Ben Greenfield dealing with his high ApoB and Trigs

#1

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—-copied here…from his blog:
Two years ago, my lipid panel was “lit up like a Christmas tree”, with elevated ApoB and lpA, along with extremely high LDL cholesterol and plaque accumulation as indicated by a CT angiography. :chart_with_upwards_trend:

Fast forward to today, and here’s my latest set of results from an at-home blood test sent to me by @SiPhoxHealth.

While my numbers are not “perfect”, they are much more stabilized than they used to be, and I am now far less concerned, especially based on my family’s history of cardiovascular disease.

So what exactly did I do? :mending_heart:

:avocado: I dialed back saturated fat. I used to be the guy who would eat the most marbled pieces of steak and eat the fatty ends off of all my pork chops. Now, only about 10% of my total fat intake is saturated and the rest are Mediterranean fats, such as extra-virgin olive oil, salmon and avocados.

:computer: I researched every last natural heart health compound and supplement for stabilizing lipid values and improving cardiovascular health, then worked with @Vitaboom.Health to create a heart health pack that I take every day. You can see the full ingredient list and how it works by clicking this link: Vitaboom Daily Supplement Protocols – Vitaboom.com. Use the code “BEN50” for 50% off your first month.

:syringe: I got on a twice monthly injection of a PCSK-9 inhibitor. Although I don’t have a screenshot here, it seems to completely put the brakes on plaque accumulation/progression.

The rationale behind my protocol was developed based on multiple podcasts I’ve done in the past several years on managing heart health. :studio_microphone:
See these resources as great starting points into your heart health journey: Heart, Home, and Hormesis: The First Steps to Optimal Health
Heart Disease & Health Hacks with Dr. Stephen Hussy: Part 1

In a perfect world, I would actually like for my cholesterol to be slightly higher, but I’m very happy that I’ve now created a scenario where plaque accumulation and heart disease risk is lower. I don’t know about you, but experiencing the dreaded “Widowmaker“ is not high on my list of priorities. :pray:

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#2

Wow, he went and got a CT angiogram. I read about it and decided I was better off without. Hard call.

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#3

I don’t see a statin as an ingredient on that list :sweat_smile:.

Just someone selling something, I guess.

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#4

Lol, so basically the PCSK9i is doing the majority of the heavy lifting here. Supplements and changing diet won’t make all that much difference.

And the statement about wishing cholesterol was higher doesn’t make sense.

And not to be a downer, but if he already has plaque, then the widowmaker is still a possibility, albeit greatly reduced if it’s stable and he stops accumulating more.

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#5

I was curious so here are the contents in his supplements:
(That company seems kinda neat in that it combines many supplements for you, but I don’t foresee paying for the privilege)

Also, I’m glad he is sharing he lowered his sat fat… I never paid much attention to him but I recall getting the sense that he was an eat all the red meat you want kind of guy.

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#6

https://www.pillpack.com/ will also do this for you AIUI

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#7

So what were his numbers? And what are they now?

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#8

Interesting indeed. But again, confirming that two injections of PCSK9i per month is doing the heavy lifting. Nothing there is going to budget your ApoB, especially if it was “extremely high” along with high Lp(a).

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#9

I used to be the guy who would eat the most marbled pieces of steak and eat the fatty ends off of all my pork chops.
If you are eating 200 grams of saturated fat a day, then changing the diet (ideally under 10 grams) will make a difference.
I agree that wishing for higher cholesterol makes no sense. It’s almost like he didn’t learn his lesson, if I was in Greenfield’s shoes I would shoot for under 10 grams of saturated fat a day and aiming for LDL of under 60… and YES adding a statin.

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#10

Very, very strange. Why would anyone care what Ben Greenfield does or doesn’t do? Who is this guy and what are his qualifications that we should care about his opinions, actions or existence? He’s some absolutely random influencer who does this influencer thing of talking with confidence about things he doesn’t have the faintest clue about, making podcasts and going on other people’s podcasts in the toxic influencer environment of mutual promotion. He is clueless and has zero qualifications to talk about health. I cannot for the life of me understand why I should spend a second of my time listening to this fellow. There’s a million like him, and frankly he’s bottom of the barrel, lowest tier of these famous for being famous time and energy vampires. If he’s not spreading misinformation, he’s selling something. Oh, look everybody, Ben freakin’ Greenfield popped off with an opinion, c’mon everybody gather around, wisdom and health is sure to flow from some inane mouth noises and stuff he thumb-typed on some blog! Can’t miss that!

This year, I personally have made a vow to cut back on wasting time on influencers big and small. Rhonda Patrick - I will not listen to her. Yes, she’s at least educated in the field, but her recommendations and the quality of her reasoning is really subpar. Life is too short. Attia - I’ll listen to some interesting guest on his podcast, but otherwise I’m blocking his newsletter and poorly reasoned bloviations. And so on. I want to cut it down to a small core of folks who earn their time through merit - but even then, only when their podcast has a show with merit (f.ex. Matt Kaeberlein, frequently has very unimpressive guests - a real mystery, what does he see in these guys like Mike Mutzel, Kevin White, Thomas Delaurer and other health non-entities). Brad Stanfield, and guys like him - nice enough, and not massive hucksters, but rarely bring anything new to the table that isn’t general knowledge anyway - sorry, nice guy, but life’s too short.

Of course, everyone has their own opinion, and YMMV. We all differ in where we find value, so no judgment at all, just expressing my own flawed personal opionion!

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#11

I don’t think this is correct.

By replacing 1% of energy from SFA to PUFA you decrease apoB by 10.2 mg/dl.

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#12

Generally speaking, what is your issue with Attia and Patrick?

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#13

He has up to half million followers, assuming 20% actually follows his advice, he can do a lot of harm. That’s the reason to care. Someone needs to keep those influencers accountable.

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#14

I have listened to PA from the beginning of his podcast, and I have bought and read his book, subscribed to his newsletter. I have therefore not reached my conclusions lightly. In short, I think PA talks a good game about evaluating evidence and the scientific method, but falls woefully short in practicing what he preaches. He underappreciates the role of diet in health outcomes to a farcical extent, and that’s based on his simply not keeping up with how epidemiological methodology has evolved - I have posted to this effect before (nutshell: today’s epidemiological methodology is not your grampa’s methodology). He runs far ahead of where the research is when it comes to exercise and when it comes to protein intake. The fact that he is unable to course correct, not just in the short term, but in the years-long term, means that I don’t want to waste time on listening to him expound on health issues, when I know that what he says might have very poor validity. Life is too short.

Rhonda Patrick, basically - lack of rigour. Kitchen sink approach. Her singular failing is something that, to be fair, most people share - including many of us here on this board - she fails to rigorously interrogate her conclusions. Instead, she - along with great numbers of people - looks for evidence that supports her thesis, instead of looking for evidence that contradicts it - the opposite of the Popperian conception of scientific hypothesis generation. Note, how she is all in on O3 FA, but refuses to update her advocacy in light of new research, which Antoine has laid out here over the past few days, and which, according to him, he has made her aware of. Why hasn’t she done for herself what Antoine has done for us here, or at the end, why has she not come out and told everyone why these studies do not impact her advice wrt. O3 FA supplementation. I try to adhere to the Popperian principles - and thus, for example, I eagerly search for negative and harmful effects of rapamycin and the drugs that I take (empagliflozin, pitavastatin) or intend to take (telmisartan, pioglitazone) - to me, that’s part of “first do no harm”. If given convincing evidence - as Antoine has done - that DHA supplementation is at the very least questionable, I’d JUMP on those studies… which btw. I have done already years ago, even before these newer studis, when there were mere hints of negative impact of DHA (on high grade PC), and have been avoiding supplementing with DHA, ever, which I have stated here months ago. That was before Antoine put together his critique of DHA in the last few days. When I saw hints of pioglitazone and rapamycin not playing nice together I immediately posted my findings (for which I got a lot of pushback!). Bottom line - I look for evidence that I AM WRONG, for the simplest of reasons - I do not wish to harm myself or others (through misinformation). I therefore find it very off putting that Rhonda Patrick has not dropped everything to immediately investigate this DHA issue, especially that her recommendations might harm countless people who follow her advice. All in all, I simply don’t trust her methodology in reaching her conclusions and her scientific rigour - this means I don’t want to waste time listening to her. Contrast that with Matt Kaeberlein and Brian Kennedy’s approach.

Again, that’s me - I am not saying others should follow these folks or not - everyone finds value in their own way, and if someone finds PA and RP of great value, I am very happy for them. And I try to be nuanced myself - if PA (or RP) have a very interesting guest, I’ll listen! Let me make it clear - these are my opinions about what value they bring to my life, and furthermore, I might be mistaken, so YMMV. I do express my - flawed - opinions/thoughts, in case someone else might be inspired to re-evaluate their own approach to health influencers and possibly benefit from such re-thinking.

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#15

I support your @CronosTempi scientific method, but please do not credit Popper. His falsification is something else and fundametally nonsense, e.g. a theory of everything (all possible observations) can by definition not provide possible observations that falsify it. Popper was promoted on political grounds, but in any field he messed around, the true experts always dismissed his nonsense.

#16

200 grams? 1,800kcal of saturated fat? :open_mouth: That’s hard to imagine. (Bear in mind, I have no idea who this person is, so maybe they were eating that much).

Thanks for sharing. Those numbers are much larger than I thought, and way larger than I’ve ever seen in myself or anybody I know. I’ve only ever witnessed lifestyle changes accounting for maybe a 20% reduction in ApoB/LDL-C. (Then again, I have HeFH, so I’m probably a terrible example!)

I assume there is some sort of “maximum ceiling” on those numbers though. Like, I can’t see that replacing 10% SFA to PUFA is going to lower your ApoB by 100 mg/dl.

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#17

If you consider his audience it does make sense. He is trying to say, “I’m still one of you but my body betrayed me so I have to deal with it”. It’s always about the money with these influencers. Still I give him credit for not hiding his PCSK9 usage…maybe that will be enough for his audience to think: maybe I should take a look.

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#18

With regards to threshold effects, (although highly predictable it seems), the study authors did look at this, note it’s median response so YMMV as you say:

Effects of reducing or increasing SFA intake on serum lipids and lipoproteins were observed across a wide range of SFA intakes, from 1.6 to 24.4% of total energy intake. Of the 177 datapoints used in the multiple regression, 113 included an SFA intake component of less than 10% of total energy intake and 65 included intakes of less than 8%. As noted in Section 2.2.4, analysis of the residuals of the regression line indicates that the relationship between a reduction or increase in SFA intake and effect on serum lipids and lipoproteins is linear with a consistent effect on serum lipids and lipoproteins across the entire range of SFA intakes. The results of the regression analysis therefore suggest reducing SFA intake to less than 10% of total energy intake may have additional benefit in terms of improving the overall serum lipoprotein profile when replacing SFA with cis-PUFA, cis-MUFA – and to a lesser extent carbohydrates – relative to higher intakes. Similarly, the results suggest a negative effect on the overall serum lipoprotein profile when increasing SFA intake from a starting point of less than 10% of total energy intake.

Results of the multiple regression analysis indicated that effects on the serum lipoprotein profile of reducing SFA intake by replacing a mixture of SFA with cis-PUFA (predominantly linoleic acid and α-linolenic acid) or cis-MUFA (predominantly oleic acid) were more favourable than replacing SFA with a mixture of carbohydrates. For total and LDL cholesterol and triglycerides in particular, the most favourable effects were observed for cis-PUFA. These results are consistent across a wide range of SFA intakes including intakes of less than 10% of total energy intake

Predicted vs. observed LDL cholesterol:

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Effects of saturated fatty acids on serum lipids and lipoproteins: a systematic review and regression analysis 2016

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#19

He’s one of the big meat podcast bros who attracts an audience of young guys trying to be like him. He has described himself as being on a modified carnivore diet and has interviewed people like Paul Saladino (for all I know he attacked his ideas, but I have a feeling that was not the case).

I had been interested in his book Boundless when it came out, but I decided that even if it was chock full of good info, I couldn’t really trust him

And, like you, as someone with a hereditary issue, yeah, my WFPB diet only does so much, so I understand why you feel diet can’t be that impactful. Even with ezetimibe, bempedoic acid, and repatha, I can only get my apob down to 42 (which is a good number, but I want it in the low 30s due to my high CAC. Having said that, I’ve seen people with luckier genes dramatically reduce their numbers with even small changes in their diet… as I sit in a corner eating kale and swallowing pills!

@Joseph_Lavelle What you said, nail on the head, 10000000%

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#20

He is an accomplished triathlete but as a health influencer he’s what I call latest health craze spammer - anything from cold plunges to “grounding”. I listened to few of his podcasts and read his book, but then he seemed to go off to the deep end so I stopped following him, too much of the crazy for me. Also selling bunch of supplements and devices with questionable efficacy.

200 grams is hyperbolic but 100 grams would actually be believable , these people start with 25 grams just in their bulletproof coffee, eggs and bacon, fatty meats, butter everything, cheese, whole milk yogurt, etc.

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