Did we get dietary saturated fats all wrong? The #HADLmodel provides a new understanding and an opportunity to get it right. THREAD👇👇👇
@simondankel @kariannesve

Increased dietary saturated fatty acids lead to increased cholesterol in lipoproteins, but we don’t know why. Enter the #HADLmodel, which explains changes in lipoprotein cholesterol as adaptive homeostatic adjustments that ensure optimal cell membrane fluidity and cell function.
We propose that circulating lipoproteins enable appropriate redistribution of cholesterol molecules between specific cells and tissues, to accomodate changes in dietary fatty acid supply, due to our omnivore nature and variable intake of fatty acids. #HADLmodel
Our #HADLmodel implies that circulating levels of LDL change for protective, not for pathological reasons; an SFA-induced raise in LDL cholesterol in healthy individuals is a normal response, while a lack of this needed response may reflect a deeper pathology in lipid handling.
Circulating lipoproteins may change for pathological reasons, when regulatory mechanisms become disrupted by pathogenic processes related e.g. to inflammatory processes. Diverging lipoprotein responses in healthy versus metabolically unhealthy individuals support this view.
Low grade inflammation can interfere with several fine-tuned signaling pathways necessary for homeostasis, including proper lipid handling. Altered circulating cholesterol levels may here reflect underlying pathogenic processes, unrelated to saturated fat intake. #HADLmodel
Dietary factors causing chronic low-grade inflammation, driven by diet-microbiome interactions, should receive more attention. The role of saturated fats in pathogenesis may be misconceived and greatly exaggerated. #HADLmodel
Is the #HADLmodel impossible? Is there more evidence to support the model? What else do we need to test in high-quality studies? Keep the discussion going - fair and factual. We need to improve the conversation on dietary fats. #publichealth #dietaryguidelines
@zoeharcombe @bigfatsurprise @DrAseemMalhotra @LDLSkeptic @ufferavnskov @malcolmken @LeventalLab @fedonlindberg @drmarkhyman @LorenCordain @chriskresser @ChrisMasterjohn @garytaubes @ProfTimNoakes @PeterAttiaMD @marionnestle @whsource @RobertLustigMD

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All modern research questions frame your mindset and self-frame research paradigm. Broad thinking: how little of everything can a citizen survive on; how cheap can your upkeep be? /1


When an American patient lands in an Austrian hospital for a back problem, a doctor tells him to perform a set of exercises.

- How many?
- Do you have anything else to do? /2

This interchange illustrates two mindsets colliding at bedside. How little can I get away with vs there is no limit to effort when it comes to your wellness. /3

When you were robbed of movement, somebody started selling you exercise. To understand that digging a ditch, to build a house, or to carry a child around, or waking to your grandparents for an hour is not the same as jogging on a treadmill... will reveal what research hides.
/4

When I talk about doing a purposeful activity outdoors, I look at complexity of movement, purpose, meaning, sun, and air, even an opportunity to meet a neighbor... that is now reduced to a calcium pill, vitamin D, an antidepressant, an osteoporosis shot, and an oxygen tank. /5

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"I lied about my basic beliefs in order to keep a prestigious job. Now that it will be zero-cost to me, I have a few things to say."


We know that elite institutions like the one Flier was in (partial) charge of rely on irrelevant status markers like private school education, whiteness, legacy, and ability to charm an old white guy at an interview.

Harvard's discriminatory policies are becoming increasingly well known, across the political spectrum (see, e.g., the recent lawsuit on discrimination against East Asian applications.)

It's refreshing to hear a senior administrator admits to personally opposing policies that attempt to remedy these basic flaws. These are flaws that harm his institution's ability to do cutting-edge research and to serve the public.

Harvard is being eclipsed by institutions that have different ideas about how to run a 21st Century institution. Stanford, for one; the UC system; the "public Ivys".