#CholesterolScience – with Ethan Weiss, MD

Hosted by Dave Feldman :: Produced by Siobhan Huggins 0:00 Intro and Ethan’s background 3:33 Cholesterol Skeptics and Concerned Medical Professionals – meeting in the middle. ( https://cholesterolcode.com/wp-conten... ) 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? ( https://cholesterolcode.com/wp-conten... ) ( https://cholesterolcode.com/wp-conten... ) 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 https://www.thelancet.com/journals/la... 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[…])" https://doi.org/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." https://doi.org/10.1016/S0140-6736(02... 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? (  / 1162070100037574656  ) Study mentioned: Influence of Low High-Density Lipoprotein Cholesterol and Elevated Triglyceride on Coronary Heart Disease Events and Response to Simvastatin Therapy in 4S https://www.ahajournals.org/doi/full/... 52:40 Open data, machine learning, and possibilities moving forward 56:20 Non-HDL and mortality from the NHANES dataset https://twitter.com/DaveKeto/status/1... 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) https://www.npr.org/2019/04/29/718227... 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