Low Carb Cardiologist on Saturated Fat, Cholesterol & ApoB | Dr. Ethan Weiss

Is high cholesterol harmful on a low carb diet? What about saturated fat?
Does high HDL-C and low triglycerides eliminate risk? How about a calcium score of zero? Low Carb Cardiologist Dr. Ethan Weiss addresses common low carb FAQs.

ApoB & ASCVD risk. you can predict per milligram per deciliter reduction in LDL-cholesterol or apoB you'll see a specific reduction in risk

the simplest answer: what's your ApoB? the role of HDL in atherosclerotic coronary disease is fascinating. triglycerides: it's the apoB component of triglycerides probably that contributes to risk, so the simplest way to think about this is what´s your apoB.

statins are not LDL-reducing drugs, or apoB reducing drugs, they're heart attack risk-reducing drugs, they happen to also reduce LDL.

high ApoB and a high HDL-cholesterol.

calcium scoring. the power of zero is much more impactful in an older person. if you have calcium in your arteries at 20 you got a problem. having zero calcium score after three or four or five years of having hypercholesterolemia or high apoB doesn't necessarily tell us much, you could be growing soft plaque. statins can raise calcium score at the same time as they lower risk. statins increase deposition of calcium but they reduce risk.

is it the saturated fat itself or is it the carbs, if I'm on a low carb diet maybe that eliminates the risk? high saturated fat confers high apoB. if your ApoB is still good, from a coronary perspective it's hard for me to go beyond the ApoB. for me it's all driven by ApoB.

oxidized or modified LDL or ApoB. drugs to specifically modulate oxidized LDL independent of overall LDL have all failed. if you have less residence time, if your LDL receptors are upregulated, it's less likely to be modified. monoclonal antibodies against oxidized LDL failed.

next week: low carb diets to maximize cardiovascular health

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Disclaimer: The contents of this video are for informational purposes only and are not intended to be medical advice, diagnosis, or treatment, nor to replace medical care. The information presented herein is accurate and conforms to the available scientific evidence to the best of the author's knowledge as of the time of posting. Always seek the advice of your physician or other qualified health provider with any questions regarding any medical condition. Never disregard professional medical advice or delay seeking it because of information contained in Nutrition Made Simple!.

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0:00 Intro
0:52 How Dr. Weiss got into low carb diets
2:20 High cholesterol on low carb
7:15 HDL-C and triglycerides
10:57 Calcium score
14:22 Saturated fat on low carb
17:07 LDL modification (oxidation etc)

[TomDOLAN-cbth]

I have been a armchair nutrition student for many years after the death of my mother, now more than 20 years ago, I have found Gil´s videos and take on so many important topics to be one of the best resources on You Tube. I hope he keeps up this important work as so much that is presented in other places are simply confusing, poorly done, opinion driven and often, plain off the mark. Real food forms the basis of all things healthy. Hope you re well Gil...

[angelocarrion]

I love videos like this. I'm always greatful when you interview scientists and experts who aren't plant based but also follow the science.

[unitedintraditions]

I did Atkins for 5 years then went Keto and back to Low Carb. Last year I developed Hyperinsulinemia 316 pmol/L. I have switched to mostly Plant-based eating Fish once or twice a week and perhaps chicken once or twice a month. I am now at 107 pmol/L. Nutrition is not a one size fits all. Find what works for you ignore the rest.

[EljinRIP]

I love these conversations with specialists who closely follow the data and just care about what the facts are. Keep em comin!

[StratsRUs]

This is a good foundation for part 2.
I eat a little meat, a steak a week, a little chicken too.Grass fed.
The rest is a range of all that is seen as healthy.I stopped added sugar totally..I stopped breads and cakes.I have rice sometimes.An egg every cupla days.I like an apple a day, blueberries etc.
I love pulses and vegetable dishes.Salmon and other oily fish is a must.
My weight is lowering.
I eat only when hungry and I approximate the intake akin to a 16/8 ...but vary it, sometimes I push it more towards 18-20 hours.
I don't beat myself up if I eat too many nuts here and there.
I am losing a steady amount.About 6 pounds every 5 weeks but I don't obsess.I just feel more nimble.
Walk about 2-3 miles a day.

This channel is the best I have found because it doesn't feel like a cult.
Not yet, anyway ! 😂
Thank you.

[aquamarine]

My ApoB shot up to >180 while on a strict keto diet. I was in good shape and good BP, but I've got two teenage kids I need to see through university. At least! I can't just die on them. So I switched to a low carbish diet by adding two cans of beans (protein + fiber) per day while swapping out SFAs and reducing dietary cholesterol generally. No more eggs or red meat, just chicken breast and fish. Now my ApoB is 83.

[seller]

We need to re-define “carbs”. I think of fruits and vegetables when carbs are mentioned while others are thinking donuts and pancakes.

[nourishedbyscience]

Good conversation, Gil and Ethan. These types of clear agenda-free, evidence-based conversations are a huge boon to the community (or at least those who are open to facts). Thank you!

[SMABEM]

A couple of nutrition geeks in full flight. Great to see you talking to someone on your same level. High carb vegan here trying to keep an open mind on low carb.

[Nimzzeee]

These videos absolutely help. An actual breakdown of foods to eat, how much and how often is even more helpful and I look forward to part 2 although a comprehensive list that we can take away is more practical.

[henkwerner]

I'm very much looking forward to the next video. I'm on a low carb diet now for two months and any guidance on best practices to keep ApoB under control is very, very welcome.

[thefreshprinceofnohair]

I have a Friend who has high triglycerides and very low HDL, he eats mostly refined carbs, I have low triglycerides and optimal HDL, I was eating a ketogenic diet at the time of the blood work, the only marker that he had that was better than me was LDL, I m not saying LDL isn’t important especially if APOB is high, but it interesting how someone that unhealthy ( he’s overweight and doesn’t exercise, still has totally normal LDL. I don’t know his APOB because his doctor only ran the standard lipid panel.

[jimmybee]

That was a great conversation. I am doing well on a low carb diet. I am looking forward to learning more about saturated fat in part 2. Thank you.

[evanlouis]

I do hope that Gil synthesizes and explains in layman terms what the low carb Cardiologist is talking about come the end of his interviews with him.

If you put a gun to my head, I could not tell you anything definitive about this conversation

[elizabethk]

First of all thank you for this video. I'm 75 no meds no pain, eat low Carb, no sugar, and exercise regularly. My LDL however, is always a bit higher than it should be. I recently had an ApoB test done, and seeing my doctor soon to discuss. I am one of the fortunate people with a doctor who is a collaborator in my health-care. This video helps me to discuss my ApoB with some degree of understanding. ALSO thanks for your thoughtfulness in having an esthetically pleasing background for your viewers. So many ignore that they don't have to look at the "mess" but we do.

[raithneach]

These type of videos are greatly appreciated, thank you. They bring clarity to really complex topics that could be difficult to understand, the explanations are just so accessible and clear. And so many of the points are pertinent given all of the noise that surrounds topics like LDL-C and cardiovascular risk. Please keep doing them, it's really helpful.

[jtucci]

Thank you for this interview, it brings well needed context to the conversation of a low carb diet which I just started as a 72 year old male with heart disease.

[patricknowlan]

These videos are terrific. Thank you so much. There's so much conflicting and confusing information out there, a lot of camps and a lot of agendas. Its refreshing and extremely helpful to listen to you cover the science without bias. Again, thanks so much!

[albrackets]

regarding the issue of high LDL-C and ASCVD risk, I am sure you have seen the hazard ratios of various conditions published in JAMA. At the top is diabetes, smoking, the various metabolic syndromes (such as obesity) on down to TGD and low HDL. At the bottom is LDL-C in terms of risk factors. So if you reverse the items with the highest risk, namely diabetes, ( and pre-diabetes assuming there is risk from that), obesity, hypertension but were stuck with higher LDL-C, wouldn't that be a good trade?

[beinoutside]

What a great discussion! Very good, clear questions and good, clear answers. Thank you both for your time and effort, much appreciated!