#19 - Dave Feldman: stress testing the lipid energy model

The Peter Attia Drive

Peter Attia, MD

Health & Fitness, Medicine, Fitness

4.7 • 7.3K Ratings

🗓️ 8 October 2018

⏱️ 190 minutes

🔗️ Recording | iTunes | RSS

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Summary

In this episode, Dave Feldman, discusses his journey from software engineer to n=1 experimenter, his experience with low-carbohydrate diets, and his hypothesis that cholesterol levels are influenced by energy metabolism.

We discuss:

Peter’s synthesis of Dave’s energy model [5:00];
Dave’s journey from software engineer to cholesterol enthusiast [15:00];
Standard blood panels, sterol panels, and what moves the needle when it comes to particle numbers [18:30];
Hyper-responders [20:00];
Lipoprotein transport [33:45];
The lean mass hyper-responder phenotype [47:30];
The progression of atherosclerosis, CAC, and CIMT [52:30];
Testing for oxidized LDL [55:30];
All-cause mortality and clinical endpoints [1:01:15];
What does “LDL as causal” mean? [1:05:15];
Dave’s low carb cholesterol challenge and drug & genetic study qualifications [1:13:15];
If all other markers are in an healthy range, but LDL-P is high, is the patient at risk? A couple of case studies, and a self-experiment [1:27:30];
Peter’s three-day exercise and ketosis experiment [1:41:00];
What are remnant lipoproteins? [1:45:00];
What might cause lean mass hyper-responders to have higher LDL particle numbers? [1:53:30];
A case study from Dave of a lean mass hyper-responder [1:56:30];
Mass balance and cholesterol flux [2:05:30];
Can a higher degree of cholesterol explain the lean mass hyper-responder phenotype? [2:10:00];
Peter’s LDL during his keto-fast-keto experiment [2:13:30];
Does substituting saturated fats with monounsaturated fats lower LDL-P and LDL-C? [2:15:45];
Dave’s carb-swap experiments [2:22:15];
Dave’s carotid intima-media thickness tests [2:41:15];
Looking for studies that stratify for high HDL-C and low TG alongside low and high LDL-C [2:53:00]; and
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Transcript

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