I recently posted on Twitter about my frustration with the way the press writes about “good” and “bad” cholesterol, and several people then asked me for the TL;DR version of ‘cholesterol 101.’ As I realize not everyone can take the time to go through the many hours of cholesterol content we have on The Drive, here is my attempt at explaining the basics of lipids, lipoproteins, and why there is no such thing as “good” or “bad” cholesterol.
Of course, if you really want to understand the field of lipidology, there is no substitute for going through our past cholesterol content. But in this video, you can certainly learn far more than most health journalists will ever know (and even more than some doctors know).
If you do want to dive into this topic more, check out some of the following content:
- AMA #34: What causes heart disease? | April 18, 2022
- Peter on how early and aggressive lowering of apoB could change the course of ASCVD | April 11, 2022
- 6-Part Series on Lipidology with Tom Dayspring, M.D., FACP, FNLAA | October 15, 2018
Thanks Peter for putting this in a nutshell. You’re such a clear explainer but your podcasts are often too long for me. You have my vote for more nutshell stuff like this!
Agreed! This was very enlightening and easy to digest. Love the podcast, but the super technical discussions on the podcast tend to have a hydrophobic effect on my brain.
No dr tell like this in such a detail way
Peter attia u r such a gem….
Thank You Peter for this excellent explanation. You have my vote for more of these nutshell video lessons.
I would like tpo comment that the icreased cholesterol is the “cry” of the injured Cell membrane.
Prof. B. Momcilovic, MD
So articulate. Such an incredibly smart man that can convey complex topics in such a understandable way. Thank you for the information!!
Thanks Peter for bringing light to ApoB. My level went from 92 in 2019 to 137 this year. I have been sounding the alarm with my cardiologist but they seem to not give one iota about this marker and tell me that because I exercise and eat well that I have nothing to worry about. Frustrating indeed.
You are the best at explaining! Can’t tell you how much I’ve used your information both personally and professionally when educating and counseling patients as a dietitian. Thank you for sharing your gift of knowledge with passion. Your pursuit of the most accurate and current information available across a spectrum of topics is so greatly appreciated.
It is shocking to me that many lipid science professionals are still using the good cholesterol bad cholesterol nomenclature! I recently read an article about a potentially great cholesterol lowering addition to the statin/ezetimibe combo in development by New Amsterdam Pharma. I was appalled and very much put off by the scientist referring to the HDL cholesterol as the “good cholesterol” and LDL cholesterol as the “bad cholesterol “.
As you mentioned, it illuminates a big question as to if the writers understanding of the subject matter Is to be believed!
Thank you for this welcome and clear explanation. I listen to your podcasts, but I often wish you would define terms (especially acronyms) and basic functions before going on to discuss them.
Another comment I have is that your podcasts are often directed to athletes, which is fine, but i wish you would also consider how what ever you are discussing relates to those of us who are already older (60+) and want to apply the knowledge in service of healthy longevity.
I’m following your podcasts with great interest. Thank you for shedding a qualitative scientific “healthy” light on medicine vs. often too popularized medical journalism. I understand the frustration, it bothers me as well.
I’m wondering if you would think this analogy works:
Imagine an alien watching a highway on earth from a powerful telescope. There are little cars on the road as well as big trucks. LDL’s are like little cars and HDLs are like big trucks. Is it good or bad to have trucks on a highway? Well it is more efficient to ship a lot of goods in a big truck, but then you go to the store in your car to buy stuff so a highway is going to normally have a mix of cars and trucks on a highway.
From your video you say HDL is not good but you also mention that LDLs have a habit of causing inflamation. Does that imply if our body is operating efficiently, it is shipping more via the ‘trucks’ rather than ‘cars’? But if you try to force that, you defeat the purpose. Kind of like having a large semi-truck go down to Wal-Mart to bring you back a single box of detergent.
Pharmacist here: This was a fantastic TL/DR on lipids. Looking forward to future talks on this. Thank you!