john banks

@noahkaufmanmd @MohammedAlo How are you getting on with your dietary changes? Hope they’re going well at the same time as your new venture!

@MohammedAlo Also, who eats 1 egg a day? Maybe it was my actual issue, but when I was a heavy egg eater, 2-3 eggs a day cooked in butter was very normal. Led to a very, very bad lipid profile.

🚨 Eggs were villainized for 40 years based on cholesterol fear, not data. The science has caught up, and the verdict is not what your doctor told you in 1987. Here is what the evidence actually says. 🫀 The original sin was a single flawed hypothesis from the 1960s. Ancel Keys linked dietary cholesterol to blood cholesterol to heart disease. The entire chain was wrong. Dietary cholesterol does not drive cardiovascular events in healthy people. The body self-regulates. When you eat more cholesterol, your liver produces less. 💓 Here is what the data actually shows. ✅ A meta-analysis of 17 prospective studies covering over 263,000 people found no significant association between egg consumption and coronary heart disease or stroke in healthy adults. ✅ The PREDIMED Trial (olive oil and Mediterranean diet) showed that egg intake within a Mediterranean dietary pattern did not increase cardiovascular risk, even at 4 eggs per week. ✅ Eggs raise HDL cholesterol. They shift LDL particles from small and dense to large and buoyant. That is the pattern associated with lower cardiovascular risk, not higher. 🔬 What eggs actually contain: Choline. Critical for brain and liver function and almost nobody gets enough. Lutein and zeaxanthin. The two nutrients most protective against macular degeneration. High-quality complete protein. All 9 essential amino acids in a single food. Vitamin D. One of the few dietary sources that actually moves the needle. ⚠️ There is one real exception. People with Type 2 diabetes show a more variable response to egg intake in some studies. If you have diabetes or insulin resistance, the conversation is more nuanced and you should have it directly with your physician. 🩺 I am a cardiologist. I have seen thousands of patients terrified of eggs while eating processed breakfast cereals labeled heart-healthy by the same guidelines that demonized whole foods. That is the real story. 🔸 The foods that actually drive cardiovascular risk are ultra-processed carbohydrates, refined seed oils in industrial quantities, trans fats, and excess sodium. Not whole eggs. Not the yolk. Not the cholesterol in a nutrient-dense food that humans have eaten for hundreds of thousands of years. "A patient who swaps a processed grain breakfast for two whole eggs daily can improve satiety, reduce postprandial glucose spikes, and support HDL particle quality. That is the difference between chasing cholesterol numbers you do not understand and actually reducing your risk." ❤️ Bottom line: Eggs are not the enemy. They never were. The fear came from a hypothesis, not a randomized trial. Eat the whole egg. Eat the yolk. Stop being afraid of a food with 13 essential nutrients. If you have Type 2 diabetes, talk to your cardiologist about your specific context. The question is no longer whether eggs raise cholesterol. The question is why we let a 60-year-old hypothesis override 263,000 patients worth of data. #Cardiology #HeartHealth #HeartDisease #CardiovascularHealth #Cholesterol #LDL #DietaryFat #NutritionalCardiology #PreventiveCardiology #MetabolicHealth

@2147mill I like Musk, but I still haven't been able to buy a RHD Plaid or the new Roadster. So I can't take this to the bank.

So we all trying to grow our portfolios for it to be worthless excellent

@llllllggggggees @DanielPriestley @grok Indeed, the type of lifestyle business he mentioned recently where profits are high and wrapped up in owner’s compensation, run from the Isle of Man, can buy 50 of the sunglasses I just purchased for my share of one similar sale.

@DanielPriestley @grok You were talking about "a business owner" not a FTSE 100 co. Implies a sole trader (though later info suggests someone who has incorporated their small business). My advice remains the same - if you are a small business keep your Fixed costs low + margins high!

A business owner wants to buy some sunglasses for £120… Step 1. Make a £1,320 sale Step 2. Pay the £1,056 of operating costs Step 3. You have £264 of pre-tax profit (20% margin) Step 4. Pay £66 corporation tax Step 5. Pay the £198 dividend Step 6. Now pay £78 dividend tax Step 7. £120 in your bank account to buy sunglasses of which £20 is VAT and £100 is the actual goods So for a business owner with 20% margins to buy £100 of goods they had to deliver £1320 of value and pay £164 of tax. … And then they call you greedy for not wanting to be taxed more.

@MohammedAlo @DrNadolsky @DrKarlNadolsky @NutritionMadeS3 @drmatthewnagra @MichaelAlbertMD @maciejbanach Do you see a role for continuing statin/ezetimibe as obicetrapib & enlicitide become available when the unmet need is Lp(a) control and LDL is easily controlled? Thinking of the rich outcome data with statins and pleiotropy beyond LDL.

Average Reduction In LDL-C Levels With Different Pharmacological Therapies sciencedirect.com/science/articl… @DrNadolsky @DrKarlNadolsky @NutritionMadeS3 @drmatthewnagra @MichaelAlbertMD @maciejbanach

@MstrHippy @richardaoneill @tylerblack32 In this case they were very much aligned, but unavailable in a timely manner.

@jcsbanks @richardaoneill @tylerblack32 What you love and what evidence shows actually works are not the same. When pressed, I would love for doctors to choose the latter.

18 to 38% of elite athletes have depression, and have a risk of depression 2x the rate of the general population. So, like, maybe exercise isn't a panacea

@richardaoneill @tylerblack32 Maybe context, the original poster is more exposed to severe cases than I was in primary care. There I would have loved to have been able to prescribe exercise instead of an SSRI to the majority…

@tylerblack32 @jcsbanks I'm surprised to hear that - a few years ago I was talking to a health economist working for one of the big pharma, and he told me exercise benchmarks in his studies just as well as any anti-depressant. Was he wrong? nhs.uk/mental-health/…

@tylerblack32 doi.org/10.1136/bmj-20…

@jcsbanks Exercise is beneficial for many reasons. Curing depression is not one of them

@whitfieldlewis6 mdpi.com/2072-6643/16/1…

So calorie restriction doesn’t work for lipedema? Eat less and move more doesn’t work? But somehow a low carb high fat diet works? I thought it was all about a “calorie deficit.” The first indication that the person you’re speaking to has no sophistication related to the matter is when they repeat the tired and easily memorized phrase, “you just need to be in a calorie deficit.” Hormones and enzymes determine fuel partition. The food you eat provides a signal to your body. Different foods have different signals due to their unique food matrices.

@FCademartiri How does this fit with the thrombotic and inflammatory effects of Lp(a), the disproportionate benefit from aspirin and the particular concerns of thin fibrous caps?

# Lp(a) Doesn't Cause Events. It Builds Plaque. For years we've known that elevated **Lipoprotein(a)** increases cardiovascular risk. The unanswered question was **how**. A new *JACC: Cardiovascular Imaging* study from the **SCAPIS** cohort suggests the answer is surprisingly simple. Among more than **28,000 individuals**, elevated Lp(a) was associated with: - more extensive coronary atherosclerosis - more obstructive CAD - earlier plaque development - higher rates of coronary events. But here's the key finding: Once the analysis accounted for **coronary plaque burden**, most of the excess risk associated with Lp(a) disappeared. Mediation analyses showed that the relationship between Lp(a) and events is largely explained by **more plaque—not necessarily more vulnerable plaque.** ## My Take This paper reinforces a concept that preventive cardiology is gradually embracing: **Risk factors matter because they create disease.** Disease is what causes events. That's why coronary imaging is becoming indispensable. The question is no longer: *"Does this patient have high Lp(a)?"* It's: **"What has high Lp(a) already done to this patient's arteries?"** ## Where PCCT Fits If plaque burden is the real mediator of risk, then the next step is obvious. Move beyond detecting stenosis. Start quantifying plaque biology. This is exactly where **Photon-Counting CT** has the potential to redefine preventive cardiology. **Treat the plaque. Not the biomarker.** #LpA #CardiacCT #PhotonCountingCT #PCCT #Atherosclerosis #PreventiveCardiology #TreatThePlaque #CardiovascularImaging

@JGreenCrypto At 27 this is awesome as many are just paying debt. Increasing income whilst keeping expenses similar through your 30s could do it. Also think what you sacrifice to save more, definite trade offs of time and other plans.

Is £1,250/month investing (starting at 27) enough to retire comfortably by 45? What do you think?🤔

@theproof I have no refined carbs, but I’ve never tested BHB. I can do a ~1Mcal swim on an avocado in the last 18 hours though so intermittently might be. I’ve been buying since this dip to possibly fund my pelacarsen. So I’m a pharma shill too.

Most people recognise that elevated LP(a) is a risk factor for cvd. Let’s play out the future. Let’s imagine the Horizon trial (due to be published end of 2026) shows significantly lower cvd events in subjects taking pelacarsen (the Lp(a) lowering drug used in this trial) with a good safety profile. Do you think folks in the low carb/keto community will generally accept this or reject it?

@notayesmansecon In the GFC, NS&I used to give a stonking return of something like RPI + 1.5%. When they dried up it was time to buy a house again.

Can anybody think why the Bank of England replaced this. RPIX 2.9% with this CPI 2.6%?

@kamikazecash I'm 51 and paying rent. There is no problem, it is <10% of my income and there is 100 years of rent liquid. Not everyone is undisciplined and needs an enforced savings plan.

Dudes will compare renting vs buying by saying “instead of buying a $600,000 house, you could put $600,000 into $SPY and have a bigger profit after 30 years.” Then they wonder why they aren’t taken seriously. Ok bro, you can be 50 years old and continue paying rent. No problem there.

@ZKForTre Mine was 3.0mmol/L (116mg/dL) which was at the upper limit of normal in two labs. Despite it being marked as normal and being median in some series, indeed I was not at all happy with it, chiefly after considering PESA.

There is virtually no recommending body in modern medicine that calls an ldl of 110 “normal,” let alone “optimal.” He is blatantly lying to you, and that’s before he enters the spin zone with the rest of his post.

@stevehill1mil You had some initial gains and can now choose. When I started investing it took about 5 years including dividends just to get back to nominal starting point, and I started investing after the blow off top.

To be honest guys I'm quite deflated. Basically all of my gains from the run this year are gone now.

@gladstein Done all that and still use meds. My pulse can quadruple during exercise at age 51, I’m not lazy and undisciplined.

It isn't easy but one can *dramatically* reduce cholesterol in just a few months by decimating sugar and alcohol intake, focusing on sleep, and being active I don't want to say "simply" because it's really hard to be consistent But I don't think most people truly need a pill

@JGreenCrypto I don’t want to lock up funds for an unknown duration and tax level, neither of which you control and a series of wasteful governments will degrade and raid.

A pension contribution of £200 a month, with basic-rate tax relief added, actually puts in £250. Over 30 years at 7% growth, that £250/month could reach roughly £280,000. Skip the tax relief by using a normal investment account instead, and you're contributing £200 a month for the same £225,000 outcome. Same effort. £55,000 difference. Just from where you put the money. Nobody explains this bit at school. Surely pensions are the way forward. Anything more to add? 👇

@DominicMcGregor Why have a government do things that people can do themselves? Tax them less instead and let them spend their money as they wish.

It shouldn’t be radical for those who earn more and pay more tax to get better benefits. Someone who earns £100,000 and pays roughly £35,000 in tax currently gets 0 hours childcare free. Those that qualify currently get 30 hours free. Why don’t we give those that earn over £100,000, 45 hours of childcare free as a thank you? Radical isn’t it.

@Wearcoby @DanielPriestley Having 50 years of living expenses liquid at age 50 was bigger than I hoped for. That’s what the sort of setup described can achieve, but crucially leaving you with time, freedom, control. It is still modest though compared to the big boys, but “enough”.

@DanielPriestley If you donr aim for bug then you wont reach your potential

Imagine the propaganda required to make people think a “lifestyle business” is a bad thing. A lifestyle business is profitable but deliberately boutique. It’s not planning to IPO, partner with PE or sell to Microsoft. It’s happily existing in a way that everyone is happy. A happy group of customers, a happy team, a happy owner and a happy bank account. No big debt, no long leases, no meetings about how to have better meetings. Fun, freedom, flexibility and financial stability. A typical lifestyle business has a team of 4-12 people, revenue of $500K - $5M and typically revolves around media, IP, software or data. Some people think it’s a weakness to want a lifestyle business. I think it’s genius.