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Engineer, podcaster, author and speaker Ivor Cummins is back on the podcast today to talk about a topic that could save your life or the life of someone you love. Coronary Artery Calcium (CAC), a direct measure of arterial calcification obtained with a CT scan, is gaining respect as the best predictor of cardiovascular events. Indirect risk factors - like LDL cholesterol, though beloved by the medical establishment, pale in comparison. Today Ivor talks about what really causes cardiovascular disease and how best to assess your risk. He discusses the science that supports the use of CAC to identify those most at risk - and by doing so, they can take steps to slow, stop or even reverse disease progression. Further validating Ivor’s work, the American College of Cardiology and the American Heart Association are now formally recommending the CAC for middle-risk patients. As if that wasn’t enough, getting a CAC scan is affordable and probably available near you. Here’s the outline of this interview with Ivor Cummins: [00:00:03] Real Food Rocks Festival. [00:01:33] Prevalence and severity of cardiovascular disease (CVD). [00:02:19] Decline in CVD between 70s and 90s: Roger, Véronique L., et al. "Time trends in the prevalence of atherosclerosis: a population-based autopsy study." The American journal of medicine110.4 (2001): 267-273. Rates of CVD from 1990-2013: O’Rourke, Kevin, et al. "Cardiovascular disease worldwide, 1990-2013." Jama 314.18 (2015): 1905-1905. [00:02:39] Causes of CVD. [00:05:27] Glycocalyx; Study: Noble, M. I. M., A. J. Drake-Holland, and H. Vink. "Hypothesis: arterial glycocalyx dysfunction is the first step in the atherothrombotic process." QJM: An International Journal of Medicine 101.7 (2008): 513-518. [00:07:07] Glucose spikes causing damage to glycocalyx; Study: Nieuwdorp, Max, et al. "Loss of endothelial glycocalyx during acute hyperglycemia coincides with endothelial dysfunction and coagulation activation in vivo." Diabetes 55.2 (2006): 480-486. [00:07:49] Glycolyx thinning at arterial branch points become regions of atherogenic risk; Study: Gouverneur, Mirella, et al. "Vasculoprotective properties of the endothelial glycocalyx: effects of fluid shear stress." Journal of internal medicine259.4 (2006): 393-400. [00:08:11] Potential autoimmune component to CVD. [00:08:18] Gabor Erdosi, admin on the Lower Insulin Facebook group. [00:09:59] Know your risk. Coronary Artery Calcium (CAC) scan. [00:10:52] Widowmaker movie. [00:11:24] David Bobbett; Irish Heart Disease Awareness (IHDA). [00:12:07] Rivers Hospital in UK. [00:15:15] An 80-year old with a low score is 20x less likely to have a cardiac event in the next 10 yrs than a 50 yr old with a high score. Study: Tota-Maharaj, Rajesh, et al. "Association of coronary artery calcium and coronary heart disease events in young and elderly participants in the multi-ethnic study of atherosclerosis: a secondary analysis of a prospective, population-based cohort." Mayo Clinic Proceedings. Vol. 89. No. 10. Elsevier, 2014. [00:15:52] 2018 ACC/AHA Multisociety Guideline on the Management of Blood Cholesterol. [00:17:34] Interpreting and understanding CAC results. [00:20:03] Value of understanding your cholesterol levels. [00:22:17] COURAGE trial: Boden, William E., et al. "Optimal medical therapy with or without PCI for stable coronary disease." New England journal of medicine 356.15 (2007): 1503-1516. ORBITA trial: Al-Lamee, Rasha, et al. "Percutaneous coronary intervention in stable angina (ORBITA): a double-blind, randomised controlled trial." The Lancet391.10115 (2018): 31-40. [00:25:47] Why isn't the medical establishment using the CAC scan to assess for CVD? [00:26:05] CAC threatens to interfere with cath lab income, gets shut down. [00:28:39] Getting your score back to zero. [00:28:44] Feature documentary: Heart of the Matter. [00:29:48] Heinz Nixdorf Recall study: Mahabadi, Amir A., et al. "The Heinz Nixdorf Recall study and its potential impact on the adoption of atherosclerosis imaging in European primary prevention guidelines." Current atherosclerosis reports 13.5 (2011): 367. [00:31:54] Physiological perspective on how CAC can possibly reverse. [00:33:45] Hyperbolic discounting; Podcast: Nudge Tactics for Performance and Health with Simon Marshall, PhD. [00:34:20] Donal O'Neill; Cereal Killers movie. [00:35:21] Half-hour Extra Time documentary (at the top of the page). [00:35:35] Cardiologist Dr. Scott Murray, president of the British Association for Cardiovascular Prevention and Rehabilitation (BACPR). [00:38:53] How to spread the word about getting scanned. [00:39:49] The Fat Emperor podcast; Episode 32: Myopia and Eye Problems: How to Resolve via Resolution of Root Causes. [00:40:11] Robert Lustig, MD. [00:41:16] LDL Cholesterol not a good predictor of actual calcification (CAC); Study: Ware, William R. "The mainstream hypothesis that LDL cholesterol drives atherosclerosis may have been falsified by non-invasive imaging of coronary artery plaque burden and progression." Medical hypotheses 73.4 (2009): 596-600. [00:42:44] Assessing your health between CAC scans: blood tests, CIMT (carotid-intima-media thickness). [00:45:53] Find a scan centre near you. Note: Also try Googling your city/state and “heart scan”. [00:46:37] If you enjoy this podcast, listen to his first podcast with us in March 2018: How Not to Die of Cardiovascular Disease. You can also check out Ivor’s book, Eat Rich, Live Long and his YouTube channel.
Can a growing global passion for lower carb / high nutrient-dense food boost demand for Irish grassfed produce? In this episode, Ivor Cummins, Chief Program Officer, IHDA outlines some context on this growing trend, along with perspectives on CVD risk-taking to better understand and optimise health. * In the 90's, Ivor completed a biochemical engineering degree, followed by 30 years spent in corporate technical leadership positions. His career specialty has been leading large worldwide teams in complex problem-solving activity. * Irish Heart Disease Awareness (IHDA.ie) is a charity established to raise awareness of heart disease, as a progressive, measurable and treatable disease, that can be detected by a simple calcification test. * The charity's founder, David Bobbett, is also CEO and majority shareholder of H&K International, one of the world's largest equipment suppliers to the Quick Service Restaurant (QSR) industry.
Read the transcript In this third episode, Ivor Cummins, Chief Program Manager of Irish Heart Disease Awareness (IHDA), shares why as a top class engineer he’s been decoding the causes of human chronic disease and obesity. He relates why orthodox healthcare is unnecessarily putting our health and lives at risk. He imparts what we can do ourselves to predict and prevent modern disease. Topics we discussed in this episode Ivor’s blood chemistry showing high serum ferritin, Gamma-Glutamyl Transferase (GGT) and cholesterol Ivor’s inability to get answers about the root cause of the high markers, nor any quantification of any increased morbidity or mortality His search for answers and the answer itself His serendipitous discovery that the risk markers used by orthodox healthcare are weak let alone optimal, even deeply misleading Better risk markers for morbidity and mortality prediction Serendipitously meeting David Bobbett who also had an axe to grind with orthodox healthcare after he discovered using his own efforts that he was very high risk, after being told he was low risk by healthcare The use of generic risk factor algorithms by orthodox healthcare and why they are not good enough Medications are often a very weak intervention e.g. little effect on all-cause mortality Correct diet and lifestyle is a more powerful intervention as it addresses the root cause Dietary root causes - primarily refined sugars, refined carbohydrates and vegetable oils (the three building blocks of manufactured “food like” products) Mixture of refined carbohydrates and fats is the least optimum for longevity and healthspan There is no more important factor in weight loss and longevity than your insulin status The bar where orthodox healthcare puts diabetes and diabetic physiology is very late in the diabetic journey, whereas it could be caught 15 years earlier The majority of the American adult population have diabetic physiology; the majority share this single metabolic disease Most doctors are not aware of insulin resistance outside the context of diabetes nor aware of insulin as a disease cause, only a medication Diabetic physiology is linked to fatty liver, obesity, heart disease, Alzheimer’s, many cancers; in fact all modern chronic diseases Orthodox healthcare is using glucose to determine diabetic status, whereas it should be using insulin, particularly post-prandial insulin Use of HOMA calculation as a cheap yet better measure of diabetic physiology Use of Kraft-Assay as the gold standard to measure of diabetic physiology Total cholesterol is a very poor risk marker LDL, the “bad” cholesterol is a very poor independent risk marker High resolution LDL analysis (LIPOPRINT/NMR) Bypassing fuzzy risk markers and guesses by using the Coronary Calcium Score (CAC) to see the disease directly The four types of people - it’s the metabolically unhealthy, thin outside, fat inside (TOFI) at the four who are most risk The orthodox intervention, low fat diets and vegetable oils, will probably just hasten your demise. Nutritional guidelines have been based upon junk science and have only exacerbated chronic disease and obesity Show links Irish Heart Disease Awareness (IHDA) Website Jeffry Gerber, MD Website Ivor Cummins Website Eat Rich, Live Long: Mastering the Low-Carb & Keto Spectrum for Weight Loss and Longevity Book David Bobbett on Independent.ie Rich List Web Page Coronary Calcium Score Web Page How Could a fit 51-year-old Have a 25pc Chance of a Massive Heart Attack Within a Year? Article Atherosclerosis Wikipedia Entry Framingham Risk Score Wikipedia Entry Framingham Risk Score Calculator Web Page Adipose Tissue Wikipedia Entry 2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk Report ACC/AHA 2013 Cardiovascular Risk Assessment Calculator Web Page The Top 10 Causes of Death - WHO Web Page
Ivor Cummins is a Biochemical Engineer who in 2012 was disturbed by a set of his own abnormal blood test results. Consultation with multiple doctors yielded little insight into the cause of his elevated cholesterol, ferritin and GGT so he turned to his analytical roots to study the problem. In the process, he evaluated hundreds of scientific papers, ultimately concluding that that flawed hypotheses and a breach of the scientific method have resulted in the current “diabesity” epidemic. Ivor is here today with Dr. Tommy Wood talking on topics related to his well-referenced new book, Eat Rich, Live Long: Mastering the Low-Carb & Keto Spectrum for Weight Loss and Great Health. They also discuss the trouble with polyunsaturated oils, advice on fat loss for the insulin sensitive, and the best test for cardiovascular disease risk (hint: it’s not LDL). If you enjoy this podcast, Ivor is a regular presenter at low-carb/keto events and maintains an active blog and social media presence. Here’s the outline of this interview with Ivor Cummins: [00:00:17] Keto Summit, Dave Feldman. [00:00:48] Boundless Health Podcast with Dr. Bret Scher. [00:01:57] Podcast: The True Root Causes of Cardiovascular Disease, with Dr. Jeffry Gerber. [00:02:15] Book: Eat Rich, Live Long: Mastering the Low-Carb & Keto Spectrum for Weight Loss and Great Health, by Ivor Cummins and Jeffry Gerber, MD. [00:02:29] Videos: here and here. [00:03:20] Insulin, IGF-1, acellular carbs. [00:03:56] Sunlight exposure, 25-OH-D video. [00:04:37] Minerals, Study: DiNicolantonio, James J., James H. O’Keefe, and William Wilson. "Subclinical magnesium deficiency: a principal driver of cardiovascular disease and a public health crisis." Open Heart 5.1 (2018): e000668. [00:05:28] Gabor Erdosi, Lower Insulin Facebook Group. [00:05:43] Video: Roads to Ruin? from Physicians for Ancestral Health 2017 conference. [00:06:01] Guðmundur Jóhannsson, gut health; Podcast: Foodloose Iceland. [00:07:40] Study: Schwalfenberg, Gerry K., and Stephen J. Genuis. "The importance of magnesium in clinical healthcare." Scientifica 2017 (2017). [00:08:10] Industrial seed oils. [00:09:05] Unilever sells its margarine business. [00:10:17] Studies: Alvheim, Anita Røyneberg, et al. "Dietary Linoleic Acid Elevates the Endocannabinoids 2‐AG and Anandamide and Promotes Weight Gain in Mice Fed a Low Fat Diet." Lipids 49.1 (2014): 59-69. And: Alvheim, Anita R., et al. "Dietary Linoleic Acid Elevates Endogenous 2‐AG and Anandamide and Induces Obesity." Obesity 20.10 (2012): 1984-1994. [00:10:48] Studies: Nanji, Amin A., and Samuel W. French. "Dietary factors and alcoholic cirrhosis." Alcoholism: Clinical and Experimental Research 10.3 (1986): 271-273. And: Kirpich, Irina A., et al. "Alcoholic liver disease: update on the role of dietary fat." Biomolecules 6.1 (2016): 1. [00:12:09] Book: Deep Nutrition: Why Your Genes Need Traditional Food, by Cate Shanahan, M.D. [00:12:45] Studies: 1. Ramsden, Christopher E., et al. "The Sydney Diet Heart Study: a randomised controlled trial of linoleic acid for secondary prevention of coronary heart disease and death." The FASEB Journal 27.1 Supplement (2013): 127-4. 2. Frantz, Ivan D., et al. "Test of effect of lipid lowering by diet on cardiovascular risk. The Minnesota Coronary Survey." Arteriosclerosis, Thrombosis, and Vascular Biology 9.1 (1989): 129-135. 3. Strandberg, Timo E., et al. "Mortality in participants and non-participants of a multifactorial prevention study of cardiovascular diseases: a 28 year follow up of the Helsinki Businessmen Study." Heart 74.4 (1995): 449-454. 4. Rose, G. A., W. B. Thomson, and R. T. Williams. "Corn oil in treatment of ischaemic heart disease." British medical journal 1.5449 (1965): 1531. [00:13:47] Study: Hooper, Lee, et al. "Reduction in saturated fat intake for cardiovascular disease." The Cochrane Library (2015). [00:15:28] Study: Ip, Clement, Christopher A. Carter, and Margot M. Ip. "Requirement of essential fatty acid for mammary tumorigenesis in the rat." Cancer Research 45.5 (1985): 1997-2001. [00:16:28] Study: Pearce, Morton Lee, and Seymour Dayton. "Incidence of cancer in men on a diet high in polyunsaturated fat." The Lancet 297.7697 (1971): 464-467. [00:16:56] Breast milk composition is now almost 50% PUFA. [00:17:50] David Bobbett. [00:19:59] Book structure. [00:20:51] Fat-loss for the insulin sensitive. [00:21:10] Videos: Jeff Gerber interviews Simon Saunders and Marty Kendall. [00:23:03] Ghrelin. [00:24:21] Protein and lean body mass. [00:26:05] Glucagon, mTOR. [00:26:22] Ron Rosedale. [00:26:34] Valter Longo. [00:27:02] IGF-1 U-shaped curve. [00:28:06] Study: Levine, Morgan E., et al. "Low protein intake is associated with a major reduction in IGF-1, cancer, and overall mortality in the 65 and younger but not older population." Cell metabolism 19.3 (2014): 407-417. [00:28:49] Book: Protein Power: The High-Protein/Low Carbohydrate Way to Lose Weight, Feel Fit, and Boost Your Health - in Just Weeks! By Michael Eades and Mary Dan Eades. [00:30:39] Study: Levine, Morgan E., et al. "Low protein intake is associated with a major reduction in IGF-1, cancer, and overall mortality in the 65 and younger but not older population." Cell metabolism 19.3 (2014): 407-417. [00:31:06] NHANES. [00:31:18] Study: Cohen, Evan, et al. "Statistical review of US macronutrient consumption data, 1965–2011: Americans have been following dietary guidelines, coincident with the rise in obesity." Nutrition 31.5 (2015): 727-732. [00:32:20] Kitavans. [00:34:05] Hyperlipid and Denise Minger. [00:36:37] Icelandic diets for longevity [00:39:07] Cardiovascular disease. [00:39:35] Basic lipid panel. [00:39:45] Study: Castelli, William P. "Lipids, risk factors and ischaemic heart disease." Atherosclerosis 124 (1996): S1-S9. [00:40:24] Ratios. [00:41:54] Study: Johnson, Kevin M., David A. Dowe, and James A. Brink. "Traditional clinical risk assessment tools do not accurately predict coronary atherosclerotic plaque burden: a CT angiography study." American Journal of Roentgenology 192.1 (2009): 235-243. Commentary: Ware, William R. "The mainstream hypothesis that LDL cholesterol drives atherosclerosis may have been falsified by non-invasive imaging of coronary artery plaque burden and progression." Medical hypotheses 73.4 (2009): 596-600. [00:42:30] Familial Hypercholesterolemia and CVD. [00:43:27] cholesterolcode.com, remnant cholesterol, Plasma Atherogenic Index. [00:44:36] Podcast: Health Outcome-Based Optimal Reference Ranges for Cholesterol [00:46:06] Coronary calcium scan. [00:46:25] Study: Nasir, Khurram, et al. "Interplay of Coronary Artery Calcification and Traditional Risk Factors for the Prediction of All-Cause Mortality in Asymptomatic Individuals Clinical Perspective." Circulation: Cardiovascular Imaging 5.4 (2012): 467-473. [00:47:54] Longitudinal score. [00:49:41] Plaque density. [00:50:11] Interview with Matt Budoff. [00:52:37] Video: Dr. Eades at Low Carb Breckenridge, Agatston score. [00:54:38] The Fat Emperor. [00:54:53] Low-carb Breckenridge 2018. [00:55:10] Ketofest, Keto Con, Low-carb USA, Refind Health. [00:55:45] Widowmaker movie.
In 2011, David Bobbett discovered that his odds of suffering a heart attack had soared. A calcification test showed he had a coronary calcification score of 906. This score was equivalent to having the arteries of an 87 year old despite the fact that David was only 51 and in "great shape" at the time. His calcium score put him at such a high risk that he had a 1 in 4 chance of having a massive heart attack in the next year if not treated. Listen to David's response when he explains his motivation for producing this powerful and important film.