The Proof with Simon Hill

Is high cholesterol on a keto diet always a problem? | Dave Feldman and William Cromwell, Md


Listen Later

Some people follow a ketogenic diet seeking to lose weight, feel more energised, or gain control over their eating habits. Others may turn to this diet in an effort to treat conditions such as epilepsy, bipolar disorder, diabetes and inflammatory diseases. Regardless of their reasoning for adopting this eating pattern, a key question remains: is there ever an instance where having high LDL cholesterol levels on a ketogenic diet can be safe? In Episode #311, I’m joined by Dr William Cromwell, MD and Dave Feldman to explore this question.

In this discussion, Dr William Cromwell and Dave Feldman share their professional opinions on whether high cholesterol on a keto diet is a problem. We investigate where their opinions align and where they differ, where Dave’s hypotheses diverge from the norm, and what we do and don’t know with the available evidence. We also explore the significance of ApoB, lifespan and healthspan considerations, research Dave is currently conducting, and much more.


Specifically, we discuss:

  • Intro (00:00)
  • Dr. William Cromwell: Background as a Lipidologist and LDL Research (01:54)
  • Dave Feldman's Ketogenic Diet and Elevated LDL Experience (05:34)
  • Unpacking the Lipid Hypothesis and Cardiovascular Risk (12:30)
  • The history and evolution of the lipid hypothesis (20:40)
  • The role of apoB lipoproteins in atherosclerosis (23:39)
  • Factors beyond apoB involved in atherosclerosis and mortality risk (31:59)
  • The complexity of interpreting mortality data in the context of apoB (41:40)
  • Macrophages and the process of atherosclerosis (44:00)
  • Beyond ApoB: Metabolic Vulnerability, Inflammation and Mortality Risk (52:57)
  • Transcytosis: A New Perspective on LDL Movement and Atherosclerosis (1:10:36)
  • Exploring Low Cholesterol Impacts and Genetic Disorders (1:17:30)
  • Macrophage function and phenotype in the context of different drivers of high apoB (1:22:30)
  • Defining Lean Mass Hyper-responders in the Context of a Ketogenic Diet (1:31:40)
  • Investigating PCSK9 and Its Effects on Healthspan (1:38:00)
  • Assessing cardiovascular risk in lean mass hyper-responders (1:43:50)
  • Statin safety, adverse effects, and patient reluctance (2:01:54)
  • Ketogenic Diets and Elevated LDL: Balancing Individual Risks and Benefits in the Absence of Long-term Data (2:10:40)
  • Insulin Resistance, ApoB, and Cardiovascular Risk: Navigating the Challenges in Assessment and Imaging (2:18:12)
  • Lean Mass Hyper-responder Study: Design, Recruitment, and Eligibility Criteria (2:32:45)
  • Closing Perspectives on Research and Dietary Options (3:04:47)
  • Outro (3:06:42)

  • Connect with Dr William Cromwell: Twitter/XLinkedIn, and https://www.mylipid.com/. Discover more of his work with Precision Health Reports: Twitter/XLinkedInFacebookInstagram, and at https://precisionhealthreports.com/.

    Connect with Dave Feldman: Twitter/XYouTube, and Instagram, and discover more of his work at https://citizensciencefoundation.org/https://ownyourlabs.com/, and https://cholesterolcode.com/.


    This episode is brought to you by:

    InsideTracker

    If you want to improve your health, you need to measure where you’re currently at. InsideTracker analyses up to 48 blood biomarkers including ApoB, LDL, HDL, A1C, and more before giving you advice to optimise your health. Get a 20% discount on your first order at insidetracker.com/simon.

    Shopify

    Shopify, the world's leading e-commerce platform, helps you turn browsers into buyers with the internet’s best-converting check out–up to 36% better compared to other leading e-commerce platforms. To boost your conversion rate, and grow your business, sign up for a one-dollar-per-month trial period at shopify.com/proof.

    Sun Home Saunas

    Invest in your body and mind with Sun Home Saunas, pioneers in crafting premium saunas and cold plunges. Safe, effective, research-backed wellness tools to improve cardiovascular health, offer psychological benefits, and reduce muscle soreness. Head to sunhomesaunas.com/theproof for $300 off your purchase.

    ...more
    View all episodesView all episodes
    Download on the App Store

    The Proof with Simon HillBy Live better for longer

    • 4.9
    • 4.9
    • 4.9
    • 4.9
    • 4.9

    4.9

    2,443 ratings


    More shows like The Proof with Simon Hill

    View all
    The Rich Roll Podcast by Rich Roll

    The Rich Roll Podcast

    11,739 Listeners

    FoundMyFitness by Rhonda Patrick, Ph.D.

    FoundMyFitness

    5,296 Listeners

    Sigma Nutrition Radio by Danny Lennon

    Sigma Nutrition Radio

    390 Listeners

    Nutrition Facts with Dr. Greger by Michael Greger, M.D. FACLM

    Nutrition Facts with Dr. Greger

    3,455 Listeners

    The Plant Based News Podcast by Plant Based News

    The Plant Based News Podcast

    346 Listeners

    Heart Doc VIP with Dr. Joel Kahn by Dr. Joel Kahn

    Heart Doc VIP with Dr. Joel Kahn

    481 Listeners

    The Exam Room by the Physicians Committee by Physicians Committee

    The Exam Room by the Physicians Committee

    3,360 Listeners

    The Peter Attia Drive by Peter Attia, MD

    The Peter Attia Drive

    7,949 Listeners

    Plant-Powered People Podcast by Toni Okamoto and Michelle Cehn

    Plant-Powered People Podcast

    392 Listeners

    Switch4Good by Dotsie Bausch and Alexandra Paul

    Switch4Good

    465 Listeners

    PLANTSTRONG Podcast by Rip Esselstyn

    PLANTSTRONG Podcast

    2,299 Listeners

    Huberman Lab by Scicomm Media

    Huberman Lab

    28,361 Listeners

    Eat to Live by Jenna Fuhrman, Dr. Fuhrman

    Eat to Live

    565 Listeners

    ZOE Science & Nutrition by ZOE

    ZOE Science & Nutrition

    1,964 Listeners

    The Dr. Gabrielle Lyon Show by Dr. Gabrielle Lyon

    The Dr. Gabrielle Lyon Show

    1,139 Listeners