Dr. Aseem Malhotra

I mean, okay, maybe it's my opinion, is that they think that there should be an old school paternalistic practice of medicine. Doctor knows best, patient do what I say.

I mean, okay, maybe it's my opinion, is that they think that there should be an old school paternalistic practice of medicine. Doctor knows best, patient do what I say.

I mean, okay, maybe it's my opinion, is that they think that there should be an old school paternalistic practice of medicine. Doctor knows best, patient do what I say.

I'm about shared decision-making. I'm about explaining to patients in a way that empowers them, that it's a more equal relationship. And that's fine. Maybe it's a philosophical disagreement, but that's the stance I'm going to take. And I'm prepared to die on that hill.

I'm about shared decision-making. I'm about explaining to patients in a way that empowers them, that it's a more equal relationship. And that's fine. Maybe it's a philosophical disagreement, but that's the stance I'm going to take. And I'm prepared to die on that hill.

I'm about shared decision-making. I'm about explaining to patients in a way that empowers them, that it's a more equal relationship. And that's fine. Maybe it's a philosophical disagreement, but that's the stance I'm going to take. And I'm prepared to die on that hill.

So how do you sort of handle those cases? So I deal with those actually quite regularly. So interestingly about the saturated fat, I think you're right, Mark. There are definitely a subgroup of people who have very high saturated fat intake. Actually, it does affect their interresistance or make their triglycerides go up. And in fact, there was a paper done by...

So how do you sort of handle those cases? So I deal with those actually quite regularly. So interestingly about the saturated fat, I think you're right, Mark. There are definitely a subgroup of people who have very high saturated fat intake. Actually, it does affect their interresistance or make their triglycerides go up. And in fact, there was a paper done by...

So how do you sort of handle those cases? So I deal with those actually quite regularly. So interestingly about the saturated fat, I think you're right, Mark. There are definitely a subgroup of people who have very high saturated fat intake. Actually, it does affect their interresistance or make their triglycerides go up. And in fact, there was a paper done by...

I think his name's Ronald Kraft, if I'm not wrong. Ron Kraus. Ron Kraus, sorry, Kraus, you're right. And he showed there was an abnormal effect on lipids if your saturated fat consumption in obviously certain groups of people was more than 18% of your total calories, right? Which is still very, very high. But again, you're absolutely right. That might happen with a certain subgroup of people.

I think his name's Ronald Kraft, if I'm not wrong. Ron Kraus. Ron Kraus, sorry, Kraus, you're right. And he showed there was an abnormal effect on lipids if your saturated fat consumption in obviously certain groups of people was more than 18% of your total calories, right? Which is still very, very high. But again, you're absolutely right. That might happen with a certain subgroup of people.

I think his name's Ronald Kraft, if I'm not wrong. Ron Kraus. Ron Kraus, sorry, Kraus, you're right. And he showed there was an abnormal effect on lipids if your saturated fat consumption in obviously certain groups of people was more than 18% of your total calories, right? Which is still very, very high. But again, you're absolutely right. That might happen with a certain subgroup of people.

I've seen, for example, a patient on a carnivore diet who actually had something like that, and when they reduced their saturated fat intake, their lipid profile got better. That's all they changed. So I agree with you. There are going to be a subset of people. What do you do with FH, the people with the familial hyperlipidemia? So let's just lay it out for people, right?

I've seen, for example, a patient on a carnivore diet who actually had something like that, and when they reduced their saturated fat intake, their lipid profile got better. That's all they changed. So I agree with you. There are going to be a subset of people. What do you do with FH, the people with the familial hyperlipidemia? So let's just lay it out for people, right?

I've seen, for example, a patient on a carnivore diet who actually had something like that, and when they reduced their saturated fat intake, their lipid profile got better. That's all they changed. So I agree with you. There are going to be a subset of people. What do you do with FH, the people with the familial hyperlipidemia? So let's just lay it out for people, right?

There are, but you talk about ApoB and lipoprotein little a, which are all these other extra markers of risk that are added in. Basic teaching in medical school, certainly what I teach medical students and junior doctors, right? Don't organize a test unless it's going to change your management plan, right? Because what's the point? So you create unnecessary anxiety, for example, for some people.

There are, but you talk about ApoB and lipoprotein little a, which are all these other extra markers of risk that are added in. Basic teaching in medical school, certainly what I teach medical students and junior doctors, right? Don't organize a test unless it's going to change your management plan, right? Because what's the point? So you create unnecessary anxiety, for example, for some people.

There are, but you talk about ApoB and lipoprotein little a, which are all these other extra markers of risk that are added in. Basic teaching in medical school, certainly what I teach medical students and junior doctors, right? Don't organize a test unless it's going to change your management plan, right? Because what's the point? So you create unnecessary anxiety, for example, for some people.

Now, I get it. People may want to know, and if that's what they want to know, that's fine. And we'll come on to management as well. if you're not going to add in a statin or whatever else, then okay, maybe those people need to be more extreme in the lifestyle.

Now, I get it. People may want to know, and if that's what they want to know, that's fine. And we'll come on to management as well. if you're not going to add in a statin or whatever else, then okay, maybe those people need to be more extreme in the lifestyle.