Exercising and losing weight

[Lala81]

Don't think this kids programme ever reached here. 

This kids show character is called Sportacus. It has a very interesting story behind it. The actor is now almost 60 and is insanely fit. 

 

[Ender]

Should we aggressively target below 120/80 for BP, i.e via medication? The old Sprint study says so, but a new Cochrane study, suggest no benefit after reaching below 140/90. But take note, speaker say the new Cochrane study evidence are not conclusive yet, and more studies are needed.

 

From Grok 3.0

Review and Key Points

The document is a transcript of a video discussing blood pressure treatment targets, focusing on the 2015 SPRINT trial and a 2022 Cochrane Review. The speaker critiques claims made by Dr. Boz, an internal medicine physician, in her video titled "The Great High Blood Pressure Scam," which challenges the SPRINT trial's findings. Below are the key points, organized by theme:

Background on Blood Pressure and Studies

• SPRINT Trial (2015): Suggested that lowering systolic blood pressure below 120 mmHg (compared to 140 mmHg) reduces cardiovascular risk in patients with cardiovascular disease.
• Cochrane Review (2022): Analyzed seven randomized controlled trials (RCTs), including SPRINT, with ~9,600 participants, comparing lower blood pressure targets (<135/85 mmHg) to standard targets (140-160/90-100 mmHg).
• Dr. Boz’s Claim: Argues that aggressively lowering blood pressure may not provide significant benefits and could lead to adverse events, labeling it a potential "scam."

Key Findings from Cochrane Review

• Mortality and Cardiovascular Outcomes:
  • No significant reduction in total mortality or cardiovascular mortality with lower blood pressure targets (relative risk ~1.05, confidence intervals overlapping 1).
  • Cardiovascular events (heart attacks, strokes, etc.) showed a borderline significant reduction (p=0.05), but not conclusive.
• Adverse Events: More withdrawals due to adverse events in the lower blood pressure group, likely due to increased medication use.
• Study Limitations:
  • Only 64% of participants in the intensive treatment group achieved the lower target, potentially skewing results.
  • Small effect size (5 mmHg difference between groups) and short trial durations (~3.5 years) limit the ability to detect long-term effects.
  • Subgroup analysis with a larger blood pressure difference (≥10 mmHg) had a smaller sample size, reducing statistical power.

Biases in Studies

• Pharmaceutical Bias: Two trials (HOT and AASK) had pharmaceutical industry funding, raising potential bias concerns.
• Early Termination Bias: The SPRINT trial was stopped early due to perceived significant results, introducing bias but justified by ethical concerns.
• Lack of Placebo: Ethical constraints prevented placebo-controlled trials, as withholding treatment for cardiovascular disease is unethical.

Relative vs. Absolute Risk

• Dr. Boz highlights the difference between relative risk (e.g., 26% increased risk) and absolute risk (e.g., 0.08% increase), using a breast cancer example to argue that relative risk can exaggerate perceived dangers.
• The speaker agrees but cautions that focusing solely on absolute risk can be misleading, as it may appear small in short-term studies but grow over time.

Ongoing Research

• The Cochrane Review noted that results are not conclusive, and additional trials are ongoing.
• The speaker references updated results (as of early 2025): two trials showed benefits in cardiovascular events with lower blood pressure, one showed no effect, and three are ongoing.

Speaker’s Main Argument

• The Cochrane Review suggests no clear benefit to lowering blood pressure below 140/90 mmHg for mortality or cardiovascular events, but the data is not definitive.
• Cardiovascular events showed a near-significant benefit, suggesting potential value in lower targets if supported by further research.
• Non-pharmacological methods to lower blood pressure are recommended as a prudent approach pending more data.

Fact-Checking

• SPRINT Trial Findings:
  • Accurate: The SPRINT trial (2015) found that targeting systolic blood pressure <120 mmHg reduced cardiovascular events compared to <140 mmHg in high-risk patients. (Source: NEJM, 2015, DOI: 10.1056/NEJMoa1511939)
  • The speaker correctly notes its early termination due to ethical concerns, as the benefit was deemed significant.
• Cochrane Review (2022):
  • Accurate: The Cochrane Review (DOI: 10.1002/14651858.CD010315.pub3) found no significant reduction in total or cardiovascular mortality with lower blood pressure targets. Cardiovascular events showed a borderline effect (RR 0.86, 95% CI 0.74-1.00, p=0.05).
  • The review highlighted adverse events and withdrawals in the intensive group, consistent with the transcript.
• Relative vs. Absolute Risk:
  • Accurate: Dr. Boz’s explanation aligns with statistical principles. Relative risk can amplify perceived effects, while absolute risk provides context. For example, a 30% relative risk increase may translate to a small absolute risk (e.g., 0.08% as in the breast cancer example).
  • The speaker’s caution about absolute risk growing over time is valid, as chronic diseases like cardiovascular disease manifest over decades.
• Bias Claims:
  • Accurate: The Cochrane Review noted potential biases, including pharmaceutical funding in some trials and early termination in SPRINT. The speaker correctly clarifies that bias assessments (e.g., ROB 2) evaluate potential bias, not actual bias.
• Ongoing Trials:
  • Partially verifiable: The speaker mentions three ongoing trials and three with results (two showing benefits, one showing no effect). Without specific citations, this cannot be fully verified, but it aligns with the Cochrane Review’s mention of ongoing studies.
• Adverse Events and Withdrawals:
  • Accurate: The Cochrane Review reported higher withdrawals in the intensive treatment group due to adverse events, likely from increased medication use.

Conclusion

The speaker provides a balanced critique of Dr. Boz’s video, acknowledging her valid points while highlighting oversights and the need for context. The Cochrane Review suggests that aggressively lowering blood pressure below 140/90 mmHg may not significantly reduce mortality or cardiovascular events, but the near-significant reduction in cardiovascular events (p=0.05) and ongoing trials indicate that definitive conclusions are premature. Non-pharmacological approaches to blood pressure management are a sensible recommendation until more data is available.

The lack of mortality benefit may reflect the short duration of trials and the high threshold for mortality endpoints, as the speaker notes. The discussion on relative vs. absolute risk is crucial, as both metrics are necessary for informed decision-making. Dr. Boz’s provocative framing ("scam") risks oversimplifying a complex issue, potentially discouraging patients from managing hypertension, which remains a major risk factor for cardiovascular disease.

Comments on the Speaker and Dr. Boz

• Speaker:
  • Strengths: The speaker demonstrates a strong understanding of study design, statistical concepts (e.g., relative vs. absolute risk, confidence intervals), and the limitations of the Cochrane Review. They provide a nuanced perspective, correcting Dr. Boz’s missteps (e.g., misinterpreting confidence intervals) while acknowledging her valid points. The emphasis on ongoing research and non-pharmacological approaches is evidence-based and patient-centered.
  • Weaknesses: The speaker’s speculative comment about new trials potentially reaching statistical significance lacks concrete data. The video’s length and promise of an "extended version" may frustrate viewers seeking concise conclusions.
• Dr. Boz:
  • Strengths: Dr. Boz effectively communicates the importance of questioning aggressive blood pressure targets and highlights the Cochrane Review’s findings. Her discussion of relative vs. absolute risk is accurate and accessible, making complex statistical concepts understandable to a lay audience.
  • Weaknesses: The sensational title "The Great High Blood Pressure Scam" risks misleading viewers by implying deliberate deception, which is not supported by evidence. Her misinterpretation of confidence intervals (e.g., suggesting a relative risk crossing 1 indicates "guessing") and minor factual errors (e.g., 14/10,000 vs. 14/1,000) undermine credibility. Additionally, her low-carb advocacy may introduce bias, though it’s not directly relevant here.

 

Final Takeaway

The evidence suggests that lowering blood pressure below 140/90 mmHg may not yet have proven benefits for mortality or cardiovascular events, but the data is inconclusive, particularly for cardiovascular events. Patients should continue managing hypertension, ideally through lifestyle changes, while awaiting further research. Both the speaker and Dr. Boz contribute valuable perspectives, but the speaker’s analysis is more rigorous and less sensationalized.

Edited April 17, 2025 by Ender

[Lala81]

On 4/17/2025 at 6:42 PM, Ender said:

Should we aggressively target below 120/80 for BP, i.e via medication? The old Sprint study says so, but a new Cochrane study, suggest no benefit after reaching below 140/90. But take note, speaker say the new Cochrane study evidence are not conclusive yet, and more studies are needed.

 

From Grok 3.0

Review and Key Points

The document is a transcript of a video discussing blood pressure treatment targets, focusing on the 2015 SPRINT trial and a 2022 Cochrane Review. The speaker critiques claims made by Dr. Boz, an internal medicine physician, in her video titled "The Great High Blood Pressure Scam," which challenges the SPRINT trial's findings. Below are the key points, organized by theme:

Background on Blood Pressure and Studies

• SPRINT Trial (2015): Suggested that lowering systolic blood pressure below 120 mmHg (compared to 140 mmHg) reduces cardiovascular risk in patients with cardiovascular disease.
• Cochrane Review (2022): Analyzed seven randomized controlled trials (RCTs), including SPRINT, with ~9,600 participants, comparing lower blood pressure targets (<135/85 mmHg) to standard targets (140-160/90-100 mmHg).
• Dr. Boz’s Claim: Argues that aggressively lowering blood pressure may not provide significant benefits and could lead to adverse events, labeling it a potential "scam."

Key Findings from Cochrane Review

• Mortality and Cardiovascular Outcomes:
  • No significant reduction in total mortality or cardiovascular mortality with lower blood pressure targets (relative risk ~1.05, confidence intervals overlapping 1).
  • Cardiovascular events (heart attacks, strokes, etc.) showed a borderline significant reduction (p=0.05), but not conclusive.
• Adverse Events: More withdrawals due to adverse events in the lower blood pressure group, likely due to increased medication use.
• Study Limitations:
  • Only 64% of participants in the intensive treatment group achieved the lower target, potentially skewing results.
  • Small effect size (5 mmHg difference between groups) and short trial durations (~3.5 years) limit the ability to detect long-term effects.
  • Subgroup analysis with a larger blood pressure difference (≥10 mmHg) had a smaller sample size, reducing statistical power.

Biases in Studies

• Pharmaceutical Bias: Two trials (HOT and AASK) had pharmaceutical industry funding, raising potential bias concerns.
• Early Termination Bias: The SPRINT trial was stopped early due to perceived significant results, introducing bias but justified by ethical concerns.
• Lack of Placebo: Ethical constraints prevented placebo-controlled trials, as withholding treatment for cardiovascular disease is unethical.

Relative vs. Absolute Risk

• Dr. Boz highlights the difference between relative risk (e.g., 26% increased risk) and absolute risk (e.g., 0.08% increase), using a breast cancer example to argue that relative risk can exaggerate perceived dangers.
• The speaker agrees but cautions that focusing solely on absolute risk can be misleading, as it may appear small in short-term studies but grow over time.

Ongoing Research

• The Cochrane Review noted that results are not conclusive, and additional trials are ongoing.
• The speaker references updated results (as of early 2025): two trials showed benefits in cardiovascular events with lower blood pressure, one showed no effect, and three are ongoing.

Speaker’s Main Argument

• The Cochrane Review suggests no clear benefit to lowering blood pressure below 140/90 mmHg for mortality or cardiovascular events, but the data is not definitive.
• Cardiovascular events showed a near-significant benefit, suggesting potential value in lower targets if supported by further research.
• Non-pharmacological methods to lower blood pressure are recommended as a prudent approach pending more data.

Fact-Checking

• SPRINT Trial Findings:
  • Accurate: The SPRINT trial (2015) found that targeting systolic blood pressure <120 mmHg reduced cardiovascular events compared to <140 mmHg in high-risk patients. (Source: NEJM, 2015, DOI: 10.1056/NEJMoa1511939)
  • The speaker correctly notes its early termination due to ethical concerns, as the benefit was deemed significant.
• Cochrane Review (2022):
  • Accurate: The Cochrane Review (DOI: 10.1002/14651858.CD010315.pub3) found no significant reduction in total or cardiovascular mortality with lower blood pressure targets. Cardiovascular events showed a borderline effect (RR 0.86, 95% CI 0.74-1.00, p=0.05).
  • The review highlighted adverse events and withdrawals in the intensive group, consistent with the transcript.
• Relative vs. Absolute Risk:
  • Accurate: Dr. Boz’s explanation aligns with statistical principles. Relative risk can amplify perceived effects, while absolute risk provides context. For example, a 30% relative risk increase may translate to a small absolute risk (e.g., 0.08% as in the breast cancer example).
  • The speaker’s caution about absolute risk growing over time is valid, as chronic diseases like cardiovascular disease manifest over decades.
• Bias Claims:
  • Accurate: The Cochrane Review noted potential biases, including pharmaceutical funding in some trials and early termination in SPRINT. The speaker correctly clarifies that bias assessments (e.g., ROB 2) evaluate potential bias, not actual bias.
• Ongoing Trials:
  • Partially verifiable: The speaker mentions three ongoing trials and three with results (two showing benefits, one showing no effect). Without specific citations, this cannot be fully verified, but it aligns with the Cochrane Review’s mention of ongoing studies.
• Adverse Events and Withdrawals:
  • Accurate: The Cochrane Review reported higher withdrawals in the intensive treatment group due to adverse events, likely from increased medication use.

Conclusion

The speaker provides a balanced critique of Dr. Boz’s video, acknowledging her valid points while highlighting oversights and the need for context. The Cochrane Review suggests that aggressively lowering blood pressure below 140/90 mmHg may not significantly reduce mortality or cardiovascular events, but the near-significant reduction in cardiovascular events (p=0.05) and ongoing trials indicate that definitive conclusions are premature. Non-pharmacological approaches to blood pressure management are a sensible recommendation until more data is available.

The lack of mortality benefit may reflect the short duration of trials and the high threshold for mortality endpoints, as the speaker notes. The discussion on relative vs. absolute risk is crucial, as both metrics are necessary for informed decision-making. Dr. Boz’s provocative framing ("scam") risks oversimplifying a complex issue, potentially discouraging patients from managing hypertension, which remains a major risk factor for cardiovascular disease.

Comments on the Speaker and Dr. Boz

• Speaker:
  • Strengths: The speaker demonstrates a strong understanding of study design, statistical concepts (e.g., relative vs. absolute risk, confidence intervals), and the limitations of the Cochrane Review. They provide a nuanced perspective, correcting Dr. Boz’s missteps (e.g., misinterpreting confidence intervals) while acknowledging her valid points. The emphasis on ongoing research and non-pharmacological approaches is evidence-based and patient-centered.
  • Weaknesses: The speaker’s speculative comment about new trials potentially reaching statistical significance lacks concrete data. The video’s length and promise of an "extended version" may frustrate viewers seeking concise conclusions.
• Dr. Boz:
  • Strengths: Dr. Boz effectively communicates the importance of questioning aggressive blood pressure targets and highlights the Cochrane Review’s findings. Her discussion of relative vs. absolute risk is accurate and accessible, making complex statistical concepts understandable to a lay audience.
  • Weaknesses: The sensational title "The Great High Blood Pressure Scam" risks misleading viewers by implying deliberate deception, which is not supported by evidence. Her misinterpretation of confidence intervals (e.g., suggesting a relative risk crossing 1 indicates "guessing") and minor factual errors (e.g., 14/10,000 vs. 14/1,000) undermine credibility. Additionally, her low-carb advocacy may introduce bias, though it’s not directly relevant here.

 

Final Takeaway

The evidence suggests that lowering blood pressure below 140/90 mmHg may not yet have proven benefits for mortality or cardiovascular events, but the data is inconclusive, particularly for cardiovascular events. Patients should continue managing hypertension, ideally through lifestyle changes, while awaiting further research. Both the speaker and Dr. Boz contribute valuable perspectives, but the speaker’s analysis is more rigorous and less sensationalized.

i would lower to <130/85 if possible for all patients. But it's very patient dependent. 

For major illnesses, the specialists often try for around 110-120mmhg. 

I doubt you will encounter problems with overmedication if you don't push to below <110mmhg. 

 

Edited April 17, 2025 by Lala81

[Ender]

Didn't know this is a real thing.  Why runners don't get it?

 

https://www.facebook.com/reel/1049594790386537

Edited April 17, 2025 by Ender

[Atonchia]

On 4/18/2025 at 5:05 AM, Ender said:

Didn't know this is a real thing.  Why runners don't get it?

 

https://www.facebook.com/reel/1049594790386537

Look more like muscle trembling when reaching point of fatigue. 

Same like doing rock wall climbing then holding position, with weight on one of the foot.... usually the calf will start to tremble if stayed too long in the position.

[Sosaria]

On 4/18/2025 at 5:05 AM, Ender said:

Didn't know this is a real thing.  Why runners don't get it?

 

https://www.facebook.com/reel/1049594790386537

Arnold talked about this, in the documentary "Pumping Iron"

 

[Ender]

Recently a new study on LMHR subgroup people (High LDL, Low Trig, High HDL), that caught media attention, it seems the take away is that among these individuals known as LMHR, high cholesterol and APoB aren't a predictor for heart disease. But this YouTube doctor break it down and suggest how the authors of the study may have downplayed their certain crucial findings to media. Almost to the point borders on ethics. Why they are so eager to portray these sub group of individuals are not susceptible to high cholesterol and APoB?

 

 

Used Claude 3.7 Sonnet Thinking model (via Perplexity). need to use advance mode for this as it need to do deep search.

Analysis of Ketogenic Diet and Heart Disease Study Video

Key Points from the Transcript

The video analyzes a controversial study examining the effects of ketogenic diets on heart health in people who developed very high LDL cholesterol levels. The main points include:

• The study followed 100 participants on ketogenic diets with very high LDL cholesterol (average 250 mg/dL) but no other major risk factors like diabetes or hypertension1
• The primary outcome measured was change in soft plaque volume in coronary arteries over one year using CT angiography
• Visual data showed approximately 90-95% of participants had some degree of plaque progression during the study period
• The study found no significant association between the level of LDL/ApoB exposure and plaque progression rates
• Baseline plaque burden was identified as the strongest predictor of future plaque progression35
• There were significant discrepancies between the data visualizations (showing widespread plaque progression) and text descriptions (claiming "most participants presented with stable soft plaque")
• The speaker identified methodological issues, including lack of a control group and potential underpowering for some analyses

Fact Checking

• Accurate statements:
  • The study design, inclusion criteria, and participant characteristics match what's described in the published papers
  • The finding that baseline plaque burden predicted progression is confirmed in the published abstracts
  • The lack of association between LDL-C/ApoB and plaque progression is stated in the official publications
  • The controversy over missing primary outcome data is acknowledged by Dr. Budoff in the interview
• Discrepancies or unverifiable claims:
  • The specific comparison to the "nature-CT" study showing 3.8x faster progression in keto participants isn't verifiable in the provided search results
  • The exact median increase of 18.8 mm³ in soft plaque mentioned by the speaker isn't directly confirmed in the provided study abstracts, though Dr. Budoff acknowledges this figure was shared by the first author

Analysis of Communication and Interpretation

1. The speaker raises valid concerns about how the study results have been communicated:
2. The press releases and interviews heavily emphasize the lack of association between LDL/ApoB and plaque progression268 while giving less attention to the observed plaque growth in most participants
3. The speaker correctly identifies limitations in making broad claims from this study:
   • No control group for direct comparison
   • Only looking at individuals with already extremely high LDL levels (limiting generalizability)
   • Relatively short follow-up period (one year) for a chronic disease process
4. The scientific communication issues identified (discrepancies between text and figures, missing primary outcome data) appear legitimate based on Dr. Budoff's responses in the interview1

Commentary on the Speaker

The speaker demonstrates:

• Scientific rigor by examining both the data and methodology critically
• Balanced approach by interviewing the senior author (Dr. Budoff) directly rather than just criticizing
• Concern for public health implications, particularly regarding how results are communicated to vulnerable populations
• Knowledge of cardiovascular research and proper study design
• No apparent bias against ketogenic diets themselves, but rather concern about specific health effects in certain populations

Conclusion

This video provides a thoughtful analysis of an important study on ketogenic diets and cardiovascular health. The speaker raises legitimate scientific and communication concerns about how the study results have been presented.

The core findings suggest that in metabolically healthy individuals following ketogenic diets with very high LDL cholesterol, baseline plaque burden—not LDL or ApoB levels—was the primary predictor of plaque progression. However, the fact that most participants showed some degree of plaque progression is a clinically significant finding that appears to have been underemphasized in communications about the study.

For individuals considering or following ketogenic diets, especially those experiencing significant LDL elevations, the most prudent approach may be personalized assessment including cardiac imaging to evaluate existing plaque burden, as this appears to be the strongest predictor of future risk in this population.

Edited April 20, 2025 by Ender

[Ender]

I asked Claude 3.7 Sonnet Thinking model to review the actual study and if it agrees with the Youtube Doctor that the authors had downplayed some crucial information.

 

--------------------------------------------------------------------------------------------------------------

This is the study he is talking about? Can you comment on it and if you agree with the Youtube doctor that certain crucial part of the findings were downplayed?

https://www.jacc.org/doi/10.1016/j.jacadv.2025.101686#mmc1

Plaque Begets Plaque, ApoB Does Not: Longitudinal Data From the KETO-CTA Trial

Analysis of the KETO-CTA Trial and its Reporting

Study Overview

The link you've shared is indeed the KETO-CTA trial published in JACC Advances that the YouTube video discusses. This study followed 100 individuals on ketogenic diets who had developed very high LDL-cholesterol levels (≥190 mg/dL) but were otherwise metabolically healthy, tracking coronary plaque progression over one year using CT angiography.

Key features of this study include:

• Participants had extremely high LDL-C (median 237 mg/dL) and ApoB (median 178 mg/dL) levels
• All participants were metabolically healthy (no diabetes, hypertension, etc.)
• Mean age was 55.3 years with an average BMI of 22.5 kg/m²
• Measurements included various plaque metrics (noncalcified plaque volume, total plaque score, etc.)23

Discrepancies in Reporting

After reviewing both the study and the YouTube critique, I do find evidence supporting the claim that crucial aspects of the findings were downplayed:

1. Data vs. Text Description: There appears to be a significant discrepancy between the visual data (figures showing widespread plaque progression) and the text description stating "most participants presented with stable NCPV (non-calcified plaque volume)". This inconsistency was acknowledged by Dr. Budoff (senior author) in the video, who admitted the sentence was poorly written and would be changed1.
2. Primary Outcome Reporting: The video correctly notes that the primary outcome (change in soft plaque volume) wasn't clearly reported in the published version1. This is unusual for a clinical trial, as primary outcomes should be prominently featured with statistical analysis.
3. Emphasis on Null Findings vs. Actual Progression: The paper strongly emphasizes the lack of association between ApoB/LDL-C and plaque progression (stated in the title and throughout), while giving less prominence to the finding that the majority of participants showed plaque progression regardless of predictors.

Interpretation Issues

The study's conclusion that the results "should be reassuring for LMHR patients and their physicians" appears inconsistent with the data showing:

1. Most participants experienced some degree of plaque progression over just one year
2. The comparison to other studies suggests potentially faster progression in this population (though this would need further verification)
3. Baseline plaque was strongly associated with future progression, but many participants with zero calcium score still showed significant soft plaque progression

Methodological Considerations

The YouTube doctor raises valid methodological points:

1. The study lacks a control group, making causal inference difficult
2. All participants already had very high LDL levels, so the study can't address what happens when moving from normal to high LDL levels
3. The one-year timeframe is relatively short for a chronic disease process

Conclusion

Based on the available information, I do agree with the YouTube doctor that certain crucial findings appear to have been downplayed in the presentation of this study. The discrepancy between the visual data showing widespread plaque progression and how this was characterized in the text is particularly concerning.

While the study makes a valuable contribution by examining this unique population, the emphasis on the lack of association between ApoB/LDL and plaque progression appears to overshadow the potentially concerning finding that most participants showed plaque progression over just one year, regardless of the predictors.

For individuals following ketogenic diets who experience significant LDL elevations, a prudent approach would include personalized risk assessment, possibly including cardiac imaging to evaluate existing plaque burden, as this was the strongest predictor of future progression in this study.

Edited April 20, 2025 by Ender

[TangoCharlie]

On 4/21/2025 at 3:54 AM, Ender said:

Recently a new study on LMHR subgroup people (High LDL, Low Trig, High HDL), that caught media attention, it seems the take away is that among these individuals known as LMHR, high cholesterol and APoB aren't a predictor for heart disease. But this YouTube doctor break it down and suggest how the authors of the study may have downplayed their certain crucial findings to media. Almost to the point borders on ethics. Why they are so eager to portray these sub group of individuals are not susceptible to high cholesterol and APoB?

 

 

Used Claude 3.7 Sonnet Thinking model (via Perplexity). need to use advance mode for this as it need to do deep search.

Analysis of Ketogenic Diet and Heart Disease Study Video

Key Points from the Transcript

The video analyzes a controversial study examining the effects of ketogenic diets on heart health in people who developed very high LDL cholesterol levels. The main points include:

• The study followed 100 participants on ketogenic diets with very high LDL cholesterol (average 250 mg/dL) but no other major risk factors like diabetes or hypertension1
• The primary outcome measured was change in soft plaque volume in coronary arteries over one year using CT angiography
• Visual data showed approximately 90-95% of participants had some degree of plaque progression during the study period
• The study found no significant association between the level of LDL/ApoB exposure and plaque progression rates
• Baseline plaque burden was identified as the strongest predictor of future plaque progression35
• There were significant discrepancies between the data visualizations (showing widespread plaque progression) and text descriptions (claiming "most participants presented with stable soft plaque")
• The speaker identified methodological issues, including lack of a control group and potential underpowering for some analyses

Fact Checking

• Accurate statements:
  • The study design, inclusion criteria, and participant characteristics match what's described in the published papers
  • The finding that baseline plaque burden predicted progression is confirmed in the published abstracts
  • The lack of association between LDL-C/ApoB and plaque progression is stated in the official publications
  • The controversy over missing primary outcome data is acknowledged by Dr. Budoff in the interview
• Discrepancies or unverifiable claims:
  • The specific comparison to the "nature-CT" study showing 3.8x faster progression in keto participants isn't verifiable in the provided search results
  • The exact median increase of 18.8 mm³ in soft plaque mentioned by the speaker isn't directly confirmed in the provided study abstracts, though Dr. Budoff acknowledges this figure was shared by the first author

Analysis of Communication and Interpretation

1. The speaker raises valid concerns about how the study results have been communicated:
2. The press releases and interviews heavily emphasize the lack of association between LDL/ApoB and plaque progression268 while giving less attention to the observed plaque growth in most participants
3. The speaker correctly identifies limitations in making broad claims from this study:
   • No control group for direct comparison
   • Only looking at individuals with already extremely high LDL levels (limiting generalizability)
   • Relatively short follow-up period (one year) for a chronic disease process
4. The scientific communication issues identified (discrepancies between text and figures, missing primary outcome data) appear legitimate based on Dr. Budoff's responses in the interview1

Commentary on the Speaker

The speaker demonstrates:

• Scientific rigor by examining both the data and methodology critically
• Balanced approach by interviewing the senior author (Dr. Budoff) directly rather than just criticizing
• Concern for public health implications, particularly regarding how results are communicated to vulnerable populations
• Knowledge of cardiovascular research and proper study design
• No apparent bias against ketogenic diets themselves, but rather concern about specific health effects in certain populations

Conclusion

This video provides a thoughtful analysis of an important study on ketogenic diets and cardiovascular health. The speaker raises legitimate scientific and communication concerns about how the study results have been presented.

The core findings suggest that in metabolically healthy individuals following ketogenic diets with very high LDL cholesterol, baseline plaque burden—not LDL or ApoB levels—was the primary predictor of plaque progression. However, the fact that most participants showed some degree of plaque progression is a clinically significant finding that appears to have been underemphasized in communications about the study.

For individuals considering or following ketogenic diets, especially those experiencing significant LDL elevations, the most prudent approach may be personalized assessment including cardiac imaging to evaluate existing plaque burden, as this appears to be the strongest predictor of future risk in this population.

Follow the money and usually can nail their motivation?

Recently also came across video feed to suggest triglycerides and HDL numbers trump LDL.

 

I belong to this group of high LDL, high HDL and low triglycerides group. Not going keto. While I do enjoy sam zum bah, I love my rice, veg and fruits too.

[mersaylee]

On 4/18/2025 at 5:05 AM, Ender said:

Didn't know this is a real thing.  Why runners don't get it?

 

https://www.facebook.com/reel/1049594790386537

No wonder nowadays i see many middle age men at the gym...want to have orgasmic sexperience...?

...I walk past only hor...😁

[Gunzy]

wrong thread

 

 

Edited April 22, 2025 by Gunzy

[Ender]

Don't use a massage gun om your neck.

 

https://www.facebook.com/reel/672045835661164

[Lala81]

On 4/21/2025 at 3:54 AM, Ender said:

Recently a new study on LMHR subgroup people (High LDL, Low Trig, High HDL), that caught media attention, it seems the take away is that among these individuals known as LMHR, high cholesterol and APoB aren't a predictor for heart disease. But this YouTube doctor break it down and suggest how the authors of the study may have downplayed their certain crucial findings to media. Almost to the point borders on ethics. Why they are so eager to portray these sub group of individuals are not susceptible to high cholesterol and APoB?

 

 

Used Claude 3.7 Sonnet Thinking model (via Perplexity). need to use advance mode for this as it need to do deep search.

Analysis of Ketogenic Diet and Heart Disease Study Video

Key Points from the Transcript

The video analyzes a controversial study examining the effects of ketogenic diets on heart health in people who developed very high LDL cholesterol levels. The main points include:

• The study followed 100 participants on ketogenic diets with very high LDL cholesterol (average 250 mg/dL) but no other major risk factors like diabetes or hypertension1
• The primary outcome measured was change in soft plaque volume in coronary arteries over one year using CT angiography
• Visual data showed approximately 90-95% of participants had some degree of plaque progression during the study period
• The study found no significant association between the level of LDL/ApoB exposure and plaque progression rates
• Baseline plaque burden was identified as the strongest predictor of future plaque progression35
• There were significant discrepancies between the data visualizations (showing widespread plaque progression) and text descriptions (claiming "most participants presented with stable soft plaque")
• The speaker identified methodological issues, including lack of a control group and potential underpowering for some analyses

Fact Checking

• Accurate statements:
  • The study design, inclusion criteria, and participant characteristics match what's described in the published papers
  • The finding that baseline plaque burden predicted progression is confirmed in the published abstracts
  • The lack of association between LDL-C/ApoB and plaque progression is stated in the official publications
  • The controversy over missing primary outcome data is acknowledged by Dr. Budoff in the interview
• Discrepancies or unverifiable claims:
  • The specific comparison to the "nature-CT" study showing 3.8x faster progression in keto participants isn't verifiable in the provided search results
  • The exact median increase of 18.8 mm³ in soft plaque mentioned by the speaker isn't directly confirmed in the provided study abstracts, though Dr. Budoff acknowledges this figure was shared by the first author

Analysis of Communication and Interpretation

1. The speaker raises valid concerns about how the study results have been communicated:
2. The press releases and interviews heavily emphasize the lack of association between LDL/ApoB and plaque progression268 while giving less attention to the observed plaque growth in most participants
3. The speaker correctly identifies limitations in making broad claims from this study:
   • No control group for direct comparison
   • Only looking at individuals with already extremely high LDL levels (limiting generalizability)
   • Relatively short follow-up period (one year) for a chronic disease process
4. The scientific communication issues identified (discrepancies between text and figures, missing primary outcome data) appear legitimate based on Dr. Budoff's responses in the interview1

Commentary on the Speaker

The speaker demonstrates:

• Scientific rigor by examining both the data and methodology critically
• Balanced approach by interviewing the senior author (Dr. Budoff) directly rather than just criticizing
• Concern for public health implications, particularly regarding how results are communicated to vulnerable populations
• Knowledge of cardiovascular research and proper study design
• No apparent bias against ketogenic diets themselves, but rather concern about specific health effects in certain populations

Conclusion

This video provides a thoughtful analysis of an important study on ketogenic diets and cardiovascular health. The speaker raises legitimate scientific and communication concerns about how the study results have been presented.

The core findings suggest that in metabolically healthy individuals following ketogenic diets with very high LDL cholesterol, baseline plaque burden—not LDL or ApoB levels—was the primary predictor of plaque progression. However, the fact that most participants showed some degree of plaque progression is a clinically significant finding that appears to have been underemphasized in communications about the study.

For individuals considering or following ketogenic diets, especially those experiencing significant LDL elevations, the most prudent approach may be personalized assessment including cardiac imaging to evaluate existing plaque burden, as this appears to be the strongest predictor of future risk in this population.

I'm self admittedly very lousy at statistics and studies but this study data is so crappy that anyone who has even the most basic understanding of how these studies are done would know there is something super fishy about this. 

How can you not mention the primary outcome in any conclusion even if it's like draft version 1.0 of the paper. 

Eat fat if you like to take it, I still drink normal fresh milk cos it makes me more full and I enjoy the taste more. I don't drink it thinking that it's more healthy than low fat milk. 

Edited April 23, 2025 by Lala81

[13177]

On 4/23/2025 at 9:01 PM, Lala81 said:

I'm self admittedly very lousy at statistics and studies but this study data is so crappy that anyone who has even the most basic understanding of how these studies are done would know there is something super fishy about this. 

How can you not mention the primary outcome in any conclusion even if it's like draft version 1.0 of the paper. 

Eat fat if you like to take it, I still drink normal fresh milk cos it makes me more full and I enjoy the taste more. I don't drink it thinking that it's more healthy than low fat milk. 

I find nothing wrong drinking normal fresh milk if you do not have health issue. Why go and drink low fat milk lo. Lol. Like some people say those low fat food not 100% would be healthy also.

[Gunzy]

@Ender saw a chinese version previously

 

https://youtu.be/sXbUAReJ5I4?feature=shared

 

Edited April 23, 2025 by Gunzy

[Ender]

Need to do weights, eat more protein and creatine.  More muscle higher survivability in cancer treatment.

 

 

https://www.facebook.com/reel/1811016616345460

[Lala81]

@Kb27

Your BP issues with your schedule. Don't actually need to do walking. 

Best bang for buck.

Just try to do wall squats for 4 short sets (lol you can do it against your PHV) 

 

[Kb27]

On 4/24/2025 at 10:04 PM, Lala81 said:

@Kb27

Your BP issues with your schedule. Don't actually need to do walking. 

Best bang for buck.

Just try to do wall squats for 4 short sets (lol you can do it against your PHV) 

 

A bit like Thai massage, where the masseuse hold the artery for a few minutes, then let go and you feel the blood rushing through. 😁