Assumptions about Dayspring based off the Attia / Feldman Podcast

attia

(John) #1

First off, I’m a big fan of Peter Attia. He seems like a really knowledgable guy. But that podcast really annoyed me. I realize there is another thread going about this but the impression I got after listening to 3 hours of that in addition to reading the transcript was that us “low carbers” are a bunch of goofs who are feeling so good on our new diets that we won’t listen to any type of science or logic.

The Peter Attia transcript shows comments like:

Attia: “Well, I’m going to keep eating my bacon and eggs like it’s mainlining, and ignoring my LDL-C because my HDL-C is high and my trigs are low, because I’m on a low carb diet, and somehow that makes me special, because no one’s proved that this is wrong.” Wow. That’s not the legacy I want."

and

Attia: “But, if they share your passion for truth, then they should happily fund you to go to an NLA meeting and spend a week there, and actually, start hanging with these guys who are way smarter than me. I’m a knucklehead, I know a lot about lipids for a knucklehead. But, I’m talking about, the smartest people in the world are the ones you need to be talking to on this topic. And they’re not at low-carb conferences, I promise you that. They’re not on Twitter, and they’re not playing patty cakes on their high-carb, whatever, low-carb blogs”

In addition to that, located in the transcript, was a bunch of what I felt were snarky “corrections” by the untouchable Thomas Dayspring. (https://peterattiamd.com/davefeldmantranscript/)

After being a bit bummed out feeling like a conspiracy theorist who is applying my disdain for nutrition guidelines to the almighty depth of research about LDL and its “obvious” cause in CAD I figured I’d go check out this Thomas Dayspring guy… maybe I’d learn why Attia comes across like such an a$$. Maybe he’d tell me that eating fat will indeed kill me.

So I watched this:

What did I learn? THAT THOMAS DAYSPRING SUPPORTS AND RECOMMENDS KETO AND SEEMS LIKE A REASONABLE GUY. I was shocked after watching that. I was expecting Dayspring to come across like vegan Dr. Khan. I assumed he would be a total ivory tower academic elitist supporting low fat eating. Not so.

So basically my rant will end with this: I feel like Attia and @DaveKeto sort of got lost in the weeds (and Peter’s tangents) of trying to prove or disprove the energy model. While yes that is amazing to debate I think some of the podcast should have been devoted to how LDL doesn’t change in majority of low carbers and that low carb has benefits that reduce the CAD risk in other ways (such as inflammation and reduction of insulin resistance). Maybe that’s just obvious to everyone but all the annoyance that Attia showed made me think he’s anti keto and that we are all going to our grave.

If anything - watch that video of Dayspring. It just reminds me that if LDL is so causal to CAD and such a killer and here we have a “top lipidologist” recommending a high fat diet… something doesn’t jive with that.


(Todd Allen) #2

Dr. Attia is a major advocate of a ketogenic diet and puts many of his patients on low carb or keto diets. But for maybe 10% of his patients he sees test results he finds very concerning. This is hugely better than the more than half of people with bad test results on high carb diets. His message is to investigate anomalous results, try to understand what is going on and if needed address it. It isn’t about whether things like fat are good or bad it is figuring out what is good or bad for you.


(Bob M) #3

No one knows what’s good or bad for you. The problem with Attia is he THINKS he knows and slams anyone who doesn’t agree with him.

I have only read part of the transcript, but I can say the tone of the interview from the part I read was truly disgusting. It’s Attia blabbering away for 4/5ths of the time. That’s not a conversation.

I think these guys have it worked out:

Unfortunately, they pulled the paper. But in the paper the authors went over a number of studies of FH (familial hypercholesterolemia, the top 1% or so of LDL and TC people) people and showed that heart disease was independent of LDL. (eg, people with FH live just as long as those without FH, multiple other examples.) They then showed that it was potentially errors in coagulation (aggregation) of blood that caused heart disease in people with FH.

Are they right? It’s certainly plausible (and fits WAY more scenarios than does the LDL = death hypothesis). Would Attia even give this a passing thought? Heck no.

Get Ivor Cummins, Dr. Malcolm Kendrick (or Uffe, if he’d be willing to do this), Attia, and Dave in a room with a moderator, someone that gives them time to answer but no more, and THAT would be interesting.


(Nicole) #4

Get Ivor Cummins, Dr. Malcolm Kendrick (or Uffe, if he’d be willing to do this), Attia, and Dave in a room with a moderator, someone that gives them time to answer but no more, and THAT would be interesting.

Yes! That would be amazing. Maybe Rogan’s show…


(Randy) #5

It’s hard to keep an open mind when Attia is so condescending.


(Karen Parrott) #6

I’m happy to help Dave get to a lipid meeting ( by donating a small amount) to learn more and talk more to the scientists. I learned lippidology in 1987-88 in a medical setting from a teacher who learned lippidology from the Cleaveland clinic. Even then, without knowing geneotyping of FH, it was complex and mind blowing. I’m a Medical Technlogist in real life, in my 31st year.

Disagreement is okay with me. Both Dr Attia and Dave bring a lot to the table. I’m a LMHR, BTW. I see cross functional learning as key in this case. The doc sees many patients, Dave meets many hyper responders. Progress is being made in that Dave is bringing us together.

It’s an interesting time and place to be. Looking forward to more key learning from both.


(KCKO, KCFO) #7

When I went looking for info on Dayspring, I found this one and stopped looking, he is with Gary Taubes. It isn’t about lipids, but it is about fats and why they are not bad for us. Love they mention the wonderful SiFi movie, Fantastic Voyage.


(Todd Allen) #8

I keep in mind he is a doctor. Considering his profession, his condescension to knowledge ratio strikes me as quite good.


(What The Fast?!) #9

Me too, but minus the lean part. My LDL (both C and P) are insanely high - higher than those discussed on the podcast - but everything else is great. After listening to the show, I’ll admit - I’m concerned. I have been moving more toward fish and unsaturated fats, but I don’t know if that’s the right path.

Since you’re a LMHR, do you worry about LDL and if so, are you modifying keto at all to account for that?


(Todd Allen) #10

Since the Attia/Feldman podcast Peter has posted a 5 part series of podcasts with Dayspring. As someone who has had significant changes in my lipid panels eating keto this series has helped me better understand the good (not hdl), the bad (not ldl) and the ugly (not triglycerides).

https://peterattiamd.com/podcast/


High cholesterol and triglycerides
(Bacon is a many-splendoured thing) #11

I hold Dr. Attia in great affection, mind, and you are right about his condescension to knowledge ratio. Nevertheless . . . there is a joke about St. Peter getting Sigmund Freud’s spirit to psychoanalyze God, who’s been acting very strangely. Dr. Freud comes out of the room after several days and says, “It’s a very serious case—He thinks He’s a doctor!” :grin:


#12

What did you mean when you said, “unfortunately, they pulled the paper”? I just downloaded it by following that link.

My frustration with the discussion between Attia and Dayspring is that it feels like they’re being coy. BOTH of them were strong LCHF advocates just a few years ago, and now Attia refers to “precious low carb diets” and Dayspring makes ominous-sounding comments about those people losing weight but not paying attention to their lipids.

And what did Attia’s nutritionist advise Dayspring to eat on his fasting days to lose all his weight? Attia said in an interview with Tim Ferris that he would post his keto-friendly adaptation of Longo;s fasting mimicking diet food, but never did. I emailed him and asked for it and never got a reply.

I downloaded and printed out the entire transcripts of the Attia/Dayspring and Attia/Feldman conversations and am going through them with a highlighter, trying to get clear about just what we need to be concerned about, but I’m not getting very far.

If you listen to Ivor Cummins and Malcolm Kendrick, there is nothing to be concerned about on keto, but I have to admit Dayspring has me wondering. I haven’t had a lipid panel done since I started keto (again) last January, so I’m going to have that done soon.

I feel really let down by Attia and Dayspring. I printed out Attia’s 9 part cholesterol series as he posted it a few years ago and read through that very carefully, read all his blog posts. Now he seems to have done an about-face with no clear statement why. Dayspring seems to be doing the same.

It leaves me feeling that they don’t know if keto is problematic (even if just for a portion of the population), but they won’t say that.


#13

But that’s just the problem - that video (and the one below, of Dayspring with Gary Taubes) is from a few years ago. Science changes, which is fine, but I want Dayspring and Attia to be clear about what they’re saying. Are they saying that their previous statements were wrong? They won’t say. Instead, they talk around the issue.


(Todd Allen) #14

I think there are still enough gaps in the science that you aren’t going to get definitive statements but my take is Dr. Attia’s current stance is keto is great for about 80% of the population. Of the remaining 20% for maybe half some things get better and some worse and the balance isn’t readily clear. For maybe 10% he sees concerning changes in lipid panels that merit careful investigation to determine what is up. For some of those, not all, the changes in lipids probably accelerate heart disease and it disturbs him that this is being overlooked or ignored by many. For some with a poor response to keto a shift from saturated fats to monounsaturated fats improves their lipid profile. It’s hard to judge when/how best to preventatively treat for heart disease and few doctors do a good job of it.


#15

That’s basically my take, too, but they don’t just SAY that clearly. Because of their public stances in the past, I think they have an obligation to make clear statements about this. They clearly don’t agree with me!


(Todd Allen) #16

No they don’t. I formed that impression in combination with several other podcasts and videos he has done.

There are moments when I am dumbfounded by cursory acknowledgements of grievous problems with medical research, drugs such as statins and their testing protocols, poor alignment between patient interests and the for profit interests of big pharma and the healthcare system, etc. followed by views that strike me as overly confident in the value of pharma and healthcare. Despite that I think Attia is probably a better doc than any I’ve had and I appreciate the info he provides.


(Bob M) #17

How does Attia know this is beneficial? How does he know this won’t CAUSE more disease than he’s trying to prevent? He does not. He simply BELIEVES it does. Therein lies the crux of the problem.

Too bad there is no NUSI to run an RCT to settle this. As it is, we’re all shooting in the dark because there are no RCTs with people who eat low carb, who get “bad” lipid profiles, and then “correct” those profiles using more monounsaturated fat. Until such time as there is an RCT, I personally just ignore my “high” LDL-p.


(Todd Allen) #18

While it is nearly impossible to be certain of anything, he has done this with patients under his care, patients with deep pockets willing to pay for the best care and testing to guide and evaluate that care unconstrained by limitations such as insurance compensation. He has hired staff to help him monitor and interpret relevant medical research and has developed relationships with leading experts with whom he consults on difficult cases. While acknowledging the limitations of medical science that’s about as good as healthcare gets, at least in the US.


(Bacon is a many-splendoured thing) #19

Just to clarify, you meant to write “LCHF,” right?


(Bacon is a many-splendoured thing) #20

Dr. Phinney says something similar, that perhaps 20% of the population is naturally insulin-sensitive and therefore fine on HCLF. My question would be whether that sensitivity changes over time, because I hit a certain point in my mid- to late-twenties when suddenly I started gaining weight, whereas before, my metabolism could handle any amount of calories and any macro ratio without gaining weight or visible fat. Was I always developing insulin-resistance, or was there a point when something changed, and insulin-resistance began?