vlmd rounds Vyvyane Loh, MD

Fuzzy science” abounds in the world, and even luminaries fall into its trap sometimes. This review clarifies the mis-explanations of important concepts in lipid science that were discussed in Peter Attia’s podcast. The interview with Dr. Thomas Dayspring resulted in a 7 hour series that promised a deep dive into cholesterol and lipoproteins. Lipid science is a complex and ever-evolving field. Understanding some of the basic tenets of the field helps us traverse more complicated topics. The intention of this review is to help clarify the important points Dr. Dayspring made and to open up the scope of the discussion by examining less considered aspects of cholesterol, lipoproteins and their functions. The deep dive into the topic by Drs. Attia and Dayspring was indeed much needed and appreciated and this review acts merely as supplementary commentary or footnotes to the discussion. Since Attia and Dayspring devoted an impressive 7 hours to their discussion, the 2 hour length in this episode respects the time and effort that went into their series by attending to their points in detail. Let me know your thoughts in the comments. What questions do you have from Dr. Dayspring’s interview?
Time stamps: 00:00 Intro 
05:11 Criteria for review 
06:53 Aligning with their intention 
09:29 Feynman's scientific principles 
11:28 Phospholipids 
18:46 Lipid Rafts 
30:54 TD: "All cells make cholesterol." 
45:28 The Rare Exceptions 50:45 Lipoproteins & cholesterol in artery walls 
1:05:59 Pools of Cholesterol 
1:09:50 Lipoprotein density
1:12:23 How apoproteins are bound 
1:15:04 Statins & liver selectivity 
1:21:05 Cholesterol functions & metabolism 
1:31:02 HDL 1:34:11 RBC membrane cholesterol 
1:36:59 Lipoprotein lineages 
1:40:48 ApoE 
1:50:40 Cholesterol's function in lipoproteins 
1:59:55 Unregulated apoB 
2:02:23 Conclusion  
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 Why Tuberculosis & Atherosclerosis are Siblings!
You can learn a lot about someone if you know their family members. That's why we're looking at Tuberculosis in this episode. 1.8 billion of the world's population has been infected by TB. Most of them have latent infection. 10.6 million had active infection in 2021. This common infectious disease has many similarities to atherosclerosis and we could learn a lot about plaque formation by looking at TB.
#tuberculosis #tb #atherosclerosis #ldl #cholesterol #metabolichealth


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We'll discuss the general process of vascular calcification and some common risk factors for this. How do smooth muscle cells in the blood vessel wall contribute to the process? And what about macrophages? How do statins affect calcification? What about CAC-scores? What would happen if you have a low score and started taking a statin? Which calcified plaques are at highest risk for rupture? Find out in this episode of vlmd rounds.
#atherosclerosis #ldl #cholesterol #calciumscore


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Improve your metabolic health: www.tulaversity.com


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Learn about the role of macrophages in atherosclerosis. Where do they really come from? How do they contribute to the plaque? How are they driving the immune reaction? What's the relation between macrophages and T cells? We'll also look at vascular inflammation in the form of autoimmune vasculitis and note the similarities with atherosclerosis.
#LDL #atherosclerosis #choelsterol #plaque #heartdisease #vasculitis #macrophages


My website: vyvyanelohmd.com
Check out the livestream dates


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Continuing on my discussion from episode 48, I lay out the real significance of the Vasa Vasorum. What is it about the vasa vasorum that plays into Atherosclerosis as an autoimmune disease? What's the real difference between the vasa vasorum of veins vs arteries?
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I've been asked so many times about which end of the blood vessel allows entry of LDL particles that I've decided to address the question in this episode. One of the reasons there is so much confusion around discussion of the vasa vasorum is that we only focus on 1 tiny aspect of it and not the whole picture. All that missing information leads to confusion, "fuzzy talk" about the vasa vasorum and the pathogenesis of atherosclerosis. I've decided to do 2 episodes on the topic and in this 1st part, we'll just look at the full description of the vasa vasorum--its structure and organization. We'll also look at what is happening at the luminal side to clarify the 'back door' vs. 'front door' issue. And then I'll reveal the true significance of the vasa vasorum in part 2. 
#vasavasorum #atherosclerosis #cholesterol #ldl #heartdisease 


Online Metabolic Foundations Program: www.tulaversity.com.
My website: vyvyanelohmd.com