Short Summary: Heart health and the ketogenic diet, with expert insights from a cardiologist and researcher.
About the guest: Matthew Budoff, MD, is a preventive cardiologist and professor of medicine at UCLA School of Medicine.
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Episode Summary: Dr. Matthew Budoff discusses cholesterol, heart disease, and his study on the ketogenic diet’s impact on lean, metabolically healthy individuals with high LDL cholesterol. He explains LDL, HDL, and triglycerides, debunking myths about their direct link to heart disease, and emphasizes the importance of coronary calcium scans to assess plaque buildup. The study found no significant plaque progression in these individuals despite elevated LDL, challenging conventional cardiology views. Budoff also covers statins, dietary cholesterol, and personalized heart health strategies.
Key Takeaways:
LDL cholesterol is not a definitive predictor of heart disease; plaque buildup, assessed via coronary calcium scans, is a better indicator.
Lean metabolically healthy people on a ketogenic diet may have high LDL without increased plaque progression after one year.
Coronary calcium scans, costing ~$100, are recommended for men around age 40 and women around 45-50 to evaluate heart disease risk.
Statins effectively lower LDL and can reverse soft plaque, but may be overprescribed for those without plaque buildup.
Dietary cholesterol has a minimal impact on blood cholesterol, as the liver produces ~85% of it.
The ketogenic diet can aid weight loss and diabetes control but may cause high LDL in some lean individuals, known as lean mass hyper-responders.
Plaque progression depends more on existing plaque than LDL levels in metabolically healthy ketogenic diet followers.
Heart health varies widely due to genetics and other unknown factors, underscoring the need for personalized assessments.
Related episode:
M&M #158: Ketosis & Ketogenic Diet: Brain & Mental Health, Metabolism, Diet & Exercise, Cancer, Diabetes | Dominic D'Agostino
*Not medical advice.
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Episode transcript below.
Episode Chapters:
00:00:00 Intro
00:01:29 Guest Introduction
00:02:36 Cholesterol Basics
00:09:15 Heart Disease Risk Factors
00:13:56 Statins and LDL Management
00:18:35 Ketogenic Diet Overview
00:24:43 Study Setup and Methods
00:31:10 Study Results
00:38:19 Heart Scan Recommendations
00:44:23 Lean Mass Hyper Responders
00:50:08 LDL Guidelines Critique
00:55:06 Final Thoughts
Full AI-generated transcript below. Beware of typos & mistranslations!
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