
Rabbi
Tel Aviv, Israel
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- Feb 28, 2020
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I am just going to drop this for info for any user that is confused or at a loss for the state of dietary messaging and fearmongering online.
There has been an ever growing constituency of health shitfluencers and gurus pushing very high red meat and saturated fat diets which eventually results in elevated LDL cholesterol. It has been well established within cardiology that LDL cholesterol (not dietary) is an independent risk factor for the development of coronary artery disease (CVD) that is both a necessary and sufficient cause.
The hypothesis of the authors of this paper and like many others including Paul Saladino is what follows:
Now researchers in the griftosphere of nutrition got together and decided to make a study design to test their hypothesis, nothing wrong with this.
They recruited handpicked people who were metabolically healthy and had as follows
They then followed these people up for 1 year and used a CTA scan (CT- angiogram), this is important because it is an extremely precise measurement which can detect both calcified and soft plaques allowing the researchers to track changes in plaque volume over time, helping to evaluate cardiovascular risk and disease progression. It’s especially useful in studies aiming to detect early signs of atherosclerosis before symptoms appear.
Their primary outcome is to measure the mean change in plaque volume over this year so they can better understand whether or not LDL cholesterol impacts plaque progression in lean metabolically healthy people.
So far so good
Now lets get to the study itself
www.sciencedirect.com
Here is the pre-release conclusion of the authors
They report that LDL cholesterol did not impact the progression of atherosclerosis
One of the authors is Nick Norwitz
he does sensationalist crap nutrition stunts on Youtube.
This guy came on my radar for being extremely slimy and posting viral videos on YouTube about eating tons of bacon/lard/butter etc and it not affecting his cholesterol. But he would never report his baseline intake of saturated fat nor would he report his baseline cholesterol numbers or any of his actual lab reports before and after. So I knew it was going to be a crapshoot when I saw his name, there are a few more there.
Anyways he and the other authors have already gone to task in media talking about how much of a success the trial is for their theory of the LMHR phenotype.
www.foxnews.com
newatlas.com
www.globenewswire.com
.
THEY NEVER FUCKING REPORTED THE CHANGE IN PLAQUE VOLUME IN THEIR PAPER.
THEY COMPLETELY OMITTED THEIR PRIMARY FUCKING OUTCOME
This is extremely concerning on multiple levels, its intentionally misleading and the authors cut the single most crucial point of data needed for their analysis.
You can zoom into their figure they've provided
So for interpretation, any dot at 0 had zero change in plague over the yearr, any dot below the zero line had a regression in plague and any dot above had an increase in plaque over the year.
How does it compare?
So what happens next?
After screaming shitting and pissing one of their authors coughs up the data for the raw numbers of mean plague change (the outcome they said they would measure) on twitter.
So the plaque progression was 18.8 mm^3
A useless number without a reference point, which brings us to the next question how does this compare to other population?
Well we don't even need to speculate, the exact same institute with many of the same authors did a similar study on healthy patients except these people DID NOT have elevated cholesterol.
So what was their plaque progression over 1 year?
It was 4.9 mm^3.
That's right, when comparing two populations head to head both metabolically healthy but one with high LDL induced through a high saturated fat diet, the high LDL group has plaque progression ~3.8 times or 280% greater than the group with normal LDL cholesterol.
THIS IS THE KEY TAKE AWAY FROM THE STUDY YOU CAN DNRD THE REST
So how exactly did the authors come to their conclusion as to why LDL did not affect the progression of plague?
Well they merely compared very high and extremely high LDL people to each other as opposed to a healthy control group, and deduced that because there was no gradient LDL did not affect the plague.
This would be like comparing a smoker who smokes 30 vs 32 cigarettes a day and deducing that cigarettes do not cause lung cancer because there is negligible difference between the two groups.
Make no mistake, the authors of this study know better they are trying to intentionally mislead their audience, they had a hypothesis is failed miserably now they are trying to spin it as a positive.
As a side note people have noted that if you point this out to any of the authors especially the Norwitz pencil neck moron he will instantly block you and carry on helping people write op-eds about this horrific research.
Here is an actual acredited MD-PhD doctor interviewing the head author of the entire study who seems to be almost clueless
Its a long watch but ill TLDR it;
The head author who seems to be plugged away from online shenanigans has no idea what the other authors have been spewing.
He concedes that there are multiple incorrect statements in the paper including statements that state that plague was stable (when it was not it was progressing)
He goes onto say that there will likely need to be a retraction of this study and be rewritten to accurately represent the findings.
SO THE TLDR FOR THE WHOLE RANT
IF YOU GET A HIGH READING FOR CHOLESTEROL ON YOUR BLOOD TEST AND YOUR DOCTOR TELLS YOU NEED TO LOWER IT, DO NOT PLAY SMARTASS THINKING YOU KNOW BETTER, YOU DONT.
SECONDLY, STOP SPEWING GARBAGE 24/7 SAYING THAT ELEVATED LDL IS NO PROBLEM WHATSOEVER AS LONG AS YOUR HEALTHY TO PEOPLE WHO DONT KNOW ANY BETTER ON THIS FORUM, IT IS ABOLUSTELY NOT.
THIRD, IF YOU ARE GETTING SERIOUS NUTRITION ADVICE FROM THIS FORUM IT MAY ALREADY BE OVER
There has been an ever growing constituency of health shitfluencers and gurus pushing very high red meat and saturated fat diets which eventually results in elevated LDL cholesterol. It has been well established within cardiology that LDL cholesterol (not dietary) is an independent risk factor for the development of coronary artery disease (CVD) that is both a necessary and sufficient cause.
The hypothesis of the authors of this paper and like many others including Paul Saladino is what follows:
- Cholesterol is not a Risk factor in and of itself, it only becomes a problem when other metabolic markers are poor
- Individuals who tend to have high cholesterol tend to be metabolically unhealthy
- Metabolically unhealthy people tend to have high(er) inflammation
- This inflammation interacts with blood cholesterol causing it to oxidize within the artery resulting in damage thus heart disease
- There are individuals who have high cholesterol (induced by diet primarily) whom have good health in other metabolic parameters including weight, these people are termed 'Lean Mass Hyper Responders' (LMHR)
Now researchers in the griftosphere of nutrition got together and decided to make a study design to test their hypothesis, nothing wrong with this.
They recruited handpicked people who were metabolically healthy and had as follows
- Very high LDL-C levels (≥190 mg/dL) after adopting a low-carb or ketogenic diet
- Low triglycerides (≤80 mg/dL)
- High HDL-C (≥60 mg/dL)
- Lean body composition
They then followed these people up for 1 year and used a CTA scan (CT- angiogram), this is important because it is an extremely precise measurement which can detect both calcified and soft plaques allowing the researchers to track changes in plaque volume over time, helping to evaluate cardiovascular risk and disease progression. It’s especially useful in studies aiming to detect early signs of atherosclerosis before symptoms appear.
Their primary outcome is to measure the mean change in plaque volume over this year so they can better understand whether or not LDL cholesterol impacts plaque progression in lean metabolically healthy people.
So far so good
Now lets get to the study itself

Plaque Begets Plaque, ApoB Does Not: Longitudinal Data From the KETO-CTA Trial
Changes in low-density lipoprotein cholesterol (LDL-C) among people following a ketogenic diet (KD) are heterogeneous. Prior work has identified an in…
Here is the pre-release conclusion of the authors
In lean metabolically healthy people on KD, neither total exposure nor changes in baseline levels of ApoB and LDL-C were associated with changes in plaque. Conversely, baseline plaque was associated with plaque progression, supporting the notion that, in this population, plaque begets plaque but ApoB does not.
They report that LDL cholesterol did not impact the progression of atherosclerosis
One of the authors is Nick Norwitz

he does sensationalist crap nutrition stunts on Youtube.
This guy came on my radar for being extremely slimy and posting viral videos on YouTube about eating tons of bacon/lard/butter etc and it not affecting his cholesterol. But he would never report his baseline intake of saturated fat nor would he report his baseline cholesterol numbers or any of his actual lab reports before and after. So I knew it was going to be a crapshoot when I saw his name, there are a few more there.
Anyways he and the other authors have already gone to task in media talking about how much of a success the trial is for their theory of the LMHR phenotype.

Low-carb keto diet may not raise heart disease risk, new study suggests
A low-carb keto diet may not increase the risk of heart disease, despite elevated cholesterol levels, a new study suggests. Researchers and doctors weigh in.

Keto diet's high cholesterol not a factor in heart disease, says study
One of the ketogenic diet's major perceived drawbacks is an increase in LDL, or so-called bad cholesterol. A new study, though, says that this cholesterol spike doesn't fit the conventional science in terms of its disease-causing ability.

New research from The Lundquist Institute finds ketogenic diet-induced high cholesterol does not predict heart disease
A one-year prospective study found that very high cholesterol in 100 otherwise metabolically healthy individuals on a ketogenic diet for an average of 5...
.
THEY NEVER FUCKING REPORTED THE CHANGE IN PLAQUE VOLUME IN THEIR PAPER.
THEY COMPLETELY OMITTED THEIR PRIMARY FUCKING OUTCOME
This is extremely concerning on multiple levels, its intentionally misleading and the authors cut the single most crucial point of data needed for their analysis.
You can zoom into their figure they've provided

So for interpretation, any dot at 0 had zero change in plague over the yearr, any dot below the zero line had a regression in plague and any dot above had an increase in plaque over the year.
How does it compare?
- There is 1 dot below zero meaning their plaque reduced
- There are 3 dots at zero meaning there was no change
- All other dots (over 100ish participants) are above zero meaning their plague showing progression and narrowing of the artery in just one years time
So what happens next?
After screaming shitting and pissing one of their authors coughs up the data for the raw numbers of mean plague change (the outcome they said they would measure) on twitter.

So the plaque progression was 18.8 mm^3
A useless number without a reference point, which brings us to the next question how does this compare to other population?
Well we don't even need to speculate, the exact same institute with many of the same authors did a similar study on healthy patients except these people DID NOT have elevated cholesterol.
So what was their plaque progression over 1 year?
It was 4.9 mm^3.
That's right, when comparing two populations head to head both metabolically healthy but one with high LDL induced through a high saturated fat diet, the high LDL group has plaque progression ~3.8 times or 280% greater than the group with normal LDL cholesterol.
Healthy With Normal Cholesterol | Healthy with High Cholesterol | |
Plague progression 1-Year | 4.9 mm^3 | 18.8 mm^3 |
THIS IS THE KEY TAKE AWAY FROM THE STUDY YOU CAN DNRD THE REST
So how exactly did the authors come to their conclusion as to why LDL did not affect the progression of plague?
Well they merely compared very high and extremely high LDL people to each other as opposed to a healthy control group, and deduced that because there was no gradient LDL did not affect the plague.
This would be like comparing a smoker who smokes 30 vs 32 cigarettes a day and deducing that cigarettes do not cause lung cancer because there is negligible difference between the two groups.

Make no mistake, the authors of this study know better they are trying to intentionally mislead their audience, they had a hypothesis is failed miserably now they are trying to spin it as a positive.
As a side note people have noted that if you point this out to any of the authors especially the Norwitz pencil neck moron he will instantly block you and carry on helping people write op-eds about this horrific research.
Here is an actual acredited MD-PhD doctor interviewing the head author of the entire study who seems to be almost clueless
Its a long watch but ill TLDR it;
The head author who seems to be plugged away from online shenanigans has no idea what the other authors have been spewing.
He concedes that there are multiple incorrect statements in the paper including statements that state that plague was stable (when it was not it was progressing)
He goes onto say that there will likely need to be a retraction of this study and be rewritten to accurately represent the findings.
SO THE TLDR FOR THE WHOLE RANT
IF YOU GET A HIGH READING FOR CHOLESTEROL ON YOUR BLOOD TEST AND YOUR DOCTOR TELLS YOU NEED TO LOWER IT, DO NOT PLAY SMARTASS THINKING YOU KNOW BETTER, YOU DONT.
SECONDLY, STOP SPEWING GARBAGE 24/7 SAYING THAT ELEVATED LDL IS NO PROBLEM WHATSOEVER AS LONG AS YOUR HEALTHY TO PEOPLE WHO DONT KNOW ANY BETTER ON THIS FORUM, IT IS ABOLUSTELY NOT.
THIRD, IF YOU ARE GETTING SERIOUS NUTRITION ADVICE FROM THIS FORUM IT MAY ALREADY BE OVER