The evidence shows that having infantile levels of APOB, at 30 to 40 milligrams per deciliter, does not pose a risk to children's health. According to clinical trial data and Mendelian randomizations, having an LDL cholesterol below 30 or an APO-B below 40 milligrams per deciliter for a long time significantly lowers the risk of developing ASCVD.
In this episode, the speaker discusses his shift in perspective on apoB levels in children and adults, the literature that supports his new standpoint and why people shouldn't wait until there's an issue to take action. The episode also covers colon cancer, discussing the hypothetical thought of doing a colonoscopy on individuals every day starting from the age of 30 and its impact on eliminating colon cancer deaths.
LDL cholesterol below 30 or an APO-B below 40 mg/dL for a long time means the risk of suffering ASCVD is low. By late 30s or early 40s, APO-B should be lowered to below the 20th percentile, especially for patients with significant genetic abnormalities like familial hypercholesterolemia.
An individual who loses 100 pounds, with 70 being fat and 30 being lean, may still be net better off due to the potential for muscle improvement. It's important to maintain lean mass during weight loss to avoid losing muscle protein synthesis and contributing to fat gain.