The Drive with Peter Attia — Tom Dayspring (2)

On: Part II of V: Lipid metrics, lipid measurements, and cholesterol regulation.

Episode: 21

Date: July 2018

Key Subjects:

  • Lipid basics.
    • Lipoproteins are needed to carry lipids around the bloodstream.
    • The lipids carried primarily include triglycerides, cholesterol, phospholipids.
  • Various types of lipoproteins.
    • Based on density (protein to lipid ratio).
    • Types of protein attached to the lipoprotein molecule (apoB, apoA, apoC – subsets of those, etc.).
  • apoB lipoproteins (= LDL)
    • The ones that get trapped in artery walls.
    • 95% of apoB is attached to LDL lipoproteins (one-to-one).
    • The higher the LDL particle count, the higher the risk of particles getting trapped.
  • Knowing LDL particle count is #1 risk indicator to check.
  • Would also be good to have an insight into cholesterol flow mechanics: the synthesis, influx and efflux of cholesterol.
    • But there are no good markers for flux.
    • Absorption: test for plant sterol absorption (weak marker).
    • Synthesis: test for cholesterol precursors such as desmasterol (decent marker).

Key Takeaways:

  • Test for apoB or LDL particle number.

  • Test for cholesterol absorption and synthesis markers (if needed).

Worth Listening:

  • 8/10

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