In this series, Dr Thomas 'Tom' Dayspring, M.D., one of the world's most recognised experts in lipidology, shares his breadth of knowledge on heart disease prevention.

Part 3 covers the types of cholesterol lowering medication, as well as testing for hyper absorbers of cholesterol.

Plenty of Tom's personal illustrations, diagrams & graphics included. You can test your knowledge by having a go at the quiz below. 

Interactive quiz:  https://forms.office.com/Pages/ResponsePage.aspx?id=jM-h1o52h0GnOLblDE3rStdKkvg0Y_NMm65uD3dzrKpUNFFYNjZSTjZKUkRYNUVZWUpGMUw2RTIzSi4u  Give Tom a follow on Twitter: https://twitter.com/Drlipid

Give Tom a follow on Twitter: https://twitter.com/Drlipid

Other appearances from Tom: 

Drive Podcast 

https://www.youtube.com/watch?v=PllTHYgWpuwWellness: 

Fact vs. Fiction 

https://podcasts.apple.com/us/podcast/a-masterclass-in-cholesterol-and-lipid-lowering/id1447250475?i=1000581954971

Nutrition Made Simple 

lp(a): https://www.youtube.com/watch?v=-WRRyG8il4g

Dietary cholesterol: https://www.youtube.com/watch?v=GkWMDnTyxfo

Coronary Calcium Score (CAC): https://www.youtube.com/watch?v=gxIeRUbHauw 

Narrative glossary on lipids provided by Tom: https://peterattiamd.com/glossary-lipids/

In this series, Thomas Dayspring, M.D., one of the world's most recognised experts in lipidology, shares his breadth of knowledge on heart disease prevention.   Part 2 covers lipid transport, cholesterol removal from cells & HDL cholesterol.    

VLDL, LDL & chylomicron residence time [02:03] 

Apolipoprotein B (ApoB) & atherosclerosis [04:24] 

Where are VLDL and chylomicron particles made ? [05:13] 

Structure and function of triglycerides [05:40] 

Triglyceride hydrolysis, genetics & lipoprotein lipase [06:40] 

Phospholipids, phospholipid transfer protein & HDL synthesis from ApoA-I [09:50] 

Function of ApoB & ApoA-I in the body [10:48] 

What happens to VLDL & chylomicron remnants ? [14:14] 

The LDL receptor-related protein (LRP) [15:50] 

Apolipoprotein E (ApoE) [16:10] 

Hepatic lipase, removal of ApoE in VLDL and a route to LDL [17:30] 

HDL as cholesterol acceptors [17:53] 

How does a HDL particle get rid of its cholesterol ? [20:58] 

Difference between the LDL receptor & LDL receptor related protein [25:43] 

Total, indirect & direct reverse cholesterol transport [26:10] 

Why did evolution make LDL circulate for 3-5 days ? [27:00] 

The big picture on lipid transportation [27:28] 

How the Framingham Study created the misconception that raising HDL “good” cholesterol is all that matters ? [30:50] 

Results from other clinical trials & HDL-C fallacies [32:30]  

Interactive Quiz:  https://www.surveymonkey.com/r/N8XK5LL

Give Tom a follow on Twitter: https://twitter.com/Drlipid   

Other appearances from Tom: 

Drive Podcast 

https://www.youtube.com/watch?v=PllTHYgWpuw 

Wellness: Fact vs. Fiction 

https://podcasts.apple.com/us/podcast/a-masterclass-in-cholesterol-and-lipid-lowering/id1447250475?i=1000581954971 

Nutrition Made Simple 

lp(a): 

https://www.youtube.com/watch?v=-WRRyG8il4g 

Dietary cholesterol: 

https://www.youtube.com/watch?v=GkWMDnTyxfo 

Coronary Calcium Score (CAC): 

https://www.youtube.com/watch?v=gxIeRUbHauw  

Narrative glossary on lipids provided by Tom: 

https://peterattiamd.com/glossary-lipids/  

In this series, Thomas Dayspring, M.D., one of the world's most recognised experts in lipidology, shares his breadth of knowledge on heart disease prevention. Part 1 covers cholesterol, atherosclerosis, production of cholesterol in the brain, lipoprotein classification and much more. This masterclass is perfect for those who cannot attend a lipid and atherosclerosis fellowship.  

Give Tom a follow on Twitter: https://twitter.com/Drlipid  

Other appearances from Tom: Drive Podcast https://www.youtube.com/watch?v=PllTHYgWpuw

Wellness: Fact vs. Fiction https://podcasts.apple.com/us/podcast/a-masterclass-in-cholesterol-and-lipid-lowering/id1447250475?i=1000581954971

Nutrition Made Simple lp(a): https://www.youtube.com/watch?v=-WRRyG8il4g

Dietary cholesterol: https://www.youtube.com/watch?v=GkWMDnTyxfo

Coronary Calcium Score (CAC): https://www.youtube.com/watch?v=gxIeRUbHauw Narrative glossary on lipids provided by Tom: https://peterattiamd.com/glossary-lipids/ 

Cholesterol crystallisation: https://pubmed.ncbi.nlm.nih.gov/27332905/ 

video

Florent has published a paper examining how we can replace physical activity in the gym with imaginary training and still get the same increases in strength. I came across his paper on imaginary training and got into contact as I had to find out more.

Where to find Florent ?

Florent Lebon is a professor at Uni of Burgundy with over 50 publications. His main research is focused on the effect of motor imagery on motor learning, performance and rehabilitation after peripheral and central nervous system injuries. His research encompasses behavioural and cognitive neuroscience and psychophysiology. The main goal is to understand the link between neural processes underlying motion (movement preparation, mental simulation and action language).

https://www.florent-lebon.com/phd-neuroscience

https://mobile.twitter.com/lebonflorent_

References:

Florent has published a paper examining how we can replace physical activity in the gym with imaginary training and still get the same increases in strength. I came across his paper on imaginary training and got into contact as I had to find out more.    

Where to find Florent ?

Florent Lebon is a professor at Uni of Burgundy with over 50 publications. His main research is focused on the effect of motor imagery on motor learning, performance and rehabilitation after peripheral and central nervous system injuries. His research encompasses behavioural and cognitive neuroscience and psychophysiology. The main goal is to understand the link between neural processes underlying motion (movement preparation, mental simulation and action language).   

https://www.florent-lebon.com/phd-neuroscience

https://mobile.twitter.com/lebonflorent_

References:  

In this episode, David Fäh from the Bern University of Applied Sciences explains his opinion on whether supplements are necessary. We discuss a range of supplements, including iron, zinc, vitamin D, folate and more. 

The overall verdict from David is that supplements can occasionally help based on the individual situation, such as during pregnancy. The most harm they will probably do is just to your wallet, but in certain cases fat soluble vitamins should be supplemented with more caution as we saw with vitamin D last time. The most important factors remain lifestyle factors related to an overall balanced diet & physical activity according to David.

Paper referenced at the start of the podcast with regard to sun exposure in Switzerland: 

https://www.nature.com/articles/s41370-019-0137-2

New interview with Gil Carvalho MD, PhD (whose Youtube channel is known as "Nutrition Made Simple") about the prevention of heart disease. Never be confused again heart disease again.

A common theme across Gil's videos on his channel has been strategies to prevent heart disease, the world's largest chronic disease.  We bring together everything he has talked about in his channel in one video, plus much more.  Topics covered include: Gil's explanation of atherosclerosis & why we tend to not see it in veins; optimal blood biomarker values to minimise risk; why ApoB may be the best measure of risk we currently have; the saturated fat threshold; the temporality component of heart disease; health promoting dietary patterns, salt alternatives & the future of food.   

00:00 Gil Carvalho & Nutrition Made Simple  

02:40 What is atherosclerosis ?  

06:48 Lack of plaque in veins 

10:05 Multifactorial disease 

11:36 The difference between LDL & ApoB 

16:00 Measurement units  

20:17 Causality & risk reduction  

26:10 Optimum ApoB 

30:38 Why does saturated fat raise risk ?  

33:33 Coconut & dark chocolate  

36:30 Considering the food not just the nutrient  

38:15 Replacement for saturated fat 

41:30 Best replacements 

43:31 Dietary habits & salt substitution

57:15 Future of food

01:02:38 Wrap-Up

Relevant Sources:

Difference between absolute & relative risk:

https://www.youtube.com/watch?v=vRRD8nXEyGM

How to read a lipid panel:

https://www.youtube.com/watch?v=4b1oj3scN7I&t=1s

Effect of dietary cholesterol on blood cholesterol:

https://www.youtube.com/watch?v=GkWMDnTyxfo

Saturated fat:

https://www.youtube.com/watch?v=mBFe1QattAU

Gil’s twitter: https://twitter.com/NutritionMadeS3

In this episode, Jana Ade describes her journey to Zambia to complete her masters thesis project. Zambia has got significant resources, such as mines, but is still one of the poorest countries in the world.  

Jana spent two months collecting data from different families in rural Zambia on how relationships within the household, breastfeeding behaviour & complementary feeding practice affect the growth of infants up to two years old. Certain areas of Zambia have stunting (reduced growth & cognitive development due to malnutrition) of nearly 50 %, so this is a critical problem that needs to be solved to help the people of Zambia leave the vicious cycle of malnutrition. 

These factors will need to be addressed in future interventions to reduce rates of stunting in Zambian children. 

Jana also describes what is was like to live in Zambia. The people of Zambia left a significant mark on Jana, and she hopes to return their one day in the future.

Couple of extra questions from the listeners which Jana replied to me by message:

David Fäh explains whether large doses of vitamin D supplementation in a monthly or annual dose are a good idea to prevent the risk of falls and fractures in the elderly. 

Vitamin D supplementation has not yet been shown to offer clinically relevant health benefits in terms of inflammation.  On the contrary, studies with harder endpoints (e.g. fracture or mortality) have not shown benefits. Moreover, vitamin D supplementation carries risks. Very high doses or administration at intervals, e.g. as a monthly or annual bolus, may actually increase the risk of falls, fractures and possibly other adverse effects. Supplementation in people with values in the normal range is superfluous, and could even do harm in extreme cases.

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6689821/

https://www.sciencedirect.com/science/article/pii/S2213858718302651?via%3Dihub

https://pubmed.ncbi.nlm.nih.gov/20460620/