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

ℹ️ EPISODE INFO

Released

January 1, 2020

Duration

3h 10m

Channel

Peter Attia MD

Watch on YouTube

▶ Open ↗

📝 EPISODE DESCRIPTION

Original release date: 10/8/2018 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. Note: this podcast gets technical at times and refers to many visuals during the discussion. The graphics, figures, and tables alluded to are provided in the show notes. In addition, there is commentary by Thomas Dayspring, M.D., in the show notes, providing corrections, clarifications, and amplification. Dave Feldman provided many graphics and some additional comments that are included in the show notes. We discuss: -Peter’s synthesis of Dave’s energy model [5:00]; -Dave’s lipid energy model; -Dave’s inversion pattern experiments; -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 a 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 Show notes page: https://peterattiamd.com/davefeldman/ For the transcript of this episode where there is more commentary from Tom Dayspring: https://peterattiamd.com/davefeldmantranscript/ About: The Peter Attia Drive is a weekly, ultra-deep-dive podcast focusing on maximizing health, longevity, critical thinking…and a few other things. With over 10 million episodes downloaded, it features topics including fasting, ketosis, Alzheimer’s disease, cancer, mental health, and much more. Peter is the founder of Attia Medical, PC, a medical practice with offices in San Diego and New York City, focusing on the applied science of longevity. The practice applies nutritional biochemistry, exercise physiology, sleep physiology, techniques to increase distress tolerance, lipidology, pharmacology, and four-system endocrinology to increase lifespan (delaying the onset of chronic disease), while simultaneously improving healthspan (quality of life). Learn more: https://peterattiamd.com/ Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on: Facebook: http://bit.ly/PeterAttiaMDFB Twitter: http://bit.ly/PeterAttiaMDTW Instagram: http://bit.ly/PeterAttiaMDIG Subscribe to The Drive: Apple Podcast: http://bit.ly/TheDriveApplePodcasts Overcast: http://bit.ly/TheDriveOvercast Spotify: http://bit.ly/TheDriveSpotify Google Play: http://bit.ly/TheDriveGooglePlay

🎤 SPEAKERS

• Peter Attia

  host

  Physician and host of The Peter Attia Drive, focused on longevity and metabolic health.

• Dave Feldman

  guest

  Independent researcher and creator of the Lipid Energy Model and the “lean mass hyper-responder” concept (cholesterolcode.com).

🧾 EPISODE SUMMARY

In this episode of Peter Attia MD, featuring Peter Attia and Dave Feldman, #19 – Dave Feldman: stress testing the lipid energy model explores peter Attia and Dave Feldman Clash Over LDL and Energy Feldman explains his energy model and the 'lean mass hyper-responder' pattern of LDL-C of 200 or higher, HDL-C of 80 or higher and triglycerides of 70 or lower, arguing it may not be atherogenic.

🔗 RELATED EPISODES

409 ‒ Inside modern drug development: the science, economics, and regulatory hurdles

#117 – Stanley Perlman, M.D., Ph.D.: Insights from a coronavirus expert on COVID-19

#150-Senator Bill Frist, MD: A modern Renaissance man's journey through science, politics & business

#130 - Carol Tavris, Ph.D. & Elliot Aronson, Ph.D.: Recognizing and overcoming cognitive dissonance

#96–David Epstein: How range of experience leads to better performance in a highly specialized world

#125 - John Arnold: The most prolific philanthropist you may not have heard of