1:32 Dr. Joel Kahn’s backstory – past career, health, and how he came to understand cholesterol and heart disease.
5:56 How and why Joel started a plant-based diet
7:44 Joel’s thoughts on experimentation and guidelines from a clinician’s perspective
10:25 Health from a nutrition-based perspective, and Joel’s observations on the history of nutrition
Study mentioned: Mortality from circulatory diseases in Norway 1940-1945.
16:45 The difficulties and ambiguities involving studies done on diets impacting health
Study mentioned: Anti-inflammatory Effect of Whole-Food Plant-Based Vegan Diet vs the American Heart Association – Recommended Diet in Patients With Coronary Artery Disease: The Randomized EVADE CAD Trial
18:40 Devil’s Advocate intro
18:50 Is there any value of any kind in having high values of LDL particles in the body and, if so, do studies account for this when looking at disease outcomes?
21:09 Is there a possible immunological benefit to high LDL particle count?
23:19 Many who go on a LCHF diet see their LDL go up but will likewise many see their HDL climb and their triglycerides drop. Is it possible that this could result in lower risk of CVD?
Researcher mentioned: William Roberts
27:52 Many studies tout changes in risk for CVD mortality yet show no difference in ACM. Doesn’t this run the risk of assuming there is an overall benefit where there is none?
Study mentioned: Helsinki Heart Study: primary-prevention trial with gemfibrozil in middle-aged men with dyslipidemia. Safety of treatment, changes in risk factors, and incidence of coronary heart disease.
31:30 Discussion on PESA study and silent atherosclerosis in apparently healthy people
Study mentioned: Prevalence, Vascular Distribution, and Multiterritorial Extent of Subclinical Atherosclerosis in a Middle-Aged Cohort: The PESA (Progression of Early Subclinical Atherosclerosis) Study.
34:18 The impression of the intention of scientists from the public
35:25 The importance of the data concerning HDL and triglycerides to the public
Study mentioned: Intensive Lifestyle Changes for Reversal of Coronary Heart Disease
38:35 The impact of money in medicine
40:44 Possible tunnel vision in engineering and research
42:22 Audience Questions Intro
42:30 Aren’t all apoB lipoproteins atherogenic?
NOTE: “apoB lipoproteins” is short for “apolipoproteinB containing lipoproteins”. ApolipoproteinB is an identifying protein on lipoproteins like chylomicrons (from the gut), and VLDL, IDL, LDL, and lipoprotein(a) (from the liver).
45:46 Could there be a case where HDL could be lower without increasing risk?
47:07 Apart from heart disease, what is the main concern you see with being a hyper-responder?
48:51 None of the risk calculators use LDL at all. Why? Why do they all show low risk as long as HDL is high and no blood pressure issues, etc.?
51:39 What do you make of the data showing LDL-C going up during fasting?
56:43 Why is high LDL bad if there is no oxidation or inflammation present? Is TG/HDL a better marker for coronary disease?
1:00:59 Why does atherosclerosis only develop in certain spots, and not evenly throughout the arterial vascular system?
1:06:32 Is there data on heart attacks and strokes in people with high LDL-P and LDL-C but with good [Atherogenic Index of Plasma], no Type 2 Diabetes, no elevated BP, low inflammation, CAC 0, etc
1:09:53 The importance of testing beyond CAC
Note: Joel Kahn mentions CIMT (Carotid Intima-Media Thickness) which is an ultrasound of the carotid arteries in the neck and can be used as an additional marker of CVD risk/progression.
1:13:12 Kudos to Dr. Joel Kahn
1:14:23 Doctors as consultants, and taking ownership of your own health
1:16:06 What comes along for the ride with meat that you find to be a problem for humans?
1:23:03 Any comment on LDL levels and infection risk?
1:25:02 Mendelian Randomization, what they say about LDL and risk, and possible issues with genetic studies
Video mentioned: A Century of Cholesterol and Coronaries
1:32:46 Final thoughts and outro
1:35:25 Where you can find Joel Kahn