In Episode #231, I sit down with Dr Alan Flanagan and Danny Lennon to examine cholesterol, statins, the ketogenic diet, and longevity.
“Getting LDL down always comes first.” – Dr Alan Flanagan
LDL cholesterol has been making waves on social media in recent years. With some diet camps making bold claims about its relevance and the apparently open-ended nature of the evidence, many laypeople may be unsure of how important cholesterol levels really are. In this episode, I’m joined by Danny Lennon and Dr Alan Flanagan to consider the role and importance of LDL cholesterol, looking at heart health on a wider scale as we recap what the literature says.
“The thing I find most difficult to accept is that there seems to be a willingness to dismiss any of the LDL evidence on the basis that it doesn’t apply to a specific population… there’s this idea that evidence becomes invalid, which is nonsensical.” – Danny Lennon
Alan Flanagan, PhD is a researcher and science-based nutrition educator. He is also the founder of Alinea Nutrition, an online education hub dedicated to providing impartial, science-based nutrition analysis. Danny Lennon is the founder of Sigma Nutrition, a company providing educational media content on evidence-based nutrition. He uses his scientific background to read and interpret the latest nutrition research and is a sought-after speaker on evidence-based nutrition.
“Academics don’t speak in the way that quacks do, with that total conviction and certainty that they’re right.” – Dr Alan Flanagan
In this episode, we take the time to unpack the basics of cardiovascular health, providing foundational knowledge and definitions before evaluating the implications. Dr Alan Flanagan and Danny Lennon address whether cholesterol matters if you’re metabolically healthy, why our veins don’t get atherosclerosis, and why our body makes cholesterol if it’s “bad for us”. They also offer advice on dietary adjustments you can make regardless of your dietary pattern, claims by social media “health gurus”, and much more.
Specifically, we discuss:
- Intro (0:00)
- Basics of Cardiovascular Health (4:29)
- ApoB for Predicting Disease (12:18)
- Heart Disease: Where things go wrong (23:23)
- What Causes Artery Damage? (38:47)
- Paul Saladino Claims (50:36)
- Is low cholesterol a problem? (1:04:07)
- Future of Gene Editing (1:27:12)
- Veins vs Arteries (1:32:28)
- Diet Claims (1:41:08)
- Healthy Keto Diet (1:54:08)
- MCT Oil (2:00:02)
- Healthy Fats (2:03:28)
- Final Thoughts (2:09:54)
- Outro (2:19:05)
Danny Lennon and Dr Alan Flanagan offer an excellent synopsis on what the evidence tells us about cardiovascular health and disease. Their knowledge is incredibly valuable, and this duo does an excellent job of bridging the gap between academia and the average person.
You can find Dr Alan Flanagan on Instagram, and learn more about Alinea Nutrition at https://www.alineanutrition.com/. Listen to his previous appearances on the show in Episode #159, Episode #225, and Episode #227.
To connect with Danny Lennon, head to his on Instagram and Twitter. Make sure to check out the Sigma Nutrition website and podcast. Danny previously appeared on The Proof in Episode #173.
The best way to support the show is to use the products and services offered by our sponsors. To check them out, and enjoy great savings, visit theproof.com/friends.
Enjoy, friends.
Simon
More about Alan Flanagan, PhD
Dr Alan Flanagan, PhD, holds an MSc and PhD in nutrition from the University of Surrey, and is a former practicing Lawyer (Barrister) from Dublin, Ireland. Alan is the founder of Alinea Nutrition, an online education hub dedicated to providing impartial, science-based nutrition analysis. Alan is also Research Communication Officer for Sigma Nutrition, creating educational resources for nutrition science. Originally a lawyer by background in Dublin, Ireland, Alan spent a decade practicing as a barrister before moving into science.
More about Danny Lennon, MSc
Danny is the founder of Sigma Nutrition, a company providing educational media content on evidence-based nutrition. Danny is the host of the top-ranked podcast Sigma Nutrition Radio, which as of 2021 has over 6 million downloads, and a monthly audience of ~100,000. His interest and knowledge spans across a number of different areas in nutrition. He has educated many nutritionists and coaches on how to program nutrition for their clients to improve body composition and adherence. Hundreds of coaches have attended his annual Sigma Nutrition Seminar over the past several years.
Danny uses his scientific background to read and interpret the latest nutrition research, before communicating the key points to his audience. In addition to his science background, Danny has also worked as a nutrition practitioner for several years. He has become well known for being the nutritionist to several professional MMA and boxing athletes. He wrote a successful book on this topic: “Sigma Weight Cutting System for MMA & Boxing”.
Danny is also a sought after speaker on evidence-based nutrition, speaking at conferences and seminars all over the world. He has resented at events all over Europe, Australia, and the United States. He has spoken at corporate organizations such as LinkedIn, Johnson & Johnson and Gilead Sciences.
Supporting studies
- 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk • PMID: 31504418
- 2021 Dietary Guidance to Improve Cardiovascular Health: A Scientific Statement From the American Heart Association • PMID: 34724806
- 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice • PMID: 34458905
- A receptor-mediated pathway for cholesterol homeostasis • PMID: 3513311
- Achievement of dual low-density lipoprotein cholesterol and high-sensitivity C-reactive protein targets more frequent with the addition of ezetimibe to simvastatin and associated with better outcomes in IMPROVE-IT • PMID: 26330412
- Apolipoprotein B and Non-HDL Cholesterol Better Reflect Residual Risk Than LDL Cholesterol in Statin-Treated Patients • PMID: 33736827
- Apolipoprotein B is an insufficient explanation for the risk of coronary disease associated with lipoprotein(a) • PMID: 33629108
- Blood cholesterol and vascular mortality by age, sex, and blood pressure: a meta-analysis of individual data from 61 prospective studies with 55,000 vascular deaths • PMID: 18061058
- Clinical efficacy and safety of achieving very low LDL-cholesterol concentrations with the PCSK9 inhibitor evolocumab: a prespecified secondary analysis of the FOURIER trial • PMID: 28859947
- Coronary Heart Disease in the Framingham Study • PMID: 13411327
- Dietary Fats and Cardiovascular Disease: A Presidential Advisory From the American Heart Association • PMID: 28620111
- Discordance of LDL Cholesterol with Alternative LDL-Related Measures and Future Coronary Events • PMID: 24345402
- Effect of very high-intensity statin therapy on regression of coronary atherosclerosis: the ASTEROID trial • PMID: 16533939
- Is Isolated Low High-Density Lipoprotein Cholesterol a Cardiovascular Disease Risk Factor? New Insights From the Framingham Offspring Study • PMID: 27166203
- Lipids, inflammation, and chronic kidney disease: a SHARP perspective • PMID: 29571452
- Long-term effects of maximally intensive statin therapy on changes in coronary atheroma composition: insights from SATURN • PMID: 24448227
- Long-Term Evolocumab in Patients With Established Atherosclerotic Cardiovascular Disease • PMID: 36031810
- Low incidence of cardiovascular disease among the Inuit–what is the evidence • PMID: 12535749
- Low-density lipoproteins cause atherosclerotic cardiovascular disease. 1. Evidence from genetic, epidemiologic, and clinical studies. A consensus statement from the European Atherosclerosis Society Consensus Panel • PMID: 28444290
- Medium-Chain Triglyceride Oil and Blood Lipids: A Systematic Review and Meta-Analysis of Randomized Trials • PMID: 34255085
- Normal LDL-Cholesterol Levels Are Associated With Subclinical Atherosclerosis in the Absence of Risk Factors • PMID: 29241485
- Optimal low-density lipoprotein is 50 to 70 mg/dl: lower is better and physiologically normal • PMID: 15172426
- Reduction in saturated fat intake for cardiovascular disease • PMID: 32827219
- THE ASSOCIATION BETWEEN LOWER LEVELS OF LOW-DENSITY LIPOPROTEIN CHOLESTEROL AND CANCER PREDATES THE DIAGNOSIS OF CANCER BY 18 YEARS • JACC
- The Effect of Coconut Oil Consumption on Cardiovascular Risk Factors: A Systematic Review and Meta-Analysis of Clinical Trials • PMID: 31928080
- Variation in PCSK9 and HMGCR and Risk of Cardiovascular Disease and Diabetes • PMID: 27959767
- Association of Triglyceride-Lowering LPL Variants and LDL-C–Lowering LDLR Variants With Risk of Coronary Heart Disease • PMID: 30694319
- 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice: Developed by the Task Force for cardiovascular disease prevention in clinical practice with representatives of the European Society of Cardiology and 12 medical societies With the special contribution of the European Association of Preventive Cardiology (EAPC) • PMID: 35525570
- Effects of apolipoprotein B on lifespan and risks of major diseases including type 2 diabetes: a mendelian randomisation analysis using outcomes in first-degree relatives • PMID: 34729547
Additional resources
- Kowa to discontinue K-877 (pemafibrate) “PROMINENT” cardiovascular outcomes study • News release, Kowa Research Institute, Inc. April 8, 2022
- Listen to the mentioned Sigma Nutrition podcast episode with Professor Chris Packard here
- More CRISPR In Human Subjects • Science
