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As a nation we spend hundreds of billions on healthcare each year, but we can’t run a 3 year study for more than 6 months because of costs ? Ridiculous.

Fiber is the easiest thing you can add to lower cholesterol, plus it's good for your gut, which in turn will also benefit your heart

Low sugar, low salt, low saturated fat. Stress management Healthy weight Mediterranean diet. Regular, adequate exercise. Manage blood pressure.

What about nattokinase for dissolving arterial plaque?

Hi Dr Brad, great video! Older athlete here. Two quick points: A cardiologist from Inverness Scotland said that angina correlates with exercise and less likely to result in sudden MI than those with no angina; second point, Dr Cho at Cleveland Clinic said 15% of ppl are hyper absorbers of LDL and these ppl respond great to switch to low fat vegan diet, dramatic lowering of LDL in these ppl. I did that and reduced LDL by 65%. She also said exercise esp. lowers triglycerides which seems right to me.

Oral High level Mk-7 dissolved in olive oil reverses calcification in arteries. I tried it for one year and ct calcium score decreased significantly. However valve calcification increased.

Dr. Brad, I was surprised you didn’t mention berberine which has been showed to reduce plaque buildup.

These 6 steps are the way, however, that way is far from "quick" if you're a person who isn't healthy due to bad habits. You should be honest about how hard it actually is to follow this road. Most people who are struggling lack the willpower to make the necessary changes.

I also listen to the advice of Dr Ford Brewer, who specialises in preventative medicine and who has decades of clinical and real life experience - his videos xan be rather long.......

Thanks again Brad...great work and very useful info!

LDL cholesterol has little to NO impact on adverse events (see refs below), to the absolute risk, statin marketing always emphasises the relative risk change, while using absolute risk for the side effects, and dubious practice such as 30-day run in period to exclude patients with side effects before trial data collection begins. The risk seems to be from the deformed Small Dense -LDL particles that can penetrate the endothelium and stimulate inflammation . It’s the particle count of SD-LDL that matters, unfortunately the NMR test that COUNTS the number of APO-B SD-LDL particles to determine your risk is not widely available or understood So where do these SD-LDL particles come from? They are formed by excess glucose, forming advanced glycation end products. This deformed glycated LDL is not recognised by liver receptors and hence it has a long half-life in circulation and it continues to damage. Calcinated “stable” plaques are brittle, they can also rupture, so much so that cardiology surgeons are often scared of clamping arteries where doppler used for guidance can produce the sound of the plaque cracking, and these pieces can break off and form clots, as well as the contents of the plaque. The “research” shown in this video needs further examination as you pointed out, it was a short study, and the size of the plaques matters, and who funded the research, and what other primary data shows, much of it is held secret, even for out of patent statins… why would it need to be kept secret… Does it show there is no benefit from cholesterol reduction in the majority population or worse, it harms (cholesterol is ESSENTIAL TO SURVIVAL) and opens the manufacturers to lawsuits? Or that it’s the side effects of inflammation reduction and anti clotting properties that are the real source of the said incident reduction? Also talk about the relative vs absolute risk reduction. Suggest those really wanting to know make up their minds after looking up video interviews with: Refs: CHOLESTEROL & CVD Dr Robert Lustig Dr Aseem Malhotra (cardiologist)

SERIOUSLY? The moderate exercise protocol (Delta CAC score) was not statistically different from zero.

Good job doc, i needed this info.

That's very cool! It's nice that we can do more than just prevention!

I am still unclear on the issue of Statins? While higher LDL-C is associated with arthersclerosis and myocardial infarction (MI) risk, there is a U-shaped all cause mortality risk with the low inflection point around 3.6 mmol/L ... See references #1 & #2 [Note: the inflection point is lower for those on statins] 1. Association between low density lipoprotein and all cause and cause specific mortality in Denmark: prospective cohort study 2. Association between low density lipoprotein cholesterol and all‑cause mortality: results from the NHANES 1999-2014 It appears that inflammation may an underlying precursor linking arthersclerosis and LDL-C levels (#3) ... 3. The critical issue linking lipids and inflammation: Clinical utility of stopping oxidative stress Coronary CT Angiography shows the correlation between MI, and localised arterial inflammation. And that ~50% of MIs might occur in the absence of arterial occlusions, due to plaque rupture/ erosion (#4). Further, it shows effective management of inflammation at sites of perivascular inflammation reverses risk. 4. Assessing Cardiovascular Risk by Using the Fat Attenuation Index in Coronary CT Angiography A concern is that statins might contribute to calcification (#5), while also helping to reduce calcification and stabilising necrotic plaque areas. 5. Impact of statins on serial coronary calcification during atheroma progression and regression The fact that arthersclerosis occurs only in arterial and not venous vessels suggest blood pressure/ turbulence as a contributor to artherosclerosis (e.g. #6) ... 6. Wall shear stress alteration: a local risk factor of atherosclerosis. The above suggests that an LDL-C within the 3.2-3.8 region, along with normal blood pressure, and well managed generalised inflammation/ oxidative stress (including metabolic syndromes etc) might provide a reasonable path towards all cause mortality risk management. This likely means a diet high in fibre and antioxidants, regular exercise, weight management through calorie control, and perhaps vitamin D3/ K2 (relevant forms) supplements can minimise (in general) all cause mortality risk without drugs ... Who would have thought it? :)

Only a few dozen things to worry about, monitor, and guess about.

If LDL alone was the problem why does it wait decades? Why do insurance actuarial tables only consider the ratio of LDL to total cholesterol? Search for the all cause mortality data on just LDL. Good luck. Now if you're eating seed oils and have oxLDL I can see the number being a factor. Is inflammation a factor? As you said. Studies are difficult.

Such a small ldl difference, some fairly large p values so dubious statistical significance, and hdl increased in both groups! Hdl increase is usual with exercise. Doesn’t have the feeling of a good study. Brad I expected more critical analysis.

Angus Barbieri's fast Starting in June 1965, Scottish man Angus Barbieri (1939 - 7 September 1990) fasted for 382 days. He lived on tea, coffee, soda water and vitamins, living at home in Tayport, Scotland, and frequently visiting Maryfield Hospital for medical evaluation. He lost 125 kg and set a record for the length of a fast.

Mediterranean diet include 1-2 glasses of wine, along with the food. That's a known reducer for CVD.

Good video. I've come to the conclusion that cholesterol issues are a byproduct of both the bodies level of vessel absorption AND amount of cholesterol. All to often, drugs only deal with amount of cholesterol. And, that may or not reduce the chance of heart disease. I wish there was a specific list of cardiologist who deal with Heart Disease PREVENTION instead of simply treatment doctors. Unfortunately, I guess there is no money in prevention.

Where does that plaque come from? Not from plants 👀🌱

In the trial the participants doing the HIIT did their sessions in the presence of coaches trained in cardiac resuscitation. My cardiologist ( who is a sports cardiologist) advises total zone 2 and no HIIT due to the risk of cardiac arrest.so this option sounds great, but probably isn’t practical for those of us with heart disease

What is the relationship between triglycerides and cardiovascular risk? Is LDL correlated but not causative?

How to know the difference between: Moderate vs. Vigorous vs. Very Vigorous ??

Thank you, Dr. Brad. By utilizing rosuvastatin and moderate exercise, and a mostly vegan diet, I managed to get my FH finally under control. At 64, I have the best test results I ever had. 💝

why dont we ever measure ApoB in routine tests? its like we only focus on ldl but that seems to be a significant factor we should look out for

Pretty good video

Wait, did it decrease the amount of plaque? Or the percentage of plaque to other cells?

I spent 10myears on the low fat diet with lots of "healthy grains" no eggs etc. and got sick gained 100 lbs and was given meds. 24 months on a low carb diet "against advice", I lost 70 lbs and got off of meds. Is conventional medical advice trustworthy? Not always.

Association does not mean causation

Statins (except lipitor) lower arterial Inflamation. All decrease cells' uptake of glucose, more insulin resistance. Except Livalo pitavastatin Livalo low dose 2mg.

The only reason medical associations recommend lowering LDL cholesterol is because it can be lowered with drugs.

Heart disease is the number one killer of people today and cancer is number two. Being over weight is the number one factor leading to an early death. People who are over weight have higher risks for high blood pressure, heart disease, diabetes and cancer. Even children today have signs of artery disease. Fast foods and sugary drinks have long term consequences. There is an obesity epidemic today where over 60% of the population is overweight or obese. What is common today and "NORMAL" is not healthy. The average person today is not healthy and is taking medications. Heart attacks were once only common in people over 65. Today people in their 40 are having heart attacks. Add more plants and vegetables to your diet and less junk and overly processed foods

Was the 25% risk reduction in relative or absolute risk. You did not specify this important factor

The way he is literally de-aging is insane omg

I guess I am the exemption on all those scientific studies. On my 55 years I had a CAC of 148. From than I did 2 times a week HIIT training, besides my zone 2 and resistance training (my VO2-max = 51,5 ml/min/kg). I take 10 mg statin, I eat a Mediterranean dieet. On my 60 years my CAC-score increased to 572!!!

Wat if you run 30 mins or 5k every day, but no HIT

Thank you! Dr. Stanfield, if you had to design a multivitamin for vegans, what would it look like?

Nattokinase

thanks Brad

What is your opinion on using something like the omron heart guide to perpetually monitor your blood pressure, and possibly something to function like an EKG. Like do you think that would give advanced warning for something like a heart attack?

Dear doctor Stanfield any suggestions on hair care products and wearable devices ?

Thanks!

Hi Dr. Stanfield, we have been hearing about the causal role that LDL cholesterol plays in ASCVD for decades now, so your message isn’t particularly helpful to anyone who hasnt been living under a rock for the past 30 years. Are you able to provide some context in terms of weighing the various risk factors for ASCVD (e.g. insulin resistance, high blood pressure, obesity, etc.) so that we can better focus our energy and resources when mitigating risk for the number 1 cause of deaths worldwide? I get the feeling that without this added context many of us simply lump all the risk factors together and treat them as if they were equivalent in terms of risk

Microplastics don’t help.

what about starchy vegetables?

Weak video. I'm a Patreon and Dr. S. is my favorite longevity doctor, but I didn't hear anything really new nor do I know what the 3 steps are.

The oxidized ldl! Aaah this great unknown :) I just wonder Why? Many are the studies of how ONLY oxidized ldl penetrates the plaque, but since there are no drugs (but only supplements and good habits to block oxidation) then it is not talked about. I really hope you will talk about it, since statins also have important known side effects.

Wgen you say low fat diet, what percentage? What is the evidence for olive oil? The studies generally compare with SAD.

Manganese and Tricaprin.

Have had high LDL all my life... Doctors begged me to go on statins... Always flatly refused. And would never go on them. 50 years old and ripped. Coronary Artery Calcium Score by catscan of Zero... Ultrasound carotid test shows ZERO buildup. Low blood pressure all my life. Never smoked. It's INFLAMMATION of the LDL that is the issue, NOT LDL by itself. Statin risks are FAR higher than their benefits.

What about triglycerides sir

What about lower dose current gen statins? Like 1mg Rosuvastatin? Is there a reason you think you need the full 5mg to get your LDL < 60?

Please Dr Brad could you undertake a video on HMB for muscles

I need a video about blood pressure medications pls❤️

Here we go again with a nether sing song,

What about less exercise+ calories restriction....more exercise= more eating more eating=more calories=shorter lifespan + rigorous exercise can cause inflamattion and increased appetite

What about K2 MK4?

Dr. Michael Greger, a vegan doctor, says that the only diet that can your LDL to 60 is the vegan diet, and that’s without meds. Is this really the case? When I went vegan, I had an LDL OF 120’ish and after 18 months or so, I got a yearly physical one day and my LDL was 72 . My doctor asked if I was getting medications from another doctor. I said “no,” I shared that maybe it was because I was vegan. She was not convinced.

What if you constantly have low blood pressure as opposed to high?

What about ezetimbe? Can it be used in "healthy" adults, without a statin.

Any opinion on L-Ergothioneine

Why you didn't mention the successful Ornish's study (10% fat whole foods vegetarian diet, aerobic exercise, smoking cessation)

Are these peer-reviewed studies and replicated? And are they run by 3rd party clinicians? And how many people are in these studies and are they properly weighted and adjusted for other factors? Like weight, other comorbidities, other risks? The size of the cholesterol is important too.

Great presentations but dont accept studies prima fascia. Whos funding them and what are political,social or monetary incentives. We may never know.

1 - Sit on your couch and don't exercise 2 - Throw away your statins and eat more beef 3 - Make sure you always have something to worry about 4 - Increase your salt and alcohol consumption 5 - Don't skip dessert

Isnt the issue with LDL is that most measurements dont split out buoyant LDL, 'small' LDL, VLDL etc, a more granular split on those studies may give more insight and more accurate prediction of individuals at risk, not everyone ends up with issues, while others are severely impacted etc.

The plaque is the problem not cholesterol

Hey Brad, The whole diet heart hypothesis was dead on arrival, and is falsified on one forgotten observation from over 100 years ago: the first heart attack on record in the US was in 1912. The attempt to resurrect it measuring APO-B as a risk factor is like claiming water contains hydrogen and then claim that is a risk factor. LDL's are not cholesterol and cholesterol is not an LDL, and both are critically important for life, health, and longevity, and neither are they atherogenic: remember 1912. LDL's are part of the Immune system. You are shooting at the wrong target. Recommending GLP1's? Really? They're OK if you don't mind compounding the problem they're supposed to solve by orders of magnitude and causing a huge loss of precious lean body mass - especially long term over two years. I expect to see a tidal wave 🌊 of lawsuits for these. Beware of sounding too much like a benefits-only enthusiastic gleeful cheerleader for Big Pharma and their ways.

If you just use common sense than you will know that healthy and strong cardiovascular system has to come from supporting nutrition and activities which supports that. Our body's chemical factory produces material to keep this system strong and healthy, or just in working condition, for as long as it can. Cholesterol is the material which is being used to repair cardiovascular system besides other uses of it, and one sign that system is repairing itself a lot is raised level of cholesterol. What that tells us is that there is happening damage to that system from incoming nutrition of lack of it. So focus should be what builds that system and what damaging it, and cholesterol obviously is not the material which is damaging it but is there to help it to be in working condition.

This video still leaves everything inconclusive. Statin drugs long term have secondary side effects. So only HIT exercise lower ldl cholesterol?

Cool!

Lowcarb or ketopeople have till now not been checked, Their LDL is the good one and the amount is no problem. And they are not getting hartattacks.

Just eat a whole plant diet. Had to repost because I wasn't being allowed to respond to the haters.

Clear plaque? 🤔🤔🤔

Nattokinase Niacin Berberine ...... And carnivore diet!!!

Go get a Coronary Artery Calcium (CAC) Test and then start eating clean keto / carnivore and then get another CAC test after 90 days. After the test you will see the results get better then stay clean keto / carnivore for life and you will be the healthiest you have ever been.