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Dave Feldman's "CholesterolJoe" experiment

Outlier said:
If you would kindly expand on your understanding of stabilisation, we could have a discussion.
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I don't have any understanding about stabilisation, whoch should be reflected in my post being posed as a question...and out of curiosity. Happy to be educated.
 
I don't want to get into an argument and I don't have access to enough studies to from an opinion of what the truth is.
There is at least one study which shows that Statins do indeed stabilise plaque, but that they do that by calcifying it.

I have seen many studies which say that the degree and rate of increase of calcified plaque (as measured by a CAC test aka Coronary Calcium CT scan)
All the following is from the Mayo Clinic:

Coronary calcium scan results are usually given as a number. The number is called the Agatston score. The score is the total area of calcium deposits and the density of the calcium.​

  • A score of zero means no calcium is seen in the heart. It suggests a low chance of developing a heart attack in the future.
  • When calcium is present, the higher the score, the higher the risk of heart disease.
  • A score of 100 to 300 means moderate plaque deposits. It's associated with a relatively high risk of a heart attack or other heart disease over the next 3 to 5 years.
  • A score greater than 300 is a sign of more extensive disease and a higher heart attack risk.
The test score also may be given as a percentage. The number is the amount of calcium in the arteries compared to other people of the same age and sex. Calcium scores of about 75% have been linked with a significantly higher risk for heart attacks.
 
ianf0ster said:
There is at least one study which shows that Statins do indeed stabilise plaque, but that they do that by calcifying it.
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But that's important, no? Given how many of the population would be unlikely to make the diet and lifestyle changes necessary to improve heart-attack risk, calcifying the stuff seems like it might be a better proposition that having it free-floating, ready to cause a blockage at any moment.



ianf0ster said:
I have seen many studies which say that the degree and rate of increase of calcified plaque (as measured by a CAC test aka Coronary Calcium CT scan)

All the following is from the Mayo Clinic:

Coronary calcium scan results are usually given as a number. The number is called the Agatston score. The score is the total area of calcium deposits and the density of the calcium.​

  • A score of zero means no calcium is seen in the heart. It suggests a low chance of developing a heart attack in the future.
  • When calcium is present, the higher the score, the higher the risk of heart disease.
  • A score of 100 to 300 means moderate plaque deposits. It's associated with a relatively high risk of a heart attack or other heart disease over the next 3 to 5 years.
  • A score greater than 300 is a sign of more extensive disease and a higher heart attack risk.
The test score also may be given as a percentage. The number is the amount of calcium in the arteries compared to other people of the same age and sex. Calcium scores of about 75% have been linked with a significantly higher risk for heart attacks.
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I've heard a lot of people claiming a zero CAC score represents zero risk (Not saying that's you). But it seems that the CAC test seems to not be able to make such predictions. Found this video interesting:

 
Beating-My-Betes said:
But that's important, no? Given how many of the population would be unlikely to make the diet and lifestyle changes necessary to improve heart-attack risk, calcifying the stuff seems like it might be a better proposition that having it free-floating, ready to cause a blockage at any moment.
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Like I said, I don't know enough to know whether overall calcified plaque is 'better' or 'worse' then non-calcified.
But I do know that in here we most definitely are talking about people who will and have made diet and lifestyle changes in order to improve their health - namely controlling their diabetes (which uncontrolled I understand to be a large, possibly doubling of the risk).
 
ianf0ster said:
Like I said, I don't know enough to know whether overall calcified plaque is 'better' or 'worse' then non-calcified.
But I do know that in here we most definitely are talking about people who will and have made diet and lifestyle changes in order to improve their health - namely controlling their diabetes (which uncontrolled I understand to be a large, possibly doubling of the risk).
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While it's true that controlling diabetes can lower risk, it's only part of the equation. But if controlled sugars plus a test that likely doesn't paint the entire picture of risk are giving people the (perhaps) false-impression that everything is A-OK, then I'm sure you'd agree that's potentially very problematic.
 
There is nothing that gives a whole picture of the risk from cardio problems. High LDL Cholesterol gives a less accurate approximation than a CAC scan. But neither of them is good enough. There is no way of ever knowing if our health is A-OK, each medication taken is a trade-off between desired effects and possible nasty side effects.

In an uncertain environment I'm extremely happy to remove my risk of diabetic complications and at the same time reduce my Cardio risk by approximately 50%! What I would not be happy to do would be to lower my LDL by eating 100gms of Oreos (or bananas) per day thus raising both my BG and BMI. But that is just my (partly informed) opinion.

I'm 73yrs old, I've had a '3xCabbage', my dad died of a heart attack when he was 45 and yet I fear diabetes complications much more than I do a heart attack.
 
ianf0ster said:
There is nothing that gives a whole picture of the risk from cardio problems. High LDL Cholesterol gives a less accurate approximation than a CAC scan. But neither of them is good enough. There is no way of ever knowing if our health is A-OK, each medication taken is a trade-off between desired effects and possible nasty side effects.

In an uncertain environment I'm extremely happy to remove my risk of diabetic complications and at the same time reduce my Cardio risk by approximately 50%! What I would not be happy to do would be to lower my LDL by eating 100gms of Oreos (or bananas) per day thus raising both my BG and BMI. But that is just my (partly informed) opinion.

I'm 73yrs old, I've had a '3xCabbage', my dad died of a heart attack when he was 45 and yet I fear diabetes complications much more than I do a heart attack.
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Thanks, but I think it's best we leave it there.
 
So often medication which is given to prevent (in actuality reduce a perceived risk of) one condition carries a different (perceived) risk of accelerating another. It's very much an individual decision how we navigate this, as it's all too easy to be simplistic about it. Sadly but not surprisingly we are seldom seen holistically by our various medics, who naturally put their own disciplines front and centre, and the person before them is seen merely as an illness to hit with big guns, not an individual who has to keep the whole show on the road (mixed metaphores, anyone?). Therefore, again, we should be cautious at what we take on trust, and our individual lived experiences, even if they sound counter to current received wisdom, are every bit as important as the conclusions drawn from laboratory research.
 
Outlier said:
Therefore, again, we should be cautious at what we take on trust, and our individual lived experiences, even if they sound counter to current received wisdom, are every bit as important as the conclusions drawn from laboratory research.
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I am not against being cautious...That's the whole point. And I'm clearly not the only here who understands that the tests we have to show heart-health are not able to give us the info with the accuracy we need. So "lived experiences" in such cases don't hold much water.

You're taking just as much "on trust" as any of us. You're just choosing different people to put said trust in.
 
Please would you explain what you think I am taking "on trust" and then we can proceed with our discussion.
 
I read the article a couple of times @Outlier - https://www.jacc.org/doi/10.1016/j.jacadv.2025.101686 - whilst it is good news for those who have seen their LDLs increase on a restricted carbohydrate diet, there are caveats to these results. The study looks at LMHR individuals. When we talk about Lean Mass Hyper Responders we are talking about lean fit individuals who see their LDLs rise to very high levels >8.00 mmol/Ls, who have HDL over >2.00 mmol/Ls and stay within range; whilst their Triglycerides levels are very low <0.6 mmol/Ls.
Other findings of note are also of interest. For those individuals who have existing plaque buildup, the results are not so positive. Existing plaque was the biggest predictor of future plaque. To put it another way people who already have some plaque are more likely to see an increase in plaque build-up regardless of LDL levels.

The winners in this study are those individuals who have zero plaque at the start of the study and continue to be at low risk.

The study is of short duration, 1 year only, so the effects of high LDL has not been evaluated over a long period of time.
 
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