Mark Bell's Power Project - Cholesterol, Red Meat Warnings & The Blood Marker You’re NOT Getting Tested (APO B) - Stan Efferding || MBPP Ep. 957

Episode Date: July 12, 2023

In Episode 957, Stan Efferding, Mark Bell, Nsima Inyang, and Andrew Zaragoza talk about what foods can lower your cholesterol and what test is necessary in order to really know where your cholesterol is. Sponsors mentioned on air: ➢ https://marekhealth.com Use code POWERPROJECT10 for 10% off ALL LABS at Marek Health! Also check out the Power Project Panel: https://marekhealth.com/powerproject Use code POWERPROJECT for $101 off! ➢ https://PowerProject.Live for the NEW Power Sandal 2.0 ➢ Piedmontese Beef: https://www.CPBeef.com/ Use Code POWER at checkout for 25% off your order plus FREE 2-Day Shipping on orders of $150   New Power Project Website: https://powerproject.live Join The Power Project Discord: https://discord.gg/yYzthQX5qN Subscribe to the new Power Project Clips Channel: https://youtube.com/channel/UC5Df31rlDXm0EJAcKsq1SUw   Special perks for our listeners below! ➢https://drinkag1.com/powerproject Recieve a year supply of Vitamin D3+K2 & 5 Travel Packs! ➢ https://withinyoubrand.com/ Code POWERPROJECT to save 15% off supplements!   ➢ https://markbellslingshot.com/ Code POWERPROJECT to save 15% off all gear and apparel!   ➢ https://mindbullet.com/ Code POWERPROJECT to save 15% off Mind Bullet!   ➢ https://goodlifeproteins.com/ Code POWERPROJECT to save up to 25% off your Build a Box   ➢ Better Fed Beef: https://betterfedbeef.com/pages/powerproject   ➢ https://hostagetape.com/powerproject Free shipping and free bedside tin!   ➢ https://thecoldplunge.com/ Code POWERPROJECT to save $150!!   ➢ Enlarging Pumps (This really works): https://bit.ly/powerproject1 Pumps explained: https://youtu.be/qPG9JXjlhpM   ➢ https://www.vivobarefoot.com/us/powerproject to save 15% off Vivo Barefoot shoes!   ➢ https://vuoriclothing.com/powerproject to automatically save 20% off your first order at Vuori!   ➢ https://www.eightsleep.com/powerproject to automatically save $150 off the Pod Pro at 8 Sleep!   Follow Mark Bell's Power Project Podcast ➢ https://www.PowerProject.live ➢ https://lnk.to/PowerProjectPodcast ➢ Insta: https://www.instagram.com/markbellspowerproject ➢ YouTube: https://www.youtube.com/markbellspowerproject   FOLLOW Mark Bell ➢ Instagram: https://www.instagram.com/marksmellybell ➢https://www.tiktok.com/@marksmellybell ➢ Facebook: https://www.facebook.com/MarkBellSuperTraining ➢ Twitter: https://twitter.com/marksmellybell   Follow Nsima Inyang ➢ https://www.breakthebar.com/learn-more ➢YouTube: https://www.youtube.com/c/NsimaInyang ➢Instagram: https://www.instagram.com/nsimainyang/?hl=en ➢TikTok: https://www.tiktok.com/@nsimayinyang?lang=en   Follow Andrew Zaragoza on all platforms ➢ https://direct.me/iamandrewz   #PowerProject #Podcast #MarkBell #FitnessPodcast #markbellspowerproject

What are people looking at when they're concerned about cholesterol? Is it still attached to heart disease? We always looked at LDL as being probably the most accurate measure of your cardiovascular disease risk. ApoB is even more accurate. You can get low-saturated fat meats. You can have a low-saturated fat diet that includes animal foods and that can lower LDL.

You can have a healthy plant-based diet or a healthy animal-based diet if you do a few things. And what we see is that when you replace saturated fats with processed carbs, you don't see a reduction in LDL. Elderly populations, the ones who have the highest LDL, live the longest. And the ones with the lowest cholesterol die sooner. It's reverse causality. Sick people, their cholesterol goes down.

That's often used as evidence for why people shouldn't worry about cholesterol. Pepperdosh family, welcome to the podcast. That's often used as evidence for your support, and enjoy the episode. All right, Stan, we're going to play a clip, and I think it can give you an opportunity to explain to people cholesterol and maybe some of the, I don't know, there's a lot of myths still with cholesterol. I actually had somebody message me yesterday and they said my wife would love to get on some sort of over-the-counter supplement to lower her cholesterol. And what do you think, like what is the main reason do you think, like why, like what are people looking at when they're concerned about cholesterol? Is it still attached to heart disease? What are people looking at when they're concerned about cholesterol?

Is it still attached to heart disease? Yeah, but it's kind of hard because people don't distinguish between what raises cholesterol in the bloodstream and from cholesterol that you eat. So we could take a dive into that today to try and help people understand. And I'll keep it real simple, but I'll refer to the people who are experts in the industry. And there's also been, I'm not saying this without insulting anybody, but the low-carb community has probably the best way to describe it is kind of been LDL denialists for many years. But I'm seeing a gradual transition. And they tend to deflect from LDL as a causal factor and then look at all the other benefits that they realize from their diet that lower their overall cardiovascular disease risk. And so tend to kind of dismiss LDL in light of the bigger picture. But I think it's still important to focus on. So we should dive into it.

Low carb people are maybe dismissive because they're like, well, don't worry about it because you're not eating sugar and it's not going to be of any negative consequence. But it still might be, huh? Yeah. I mean, and there's an overall risk that's – it's many things that go into cardiovascular disease risk, including obviously your – I don't want to say BMI, but your body fat percentage. Yes. Your exercise, your sleep, your total dietary pattern, blood markers that we can talk about today, triglycerides, triglycerides, type 2 diabetes or insulin resistance, all those things obviously influence your hazard ratio for mortality risk. And so if you can improve all of those things and your total risk comes down, it's easy to say, well, maybe this isn't as important.

But it's also important. Why wouldn't we address it if it's possible? And we can talk about the ways to do that that still allow you to be low carb. And that, you know, that would be something I think would allow people to, to get the benefits of their low carb diet, all of the things that they've realized, which we can talk about some of the benefits are, but at the same time, reduce their long-term cardiovascular disease risk. It's still the number one killer. So we should pay attention to it. Yeah. Andrew, let's bring up this clip. We have a clip from Simon Hill where I thought he did a really good job of describing, I guess you would say, you know, kind of plants versus meat. But

some of the comparison I felt was a little bit unfair. Now, we've got to be fair to Simon as well. It's a one-minute clip or 90-second clip or however long you got for some of those reels. And so because of that, it's very hard to really explain much of anything when you only got 90 seconds. But we will have him on the show at some point, and we'll get his rebuttal and more information from him. But for now, let's kind of play this and let's go through it. If you've been told animal protein is superior to plant protein, you must listen to this. There's now countless studies showing that plant protein

is just as good as animal protein for building muscle if total protein needs are met. Hang on, hang on. Let's try that again. Maybe this is more compelling. There's now countless studies showing that plant protein is just as good as animal protein for building muscle if total protein needs are met. On top of that, we know that when you swap out animal protein for plant protein, you'll lower your ApoB level. Can we pause for a second?

Yeah, let's pause for a second before we dive into some of the ApoB stuff. And to my understanding that, and I've never tried this before, I've never tried like a vegan or plant-based diet. It's my understanding that it's pretty hard to hit protein markers when you're primarily eating plants, but maybe some people can effectively navigate that through beans and peas. Tofu, tempeh. Yeah, right? Yeah, I guess it depends on what your protein marker is for an athlete who's highly active, trying to build muscle, maybe they need more protein.

For the average individual, I don't think that's difficult. And you're right, beans. Generally, a lot of the vegans, and I have a chapter in the vertical diet on vegetarian and vegan diets. I've trained vegan athletes up to and including competition. So for me, it's really all about outcomes and performance and that's consistent with their preference. There's many paths to the same destination, whether it's keto or vegan or paleo or intermittent fasting. I don't care. I ask people when they like to eat, what they like to eat, and that kind of thing because ultimately compliance is a science.

But a lot of what I recommend for my clients would be to use a protein powder, a pea isolate or a brown rice powder. They're very high in leucine, so you can get a sufficient threshold met to get your, to trigger your muscle protein synthesis. And so that becomes quite easy. And it depends, are you vegan or are you vegetarian? Vegetarians, whether it's lacto-alvo or pescatarian with fish, a lot less, you know, of challenge, but mostly a supplement or lots of beans and rice and soy. And that would just be a matter of personal preference.

But understand that vegan is just by its definition an ethical position. And so a lot of decisions they make aren't necessarily primarily for convenience or compliance or ease of compliance. And so we have to accommodate that with the clients that choose that path. Before we dive in on Abe, do you have a question? Oh, yeah. I was just curious about the idea of we did have Gabrielle Lyon. She did mention how and I think he made a video using her clip, but she did mention how animal protein is superior to plant protein.

So is that statement, is that false or is it superior in some ways? Yeah, it depends on how you measure it in terms of the number of amino acids that it provides. But you look at, and Gabrielle Lyon's fantastic. She studied under Don Lehman. Don Lehman has himself said the same thing that Simon just said, is that Simon says, the same thing that Simon says is, Don says that if you get enough protein, 20, probably 30% more than if, say, you needed, you know, 150 grams of protein to satisfy your requirements for the day, maybe you'd need to get 180 grams on a vegan diet.

And that would be excluding, say, soy protein or a rice blend because those would be kind of on an even par in terms of gram for gram, in terms of their ability to stimulate muscle protein synthesis. So you eat a little bit more simply because the absorption rate. Bioavailability is the word you hear all the time. A little bit less. It doesn't seem to be a big problem. They seem to be able to meet those needs. Again, compliance is probably one of my biggest challenges.

To do a healthy vegan diet. You can do a shitty vegan diet. You can eat a lot of ultra-processed foods. And so to do a healthy vegan diet. I also have a little harder time, like with guys that are trying to gain weight who may have some digestive distress on top of that depending on how much fiber generally is what the challenge is. And you titrate that over time. Be very careful to try to build that up.

But ultimately it becomes really difficult to eat the volume of food necessary just to maintain fuel workouts and grow. That's another challenge that I have. And so I probably have to end up throwing a lot of white rice at those guys. So, you know, the foundation obviously is going to be your protein. It's going to be your potassium-rich fruits and vegetables, et cetera. And then at some point, it's just, I got to get the calories in order to meet my demands. And nowadays, we have access to supplements and stuff like that. Like if you buy essential amino acid blends and things like that, you can buy ones that are vegan and things of that nature. So I imagine people could add that to shakes or something like that if they were really that concerned about the amino acid profile.

Yeah. And I used to think the same thing, of course. I didn't think you could get adequate protein from vegetables. But beans in particular and with the protein supplements you can. We've also seen Stu Phillips weigh in on this recently, and he says the same thing, as does Brett Contreras and Brad Schoenfeld. You can get sufficient protein from a vegetable-only diet. So before he says ApoB and dives into it a lot more, can you just maybe give us a little idea of

what that even is and what's the importance of ApoB? Well, we always looked at LDL as being probably the most accurate measure of your cardiovascular disease risk. ApoB is even more accurate. ApoB is an atherogenic lipoprotein. Your body can't circulate fats through the bloodstream because fat and water don't mix. And so it houses the fats in a protein courier. We call it a shuttle or a bus or a boat. And ApoB is a lipoprotein that travels on those particles, LDL, VLDL, chylomicrons. And that seems to be the measurable,

most accurately measurable predictor of atherogenic, potentially atherogenic plaques that can deposit into the arterial wall and create calcification. So ApoB is probably the single most accurate biomarker, blood marker, now that we can measure that we want to kind of control to minimize our exposure to cardiovascular disease risk. Cool. All right, let's see if we can play it. ...predictor of your risk of developing cardiovascular disease. Here's a clinical trial that looked at this directly. If you're promoting animal protein as superior to plant protein,

please read this paper. And here's a meta-analysis from just this week showing that vegetarian and vegan diets lower ApoB to a level that's associated with a 20% reduction in cardiovascular disease risk. And that's simply from the change to just one biomarker. It doesn't even include all of the other benefits from eating more plants. Total risk reduction would actually be much greater than 20%. Most people are walking around and going to bed

each night with an ApoB level that is resulting in fatty plaque building up inside their arteries. No surprise really, given that 70 to 85% of the average person's protein intake in countries like the USA is coming from animal protein. This fatty plaque deposition in the wall of your arteries is usually fine in your 20s and 30s, and sometimes even in your 40s. But by the sixth decade and on, that's when it usually has built up enough to cause problems, often a fatal heart attack or a debilitating stroke. If longevity is important to you, something that you value, being healthy when your kids and grandkids are growing up, stop getting sucked into the messaging online

that animal protein is superior. This is not evidence-based and as far as I can tell is ideological and rooted in the idea that meat is masculine and symbolizes prosperity. What's superior is protein that you can use to build muscle and strength and lower your risk of cardiometabolic disease at the same time. And that my friends, whether a popular view or not is plant protein. To learn more about optimizing your health and longevity, tune into my podcast, The Proof, where I release a new episode each week. Cool. What are some of your thoughts on that? Well, I mean, Simon's not here to defend himself, not that he needs defended defend it, but to have the proper conversation. You certainly want some back and forth on it.

But the thing is, is that the nutrition industry as a whole has started to shy away from looking at individual foods and looking at the full dietary pattern and certainly individual micronutrients within a food. And we're trying to look at the total dietary pattern. Also, we don't want to be over-restrictive. Meats in general across the board can be very enjoyable for people and can be part of a healthy lifestyle that's sustainable. And that's what's the most important thing.

I was on Tom Hilliard's podcast and I mentioned that 90 to 95 percent of health benefits are realized simply from weight loss itself, irrespective of diet. That was the best I've ever seen you do on a podcast. That was incredible. Yeah, thank you. You did a great job on that one. I took a lot of flack from that because I talked about even the McDonald's diet. Oh, Lord. Will ultimately with weight loss result in improvement in blood pressure and blood sugars and fatty liver and cholesterol.

I was doing that for years. Yeah. Presuming that you lose weight. I didn't – I didn't make that stuff up. There's plenty of studies to show that. And that's the conclusion of the authors and those studies that weight loss is the primary driver of the health benefits. And now what they clipped off before everybody freaked out all over social media was when I said I would never recommend

a McDonald's diet. And some of the reasons are satiety is a big one, but also because of potentially the long-term effects on whether micronutrient deficiencies or saturated elevated LDLs or ApoB. And one of the key drivers of elevated LDLs is saturated fat. Simon says in that video that meats cause cardiovascular disease. Saturated fat can elevate LDL and cause cardiovascular disease. But you can get low saturated fat meats. You can have a low saturated fat diet that includes animal foods and that can lower LDL. Maybe not to the same degree, but at some point, the risk-reward becomes so minimal that as compared to what, again, your preferred dietary practices are,

it's not worth over-worrying about, over-concerning yourself with it. And I was on Joey Munoz's, he's a PhD in nutrition, he's a team biolane recently. And one of the things that Joey talks about a lot is not being over-restrictive, not putting people on diets that they can't adhere to. That's one of my biggest challenges, again, as mentioned earlier with people who are transitioning to vegan diets. They just don't seem to be able to adhere to them very long if they don't enjoy that kind of thing or don't have another compelling reason, be it ethics or environmental, but just in terms of the joyability. And maybe Simon does a great job

providing people. Matter of fact, I just talked to a lady yesterday. I can't remember her day before yesterday yesterday I think it was at the dentist and she was telling me she tried the vegan diet and it was working great for a while because her trainer was preparing a lot of her meals for her and then when she tried to do it herself she couldn't prepare the meals as good and she fell off because they just didn't taste good and so that can be a huge component in terms of compliance is how does the food taste but I don't mean to to on and on, but I think what's important to realize is that you can have a healthy plant-based diet or a healthy animal-based

diet if you do a few things. One is try and reduce saturated fats. That seems to be the primary driver or is and has been proven many times over the years to be the primary driver of elevated LDL. An easy way to do that is just to select leaner meats. Select leaner meats. Maybe select 2% yogurt or fat-free yogurt, things like that. Yeah. I've always recommended – I've never been against saturated fats. I've always thought saturated fats were fine to have in the diet.

But my fat recommendations have always been my macro recommendations for more than a decade now. And Chris Bell asked me earlier today, he says, what's changed in your diet? How has it evolved? And a lot of it is just kind of nuance in how I explain things in individual, inter-individual variability. But generally speaking, the macro is the same. Somewhere around 15% to 30% fat, and I make those adjustments based on you want a minimum amount of fat because it's good for sleep, for hormones, for fat-soluble vitamin absorption. You want to get at least 15% or you'll start to suffer from some of those consequences. But I don't really go north

of 30%. I put proteins at about 30-35% if I can. And not just for the muscle building benefit. There's other things, proteins used for, obviously, neurotransmitters, enzymes, etc., etc. But for the satiety benefit we've talked about before.

Dudes are hungry. Yeah, and the thermic effect of food, you know, all the things that benefit weight loss. You've actually heard me say I reduce proteins for people trying to gain weight because it satiates them to the point where, and in a calorie surplus, I don't need high protein because it's protein sparing and they can still gain muscle with say 0.8 or 0.7 grams per pound. But generally speaking, most of my clients are interested in weight loss. And so I'll bring their protein up to about 30% of total calories. And then I've said that, you know, fats are right about 30% total calories from a variety of lean sources.

And that would be top certainly, you always hear me talk about top certainly sick, 96 for beef, fat-free Greek yogurt, egg-white blends, salmon. The saturated fat content of, say, a top sirlo, and 30% of that fat is saturated fat, 30% and 30%, 9%, that's below the American Heart Association's recommendation for where to keep saturated fats as a percentage of total calories in the diet. So I've always been real consistent in that. A lot of people who didn't actually read my diet will bastardize it and start eating ribeyes and fast food 75-25 beef patties. 80-20 ground beef and rice.

80-20 ground beef. Which is delicious. And then next thing you know, the LDLs elevate. Another problem is, it's not talked about a lot, is what you replace the saturated fat with. And of course, the foundation of my diet is fruits and vegetables. Some people forget that, you know, spinach, carrots, almonds, all sorts of fruits, usually low sugar fruits, oranges, berries, strawberries, raspberries, blueberries. I've got a lot of that in there. And maybe even the foundation, a little oatmeal, say for breakfast, which is a good soluble fiber. And they'll go right to white rice. And what we see is that when you replace

saturated fats with processed carbs, you don't see a reduction in LDL. And so it leads some people and some research to suggest that there's no benefit. But the replacement matters. So you've gotten your labs done, whether it's six months ago or a year ago, and you want to know where things are at, but you don't want to get a full panel again. That's why I've partnered with Merrick Health owned by Derek from More Plates, More Dates, and we have something called the Check It panel. This is an affordable panel with 55 different labs that allow you to see all those different biomarkers. And you can get this channel every month or every two months, whatever frequency you like, but it will give you all the specific labs that you want to know so that you can make

sure that you're moving in the right direction for your specific hormones. Andrew, how can they get their hands on it? Yes, that's over at merrickhealth.com slash power project. That's M-A-R-R-E-K health.com slash power project. There you guys will see our checkout panel. Load that into your cart and at checkout enter promo code power project 10 to save 10% off of that panel. Again, merrickhealth.com slash power project links in the description as well as the podcast show notes. Your guest was on a few months ago, and I didn't say his name or anything, put him on the spot. He's not here to defend himself either. But he mentioned a study by the Journal of American Cardiology, JCC, that specifically did just that.

They did a few things wrong in the study where they claimed that saturated fats were not predictive of cardiovascular disease. is wrong in the study where they claim that saturated fats were not predictive of cardiovascular disease. Very common mistakes that are made, probably a lot of things our audience has heard that they don't have a kind of an explanation for. But in these studies that people like to to talk about a few things occur um one i mentioned um is that there's an s-shaped curve with research on saturated fats we call a sigmoidal curve and if you take the people who are eating between say say, 4% and 12% saturated fat, and you isolate that group of people, and you compare the 4% to the 12%, you don't see an increase in cardiovascular disease risk

because they're pretty much in the same category. But then when you start to get north of 14, 18%, you see this significant inflection point, an increase in cardiovascular disease. And then you get up here and we see people that will start to study people in this range. And again, at the top of the S shape of the curve, you will not see an increase in cardiovascular disease risk comparing people with 22 to 26% saturated fat intake. And so if you just present that research rather than looking at comparing the two extremes, you won't see the increase in risk. And that's one way in which studies like this, the JAC study in particular did that, can not paint the whole picture. Another thing that they do and was mentioned recently is the reverse causality.

You guys I'm certain have heard and most of us have been around this and followed this. They've said – a lot of people will say that elderly populations, the ones who have the highest LDL live the longest, the highest cholesterol. And the ones with the lowest cholesterol die sooner. And that's not because the low cholesterol is causing disease or the high cholesterol is preventing disease. It's reverse causality. Sick people, their cholesterol goes down. So when you get somebody that's 70 75 80 years old who's suffering from cancer and heart disease their cholesterol will go down it's not the causal factor the heart disease is causing the lower cholesterol and that person's passing away and then when you compare who passes away the ones with the lower cholesterol pass away at a greater

rate but it's because they have a disease state that's creating the low cholesterol, reverse causality. That's often used as evidence for why people shouldn't worry about cholesterol. Although I would suggest that when you're 75, 80 years old, it's a little late. That's the thing about cholesterol is it's a 30, 40, 50-year disease. It accumulates over many decades. 40, 50 year disease. It accumulates over many decades. And so you can feel perfectly fine and not think that you have anything to worry about. And one of the things I also noted here is that you can, oftentimes I've talked about before the CAC scan, coronary artery calcification scan. You can go in and have a zero score. It doesn't tell

you much because about 50% of the people who die of cardiovascular disease or heart attacks have a zero CIC scan. It can tell you if you have some atherosclerotic plaque built up, but it does not see soft plaque that's accumulating. And it may be many, many years, a decade or two decades before that turns into hard plaque that's identifiable on a CAC scan. And so the soft plaque is of concern as well. That can cause an event. And so there's a coronary angiography to test with contrast dye and MRI that can show you how much soft plaque you have. to test with contrast dye and MRI that can show you how much soft plaque you have. And that would probably be a better predictor of what your current status is for your cardiovascular disease risk. Can I ask you a quick question about the S-shaped curve and the saturated fat that you mentioned?

Yep. I think you mentioned on the top of the curve, just like individuals who they intake about 22 to 28% of saturated fat and there's minimal cardiovascular disease risk at that top of the curve? Minimal difference between them. If I take a group of people who are consuming 20% saturated fat and a group of people who are consuming 30% saturated fat, there's very little difference in cardiovascular disease risk between them. But if you compare them to the group that's consuming between 2% and 12%, there's a huge difference. So what we call the inflection point on that S-shaped curve where that's when you see the disease risk skyrocket.

But they're picking out – Nina Teicholz is famous for this. Look, I read Nina's book. I thought it was fantastic, well-referenced. Unfortunately, it had a lot of these problems in it. I think Gary Taubes is another one. Read his book. Very well referenced. The accuracy of the references is what's often challenged.

Peter Attia used to be keto and used to – I think he's had Gary Taubes on for many years. He was big into the low carb. He's evolved, which I think it's important to mention. There's a lot of people who over the last five years have very smart people who have made a significant change in their opinions on that. Alan Flanagan is one from Alinea Nutrition who used to believe saturated fat didn't matter from five, six years ago. Now he's got a PhD in nutrition. He's looked through the research. He's since changed his position on that. Dr. Elaine Norton, as recently as I think four years ago,

said that saturated fat didn't matter. It's a very different opinion today. PhD in nutrition. Dr. Kamal Patel, PhD in nutrition, examine.com. They have 14, I think, PhDs in their group. And they're pretty highly regarded as one of the premier sources of supplement information. It's probably as recently as a year, 18 months ago, they had posted one of those studies, like the JACC study, which is highly flawed based on the reasons that I just mentioned. that I just mentioned.

And there may have even been a – I don't want to say this and not be accurate, but there may have even been a Cochrane review, an older Cochrane review that suggested the same thing. But the newer Cochrane reviews support the LDL, what they call lipid heart hypothesis. Elevated saturated fats increase LDL, increases cardiovascular disease risk. Kamal Patel had posted on his site and I posted on Instagram because people were suggesting that I had a particular penchant for saturated fats even though as I explained earlier, I'm under 10 percent as a recommendation of total calories. I just didn't demonize them I guess harshly enough to – but I posted that on my site and Kamal ultimately said, oops, and changed that and updated it. But my point is, is that if you're out there in the

audience listening and you probably already shut your ears off because I've suggested something that runs contrary to your firmly held belief based on, you know, whatever information you've obtained from a journalist or a chiropractor, God forbid, or even an engineer as in Dave Feldman. And I used to follow all his stuff and lean mass hyper responders and all that other stuff. If that's been the information that you've been listening to, which we tend to do, we tend to go out and find things that support our bias. The low-carb community is famous for that.

Although I'll give them credit. They invited – to my understanding, they invited Lane Norton this year to speak at their low-carb conference. So we'll see if – what kind of progress could be made there. I think they're evolving. And by that, I mean you can – I mentioned earlier. You can go low-carb and still eat healthy. You just have to keep saturated fats down. More salmon, more avocado, more olive oil, more nuts and seeds, and still no carbs if that's your preference.

And I found some benefit as mentioned earlier as we were talking to Chris Bell. I get a clarity of mind when I eat fewer carbs. But my performance suffers in the gym, my anaerobic lifting strength and performance. And so I'm constantly weighing, you know, maybe I don't eat carbs on my day off, but I do eat carbs pre-workout. And we were talking about the fact that a lot of the people who were staunchly keto, intermittent fast, Paul Saladino is one. I DM Paul Saladino. It must have been at least four years ago now. And I said, where are you getting your calcium from? And he says, you can get calcium from bone marrow.

I'm like, no, no, no, no, no. Where are you getting your calcium from? Nobody's eating 1,000 milligrams a day of calcium from bone marrow. And that kind of started us on a conversation that ultimately ended up with me and with myself and Dr. Damon McKeown, my co-author of The Vertical Diet, who's a PhD RDN, Director of Dietetics for UNLV. We went on Paul's site and we started talking about the benefits of carbohydrates, particularly around workouts for anaerobic training and calcium. Ultimately, now Paul eats yogurt and fruit

and feels much better as a result. We often see this. We see people utilize a particular elimination or restriction diet, which I've talked about the low FODMAP diet for that benefit for people with IBS or digestive distress. They'll use it as initial intervention, and they'll realize a significant decrease in symptoms, whatever it was that, whether it's a skin condition or, you know,

Dr. Sean Baker's talked about the myriad of benefits that people have realized from going on a carnivore diet. It's an elimination diet. And I think it's an acute intervention. I think even Thomas DeLauer more recently has said, look, I used keto to lose a hundred pounds, now that I've lost 100 pounds, I don't feel too good on keto. And so he started introducing, you know, at least maybe initially with some carbohydrates around workouts, etc, etc. So I'm not trying to overturn anybody's apple cart here or create camps. I'm just saying that back to what I first said, the overall dietary pattern is what matters most. And how does that affect your health, your performance, your biomarkers? And can you design your diet such that you can mitigate the risks associated with the risks associated with cardiovascular disease and cancer,

the number one and number two killers. And as suggested, we can do that with including meat as if we monitor saturated fats and keep fiber, particularly soluble fiber, up and body weight, sleep, regular exercise. It's a host of things that can help bring your cardiovascular disease risk down. Do you feel like it's maybe unfair comparison sometimes to compare plants versus meat? In a sense that like meat is going to be typically loaded with a lot of calories. And if we just say meat, like it would be great to define what kind of meat are we talking about here? Because if it's like a chicken breast

or if it's a Piedmontese steak, which is a whole other animal. Yeah, very low in fat. You know, it makes you kind of curious. It's interesting what you said there is meat associated with a lot of calories. Is it the meat associated with a number of calories or is it the fatty content of the meat?

Is it everything that goes with it? We're familiar with the healthy user bias. tend to eat more meat french fries or something like that yeah they tend to eat the french fries and the cheeseburgers and the bacon and they smoke more drink more weigh more exercise drive a little faster yeah that's the healthy user bias that's probably the the macho masculine reference i i don't certainly i don't personally perceive it as such. I enjoy the taste. That's my preference. And I would suggest that anybody who's going on a diet try and include the foods that you enjoy, that you'll eat consistently.

I would say that just even in a standpoint of like just the way some of these foods are found in nature, that protein and fat always go together. And when you have a plant, there's not a bolus of calories that are associated with it. It just might be sugar or it might just be like fiber. Yeah. We're willing, when I say we are willing, academics and nutrition, even vegans and vegetarians, only when I say we are willing, academics and nutrition, even vegans and vegetarians, although they have an ethical position against not eating animals, they're willing to recognize there's a difference in the types of dairy. Whether they choose to consume it or not, they'll recognize that there's a kind of exists on a spectrum and that a fat-free Greek yogurt is different than a full-fat milk,

is different than butter. All dairy, butter being very high in saturated fat, no calcium, no protein. Fat-free Greek yogurt, fermented probiotics, high in protein, high in calcium, milk kind of being the middle of that, whether or not it's – if it's not an allergy situation, it's at least neutral in terms of cardiovascular disease risk. There a couple reasons for that dairy in particular um has what's called the milk fat globulin membrane which is a fat that doesn't uh appear to raise ldl cholesterol and so it's another thing the jacc article does is is that they

when they make replacements of saturated fat they'll make replacements with something that – like a dairy, like a yogurt or a milk or cheese, fermented foods that can prevent the elevation or don't contribute to the elevation of LDL and say, look, high saturated fats don't increase LDL. As opposed to butter, ribeyes, bacon, really high saturated fat foods. And that's not to say you can't incorporate some of those. I'm saying that the overall dietary pattern suggests that you should keep that below 10% of total calories, the saturated fat, those that contribute to an elevation of LDL. And so that community is willing to accept that there's a range of dairy, but not do so with, say, just red meat as discussed. Um, difference in a ribeye and a top sirloin steak and a, and a Piedmontese. I mean, Piedmontese is ribeyes.

You can cut it with a spoon and it's got like two grams of fat in it. You know, it's incredible. Again, total saturated fat intake being less than 10%. And then what else is with the diet in terms of that pattern? We already talked about processed carbs, white breads, rice, et cetera, like that. Sugars will prevent you from seeing a decrease in LDL. whereas fibrous carbs, particularly soluble fiber, can help increase LDL clearance from the body. And so those would be your go-to. It would be part of your foundation.

And as I mentioned in the diet that I've always recommended, having carrots and fruits and nuts and those kinds of things and spinach, et cetera, in the diet. And you could get higher on the soluble fiber list by adding in some beans. As it turns out, lentils are a low FODMAP food that causes less gas than others. And if you soak them for an extended period of time, I think it's about 18 hours, that they'll be even less gas. And then again, titrating that over time. It's when you make significant changes. You add 15 grams of fiber to your diet

tomorrow, you're going to have some problems. When I was in college, I looked at everything in terms of calories. Three Big Macs was 2,000 calories, right? And I would go eat three Big Macs. That's all. I just wanted to get huge. And then there was the Go Mad. I think a gallon of milk is like, what, 2,400, 2,700 calories in a gallon of milk. You didn't have a girlfriend. 2,700 calories in a gallon of milk. You didn't have a girlfriend. Well, somebody had to pay the rent and the food. So, yeah.

Somebody had to work for a living while I was in the gym lifting and eating. I always say, what's the joke? What do you call a bodybuilder without a girlfriend? Homeless. So I looked at things in terms of just total calories. I think one time there was this family-sized bag of Fig Newtons, huge thick ones, and I grabbed that and a gallon of whole milk. And I was like, there's like 3,000, 4,000 calories I was going to eat.

I missed two days of work after doing that. Coming out of both ends, I was just running back and forth. I would sit and then I would kneel, and then I would sit and I would kneel. That was the most painful experience I've ever had. And it gives you a bit of empathy for those people who suffer from IBS. Yeah. It probably restructured your gut microbiome. Yeah.

All at once. You can do that. So I don't know where I trailed off to, but I was trying to get down to suggest that that dietary pattern should include decreasing saturated fats. And that can include vegan sources. That can include palm oil and coconut oil are just as likely to elevate LDL because they're high in saturated fat as would a ribeye or a hot dog or a bacon or those kinds of things.

So you got to be cautious about which saturated fats raise LDL, as mentioned, which ones are neutral or protective and which ones can potentially reduce ldl and help with saturated fat clearance which would be your your oatmeal guys summer is here and it's time to get some new footwear i'm not talking about these flip-flops suck i used to love them but they are messing with the way you walk and they're actually messing with your feet

because every step you take in a flip-flop the big toe, which can have some long-term ramifications. That's why we have been wearing our power sandals. And this is actually version two of our power sandal, which is live now at powerproject.live. It is zero drop, has a German leather footbed. So it's comfortable as fuck. It has a vibram sole, which is going to last you thousands of miles to walk in. You can run, you can hike, you can walk, you can lift in these sandals. And because of the heel strap, it's going to stay connected to your foot so that when you run, which you can literally run in these sandals, or when you walk, every step is just like if you're walking barefoot. We love these things, and that's why we've partnered with Shama to make our version two,

which is much cleaner than our version one. Both versions are on the powerproject.live website, so get your new summer footwear, the power sandals. Peace. Vegetables and fruits. Maybe there's a good argument to, rather than maybe just picking meat,

rather than maybe just picking plants, maybe we go somewhere in the middle. And that's kind of what Joey Munoz suggested is that you kind of want to – and that kind of leads to the point that you don't want to be overly restrictive. You talk about a carnivore diet being restrictive. I would suggest that a vegan diet could be pretty restrictive. You're eliminating, as you would in a, say, a paleo. eliminating, as you would in, say, a paleo. And that might put certain people into a position where they might binge or relapse or gain their weight back just because of lack of compliance.

But all diets seem to fail after about two years. We see, what, after one year, a 50% relapse in weight gain. And within three to five years, I've seen statistics from 80% to 95%. Not my statistics. Elaine Norton's talked about these many times. It's difficult. Most people tend to relapse and have recidivism and gain the weight back. So I've always focused on compliance.

And if something's overrestrictive, then that is going to lead to binging behavior or just going off of the diet. I hate to look at a diet as something just to lose weight. It's the food that you eat, and it should be a lifestyle. In front of my books, it's simple, sensible, and sustainable. So there shouldn't even be an off, maybe. Yeah, there shouldn't even be an off. I made a couple notes here that I thought might be of interest to the people who said, what do I do now?

Obviously, we talked about things that cause cardiovascular disease or elevated cholesterol or LDL in the system. Genetics is the primary driver, being overweight, lack of exercise, too much saturated fat, as mentioned, too many processed foods. Talk about what types of foods you use to replace the saturated fats. Quick question, Stan. Go ahead. On that note of processed foods, processed meats versus like unprocessed meats. Because like there are some people that are carnivore who are like processed meats aren't a big deal. Protein. There are some who are like that is lower quality.

Like Lane Norton mentions that. Quite a few people mention that. So what are your thoughts on processed versus unprocessed meats? Well, not that I'm a big fan of the IARC committee, but the World Health Organization's cancer research group, they just came out with a classified aspartame as cancerous, and so everybody's shitting on diet sodas, and this is kind of the big thing now. But they classified processed meats as a probable carcinogen.

I think a lot of it has to do with cooking those, particularly the nitrites when they get exposed to heat, how they change and how that might affect cancer. But there's a lot of nitrites in vegetables, but you don't cook them is the thing. And they can help increase nitric oxide and vasodilation and lower blood pressure and have potassium associated with them. So generally speaking, I would, I say a lot of them are pretty high in saturated fats if you're talking about LDL and then the other concerns, the cancer. Not a big fan of processed meats. Again, I think it's dose makes the poison. And what does your overall dietary pattern look like? I think that would probably be

the biggest consideration. How much of it are you eating and is at the expense or the exclusion of what? Okay. You know. Where was I here? Too many processed foods. There we go. Not enough soluble fiber. Some medications.

Age, obviously. This is certainly why it's more of a concern to me now at 55 than it was at 40 is because as you age, your LDL tends to start creeping up. Hypothyroidism is another big one. Under hypothyroidism, there's plenty of published research that suggests that if your TSH is above 2, you should probably be focused on trying to get your thyroid back in order before you start mucking around with your lipids because it helps with cholesterol clearance as well. So get a thyroid test. It's part of the, obviously what we do at Merrick Health is, or what they do at Merrick Health is test that. Kidney disease, fatty liver inflammation.

Another big thing that the low-carb community or carnivores talk about is the fact that if you have good endothelial health, you're less likely to have those atherosclerotic plaques lodging in your blood vessel lining, the endothelial layer that surrounds the lumen of the blood vessels. And there's a number of things that can affect your endothelial lining that can make you more susceptible. Cigarette smoking, alcohol, high blood pressure, high blood sugar, high iron, and then having sufficient estrogen helps. These are all people taking anti-estrogens, and it can make your blood vessels more susceptible, less pliable. And then just, I'll talk about drugs later or medications later. But when you're talking about endothelial function,

tadalafil increases, which is Cialis. But a low-dose Cialis is commonly recommended to help with blood pressure because it vasodilates, increases nitric oxide, helps with blood flow, helps with the integrity of that blood vessel wall. So what do we do? We get a blood test. We've talked about this for years. And I can't say enough about Merrick Health providing the blood tests that they've provided. I used to pay twice as much for half the information using an online company until Merrick Health came along. Go to stanheffering.com, scroll down to blood test and click on it. I've got the entire, all the information there that you need.

You click over to Merrick Health and they've got a blood panel on there. It's like $160. Use stanefferting as discount code. It's all on my website explaining it for 140 bucks. Blood testing, the cost has usually been the barrier entry. But I don't think anybody that's a power lifter, bodybuilder, strong man, off-season, you know, anybody carrying any significant on a mass should not be getting a blood test immediately. And as a baseline, I think everybody should, irrespective of what you presume your current health to be because you don't know. You don't have to be fat to have ILDL.

You can be in perfect shape. Bob Harper, perfect example of that, although he did have a genetic predisposition. I think his mom had a heart attack, but he was keto at the time. And I don't know what kind of constitution of his fats Bob Harper was, but he was keto at the time that he had the heart attack. Again, genetic. And Bob Harper was most famously from The Biggest Loser. It was a trainer there. So it was a very public experience. But the point being is there's a fit individual. Dr. Lane Norton eats 60 grams of fiber a day. It's my understanding that he was unable to get his LDL below 130. Ideally, you'd like to see that under 100.

Again, I'm using LDL and ApoB interchangeably because they tend to go up and down together. ApoB is a more accurate measure. You'd like to see that under 100, probably ideally 80, if you don't have any preexisting evidence of cardiovascular disease. He couldn't get it under 130, so he did actually start using a medication for that. And there's a very healthy individual who eats a ton of fiber and exercises regularly and maintains a good body mass. So I'm just saying that for anybody watching, I find this particularly laughable for anybody using performance enhancing drugs to start whining about whether or not they're going to take

a prescription medication to help their health, you know, because we know where that crap comes from. You know, it's all made in underground labs in somebody's bathroom from powders from China. comes from. It's all made in underground labs in somebody's bathroom, powders from China. And then these guys, they got all this, what are you doing? As long as you're not doing that, you've got all this stuff that you're injecting to get bigger. And God forbid you'd tell them to lower your blood pressure or take a medication, which I'll talk about later, to control your LDL. Can I ask you something about that, Stan? Now, I'm curious. Do you think that, you know, I don't know what, for example,

Lane Norton's exercise routine looks like. I know he lifts a lot. I don't know how much cardio he does for his heart health in general. But, you know, I mean, I'm 30, so my blood work came back great. My LDL was great. My APLB was like 78. I'm not going to use my N of 1, but the thing is, is like, I do a lot of cardiovascular work because of just my activity, jujitsu, et cetera. And I wonder if, if like, if somebody were to be able to add in some level of

not just walking, but activity that gets their heart rate up outside of lifting, would that be something that could benefit them? It contributes. It contributes. And again, there's a lot of interview. Some people like in lane situation situation probably has a predisposition. He probably has a genetic hypokalesterolemia that is causing that elevation. There's not much you can do about it. For those people, the only way to get that ApoB down is going to be medication. They could try and try and try. You'll probably get a little further along with Simon's suggestions, to be honest with you,

just eliminating all saturated fats. And I know people are worried, well, what if I eliminate all saturated fats? Very little of the cholesterol that's going through your bloodstream is in your bloodstream. It's throughout your body. And every cell in your body manufactures cholesterol, including the brain, and it doesn't need you to eat cholesterol to get cholesterol for your brain. It does it itself. So babies, children, their cholesterol is around 20 nanograms per deciliter. And so when you've got a 130 or, you know, and some other maybe co-contributors to cardiovascular disease and a doctor recommends some sort of medication,

it's probably advisable. And particularly if you have high triglycerides or high blood pressure or any of these other issues or you've got some evidence of calcification from a CAC scan, you treat the individual, not one specific marker. But yes, exercise is one. Lifestyle doesn't always work, I guess, is the point of that conversation with Lane Norton and other people who eat low saturated fat and high fiber. They may not be able to get those numbers

to where they don't see a progression of plaque buildup. When you get the LDL or ApoB down below 60, you no longer see a progression of atherosclerotic plaque buildup. So that's a pretty nice number to be shooting for. Very hard to achieve without medication, which we'll talk about in a minute. So on the blood test, you get the lipid panel. People hear a lot of things about lipids. Total cholesterol, probably not a very good measure of your cardiovascular disease risk. Triglycerides, as mentioned earlier, is probably a better marker of your cardiovascular disease risk. Triglycerides, as mentioned earlier,

is probably a better marker of your insulin sensitivity. HDL, everybody talks about good cholesterol, bad cholesterol. Not much evidence that HDL matters, even if it's high. It might even be that you're a hyperabsorber and that they're putting the cholesterol particles into the HDLs because there's no more room for them. But here's how we know that because people have heard that HDL actually takes cholesterol out of the endothelium and takes it back to the liver. When you artificially elevate HDL with niacin

or other interventions, it doesn't improve cardiovascular disease risk. So focusing on elevating HDL, not something you should be concerned about. LDL-ApoB, as mentioned, that's the primary marker. Some people talk about small versus large plaques. They're both atherogenic. There's no difference between the two. They can both penetrate the endothelial layer, and they can both create atherosclerotic plaques. So that

is not an effective measure. That may or may not have been part of that JACC article as well that people often reference, but it's not a reliable measure. And of course, inflammation is important. We talked about the endothelial lining in terms of blood pressure, but also things like homocysteine and HSCRP or C-reactive protein marker for inflammation if that's chronic. We talked about TSH. We talked about the coronary artery calcification scan or a carotid intramedial thickness, a CIMT test. I think the coronary angiography is probably the most accurate of what your blood vessels look like in terms of soft plaque currently accumulating. That kind of thing, accumulation of soft plaques, you're not going to feel it necessarily until it's rather progressed. But much like prediabetes, what we start to see is problems with erectile dysfunction.

Because it's kind of like the canary in the coal mine. These things, elevated blood sugars and elevated soft plaque can restrict microvasculature, the capillaries, and that's what things like Viagra and Cialis help with. They help open up those capillaries. Well, some people will start taking those medications and think that they've fixed their problem, but they're really just kicking the can down the road because those plaques and those blood sugar problems, you've seen people with black feet, you know, from blood flow restriction from diabetes and from a buildup of these soft plaques, that's a pretty good indicator that you need to change something, whether it's blood sugars or plaques. You need to change

something in order to improve your blood flow so that you can recover from those problems with erectile dysfunction. So we mentioned my macros earlier. I talked about protein, fats, and carbs, and kind of what I recommend. We talked about alternatives to high saturated fat keto diets being more monounsaturated fats such as avocado, nuts and seeds, olive oil, and you could still be low carb on that. and you could still be low carb on that. Another thing people often ask about is cholesterol in the diet that you consume, such as eggs. They want to see, does that increase my cardiovascular disease risk? For the vast majority of people, it does not.

The dietary guidelines, I think your guest mentioned this just a few months ago, for Americans now suggests that cholesterol is not a nutrient of concern for overconsumption. That's a quote from the American College of Cardiology and the American Heart Association. And here's the reason why. Cholesterol that you eat is esterified and very little of it is converted into free cholesterol that can be absorbed into the bloodstream. Now, that's for the vast majority of people. There are some people who are hyperabsorbers that will absorb that cholesterol. And so those people with a blood test can identify.

Maybe they pull out eggs for a month and see if it improves. But otherwise, there's usually those people do need medication. but otherwise there's usually those people do need medication even walter willett and i say even walter willett because he's a he's a vegan as well and publishes for harvard he's probably one of the most quoted researchers in history for nutrition but the reason i say even walter willett is because he has a presumed bias as a vegan to avoid animal foods. He says he realized back in the late 70s, there was not a single study showing that people who ate more cholesterol or specifically ate more eggs, which are uniquely high in cholesterol, had higher risk of heart attack.

That's Walter Willett's quote. That's not mine. Tom Dayspring, which is someone I think that people should write down that name, Tom Dayspring, he's done a think that people should write down that name, Tom Dayspring. He's done a number of interviews with Dr. Peter Attia, Gil Carvalho. Have you talked to him from Nutrition Made Simple? No. MD, PhD?

Great, great. Fantastic guy. I think, yeah, I just sent him to you guys yesterday. Yeah, he's great. He's got a series. series, Simon has, I think, at least two different interviews with Tom Dayspring, who said on Simon's show, it's funny that Mark called me two days ago, and he's like, hey, check this guy out. I got this guy. He's saying this shit about red meat, and he's a vegan, and blah, blah, blah, thinking I'd get all, you know, pissed off when I come down here, and so I changed my flight. I was supposed to come in yesterday afternoon.

I changed my flight. I got up at 5 a.m. So I'm going to fly up here so I could fight with Simon. And he said, I got this soy boy. I mean, this guy Simon coming up. And so I downloaded his book and I spent 10 hours reading his book and taking pages and pages of notes because I wanted to be able to have a conversation at length about all this stuff, which, you know,

obviously Simon had, I think, some challenges with travel, so he wasn't able to be here. But what Mark wasn't aware of at the time, and I wasn't going to let Simon know when he showed up, I was going to pretend like I'd never met him before, never heard of him before. I've been watching Simon for damn near two years. He's got an extraordinary lineup of top academically accredited PhDs and has for some time. I've watched hundreds of hours of his stuff. And what I do is when I see something that somebody says, I timestamp it. I copy and paste it and put it in my notepad. Hence being able to pull these references out, because that was something that Walter

Willett said many years ago. Just and I keep it kind of like under my eggs column or under my cholesterol column or under my, you know, and so that's when people ask me, what, you know, what do you think about this particular topic? I usually have acquired a list of what I consider to be people who are credentialed and qualified and respected in that industry, not cherry picking people who just agree with me. And so anyhow, Tom Dayspring said dietary cholesterol has nothing to do with the amount of cholesterol in the system or cardiovascular disease outcomes. That was on Simon Hill's show. So I don't think eggs are a concern for most people.

Those could make the poison. We do have studies showing in burn patient recovery, 36 eggs a day does not raise LDL. We've got some pretty extreme studies, but that might be under those particular conditions. in some pretty extreme studies, but that might be under those particular conditions. As for red meat, we do have many studies suggesting that red meat can be used responsibly and not raise LDL cholesterol if the saturated fat's under control. One is the BOLD study, Beef in an Optimal Lean Diet study.

Effects of lipids, lipoproteins, and apolipoproteins, suggested the same thing, that the macronutrient compositions, when they're similar, similar to the DASH diet in terms of reducing LDL cholesterol. Another one here that Lane Norton often refers to as this study, co-consumption of vegetables and fruits, whole grains and fiber with meats reduces cancer risk. And this is a cohort from Mrs. Alberta's project. Berta's project. So that's the important thing. Again, the dietary pattern in total, what the fat content of the food is in particular. Those are things that are most important. We covered most of this, I think. Lifestyle, lose weight, address inflammation, get your thyroid checked and optimized, increase soluble fiber, decrease saturated fats, butter, bacon, hot dogs, coconut oil, palm oil, lard, use leaner meats, fat-free Greek yogurt, salmon, eggs.

That's probably the bulk of it. Power Project Family, we talk about beef and meat all the time on the podcast. That's why we've partnered with Certified Piedmontese Beef. But did you know this? That 85% of all grass-fed, grass-finished beef in the United States is imported from other countries? 85%. Damn. But Certified Piedmontese is made in the U.S. of A.

America. America. Fuck yeah. So go ahead and get some of the best tasting, some of the leanest, some of the best beef from Piedmontese. Andrew, how can they get it? Absolutely. So you guys can head over to cpbeef.com and check out enter promo code power to save 25% off your entire order.

And if your order is $150 or more, you get free two-day shipping. Again, cpbeef.com. Links to them down in the description as well as the podcast show notes. Fuck yeah! Links to them down in the description as well as the podcast show notes. Fuck yeah! Do you think any of this stuff needs to be limited or even looked at if you simply just don't overeat? You're a lot less likely to have those conditions.

Like if you consume 50% saturated fat but you don't overeat. You still may be susceptible. I get a blood test. How do you know? Right. You know, I said that many years ago. How do you know? You know, I was just talking about vitamin deficiencies at the time, which blood tests aren't even the best, the most accurate.

But how do you know what you're deficient in or what you have an excess of before you can make any of those decisions to employ some intervention to control something that you don't even know where it's at. You know, I recommend consuming vitamin D because a large percentage of the population are vitamin D deficient, but some people aren't. And if you over consume vitamin D, then you can get hypercalcemia where your calcium starts to increase. Lastly, on this list, medications. We've come a long way. There was some five years ago where I was – I put down statins on my – I have this slide that I show. I talk about this brilliant philosopher who had said one time that weakness is never a strength.

And the next slide is a picture of Mark Bell's fatty face. And I said, well, okay, it was Mark Bell. But even a broken clock is right twice a day, right? But that is how I've lived my entire life, that strength is never weakness, weakness is never strength. We as athletes, particularly iron people who lift weights, we know exactly, we can measure it, what our performance is in terms of strength or you know

sets and reps and it's immediate feedback for us when we go into the gym and we lift something and if we're not as strong as we were last week that's a problem and you can usually pinpoint something that happened in the last 72 hours bad night of meal, extra stress, that kind of thing. And you can employ something to remedy that. So I've always said weakness is never a strength. And so I have this list of things that make you weak. And I go down things like anti-estrogens, anti-inflammatories. And I had statins on that list some five years ago because we would see a high instance of myalgia, muscle pain. You've heard of that as a symptom common, and that was usually with high-dose statins,

the ones that were utilized at the time. Things have evolved. We've got now some, we, the industry, and people always are like, well, big pharma. Look, this stuff works. It works well and has very few side effects. And they have non-statin therapies now, a couple of them. What Tom Daystring recommends and what Merrick Health recommends and what I've seen work with my clients who have been in need of and couldn't get their cholesterol down is a dual therapy, low dose.

A product called azetamib is not a statin. It helps prevent cholesterol absorption. And then a small dose of a statin called rosuvastatin, which is also very low in side effects compared to some of the previous evolutions, which helps increase clearance. And so now you're working on both ends of the spectrum. That can have a dramatic effect on decreasing cholesterol, 30 plus percent. And then there's one that is even more powerful called the PCSK9 inhibitors. Now, the azetamide and brazuva statin are very affordable. These are dirt cheap medications.

Azetamide and brazuva statin are very affordable. These are dirt cheap medications. And I haven't had any feedback from my clients that suggests that they're having any adverse effects from those. PCSK9 inhibitors are even more effective, but they're very expensive, somewhere around $800, $900 a month if you can't get insurance for those. But those are the medications that we recommend. They're extraordinarily effective if the lifestyle doesn't work, which would be the first intervention that you would take, trying to find out if you're a hyperabsorber and maybe having to eliminate cholesterol consumption in eggs

for a small percentage of people, but certainly reducing saturated fat. If all of those things don't work, and they don't work for a lot of people, to be honest with you, a lot of folks still find that their ApoB is above 100. And as mentioned earlier, with no indication of cardiovascular disease, calcification from those other tests, the CIMT and the coronary angiography, keeping it below 80 seems to be a safe place. Dr. Peter T is more recently another, Tom Dayspring, etc. If you've got some indication of a small amount of atherosclerotic plaque, whether it's calcified or soft plaque, below 60. It's hard to achieve with lifestyle, probably need the medical intervention.

And because it's a pharmaceutical drug, of course, we're like, you can at the same time hate pharmaceutical companies and believe that these drugs are safe and effective. That's not mutually exclusive. And they're very affordable, the ones that I mentioned, and not have to have some position based on, on pharmaceutical companies. And so I think it's a, it's certainly worth getting tested and, and, uh, fixing that problem because it is the number one killer. You guys got any other questions? Uh, I guess so. Um, so I got my labs done in January, so it's time to redo them again, but I was eating 10 eggs a day and my, all the cholesterol, even though you said that they didn't matter, they were all in the green, but the LDL was 134. Since then I've kind

of, I've tapered off a little bit. So now I'm only eating six to seven a day. But do you think that that was the, maybe the main culprit? Like I might be a, as you said, I think a hyper absorber of that cholesterol. It's possible. And 10 eggs a day is a lot, you know, I think a hyper absorber of that cholesterol? It's possible. 10 eggs a day is a lot. You might not even have to be a hyper absorber but a small percentage of the population does respond with an elevated LDL to excess cholesterol consumption.

So I'm glad that you got the blood test and that you reduced them and now a subsequent blood test could tell you whether you cut them out entirely or bring them down to four or six if you see that start to come down maybe you've pinpointed your problem so I'm such a big fan of measuring intervening and then

checking back later yeah that's all I got take us out of here Andrew thank you everybody for checking out this short episode make sure you guys stick around so that we guys can catch Stan's next episode, which will go crazy and in depth with all kinds of fun stuff. Follow

the podcast at MBPowerProject. My Instagram is at IamAndrewZ and Seema. And Seema Inyang. Stan, where can people find you? Stan Efferning. Everything's stanefferning.com is the website. I've got the Vertical Diet 3.0 e-book, soon to be 4.0. And the meal prep is always available. Monster Mash, delivered to your door nationwide0 um and the meal prep uh is always available monster mash delivered

to your door nationwide is available there at stan efforting.com um youtube stan effort old videos there i just put up a new video recently i was making some salmon who knows i i think i'm going to revive those and go back and remake all of them with an appropriate updated nuance as discussed today i think that's kind of my next plan. And then lastly, Instagram, at Stan Everdeen. I do have one question for you. Sure. Because like this is, you know, getting blood work done and looking at yourself like an individual,

it's good understanding how a lot of these things work in the population with these studies. But if someone, you know, let's say someone does eat a large amount of saturated fat, but everything in terms of their blood work does seem to look pretty good. You see that from a lot of people. How should they look at that? Because if they're eating high saturated fat and then studies say that this is bad, but

their blood work doesn't reflect that, should they make change? It's not necessary. What do you think? Yeah, the driver of cardiovascular disease is the elevated ApoB, not the saturated fat. If saturated fat doesn't cause you – if you've got extraordinary clearance and minimal absorption and you can eat like that, that's great. It's the old – you've got this 90-year-old person that's been smoking a pack a day. Yeah. It doesn't seem to affect some people. It's not a suggestion that – it doesn't make – those are always the examples that are given. My dad has been eating bacon and grease and he's 95 years old.

That's great. That's your dad. But across – studies across the population, on average, what we talked about today is what you kind of want to look at. Look at the biomarkers. Same thing is true, I would say, with sodium. Same thing is true, I would say, with sodium. For people who aren't hypertensive or sodium sensitive, other than the concentration and potentially its impact on the endothelial layers,

which is why sodium should always be consumed with plenty of water, the concentration matters, then those people don't have an adverse effect from sodium. So it's really individualistic and it's how do you respond to that in what quantity for what duration of time. And only the blood tests and the blood pressure monitoring can can help you determine that got it strength is never weakness weakness never strength catch you guys later