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klipklop 6 days ago

What I always wondered is if I get this test done, what would I even do with the results? If my arteries are already clogged, etc.

Can this plaque be reversed?

Theodores 5 days ago | parent | next [-]

I hope so!

There are many different schools of thought regarding diet and nutrition. No topic is more controversial since everyone with a stomach has an opinion.

There is science but that has to be believed in. Depending on your favourite foods and your values, you have to dismiss one half of the science as paid for by big beef or the other half as vegan propaganda.

A change in my environment led me to re-evaluate my food choices and I was open minded to completely changing everything. However, I did not go down the butter and bacon route. I became strictly whole food, plant based. This means always cooking from scratch with no processed foods or animal products. It is just an ongoing experiment with a study size of just one.

I did my research and upped my kitchen game. I was surprised at how much I used to enjoy no longer interests me and how easy it has been to stick to a diet rich in vegetables, beans, pulses and much else that I previously never cared for.

So, why am I telling you this?

Well, some believe that a whole food, plant based diet is best for your arteries. Having given it a spin to have a body that I am happy with, I am hoping they are right.

Do your own research with scepticism. Remember that nutrition is highly controversial and, just out of intellectual curiosity, see how it goes on a whole food, plant based diet. Originally I was only going to try and go without processed food for a month, but, with that target met, I kept going and learned more about nutrition just in case there was anything I was missing out on. The only thing turned out to be vitamin B12, which I supplement, with that being the only supplement.

ethan_smith 6 days ago | parent | prev | next [-]

Plaque regression is possible through aggressive LDL lowering (statins+ezetimibe/PCSK9i), lifestyle changes, and has been documented in clinical trials like REVERSAL and ASTEROID showing 6-9% regression with intensive therapy.

wrs 6 days ago | parent | prev | next [-]

Normally yes, through some combination of diet, exercise, statins, and the new kid on the block, PCSK9 inhibitors.

FollowingTheDao 6 days ago | parent [-]

Manganese has been show to reverse plaques.

https://medicalxpress.com/news/2023-11-manganese-bullet-card...

quantumwoke 5 days ago | parent | prev | next [-]

AIUI per my doctor wife, plaque cannot currently be reversed with a medication. It's about minimising future risk rather than reversing damage. Remodelling the plaque with medications does happen to a limited extent as commented elsewhere in this thread.

lokrian 4 days ago | parent | prev | next [-]

At least one clinical trial is underway for a drug that can remove the plaques: https://www.lifespan.io/news/cyclarity-launches-human-trial-... But yeah, we badly need more companies doing more research in this space.

DiabloD3 6 days ago | parent | prev [-]

Yes.

anonzzzies 6 days ago | parent [-]

... more info please..

DiabloD3 6 days ago | parent [-]

So, the simple explanation is this: Cholesterol is a necessary and important chemical, specifically, it is a sterol, and a precursor for Vitamin D, cortisol, estrogen, testosterone, and the substance that makes up the myelin sheath is. Cholesterol is not, and never will be, "the bad guy". Your body produces almost a gram of it a day, but dietary amounts are only about a third of that.

It it also the backbone of apolipoprotein, which is the actual thing your Doctor is talking about when they say "good cholesterol" and "bad cholesterol". Apo combined with other things (triglycerides and phospholipids) make HDL, LDL, and other familiar "cholesterol particles".

Since they shuttle fatty acids around, these fatty acids can be oxidized. When there are too many lipoprotein particles than your cells can safely clear, macrophages end up being targeted by the particles. Macrophages that take on too many damaged particles (damaged by the fatty acid oxidizing) can ram into arterial walls, which summons platelets to try to fix it.

The platelets use a calcium-based substance to fix the damage. Its sorta like organic concrete. Over a lifetime, your arteries become clogged with the concrete.

So.

The western diet and lifestyle lacks many important things required for healthy living. One of these is sufficient sun. Although Vitamin D supplementation is absolutely required for many people (most science is indicating that 2000 IU isn't even enough but is a bare minimum), we also have extremely little K2 in our diet compared to our ancestors, since it comes from certain fermented foods, and we largely no longer eat the correct fermented in sufficient amounts foods, even though it has been a staple of our diet at least 20 or 30 thousand years; long enough that it has changed our gut bacteria to basically necessitate it for many reasons.

K2 is required for signaling of arterial plaque removal, among other things. That organic concrete? It's not meant to be permanent, its meant to merely to stop you from potentially hemorrhaging.

Also, fun fact, anticoagulants that act as K2 antagonists (Warfarin, etc) lead to vastly increased arterial calcification (since, as an antagonist, it blocks K2 signaling). Those anticoagulants also can lead to brittle bones, because K2 is also used for signaling in a few biological processes that want to deposit the calcium in the right place.

So, I could just say "eat healthily", but nobody knows what the fuck that means. Beef liver and hard cheeses are good sources of K2, so is Sauerkraut and Kimchi. Supplement companies also sell good Vitamin K-focused multivitamins, many of which are a oil-filled gelcap with K1, K2 MK4, K2 MK7, and a meaningful D dosage (so its a drop in replacement for your daily D gelcap) (ex: Jarrow K-Right, but all the major good ones have a product like that).

moltar 6 days ago | parent [-]

Since you appear to be quite knowledgeable on the matter, I wonder what’s your opinion on Cholesterol Code and Dave Feldman? Thank you.

DiabloD3 5 days ago | parent [-]

I have not seen it yet, however I have heard favorable responses about it. The responses have largely been that Dave's theory is basically a near-complete summary of science that doesn't include roughly the past 5ish years of scientific advancement, so it isn't entirely right, but a good deal of the way there. He's been shaping this theory for like a decade now. People who are more familiar with this (such as career research endocrinologists) have given favorable commentary about it, but it isn't perfect and has small gaps.

I have seen him speak about his theory on a few well known medical/science podcasts, so I am a little familiar with his work so far. I find it interesting that he isn't a career biologist in any way, but a software engineer. So, I imagine he'd fit in with the HN crowd quite well.

The major part of his theory I think that is interesting is people who have weird insulin responses (ie, have been or are insulin resistant; so, have, had, or will have Diabetes) have largely shaped what we consider normal cholesterol numbers. Also, people who are lean and eat low carb may just naturally have different ratios of cholesterol numbers; iirc part of his argument involves the LDL-P(articles) to LDL-C(holesterol in the particles) ratio or LDL-C to TG ratios, and how it may be that they have "bad" ratios that most doctors would try to treat with statins, but there is actually nothing wrong with them, as other biomarkers and CAC scans indicate there is no increase in arterial damage even though they have "bad" ratios.

So yeah, I'd consider it worth watching, but don't take it as gospel. If it shows up on a streaming service I have, I'll consider giving it a watch.

moltar 5 days ago | parent [-]

Thank you for the thoughtful and thorough response!