#19 - Dave Feldman: stress testing the lipid energy model
The Peter Attia Drive - A podcast by Peter Attia, MD - Mondays
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 More Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.