I am writing this post because someone asked for me to comment on the ideas of major low-carbohydrate diet advocates, specifically, the idea that LDL cholesterol does not cause cardiovascular disease.
Labeling a theory as “denialism” has no place in science. It’s the type of unscientific name calling that is polarizing and anti-productive.
One thing that you don’t seem to consider is that low carb ketogenic diets typically increase the size of the LDL particles with less of the small dense LDL particles as well as increase HDL concentration.
Would you mind if I call you a “fluffy LDL particle denier” for failing to recognize this?
Particle size has negligible effects and may not even matter. It's an old theory that is no longer widely considered because the evidence has generally counted against it. Particle number is what counts. Particle size tends to reflect metabolic dysfunction, which is the real cause of the increased CVD risk among those with small particle size.
As for labeling something denialism, you're right, that's an anti-scientific term. I shouldn't have used it. I don't regard the online debate about the role of LDL in cardiovascular disease a legitimate, but I could also be wrong and should be open to the possibility that I am. Using the term denialism forecloses that openness and is for that reason anti-scientific. I was using denialism as a shorthand for a specific belief, but I should find a different shorthand. I will edit the post if I can come up with something.
Do you happen to subscribe to “A Midwestern Doctor And The Forgotten Side Of Medicine”? He did an interesting article on statins . Today he wrote a very interesting article on blood pressure and heart disease
Kevin, You clearly have a (possibly lifetime) chip-on-your-shoulder about your work on the covid scamdemic. Recognizing that it had truly horrific personal repercussions for you this is understandable. But I wanted to tell you that many of us found your covid work among your best work and that you left behind a more educated readership who really appreciate it. That doesn't fix getting tossed from medical school -- I get it. But (as medical school faculty) seeing the quality of many who would have been your classmates, maybe you will avoid being lumped with a group that is going to cause serious harm through their practice careers. Might be a small upside. In any case, this is an interesting piece on the LDL/IR axis expressed plainly enough that anyone can understand it. Many thanks.
I’m still really conflicted about what I should do or if I should try to go back. I don’t want this chip on my shoulder. I remember reading about how Dave Mustaine never got over being kicked out of Metallica even though he went on to found one of the most successful metal/rock bands of all time. I don’t want to become super successful—that’s even assuming I do—just to feel the same way. I don’t want to hold onto that kind of resentment. It is hard for me to see past it. I find joy in things, but it keeps coming back. I feel so incredibly misunderstood and mistreated. I want some kind of peace that I am not sure I will ever be able to find. I accept this, but I do not want it. Long ago, I thought I was beyond feelings like these, but here they are. And they are a cancer, and I do not want them. The sense of my life was stripped. Medicine meant so much more to me than most people could imagine. It meant more to me than most of my peers and teachers who tried to ruin me, I’m sure. I am a tough person, and I can take it, but I am so confused about what to do. Should I walk away and try to win somewhere else? Or will I be haunted? Should I try to get back into medicine? Or will I be blocked or feel silenced? I do not know what to do.
I am glad that you liked what I wrote. I wrote it quickly. I would be happy to include figures and references if people would like that.
Talking of "denialism" and "pseudoscience" is an effective way to stop people listening to you. I avoid doing that even on topics where I'm sure of my views. I'm not aware of low carbers rejecting any role for LDL but I'll take your word for it. I suspect that it is not cholesterol nor LDL that matters much. More important is the oxidation of LDL. That's what causes lesions that allow plaque buildup. The size and fluffiness of LDL and VLDL particles may also be important. I am not at all sure about that, but it is a view that is not denialist nor one that panics about LDL.
I addressed this in another comment. Using the term denialism was unscientific. But I'm not going to be persuaded by someone telling me that I should care about others listening to me. I'm going to be persuaded by someone telling me how I can be more accurate.
Labeling a theory as “denialism” has no place in science. It’s the type of unscientific name calling that is polarizing and anti-productive.
One thing that you don’t seem to consider is that low carb ketogenic diets typically increase the size of the LDL particles with less of the small dense LDL particles as well as increase HDL concentration.
Would you mind if I call you a “fluffy LDL particle denier” for failing to recognize this?
Particle size has negligible effects and may not even matter. It's an old theory that is no longer widely considered because the evidence has generally counted against it. Particle number is what counts. Particle size tends to reflect metabolic dysfunction, which is the real cause of the increased CVD risk among those with small particle size.
As for labeling something denialism, you're right, that's an anti-scientific term. I shouldn't have used it. I don't regard the online debate about the role of LDL in cardiovascular disease a legitimate, but I could also be wrong and should be open to the possibility that I am. Using the term denialism forecloses that openness and is for that reason anti-scientific. I was using denialism as a shorthand for a specific belief, but I should find a different shorthand. I will edit the post if I can come up with something.
Thank you for your non-inflammatory response.
Is there a study supporting the LDL count only rather than LDL particle size or LDL/HDL ratio and inflammatory markers being a better measure of risk?
Let me try to find and I will send by Friday
Do you happen to subscribe to “A Midwestern Doctor And The Forgotten Side Of Medicine”? He did an interesting article on statins . Today he wrote a very interesting article on blood pressure and heart disease
I think Midwestern Doctor is a female. Read her clothing article, which is quite elaborate regarding bras. Guys don’t that.
Kevin, You clearly have a (possibly lifetime) chip-on-your-shoulder about your work on the covid scamdemic. Recognizing that it had truly horrific personal repercussions for you this is understandable. But I wanted to tell you that many of us found your covid work among your best work and that you left behind a more educated readership who really appreciate it. That doesn't fix getting tossed from medical school -- I get it. But (as medical school faculty) seeing the quality of many who would have been your classmates, maybe you will avoid being lumped with a group that is going to cause serious harm through their practice careers. Might be a small upside. In any case, this is an interesting piece on the LDL/IR axis expressed plainly enough that anyone can understand it. Many thanks.
I’m still really conflicted about what I should do or if I should try to go back. I don’t want this chip on my shoulder. I remember reading about how Dave Mustaine never got over being kicked out of Metallica even though he went on to found one of the most successful metal/rock bands of all time. I don’t want to become super successful—that’s even assuming I do—just to feel the same way. I don’t want to hold onto that kind of resentment. It is hard for me to see past it. I find joy in things, but it keeps coming back. I feel so incredibly misunderstood and mistreated. I want some kind of peace that I am not sure I will ever be able to find. I accept this, but I do not want it. Long ago, I thought I was beyond feelings like these, but here they are. And they are a cancer, and I do not want them. The sense of my life was stripped. Medicine meant so much more to me than most people could imagine. It meant more to me than most of my peers and teachers who tried to ruin me, I’m sure. I am a tough person, and I can take it, but I am so confused about what to do. Should I walk away and try to win somewhere else? Or will I be haunted? Should I try to get back into medicine? Or will I be blocked or feel silenced? I do not know what to do.
I am glad that you liked what I wrote. I wrote it quickly. I would be happy to include figures and references if people would like that.
I would like that!
I'm stunned that anyone who claims to be a researcher would take a statin....
Talking of "denialism" and "pseudoscience" is an effective way to stop people listening to you. I avoid doing that even on topics where I'm sure of my views. I'm not aware of low carbers rejecting any role for LDL but I'll take your word for it. I suspect that it is not cholesterol nor LDL that matters much. More important is the oxidation of LDL. That's what causes lesions that allow plaque buildup. The size and fluffiness of LDL and VLDL particles may also be important. I am not at all sure about that, but it is a view that is not denialist nor one that panics about LDL.
I addressed this in another comment. Using the term denialism was unscientific. But I'm not going to be persuaded by someone telling me that I should care about others listening to me. I'm going to be persuaded by someone telling me how I can be more accurate.