Controversial Thoughts: When high cholesterol is GOOD!

Paul Saladino MD podcast

Paul Saladino, MD

Medicine, Health & Fitness

4.8 • 2.7K Ratings

🗓️ 23 October 2020

⏱️ 27 minutes

🔗️ Recording | iTunes | RSS

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Summary

Is high cholesterol always a bad thing? I say no! Context matters greatly here, as in are you metabolically healthy? Do you know how to assay this? Many people eating an ancestral type diet like carnivore, carnivore-ish, keto, paleo, etc. (like me!) will see LDL rise, but I don't believe this is a bad thing if we are insulin sensitive/metabolically healthy- this is the importance of context. I discuss the importance of considering context in discussions of LDL, Lp (a), uric acid, and APOE4 in this video. Get ready for a wild ride. #theremembering

Check out heartandsoil.co if you need more nose to tail nutrition in your life. The JRE show notes are there as well.

Transcript

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0:00.0	What is up you guys? Welcome to yet another edition of controversial thoughts.
0:05.0	I have been wanting to make this exact video for a very long time.
0:10.0	I want to talk about the importance of context.
0:13.0	This came up on Joe Rogan's podcast. All of the show notes for that are at heart and soil.co.
0:20.0	Front slash Rogan. There are probably over 300 references there.
0:25.0	We didn't get to talk about all of them on the show, but many of the things that did cover are there.
0:29.0	Plus lots of other points regarding different aspects of animal based diets, evolutionary eating and ancestral themes around eating.
0:37.0	One of the biggest things that keeps coming up on I think about this is the importance of context.
0:42.0	This is when you hear me talk about metabolic health and how critical metabolic health is for interpreting things like lipids, LDL, lipoprotein, little A,
0:52.0	but also things like uric acid and apoi for among others.
0:57.0	So I want to touch on all of those briefly in this video and show you guys how context that is whether an individual is metabolically healthy or unwell or has inflammation.
1:07.0	And all of these are sort of proxies for the same condition of underlying metabolic health affects risk with many of these markers.
1:15.0	Now this I believe is Western medicine misses time and time again.
1:21.0	They don't think about context. We're not taught to think about context in medical school.
1:25.0	We assume that all of the population is ill, which is a reasonable assumption when probably greater than 80% of the population is metabolically unwell.
1:34.0	But most of us in this sphere who think about our health, who are doing carnivore or carnivory diets or ketogenic diets or paleo like diets are not part of the 80 to 88% of the population that is metabolically unwell.
1:47.0	We are metabolically healthy, but some of us get high levels of LDL.
1:51.0	This is exactly what I talked about on Joe Rogan.
1:54.0	As you saw me post on Twitter recently in 2014, my LDL was 120 some I'll show you guys my LDL from 2014.
2:06.0	This is a screenshot of my lipids from when I was in medical school, the University of Arizona.
2:13.0	You can see here my LDL was 126 in 2014.
2:18.0	My AST and ALT were normal.
	...

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