What causes cardiovascular disease (Lipid Series – Part 1) | Dr Thomas Dayspring

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If you’re a long-time listener of The Proof, you’ll know that I have a deep passion for better understanding heart disease and communicating this knowledge alongside the world’s leading scientists. This personal interest is one that I’m sure many listeners will share; almost everyone has either personally struggled with cardiovascular health or knows someone who has. In this three-part series with Dr Thomas Dayspring, we undertake an extended education journey on cardiovascular disease and blood lipids.

“The sooner in life you recognise [atherosclerotic disease] risk and you treat it appropriately, I think you can eliminate atherosclerotic disease as a morbidity and certainly as a mortality.”

Episode #251 forms Part One of this series. In this conversation, Dr Dayspring provides the foundational, technical knowledge needed to understand blood lipids, taking a deep dive into how our body absorbs lipids (fats and sterols) and transports them throughout the body. All in all, we examine what the lipid transport system is, the key parts of the system, and what happens when it goes wrong.

Importantly, Dr Dayspring is an excellent communicator, delivering complex information in a way that is digestible and engaging. If you can watch Episode #251 on YouTube I would highly recommend it; not only does Dr Dayspring speak with clarity, but is also an excellent illustrator. You will find explanatory illustrations and my key takeaways live in video format.

“ApoB is by far the best metric that every human should get tested for when they do their cardiovascular risk assessments.”

Dr Thomas Dayspring is a Fellow of both the American College of Physicians and the National Lipid Association and is certified in internal medicine and clinical lipidology. He is currently a virtual cardiovascular educational research assistant and clinical lipidology at a prestigious national practice, and has given over 4000 domestic and international lectures among a suite of other career achievements. Dr Dayspring is a true expert in lipidology, and continuously helps wider audiences make sense of this complex topic.

In this introductory episode, listeners will gain a deeper appreciation for what cholesterol and triglycerides are, how they are absorbed in the small intestine, and how they are transported through plasma (circulation). Dr Dayspring clearly outlines the two primary places where lipoproteins are produced – the small intestine and liver – and the function of the major classes of lipoproteins (chylomicrons, VLDLs, IDLs, LDLs, and HDLs).

We consider risk factors for atherosclerosis, discussing what goes wrong within the lipid transportation system that causes cholesterol to be deposited into the artery wall in a process called atherogenesis. We also address misconceptions about cardiovascular disease and the endothelium that are commonly perpetuated online, genetic influence, dietary cholesterol, and much, much more.

Specifically, we discuss:

  • Intro (00:00)
  • Turning a family heartache into a mission (05:12)
  • Atherosclerosis and the role of lipids (14:52)
  • Lipoproteins & cholesterol transport and recycling (28:01)
  • Cholesterol’s role in lipoproteins (54:00)
  • Is ApoB a more accurate marker of cardiovascular risk? (58:38)
  • Endothelial transcytosis of lipoproteins (1:07:10)
  • LDL aggregation (1:16:42)
  • LDL particle retention and inflammation (1:23:15)
  • Difference between veins and arteries (1:28:55)
  • Atherosclerosis and genetics (1:30:22)
  • High-fat diets and cholesterol (1:44:01)
  • Fiber and cholesterol absorption (1:48:14)
  • Outro (1:57:48)

Knowledge is power, and understanding your body is the most powerful tool you can have for taking control of your health. I hope you find value in Part One of this masterclass with Dr Dayspring, and appreciate his attention to detail, patience, and obvious passion. I know Dr Dayspring’s work has helped me make sense of this complex system, and the tips imbedded throughout this episode will help you better understand your own body. Stay tuned for Part Two and Part Three of this series, where we will examine how to assess cardiovascular disease risk, prevent it, and treat it.

The best place to connect with Dr Thomas Dayspring is on Twitter, @DrLipid. Learn more about Dr Dayspring’s career and current work on LinkedIn.

To assist with the digestibility of this content my team and I, along with Dr Dayspring, have added a bunch of illustrations and graphs to the video format of these episodes. So if you are visually inclined you can watch these episodes on our YouTube channel. Even if you prefer listening to the first time through audio, I highly recommend coming back for a second pass with the video versions. 

Get your copy of the Lipid Series Cheat Sheet at theproof.com/lipidseries. This comprehensive resource provides valuable insights on assessing your risk, preventing, and treating atherosclerotic cardiovascular disease (ASCVD), the leading cause of death worldwide. The PDF not only highlights key learnings from the 3-Part Lipid Series but also includes a 1-week meal plan designed to promote healthy cholesterol levels.

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.


More about Thomas Dayspring, PhD

Thomas Dayspring, who resides in the Richmond, VA area is a Fellow of both the American College of Physicians and the National Lipid Association and is certified in internal medicine, and clinical lipidology. After practicing in New Jersey for 37 years, in 2012 he moved to Virginia and served as an educational director for a nonprofit cardiovascular foundation and later as a Chief Academic Advisor for two major CV laboratories until mid-2019. Currently, he is a virtual cardiovascular educational research assistant & clinical lipidologist at a prestigious national practice. Career-wise he has given over 4000 domestic (all 50 states) and international lectures, including over 600 CME programs on atherothrombosis, lipids/lipoproteins (and their treatment), vascular biology, biomarker testing, and women’s cardiovascular issues. He has authored several manuscripts and lipid textbook chapters and performed several podcasts. Until 2019 he was an Associate Editor of the Journal of Clinical Lipidology. He was the recipient of the 2011 National Lipid Association’s Presidents Award for services to clinical lipidology. He has over 25K followers on his educational Twitter feed (@Drlipid). He is a Social Media Ambassador for the European Atherosclerosis Society.

Supporting studies

  • Apolipoprotein B-containing lipoproteins and atherosclerotic cardiovascular disease • PMID: 28299190
  • Dietary Fiber, Atherosclerosis, and Cardiovascular Disease • PMID: 31126110
  • Effect of Low Cholesterol on Steroid Hormones and Vitamin E Levels: Just a Theory or Real Concern? • PMID: 26405182
  • 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
  • Effects of Evolocumab on Vitamin E and Steroid Hormone Levels: Results From the 52-Week, Phase 3, Double-Blind, Randomized, Placebo-Controlled DESCARTES Study • PMID: 26228031
  • Hypertension, the changing pattern of drug usage • PMID: 19287817
  • 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
  • Low-density lipoproteins cause atherosclerotic cardiovascular disease: pathophysiological, genetic, and therapeutic insights: a consensus statement from the European Atherosclerosis Society Consensus Panel • PMID: 32052833
  • Microbial impact on cholesterol and bile acid metabolism: current status and future prospects • PMID: 30487175
  • Optimal low-density lipoprotein is 50 to 70 mg/dl: lower is better and physiologically normal • PMID: 15172426
  • Probucol Trial for Secondary Prevention of Atherosclerotic Events in Patients with Coronary Heart Disease (PROSPECTIVE) • PMID: 32336695
  • Role of liver in the maintenance of cholesterol and low density lipoprotein homeostasis in different animal species, including humans • PMID: 8245716
  • The cardiovascular system and the biochemistry of grafts used in heart surgery • PMID: 24324924
  • There is urgent need to treat atherosclerotic cardiovascular disease risk earlier, more intensively, and with greater precision: A review of current practice and recommendations for improved effectiveness • PMID: 36124049

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