Understanding ApoB and LDL: The Longevity Factors
In a profound conversation between two esteemed health experts, Dr. Peter Attia and Dr. Andrew Huberman, the duo discusses the critical relevance of low ApoB and LDL cholesterol levels to longevity.
How is Smoking Related to Causality in Medicine?
Firstly, Attia and Huberman lay a foundational understanding of the criticality of causality in medicine, using the link between smoking and lung cancer as an illustration.
"If you believe that smoking is causally related to lung cancer, then smoking cessation reduces the probability of lung cancer. That is a logical equivalency," Dr. Attia asserts.
The critical element here is recognizing that cause and effect relationships in medicine can be as significant as they are in everyday life.
ApoB and LDL: The Underestimated Factors
The main focus of their discussion, however, revolves around ApoB and LDL cholesterol, factors often underestimated in medical practices today. Here's where the analogy to smoking comes in.
"There is no ambiguity that ApoB is causally related to atherosclerosis," Dr. Attia points out.
This statement, backed by numerous clinical trials, epidemiologic literature, and Mendelian randomizations, stresses that the levels of LDL cholesterol or ApoB have a direct, causal relationship with atherosclerosis.
Challenging the Current Approach in Medicine
As per the present medical protocol, an individual's risk for a major adverse cardiac event (MACE) - heart attack, stroke, or death resulting from these, is calculated based on a 10-year prediction. This estimation considers multiple factors, including cholesterol levels, blood pressure, and smoking habits, among others. However, according to Dr. Attia, this methodology has inherent flaws.
"If a risk is causal and it is modifiable, it should be modified regardless of the risk tail in duration," he argues.
Thus, treating LDL or ApoB levels shouldn't depend on the calculated risk, but on the principle of causality. This statement effectively challenges the conventional approach in medicine today.
Setting New Standards for ApoB and LDL Levels
Moving forward, the conversation dives into the specifics of what ApoB and LDL levels should ideally be. For individuals with no evidence of disease or risk factors, Dr. Attia suggests aiming for the 5th percentile of the population, around 60 milligrams per deciliter. For those with more risk factors, ApoB should be treated to the 1st percentile, approximately 30 to 40 milligrams per deciliter.
In response to a question from Dr. Huberman, Dr. Attia explains that a figure in the low 130s is a "huge red flag," despite exceptions in some individuals. In essence, the higher the ApoB and LDL levels, the greater the potential for health issues, based on a cause-and-effect perspective.
In conclusion, this in-depth discussion with Dr. Peter Attia and Dr. Andrew Huberman sheds light on the importance of understanding and managing ApoB and LDL cholesterol levels. It highlights the need to scrutinize our approach to these essential aspects of health, giving us an opportunity to alter our lifestyles, adopt better medical practices, and work towards a longer, healthier life.
Now that you understand the significance of these factors in enhancing longevity, it's time to rethink how we view our health. Just like the causality between smoking and lung cancer is universally accepted, it's high time we acknowledge and act upon the crucial connection between ApoB, LDL cholesterol, and heart health.
Making the Best Judgment for Individual Health
Just as not every smoker gets lung cancer, not everyone with high cholesterol will suffer from atherosclerosis. But this doesn't negate the causal relationship between these factors.
"You basically have to ask the question, how do I make the best judgment about an individual from heterogeneous population data and based on what are causal and non-causal inferences around risk," Dr. Attia reasons.
The takeaway here is that it's not about the certainty of developing a condition but the risk associated with it. Lowering this risk, when possible, should always be a priority.
The Path Towards a Healthier Future
In this riveting conversation, Dr. Attia and Dr. Huberman effectively challenge the status quo, questioning the logic behind current medical practices and proposing a more effective and informed approach. Their discussion underscores the importance of reevaluating our health strategies and embracing new knowledge and perspectives.
As we move forward in our health journeys, it's crucial to remember that while ApoB and LDL cholesterol levels are just one aspect of our overall health, they are key indicators that can guide us towards a healthier, longer life. It's time we take this critical knowledge, apply it, and step into a healthier future.
The fundamental truth, beautifully highlighted in this insightful discussion, is this: "The earlier you start, the less aggressive you need to be, the less damage that's there already." Whether it's quitting smoking or managing our cholesterol levels, proactive steps today can make a significant difference in the longevity and quality of our lives tomorrow.