Post
by VanCanada » Sun Sep 09, 2012 2:37 pm
Dr. Thomas Dayspring interview by Jimmy Moore on 'Livin' La Vida Low Carb' podcast #585
Podcast notes by VanCanada of Vancouver, Canada (Part 1 of 2)
Minute 3: Dr. Dayspring did his medical residency in the 1970's.
Minute 4:
--> He (Dr. Dayspring) has given over four thousand talks "trying to bring health care professionals up to par on the radically changing science of lipidology".
--> His talks have been given in all fifty states and several countries around the world.
--> He was awarded the highest honor of his life by the National Lipid Association with their 2011 President's Award, given to one person per year for contributions to clinical lipidology. "It's kind of amazing a real world lipidologist wound up there."
Minute 5:'
--> The science of lipidology has so radically changed. "What most doctors were taught in their training (in) medical school, even up until recently, is pretty much dead wrong."
Minute 11:
--> "The sine qua non for atherosclerosis is you have to have sterols in your artery wall. If you do not, you do not have this disease, you cannot die of this disease, you cannot have any morbidity to this disease. So, cholesterol is the killer, but ONLY if it's in your artery wall."
--> Cholesterol is necessary for life.
--> The cholesterol in our blood doesn't kill us, only the cholesterol in the artery walls.
--> There is no correlation between the cholesterol in our blood and the cholesterol in our artery walls.
Minute 14:
--> The only way lipids (cholesterol, fatty acids, and triglycerides) are trafficked in plasma are as passengers in protein wrapped vehicles called lipoproteins.
--> To make lipids soluble they are wrapped with proteins called apo-lipoproteins. "The whole protein wrapped fat ball is called a lipoprotein".
Minute 15:
--> People with a normal number of lipoproteins (a number that can be cleared by either the liver or the intestines) remain healthy and don't get atherosclerosis. If one has a greater number of a certain lipoprotein than can be cleared by the intestines or liver, then that lipoprotein will crash the artery wall and create plaque there. A lipoprotein that crashes the arterial wall is called an atherogenic lipoprotein. It is like a dump truck in Dr. Dayspring's home state of New Jersey that's called an 'illegal dumper'.
Minute 16:
--> You can't get heart disease if the lipoproteins don't crash the artery wall. It doesn't matter how much cholesterol the lipoproteins are carrying.
--> A high total cholesterol may not be good, but if the cholesterol doesn't enter the artery wall you're not at risk for heart disease. A high number of LDL particles is a bad sign, a sign of atherogenesis. A low number of HDL is also a bad sign.
Minute 17:
--> In medicine it had just been assumed that the amount of cholesterol (HDL, LDL and LDL subtypes) was a predictor of the number of lipoprotein particles. "But there is very little truth to that". In some people they correspond to one another, in other people they do not. Where they do not they are called "discordant". The cholesterol amount and the lipoprotein particle number are not correlated; they are not predictive. "You can have a high cholesterol level and normal particle number (which would be a low risk) [edit: and which often leads to unnecessary use of statins {like a false positive diagnosis?}]. Or a normal cholesterol level and nightmare particle number, in which case you are at risk for heart disease" [edit: like a false negative diagnosis?]. Everything comes down to management of lipoprotein particle number.
Minute 18:
--> Why do we use statins? "Statins upregulate a protein in the liver that grabs these atherogenic particles and pulls them back into the liver. Of course we would rather those particles go back to the liver for catabolism than enter the artery wall. Of course the total cholesterol will go down, BUT the key question is "Did the statin drug remove the proper number of LDL particles?" If it did, the statin saved your life. If the statin removed enough particles to lower your LDL cholesterol amount but there is still an excessive number left behind, those are the people that get events on statin therapy."
--> "This is why clinicians, when they follow at risk people, would do a MUCH better job if they were counting particles rather than assaying how much cholesterol is collectively in those particles."