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🛡️ Debate/🗡️ Opponents/Dave Feldman.md

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+# Lipid Triad
+
+https://pubmed.ncbi.nlm.nih.gov/29241485/
+
+"Many CVRF-free middle-aged individuals have atherosclerosis. LDL-C, even at levels currently considered normal, is independently associated with the presence and extent of early systemic atherosclerosis in the absence of major CVRFs. These findings support more effective LDL-C lowering for primordial prevention, even in individuals conventionally considered at optimal risk."
+
+Lipid combos:
+https://pubmed.ncbi.nlm.nih.gov/25458651/
+
+"Aside from isolated hypertriglyceridemia, low levels of HDL-C, high levels of LDL-C, and high levels of TG in any combination were associated with increased risk of CVD."
+
+LMHR paper:
+https://pubmed.ncbi.nlm.nih.gov/35106434/
+
+"These data suggest that, in contrast to the typical pattern of dyslipidemia, greater LDL cholesterol elevation on a CRD tends to occur in the context of otherwise low cardiometabolic risk."
+
+---
+
+# LDL Bounty
+
+## Criteria
+
+1. **HDL Cholesterol of 50 mg/dL or above (≥ 1.29 mmol/L)**
+2. **Triglycerides of 100 mg/dL or below (≤ 1.13 mmol/L)**
+3. **LDL Cholesterol of 130 mg/dL or above (≥ 3.36 mmol/L)**
+4. **Either high Coronary Heart Disease (CHD) or high Cardiovascular Disease (CVD) (see the section below)**
+5. By “**normal**” and “**non-treated**“, I mean:
+    - No stratifying by specific genetics
+    - No stratifying by drugs (no drug studies)
+    - No stratifying by a particular illness in advance of the study. (duh!)
+    - _In other words, just a generally broad group of people like [Framingham Offspring](https://www.ncbi.nlm.nih.gov/pubmed/27166203) or the [Jeppesen study](https://www.ncbi.nlm.nih.gov/pubmed/11176761)_
+6. And here’s some fine print that should be obvious, but just in case…
+    - The study needs to be published in a reputable journal
+    - It has to be dated before this article was posted, of course
+    - The study needs to have at least 400 participants that are stratified by this criteria. (The two studies above have over 500)
+    - I’d prefer no unusual “modeling” or “adjustments” to alter the data too far from it’s original set. This one goes by the honor system — if you have such a study and it is clearly warranted, I can give it a pass.
+
+"High" defined as greater than the average rates of CVD per age group in the American population.
+
+### Criticisms
+
+1. Vanishingly small population subset. Unreasonable to expect it to have been studied.
+2. If studied in the general population, they won't be keto, so translation to keto subjects may be dubious.
+3. The sheer weight of the evidence in favour of LDL's causal role in ASCVD cuts deeply against the notion that this population subset would be protected to begin with.
+4. Comparing this isolated cohort to the American general population is methodology that is beyond fringe, bordering on insane.
+5. Ultimately if this is taken to be an indication that LDL is fine in this particular context, it would qualify as an appeal to ignorance.
+
+---
+
+# Hashtags
+
+#lipidology 
+#lipid_triad
+#LMHR
+#LDL 
+#triglycerides 
+#HDL 
+#clowns
+#clownery
+#debate 
+#debate_opponents