All right, welcome back, team, to the Building a Lifelong Athletes podcast. Thanks so much for stopping by. I really appreciate it. If we haven't had the chance to meet yet, my name is Jordan Renke. I'm a dual-board certified physician in family and sports medicine. And the goal of this podcast is to keep you active and healthy for life through actionable Evans Informer Education. I really appreciate you being here today. We're talking all about LDL. So I talk about this a lot. So, LDL, low-density level proteins. You know, it's the quote-unquote bad cholesterol. This is something I talk about a lot. And it's just, I want to talk about it again today because I keep seeing things and I wanted to kind of get this out there. So. There's a conflict, if you look online, between cholesterol camps. So essentially, there's this conflict between the medical consensus and public perception, right? The cornerstone of preventative cardiology is saying that elevated LDL or APOB, I'll step back and APOB is the protein on all the atherogenic lipoproteins, so it's a probably better marker than LDL. So they're kind of a proxy, but, anyways. Elevated LDL or adlectoproteins is a primary and direct cause of atherosclerosis. That's like the kind of understanding in cardiology. That's the theory we're going with. This is understood as the lipid hypothesis, the central organizing principle for decades and decades now. And so, this isn't some niche academic debate, right? So, cardiovascular disease is huge, the number one killer worldwide. I'm talking about hearts, you know, heart attacks, strokes, things like that. But for some reason, there's significant public skepticism still, fueled by lots of online discourse. You know, if you go online, there's lots, lots of people talking about this, and it creates a lot of confusion for patients and people online trying to make health decisions, right? They read and hear these conflicting things and they get worried. And so. For me, I wanted to know why this disconnect exists. So, how can a medical understanding like the Lipid hypothesis be so fiercely debated outside of the clinics and on the internet? That's really what I'm looking for. And so, yeah, that's where we're going to dive in here. First, I do want to acknowledge there is definitely value for scientific skepticism, right? And I think that's wonderful. Like, we, you know, though, we used to think the Earth was the center of the universe, right? And someone challenged that. And so I'm not saying that things can't change. They just take a while to do it, and they have to have good, solid evidence to do that. And so, I'm not by any way saying, like, hey, we should quite question things. I think that's great. But under-substantiated claims can lead to, in this day and age, Legitimacy, right? So, people have a loud voice, loud platform. And if their views aren't backed up by the same amount of evidence as something else, it can still seem incredibly, incredibly legitimate, saying, wow, like, look at these people talk about it. You know, they're talking with such confidence. That's what's going on. And, and really, I wanted to introduce the stakes, right? So, for me, I think the stakes are huge on this, right? This is my main question. If we get this wrong, if we don't understand this, if one of us is wrong, there could be enormous Consequences to this, right? So, yes, and so I think that's kind of what it is, and where we're going from here. And so, the skeptics, kind of what they say is, hey. LDL is not directly related to heart disease. That's pretty much a big thing. And, you know, that's a big claim. When they say that, that's a big claim. And traditionally, when that happens, you have to have pretty solid evidence. And then, you know, there are definitely Papers out there, right, that don't fit that entire narrative, right? So there are lots of different articles you can go out there and say, hey, it doesn't fit that perfectly. But there are a handful of papers that kind of have published and show this, but they lack the scale, quantity, and consistency. That challenges decades of accumulated research talking about LDL's calls of role, in my opinion. I don't think the amount of evidence is there equally, that's for sure. And so, the issue isn't an issue of evidence asymmetry, right? So, a mountain of data on one side versus a collection of Other cherry pick studies on the other side, that's kind of where it goes from here. And I know everyone will say, like, oh, you're just cherry picking that, you're cherry picking that. On in totality, in totality, it seems to me that there's a much, much, much higher and more robust literature Database for the LDL hypothesis, but hey, that's what we're getting. And once again, I do want to talk about the potential cost of being wrong, right? It's not abstract. It's not just like, oh, like I'm wrong, like nothing happens. Like, it's measured in. Heart attacks, strokes, and shortened lives. That's essentially what it comes down to. That's why, for me, this is so important. Once again, I do not care. I'll say this again: I don't care what you do. I do not care if you think, hey, you're wrong. And that's fine. That's okay to have adult disagreements. I'm okay with that. But I just want everyone to be informed. That's the biggest thing for me: I have my patients be informed. Because I have patients come in, mine's already made up, absolutely made up. They saw something online that they're not going to do this XYZ. I, you know, I can talk to him about it, but a lot of times the decision is already made. And so I just want you to have information before you make the decision, and that's totally fine. But stakes can be huge here, right? So, ignoring this. It isn't just skepticism. It's not just one thing. It's high stakes. It's a high stakes battle right here. And so that's what we're looking for. And so, once again, just want you to have the understanding of why I think about this, how I think about this, so we can make a kind of informed decision. So. I kind of went back and kind of dug into a little history of where did these like arguments come from? Like, how did this come about, right? So, we have the traditional medical establishment, and then kind of this anti-traditional establishment now here saying actually it doesn't matter. And so there's a couple of different things I see. So, first, it's kind of like the intuition claim, right? So, cholesterol is a vital molecule, they'll say, you know, it can't be harmful, like it's naturally made, it can't be harmful. And it's kind of right, it's intuitive, it's biological, it flames cholesterol, it kind of is natural, right? Like, oh, that makes sense, and that's it. Um, but really, what's happening here is they're conflating cholesterol's unnecessary presence in cells with the pathological concentration in the bloodstream. That's like saying sugar is necessary, glucose is necessary. It's absolutely great. But yeah, when it's 300 milligrams per deciliter in your blood, that's a bad thing. We know that's bad. And so just because something's natural doesn't necessarily mean that. If you also dig back a little bit as well, you know, there's lots of people going back there. You know, it initially starts with, they say, also cherry-picking data from Ansel Keys back in the day, saying he looked at different studies across the world, different countries, and saw, hey, On average, cholesterol had an issue, and there was a correlation with cholesterol and heart disease. And people say he started by cherry picking and saying, if he would have picked all the studies, including like France, like there's something called the French paradox, where they eat more cheese and have more saturated fat. But don't have heart disease, what's going on? And they're saying he cherry-picked that data. And so, from the start, it was a flawed theory and hypothesis. And we've kind of piggybacked on that and gone from there. So, that's another kind of where this came from as well. Another thing that was commonly cited is that correlation is not causation. That's a standard argument people say: is like correlation is not causation. They're saying the link between LDL and heart disease is merely an association, not a proof of cause, right? This is a very, very valid idea. Like, this is great science. It's very good to understand that. That, yeah, causation is not caused by correlation. So, correlation is just that saying, hey, something's going on. You can't. Prove anything from it. But this uses a valid scientific principle to sound rigorous and cast doubt on a fundamental epidemiologic study, right? So these are very, very important studies for everybody, for all different types of science, but very important. But this is what I see commonly here. This is my kind of experience that I've seen. There's kind of a double standard there, right? So they correctly state that correlation is not causation, absolutely, to dismiss decades of observational data linking LDL with heart disease. And they do that because. They say, hey, you can't do that. And there's also some studies that when you look at LDL, it doesn't necessarily show heart disease. So every study doesn't show that. And that's very valid as well. That's like kind of another reason why people are like, well, why wouldn't it show up in every study? There's lots of reasons why they might not happen. That being said, they say, hey, correlation, not causation, and it doesn't look like LDL is linked to heart disease. But then they use often even lower quality studies, observational studies, you know, studies that look at. Saturated fat and heart disease, and found that there wasn't a strong link between saturated fat and heart disease. And they say, Hey, look at that. They present this correlational data as if it were definitive proof that debunks the consensus. So they're saying, Hey, this is cherry-picked. I mean, this is something I've seen. Routinely, routinely, we say, hey, this, this, what the research they did, it's garbage. Like this one, it does not show LDL there. But look at this. This same study design showed that saturated fat was not linked to heart disease. So, what do you say about that? You know, the answer would be like, Well, what do you say about that? Like, if you discredit one study that's epigene logic, why are you putting so much weight in the other one? And so, I see that all the time where it's just a huge disconnect. You know, it's because they've already had preconceived notions, right? Like, this is what I want to believe. So, I'm going to believe that versus, you know, it's the same level of evidence. And so, it's an internally inconsistent argument, right? The standard of evidence they demand from the mainstream is one they don't apply to their own cherry-picked kind of studies. And so, Not everybody, and then there's tons of people out there who are very academically rigorous and have integrity about this. So I'm not saying that at all, but I see that's a common argument for people saying, oh, like this and there. So this is once again, just common things. I have no problem with anybody who believes in this narrative or believes that the science shows that. Like everyone has different opinions in the world today, in 2025, I think we know that lots of people have different opinions, and I'm okay with that. But that's something I say that, hey, if you're going to be critical of these studies, then you need to be critical of your own studies as well. On top of that, another thing that I found is people talking about statin conspiracies and the power of statistical framing. So essentially, People will say that statins are dangerous, their benefits are minimal, and they're pushed by big pharma for profit is essentially what it comes down to. And by having LDL as a target, we can use pharmaceuticals to lower it. You know, making money for big pharma. And so they say a core tactic that's used is misrepresenting risk reduction. So there's something called relative risk reduction. And a lot of times studies will report that statins have reduced heart attacks by about 30%, right? So it sounds very impressive. But then relative is just like the percent change, really. It's not that big. So they'll also use something called the absolute risk reduction, where the absolute risk reduction is actually looking at the total amount of people, how much is going down. They'll say the risk from there drops from 3% to 2. 1%, making the absolute risk reduction only 0. 9%. So it sounds tiny. The argument would be then: well, they present, if they only presented this relative risk, it sounds huge. If you present only this tiny absolute risk, the question is: why would we risk side effects from medication for a benefit less than 1%? And that's actually a really valid question, right? I think it's worth pointing out that. Relative risk can sound impressive, and that's very, very important to understand that, hey, we've talked about relative risk, what is the absolute risk? So, I do agree there. We should always look for absolute risk reduction. However, a lot of times that 1% absolute risk reduction, it's what's seen in the study, right? In the studies, a lot of times a short trial, anywhere from 2 to 5E or something like that. And so, atherclirosis is a lifelong disease, and the goal of LDL reduction is to lower risk over decades. So, you take that 1% risk reduction over five years, 10 years, 20 years, 40 years. It can become a huge, huge implication of decreasing risk. So, right, it's just one percent over a couple of years, multiply that out, you're getting multiples of that risk reduction. So, that's that's one of those things where that's one of the issues that I see. Something to think about. And then it's kind of this perfect storm, right? Like all this is kind of coming up and coming up, and then we kind of have this explosion of social media, right? So social media algorithms. Uh, can produce, I would say, not a lot of differing thought is kind of all I say. Echo chambers is another way of saying that. And I mean, everyone's guilty of this, right? You scroll, and YouTube gives you what it wants, and What you want, and whether you like that or not, like it just gives you things that it thinks you're going to like and you spend time on. And so, whether something makes you happy or makes you sad, they don't care as long as you spend time on it. But this does create an ecosystem where there's these decontextualized arguments, right? You just see these videos over and over and over saying one point of view. And so they're amplified, reinforced, and then Everything all of a sudden starts to become legit, right? It looks very legit. And it's like, whoa, this is a legit alternative to the other scientific consensus. Like, mainstream's wrong, like, big pharma is trying to trap us all. And then it just becomes a vicious cycle over and over and over. And so. That's something that I've seen, and I mean, we're all guilty of it. You can just realize: like, how did I get scrolling on this? You're like, what the heck happened? And so, something to look out for, that's for sure. And so the counter argument then to that, and once again, I'm just kind of laying out the argument here, obviously, kind of kind of make clear where I stand currently. But the counter argument to that is, well, we have like the body evidence seems to point In the direction that LDL is pretty important, is kind of what it comes down to. They say the, you know, the strength of the LDL causality case comes from multiple different lines of research, right? Different high-quality evidence that all kind of point towards the same outcome. And so. The strategy, it kind of attacks dismantling the skeptics' reliance, right? So they're saying, hey, they find individual studies here and there. You know, the thing within, okay, we have a bunch of different studies from a bunch of different lines of evidence from genetics to pharmacology, all those things like. Could it actually be what's the chance of those all being wrong in the same direction? Like, oh, we're all wrong in the same direction. So, that's one thing we think about. So, the first level of evidence and kind of first line is epidemiology. And I've kind of talked about it before. We have some landmark studies. That followed massive populations for decades, right? And it kind of established a kind of dose-dependent association with a higher the LDL, the higher the future risk of heart disease. Once again, these are not perfect, and not every one of them shows that all the time, but on average, it kind of seems there. And so, the critical point is this: like What's going on here? And it's very, very important to understand. This is just a starting point, right? It's the observation that prompts the causality question: saying, hey, this trend's going on. Let's look into it. And so a lot of people stop there saying, oh, like these observational studies are worthless. And I wouldn't say they're worthless, but they're a good stepping stone to say, hey, we see this trend. What's actually going on? Another level of evidence are genetic studies, so like things like Mendelian randomization. So essentially, this studies people with genetic variants that give them either a lifelong high or low LDL. Independent of lifestyle. So, their genes have kind of already determined it, whether it's through familial hypocholsterolemia or some issue with the PCSK9 gene. We can get these phenotypes of people who have these specific. Clinical pictures, clinical situations where they have high or low LDL just based on their genetics. So they're saying pretty much what's happening is people with these genes for high LDL tend to get more aggressive early heart disease, and people with low LDL are protected from that. And so essentially what this is, this is nature's randomized trial, right? It kind of severs the link from confounding lifestyle factors and provides powerful proof of a direct causal link or understanding of that. And I know these are also not perfect as well. You can take every study and say they're not perfect, but once again, we're just looking at totality of evidence. So, kind of a cool one saying, hey, we're taking all the lifestyle stuff. We're just looking at your genes, and that's kind of very interesting to see. And then the other big group of studies we have are randomized controlled trials, right? So, interventional studies, and it's kind of the gold standard here, right? So, this is very helpful: actively intervening by lowering LDL with drugs and measuring the direct impact on heart attacks and strokes. So, this is what we're looking at. When we do something about this, what happens? And so, first studies are the statin studies. We know those. There's dozens of randomized controlled trials looking at that, and they pharmacologically lower LDL. With statins directly significantly reducing cardiovascular bands compared to placebos, right? And so some people say, well, it wasn't that impressive. Look at the absolute versus relative. And once again, just looking at directionality here, like, well, what do they point directionally? It seems like it helps that. And some people even say, well, like statins have some other effects, something called pleiotropic effects, meaning they work in other ways as well. Maybe they're anti-inflammatory, and that's the real improvement. So then they did even more studies using different medications, right? Things like azetamide, PCSK9 inhibitors. There's other additional randomized controlled trials that use different medications that also lower LDL that seem to prove and point that through entirely different biological mechanisms that we get the same benefit of decreasing heart attacks and all that stuff. So we're having the decreased Outcomes with statins, but also non-statin medications as well. And so it's very important. So this is a you know, a big, a big thing to show, right? It proves that the benefit is tied to The direct act of lowering LDL or APOB, not necessarily through other interventions or other things. So that's kind of the idea behind that. So it's kind of what we look for. And yeah, I think those are generally where we're seeing that data coming from, and like the general argument that, hey, like on total, directionally, it looks like we're heading that way. Like, it seems like it's pointing in that direction. That's where it's coming from. And yeah, that's kind of where we're at. And so. The big thing is, though, like, what if we're wrong? That's the question. Like, what if each party is wrong? That's the big thing to look at there. And it's definitely not a benign question, right? We're measuring a measurable public health outcome, right? So, if we have increased skepticism and we don't take medications, what happens? Well, there definitely can be consequences of this, right? So, there are real-world studies showing that they looked at a group of people who discontinue their medication. Versus the other one who kind of continued on. The people who discontinued their medications consistently had a high risk of heart attacks, strokes, death from any causes, also. This data kind of transformed the cost of like being wrong from just like this concept to actually something quantifiable and hard, right? So that's the question I have, people. And once again, I really don't have a horse in this race. I'm just kind of putting out the information that I've seen and kind of go from there. The question is: what if you're wrong, right? So, if you believe that LDL does not matter and you're wrong. And you have a high life accumulation of LDL, that could be a really, really big and big problem. The other end is, well, what if you're wrong? What if you think LDL lowering is beneficial? It turns out it's not. Then you just probably run a medication for a long time. And, you know, there can always be side effects to medications, absolutely. But I wouldn't expect to see the mortality, heart attacks, strokes, like big, big, big bad outcomes that we would see at the other camp. And so the question is: like, how does that balance, right? Like, Are you willing to risk A for B? Like, are you willing to risk these potential side effects because you believe this viewpoint? And that's literally every decision we make in our lives. I'm not trying to sound scary, but the idea is every time we take a medication, anytime we do A workout program. Anytime we do a diet, whatever it is, you're making a choice of like, hey, I think this is worth it versus these side effects or risks. And so that's something to think about. But yeah, so we always want to risk think about what's going on in the future. And kind of you can contrast the likely future of a high-risk patient who adheres to treatment versus one who rejects it. And that's kind of the cost in terms of lost years, moments or time with family, all those big things. And so it's a lot when you think about it. It sounds so it's almost a Kind of a collective gamble, right? So that's kind of what we're thinking about. So a widespread rejection of the standard of care could potentially lead to more issues down the line. That's that's what I'm my biggest fear is that people Are you doing something because they saw it online, not because they truly understand it and they haven't really thought about potential risks? If you're like Jordan, I don't care. Like, I feel great on this diet and I won't change and I won't do anything. More power to you. That's great. As long as you have. You know, understanding of that, and you could you said, like, you've been counseled that this could happen. I'm fine with that. And so, really, bringing it home here, I just want to talk about how do we kind of make sense of this? How do we navigate the noise, kind of protecting your health? And so. Overall, we talked about where this comes from, right? So there's confusion of LDL and whatnot. And it seems like it's a very, very big argument everywhere. It doesn't quite get up to the mainstream level, but it is because we see Social media has become mainstream. So, anything that's valid on social media thus has to be addressed by the medical establishment. And that's essentially one of the reasons I do this podcast is to kind of bridge that gap between what I see online. Versus what I see in clinic and what I've learned, and kind of find where do we all agree? You know, the big thing is, everyone always agrees. Like, people want a high-quality life, they want to live well, they want to move well, they want to feel well. They want to do all these things. And so we all can agree on that. We're just having different opinions of how we get there. And so that's kind of where we're at. So I do want to always provide a framework for kind of how we evaluate health information. The first things first is, you know, where is this coming from, right? So who's the source? And once again, this is not to gatekeep and say people who aren't, you know, cardiologists, lipidologists, have no information. No, that's not the case. Like, obviously. I'm just a dude who likes this stuff. I'm kind of in nerd out about lipidology. I think it's fun and I have an interest in this, but like I wouldn't call myself an expert by any means. And so I shouldn't be the final word for you by any means. You should be, you know, getting additional cooperation as well. But you know, is there someone who has a general understanding of what's going on in terms of have they done a lot of research on cardiovascular health, cardiovascular disease? Have they taken care of patients who've done this? That's another big thing. A lot of people can spout information, but if they've never actually taken care of someone, have no real, no real responsibility for someone, that's a whole different thing, right? When I have to be held accountable for what I do, that's a whole big thing. One skin doesn't have to be an expert in the field, but at least be talking about it. You know, I see people who are talking very confidently, very, very confidently about statin medications. Who don't really have a significant background in science. And once again, not trying to gatekeep, but it's like if you don't understand at least the base understanding of physiology of it, then it's going to be hard to really, truly understand this and go from there. But that's neither here nor there. Also, if anyone ties to a specific supplement they're selling you on, right? So, hey, like this is a thing. They're wrong. So, this is what should be. And then they scare you into consuming something or buying something. That's always questionable as well. This one, usually it's not. I'll be honest with you. People are just saying, Hey, eat this diet. And they say, You don't do anything. So that's not necessarily a conflict of interest, but you should always be aware of that as well. And then a kind of a thought experiment I like to do is, in my head, I ask, what's more likely? What's more likely? Is it more likely that a group of online personalities Are correct, and that the entire every major medical and scientific body on the planet and tens of thousands of scientists who have dedicated their entire lives to this, that they're all wrong, and this group of people are right. What's more likely? Once again, I'm not saying that can't be the case. That absolutely could be the case. Pretty much any major scientific revolution has happened there. The germ theory. People were laughing, he was laughed out of there saying, like, no, that's not the case. Like, German cause. So, like, I'm not saying that's not the case, but I'm just saying, with good, good evidence that we have, like, the current Encounters that we have. We have lots and lots of literature and multiple avenues of studies and different types of studies. We're in a very, very different place than when we were hundreds of years ago when people were laughing and saying, oh, like, no, it's It's humors and whatnot. Like, we just have a whole different level of data there. So, like, today, every single person who studied this for their lifetime, are they wrong? And some other random person online is right. You know, that's not for me to decide. And once again, kind of taking away, the consensus could absolutely be wrong, right? A consensus of this magnitude, though, it definitely exists a large amount of Data on the other side. And that's the big thing that we're looking for. And it's just not quite there yet. And so I'm open to this. I will tell people: like, honestly, I used to be in this camp. I used to be, you know, before medical school. Did the paleo diet, right? Or, you know, a low-carb diet, and you were, they said, eat bacon, eat butter, it doesn't matter. And I, that's awesome. It's funny to hear because it's like, yeah, this is delicious. It's fun. And I thought saturated fat didn't matter at all. So I've been there. And then as I started kind of the medical process. Um, learned to kind of critically review literature and look at the studies and whatnot. I just felt like, hey, for me, the risk is more like, what if I ignore this? Like, to me, the risk is higher than if I just. Stick the other way. That's kind of my personal preference. And the thing I always think about is: people say, hey, it's not LDL, it's inflammation. It's inflammation, it's insulin resistance. Like, that's the case. Okay, maybe that is the case. Maybe that is the case that those two things play a huge role in startup. All I know though is that for heart disease, what causes it? It is endothelial damage, so disruption to your blood vessels, inflammation, absolutely, and some sort of fuel, right? So LDL or APOB particles. Like it's those three things, like. And you cannot take them apart. Like, that's the thing that people are doing today. They're saying, hey, LDL doesn't matter as long as the other two are locked in. Like, show me that. Show me studies of people who've been able to do that, that you just take that away, and then nothing happened. Like, we don't have that yet. That's the big thing for me. It's like, you're just banking on the idea that, oh, yeah, this makes sense intuitively and it should be fine. And we do know that insulin resistance is really bad. We know that. We know that inflammation is bad for heart disease. But to say that LVL doesn't matter, what you're saying is essentially in a fire scenario, like the Tinder, you're just like lighting sparks next to a huge pile of Tinder. Which is your LDL, and you're saying, Oh, like, I'm good. The sparks never get there. And then all of a sudden, wind blows, spark carries over, starts a fire. And so, what I'm saying is, life happens, and it's very hard to control everything, whether it's stress, whether it's your genetics. Whether you get an illness, something happens in your life that leads to stress and leads to inflammation, it's hard to do, you know, other pollutants or exposures, all those things. I just don't think you can control that. That's my biggest thing. I don't feel like I can confidently control every single thing in my life that can guarantee I won't have cardiovascular disease. And so that's kind of where I sit. And that's once again, the risk. The equation for me was: hey, I'm more comfortable controlling every risk factor. Do I think blood sugar is important? Yeah. Do I think inflammation is important? Absolutely. Do I think LDL is important? I do. And so I want to improve all those things, right? And it's blood pressures. What's all those things together? For me, why wouldn't we want to kind of bring those down? And so, for me as well, and I keep saying for me, for me, but once again, this is just a kind of where I think about things. If I think about Where we are in society today, right? Like we've had hundreds of years of scientific advancement. So it's not this question of either or, like, oh, you are big pharma versus I'm all natural. And they're trying to get you, like, why can't we mesh the two? I think there's some really, really good things to people who eat like low-carb diets and all that stuff. I think it's wonderful in terms of like, it's hard to eat really a garbage food, right? You know, although keto has done a Good job of making keto-friendly foods that are just garbage as well. But a lot of times, these people are eating super, you know, minimally processed whole food diets. That's wonderful. That's great. We have that. But then we just completely forget that, like, medicine exists and we found things, right? So it's one of those things where why not use both if we can control every risk factor, if we know that LDL or those things make up the plaque, right? We know the cholesterol makes up the plaque. Why can't we just turn down all the levers, right? So, maybe you like eating in this specific dietary pattern, but maybe we need to take a medication to control our risk factors. Once again, if you don't want to do that, that's totally fine as well. I respect that. It's one of those things where. Everyone can make their own decision. You're an autonomous adult. I'm okay with that. And I do believe, like, everyone listening to this, I believe you are a human who is worthy of respect. Uh, and love, and like you are intrinsically valuable. I believe that. So, I don't want to hear the wars of people saying, like, oh, there's some, I've heard people say, like, I won't take care of people who eat this way. I mean. Just the other day, I saw someone who was carnivore and it was, you know, doing great, lost like 80 pounds, doing like reverse diabetes, like blood pressure is normal. Everything is wonderful, wonderful. But his LDL is through the roof, right? And the problem is he has, you know, 50% stenosis already on a heart scan, and we know that. We know that. And there's pretty good data showing that when we have higher levels of that stuff and plaque already existing, that that plaque will continue to grow. And I worry that we had a good conversation. We talked about things. And at the end of the day, A lot of times, people come into my office already with a decision made, and my job is to kind of just work with them the best that we can. And if I, you know, all I want to be is a pebble in someone's shoe today. I don't expect anyone's going to come to this and listen to this and be like, Oh man, that guy totally convinced me. That random dude on the internet convinced me. No, that's not how the internet works. You're gonna, it takes time, it takes hours and hours and hours and lots of repetition hearing things. All I want to be is a pebble in your shoe to think: like, hey, what if What if I'm wrong in this situation? And for me, like, I've definitely thought about that a lot. Like, what if I'm wrong? That's a big question. And I, you know, would I like that? No, of course I would not. You know, do I think I'm doing something dangerous by my current approach? Like, I don't think that's the case. Like, for me, And I say, I come from a different approach, right? I'm a doctor. My first thing is first, do no harm, right? So, if there's a chance that somehow you know I'm wrong and it leads to lots of issues down the line, then I have to live with that. And that's other people who have to live with that. And I hurt other people. So, that's a big thing for me. And so, yeah, I'm probably going to be a little more cautious because that's kind of my personality and that's like the job I've taken and what I do. So, that's kind of how I think about it. But I've been rambling these last probably 10 minutes. I apologize about that. But it's just very, very important and it means a lot to me because. I see people come in not quite understanding, or I've heard the whole story. And I just want to have the story of understanding of both sides. Hopefully, I was relatively unbiased. Obviously, we know my. Perspective is a little bit, but I understand that once again, if you come in and we can have a civil conversation on this, like I will never, I'm not going to harp on you for if this is how you feel, and that's fine. I'll probably continue to talk and ask questions and try to. Figure out where you're coming from. But yeah, you're a human and you're important. And yeah, I care about you and I want you the best for you. That's what it is. But if you are doing this, I'm not your doctor. Listen to your doctor for health advice, right? The internet's for information. Your doctor is where you make the decision, right? So all personal risk. All these things. It's a multifaceted choice, right? Work with your doctor to make a specific treatment that works for you, right? There's going to be potential risks, potential benefits. Use all that stuff, use your knowledge to ask better questions, have informed conversations, and kind of work together as a team. I think that's the big thing. Um, that's really gonna be it for today, though. I really appreciate you listening to the end and made it through that. It means the world to me. And if you like this, it would mean the world if you share this with a friend, or if you liked it on YouTube, or yeah, just Share it around on social media. That'd be wonderful. I'm just so we can get this out. I think it's an important message for people to hear. But that's going to be it for today. Now, get up your phone, get outside, have a great rest of your day. We'll see you next time. Disclaimer: This podcast is for entertainment, education, and informational purposes only. The topics discussed should not solely be used to diagnose, treat, or prevent any condition. The information presented here was created with an evidence-based approach, but please keep in mind that science is always changing, and at the time of listening to this, there may be some new data that makes this information incomplete or inaccurate. Always seek the advice of your personal physician or qualified healthcare provider for questions regarding any medical condition.
