on endothelial cells
40:18 Different contexts for high LDL-P – metabolically healthy vs diseased
42:05 What is your opinion on high lipoprotein(a)?
NOTE: Lipoprotein(a) is considered an important cardiovascular risk factor. Like HDL and LDL it is a lipoprotein found in the bloodstream in humans, however it has a unique apolipoprotein: apo(a).
Blog post mentioned: The Big Deal about Lipoprotein(a)
44:25 LP-PLA2 as a risk factor – and what is “high”?
49:17 Why did Ivor call Ancel Keys misinformed?
NOTE: Ancel Keys was a physiologist and researcher, most known for his Seven Countries Study (first presented in 1955), and for popularizing the idea that saturated fat and cholesterol cause heart disease.
55:06 Your thoughts on taking statins on a ketogenic diet?
56:58 How would a person on a whole food plant-based diet lower their cholesterol? And for someone leading a healthy lifestyle is high cholesterol still a risk factor?
1:01:00 Is isolated high LDL high risk?
1:05:07 Updated 2018 guidelines
1:06:45: Where does the LDL >190 mg/dL cutoff come from?
Study mentioned: Low-Density Lipoprotein Cholesterol Lowering for the Primary Prevention of Cardiovascular Disease Among Men With Primary Elevations of Low-Density Lipoprotein Cholesterol Levels of 190 mg/dL or Above: Analyses From the WOSCOPS (West of Scotland Coronary Prevention Study) 5-Year Randomized Trial and 20-Year Observational Follow-Up.
1:09:55 Could context matter for calculating Total/HDL?
1:11:55 Assuming saturated fat raises LDL, and assuming LDL causes heart disease assuming all other things remain constant can it other factors influence risk?
1:14:54 Questions from Chat Intro
1:15:18 Please tell us about your high ferritin, and how it relates [to health]
1:21:08 The apparent modern pushback against HDL
Study mentioned: HDL and cholesterol: life after the divorce?
1:27:45 For Lean Mass Hyper-responders on LCHF/keto if there is temporary systemic inflammation is there reason to lower LDL/apoB to avoid atherogenesis?
1:30:18 Can anything be done to improve particle size and number?
1:33:22 Should you be concerned about isolated low HDL if all other markers look okay?
1:39:57 Keto critics say keto is unhealthy long-term but provide no reasons. Is this because there are no reasons, or if anyone knows a reason please let us know.
1:42:55 Where you can find Ivor
Facebook: Ivor Cummins
Website: The Fat Emperor
Youtube: Ivor Cummins
1:43:15 A note for Joel Kahn
1:46:26 Credits and Outro