Nick Norwitz
speaker
450 appearances
2 recordings
2 series
first heard Apr 2025
last heard Apr 2025
Nick Norwitz’s voice in public audio — every appearance, attributed to the second.
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And I said, what I'm gonna do is an experiment. In this experiment, I'm gonna lock in my diet as a kind of strict baseline ketogenic diet, my normal one, for a couple weeks, and then I'm gonna do an intervention where I eat Oreo cookies, a sleeve per day, so that's 12 cookies, about 100 grams of net carbs, in addition to my diet. So I'm not swapping out fat, I'm adding this.
So I'm actually adding saturated fat, along with sugar and carbs, for about two weeks, and then I'm gonna do a washout period, kind of reset everything, and end up being a three-month washout period, And then I'm gonna try high-intensity statin therapy. So it was Crestor, 20 milligrams for six weeks. Gorilla statin.
I wanted to steel man the comparator, which in this case was, you know, frontline therapy, statin therapy.
In addition to this, I know how to dot my I's and cross my T's, so I went to Harvard, their institutional review board, got the appropriate exemptions for this experiment, had my PCP ordering all my labs into my electronical medical record, and then I got a consultant lipidologist, I don't know if you know Professor William Cromwell, but he trained Thomas Dayspring, Thomas Dayspring trained Peter Attia in lipidology.
So, William Cuomo, over 30 years of experience, he's the senior author on this paper and was consulting. So, I did this as by the books as you could in Oreo experiment. And then I executed and published the results, which were that the Oreo cookies lowered my LDL by 71% in just 16 days.
Now, the reason it was 16 days and not 14, I had mentioned two weeks, was because at the two-week mark, the drop was so astronomical. We wanted to make sure it wasn't a lab error, so we wanted to triplicate. So we said, we're going to measure the next two days. And it was still dropping. So that was the effect of the Oreo. And then the statins lowered my LDL by 32.5%.
So more than double the effect of the statin by eating Oreos.
Me understanding the physiology in myself. So we talked about different things can drive biomarkers up or down, and the context matters. So our understanding of why lean people have high LDL and low carb has to do with the fact that the leaner and the more insulin sensitive you are,
when you go low carb when you go keto and the carbohydrate stores and your liver starts to drop it kicks off this cycle whereby you're burning a lot more fat as fuel and you're actually releasing more free fatty acid from your fat cells into your bloodstream and then those free fatty acids need to cycle throughout the the liver and then back through the body so they get taken up by the liver packaged on these big ship-like particles containing cholesterol and stored fat
They're called VLDL. And then the VLDL dropped the stored fat, the triglycerides, back off at the muscle tissue and the fat tissue. And what happens in this process is that those big particles that are packed with the stored fat have the fat siphoned out of them. They shrink down into LDL particles that contain LDL cholesterol. And what you end up with as a result of this system is very high LDL.
It's like a decay product of the thing that was transporting the energy effectively. An epiphenomenon. So yes, there are these particles that are the precursors to LDL. They drop off their cargo, the fat, at fat tissue to replenish small fat cells and muscle tissue. And then the VLDL will shrink.
the vldl has a lot of triglycerides in it it drops off the triglycerides and becomes an ldl which sticks around longer than the vldl so what you end up with is actually very low triglycerides because the triglycerides get sucked out so fast triglycerides are low not high your ldl ups are being very high because the vldl are being turned over really really quickly into ldl and then as an added nuance when the vldl shrink remember they're big spheres they lose surface components
from their shell, you could say, and some of that is cholesterol that gets picked up by HDL. So the result is this pattern of very high LDL, high HDL, and low triglycerides. The high LDL, the high HDL, the low triglycerides with particular thresholds is what we call lean mass hyper-responders, and is this pattern we see on lean people who go low carb.
But we can get a little bit more into the model if you want, but the point is the model starts with your metabolism shifting towards lots of fat burning. So if you put carbs back into the system, it puts the brake on the system, or at least takes the foot off the gas pedal, and your LDL should drop. That is the prediction of the model. So it should drop with any carb.
The fact of the matter is, even before I did the Oreo experiment, we had used sweet potatoes in patients. There are case reports on this, or fruit, or starches. It just wasn't sexy enough to catch headlines. So I'm like, what is? And I'm like, Oreo cookies, that should do it. So I did a rigorous controlled experiment with my locked in baseline diet, a pure addition.
You can look at all the macro breakdowns in the paper. And the result was the Oreo cookies lowered my LDL by a dramatic 71%. And I'll just say as an aside.
Well, the fact of the matter is, I think you learn so much in science and medicine by studying the outliers. And when you do the randomized control trial, yes, it has certain benefits, but you're, by the nature of the study, looking at a large group of diverse humans. So when you get a, quote, statistically significant result, that doesn't speak to any individual in the trial.
And if we want to shift medicine towards more focusing on targeting underlying metabolic dysfunctions in an individual manner, then we need to start taking the mindset of N equals one medicine. And we have more and more tools where we can do this.
Things like multiomics, where we take an individual's genome and microbiome transcript and you integrate them into an incredibly high resolution picture of the individual. If you take that mindset, then you can get incredible results. in a reproducible manner, like lowering your LDL with Oreo cookies. I'm not saying that's healthy, I'm just saying it's incredible.
And it's explainable when you understand the physiology. And is it generalizable? I've actually had other doctors at Harvard replicate this who are lean mass hyper-responders. There are actually quite a decent number of lean mass hyper-responders, people at Keto at Harvard.
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