Ivor Cummins BE(Chem) CEng MIEI PMP® completed a Chemical Engineering degree at UCD in 1990. He has since spent over 25 years in corporate technical leadership and management positions, and was shortlisted in 2015 as one of the top 6 of 500 applicants for “Irish Chartered Engineer of the Year”. Ivor’s focus and specialty is leading teams in complex problem-solving scenarios. He has often led worldwide teams with over 60-70 engineers working on major technical issues; the largest of these involved product issues where hundreds of millions of dollars were in the balance.
Several years ago, Ivor encountered a complex technical challenge in his personal life. Receiving poor blood test results, he was unable to get solutions via the doctors consulted. He thus embarked on an intense period of biochemical research into the science of human metabolism. Within eight weeks he had resolved and optimised all of his blood test metrics. Also, he had shed over 15Kg of body fat with relative ease.
In the following years he continued his research on the many “root causes” of modern disease, from “cholesterol” through to insulin resistance. He has become a professional speaker of note, giving many public lectures and chairing interviews with worldwide health experts. Most notably he was invited by the President of the British Association for Cardiovascular Prevention and Rehabilitation (BACPR) to give a keynote talk on heart disease root causes, at their annual conference in London last October.
All of Ivor’s public lectures and interviews are available on his YouTube channel, where over four million views have been recorded to date: https://www.youtube.com/channel/UCPn4FsiQP15nudug9FDhluA.
His book on chronic disease root causes and resolution strategies (co-authored with Denver doctor Jeffry Gerber MD, FAAFP) was released by a major US publisher on February 27th 2018:
His blog and other content is available at www.thefatemperor.com
Ivor lives in Dublin, Ireland, with his wife and five children.
Ivor Cummins BE(Chem) CEng MIEI PMP completed a Biochemical Engineering degree in 1990. He has since spent 30 years in corporate technical leadership positions. His career specialty has been leading large worldwide teams in complex problem-solving activity.Перейти в профиль
So I sat alone with my father while he died and his breath became very rapid and then suddenly it stopped and he was out of breath and out of time. I need to 72 years old. But his decline started long before the heart attacks the tokim. He had vascular demention is early 60s on his razor-sharp mind had clearly fall on the way and it became very tense and uncomfortable for his last four years. So he lost I think around 15 years of potential life span, but he lost around 20 years
of potential healthspan. So let's talk a little about that. So here's the mortality curve for 1925 30% of people got over 70 approximately. Not too bad. Here's the current mortality curve quite a lot better. People are getting open to the 80s and the 90s. No toll. Infant mortality is a big change that's made things a lot better. But In fairness we stretched out an age as well smoking cessation. All the medications medical procedures many other factors have improved things.
But it's my proposal. If we did or had all the right choices in nutrition and lifestyle we could push the curve after that green curve. Got a lot of extra a year. Out of you make very bad choices perhaps because we're missing formed we can pull back to the red curve now. That's the lifespan. But I'd really like to talk about healthspan because there's no point living long. If you can't enjoy life and be active and engage in life. So all the curves move back for Health Spine or quality adjusted life years. And it's important to note that the first part of
her life while they can be found. We often post our ass to put aside money and security to enjoy the future. The retirement. I know I did and still do. Smart pants like my kids of course have all the knowledge and the wish to push right have to the green line. I've no doubt. And people like my fault or end up back more at the red line and they might be very smart witchy walls, but not have the knowledge or perhaps been misinformed enough quite made the right choices. What's the play for wrote in this Zone that you may or may not access?
Well, there's a retirement there's Golf Course Port if you're fit and healthy reading holidays and you can get to watch the grandchildren grow up and maybe be part of their development. So there's a lot of important stuff out here to play for. What's the biggest issue that stops is accessing. Great time? It's arthro sclerosis, the degenerative disease of arteries inflammatory and nature. You see a young guy in the left there at the inner wall that are arteries are clean. No problems. The average middle-aged office worker in contrast will have to beginnings of atheroma, like
pustules are boils growing in the inner wall of the archery. What time is the person keeps driving this for Progressive disease you'll get calcified plaque on your body in its wisdom will bring in calcium to show her up and strengthen this week areas. So they don't burst and kill you. But if you keep pushing progression, eventually, I got ruptures you got more vulnerable plaque you look up breakouts. They may be asymptomatic. You may not know system your talk may think you're okay, but you're on a vector and it only has one end and that's the big one which takes it all the way.
But wouldn't it be great to go back 10 or 20 years in the time machine and actually see that you are calcifying on a massive risk building up in your future and if you had the knowledge rise and it's not easy to acquire you can put in the root calls fix those the right ones to stabilize your disease process on stop progression and we know they can be doing and your calcium would still stay there, but you would not keep pushing progression and that's what really kills you. So you would stabilize the score on the disease and you could actually avoid that heart
attack or put it off for quite a long time. So let's talk about CAC score. The calcification scan which is the master measure for cardiac disease. On the left there. We have us, but a green circle a lucky guy with no calcium whatsoever. And that's dr. Jeff Garber cuz he's a smarty pants as well. On the rice. We have a very different high-risk patient. She can see all the chalk in the red circle are in the car me are trees and this person as a mess of the higher risk than Jeff would have its $100 test non-invasive. Best test you can do
for the money on the incredible. It gives I hear about radiation rise. Okay. Well, I'm an engineer. I know about that stuff. It's less than 1 millisievert nowadays. And if you look up the radiological Institute calculator for risk that surround an extra one in 20,000 risk of a problem for this dose of radiation, which an engineering terms rounds off to zero so I wouldn't worry too much about that one. It doesn't see the soft plaque. Well that's not actually relevant. If you understand this technology, the calcification shows the overall tax burden which
represents the burden of soft plaque and that's why it's such an incredible predictor of your future. Are all astronauts and presidents must have to scan because they're important. You guys important? I'd like to think so. Here's one story. They all say the same thing but it's a quickie one people with a zero and middle-aged have a very low rate of heart attacks in the following 10 years. It's not zero, you still got to watch uploads but very low and intermediate score in the sky on your maybe ten times more likely
and a high score maybe 20 to 25 times more likely to have a heart attack that this blows away the blood risk factors. I shouldn't even need to say it. Astoria got a couple weeks ago. I liked we can see here age categories. And of course as you got older there is a much higher chance in the next 10 years of a heart attack. In fact age is the biggest Prime of her for risk in the calculators. They use to medicate people much bigger than any other risk factor. You can see Framingham risk across the bottom as you get older you automatically become higher risk. That's why older
people get off all medications, but let's forget about age and look at calcification results for these people and this study How we see that is 0 scoring a two-year-old has the same 10-year risk as a zero scoring 50 year old. Same for intermediate scores and certainly the same for high scores. So it transcends age calcification transcends the other risk factors. I give you a different view a fifty-year-old with an intermediate score has three or four times the risk in the next 10 years of a heart attack as an 8 year old with a zero
score. Fancy Love a 50 year old with a high score has a massively higher risk in the following 10 years down the nature old with a zero score. My boss David Baba's got this situation 6 years ago and he got very angry cuz he's a half and then kind of guy and he doesn't take anything lying down and he found out he's a massive score undiagnosed diabetes and three blocked arteries and no one in five years of executive medical told him anything other than he was in fantastic shape calcium
scan was not available for everyone to save lives and he put four million dollars into Irish heart disease awareness who I work on behalf of an our goal is to save people's lives to let them know what's really happening inside. Is there a hope of course there is if you stop progression you massively drop your risk. So here we have people with very high scores a terrible Outlook and they have increased more than 15% per year over the years and they have a 50% rate of heart events. That's catastrophic worse than Russian Roulette.
What's similar people with similar or very high score who achieved less than 15% increase per year. They slowed their progression like David did. They have a baseline background rate of heart attacks similar to a low-scoring person. She just need to know how to do this. So fly what dries progression? What on the left juicy Western white man on the distribution of calcification by age? And as you can see the worst 20 10% of calcifiers at the back for the rat is get massively calcified over the decades. In fact the top
10% calcified people account for 40% of her all heart events and the lowest scores and zeros account for very few. Put the samain man have no calcification. I know heart disease strike and comparison on these indigenous populations and the catalans are the same basically no calcification that hardly increases with age. It appears. They're almost immune. I'm not going to show you some of the factors that would account for this note that the samain on the top and both have the same or higher LDL particle counts as
the Western white van. So why why did I have no disease but here's some things they have their very low insulin levels for a low glucose. No diabetic physiology. No Matson. No, hyperinsulinemia insulin resistance syndrome. They have no hypertension. Their blood pressure doesn't rise with age on like everyone in the western world no sense for the Beastie no trophy grade homework at 3 to omega-6 ratio in an all natural diet. Am I going to introduce this target list, which were going to see in the coming slides on this is just a ruthless from me as to what's really
important to avoid in order to achieve your retirement. Courting disaster will take a leaf from the airline industry an air crash investigations and disasters. There's many safety. There's put in to stop them happening. So there are on this is reason swiss cheese model. I'm basically all of the Safety Systems if there's a small failure in each one the trajectory of the accident can line up and get right through and you have a disaster. If just one safety system was kept working fully there's no disaster. I like I like
the model. What about cardiac disasters what we've got the atherosclerosis trajectory and it needs many factors lined up to allowed to give you a heart attack. If you fix a major factor, it's not a guarantee in the disease. Like I throw scroll saws you lower your chances for sure. But if it's this personal and it's your future you'd want to fix several major factors from my list to get a reasonable assurance that you solve the problem course, you can verify that with calcification. And again, these are the factors you want to be looking ass from
working on and there might be something there that are missing that are notable to talk about those shortly. So what about our friend cholesterol cholesterol has a parent and heart disease. There is no question about Jesus, but it's important that you keep cholesterol in perspective. So if you look at a high LDL particle count now and its potential trajectory to give you a heart attack. It is a substantial risk factor with pretty strong Hazard ratios. And if you change your diet on your LDL particle count shoots off or any other inflammatory markers, you got to make them sure
that you check that. That's not a specific problem that it's okay in your case. You can't assume anything. But the factors I'll choose which mediator decide whether the LDL is a problem are listed here. I won't read them out because I'm going to go through each one in a small amount of detail not too heavy. So here's your archery on you. Got your blood flowing there and your LDL particles and purple flowing along. And the LDL Terry is that these particles willy-nilly make their way into your artery wall, thereupon. They can get tracked an oxidized and become
part of the actress graphic millier. And they would lead to an inflammatory Cascade along with other factors. So this is a very simple Terry almost simplistic often missing. In the Naruto are the five layers that decide whether or not there is a problem. So I'll briefly go through those from research. I did the latter part of last year. So layerzero, the zero Theron calling Ash is oxidized ldls in your bloodstream in your plasma. Andresen papers and experiments are suggesting. It's damage to the LDL in your bulge that leads to mod. Minimally oxidized LDL
modified LDL. I'm not Truluck's 1 receptor is brought into the wall for clearance and can add to the arthrosclerotic process. But you'll see Nation damaged LDL particles in the green circle some teams and some diet is suggesting do not really partake in a meaningful way. So you want to know if you've left the particles are they oxidized? That's the first thing. My little Target list is the time go to read Ezra list four things that will lead to oxidized LDL. So that's why we're going to keep seeing this list
on the glycocalyx that this is an exotic structure extraordinary that grows like hairs on the inside wall of your archery and its effect on LDL and it managers van access is your arterial wall many components highly complex and here's a high-def and the reason is when you take an archery as if so, this is so delicate. It's gone before you can see if so they know what's there now? Here's one of my many papers on this. I know quote the title arterial. Glycocalyx
dysfunction is the first step in the afterworld thrombotic process. That's a pretty strong title for a paper cuz most people think it's ldls going in but I managed to this layer could be a very early initiating step, but we don't talk about it. We don't talk about the hell bar glycocalyx. The papers and studies that show what does damage or glycocalyx with very significant impact high sugar sad diets hypertension oxidative stress oxidized the album not native LDL and experiments smoking of course damage is everything
an arterial morphology. So that's real sclerosis is focal in nature. You can have a big enough Aroma just about to kill you and right across the Arts aim archery nearby. The wall isn't perfect health on this and other teams are proposing that glycocalyx locally damaged is one of the reasons for the focal nature of atherosclerosis among others. No surprises our Target list excellently tallies with all those bad things. I just showed you which damage the glycocalyx. Endothelial cells single-celled layer
on the inside of your artery that manages the ldls coming across into the wall and many other things. Basically, there's two ways for ldls to come across the endothelial barrier a there is transcytosis. And this is a highly complex process design by Eeveelution to move LDL from your blood into your arterial wall. It's a managed process right turn to imagine that process was designed to give you a heart attack. But there you go be is paracellular transport and that is simply when LDL kind of leak
between the different cells and get through the tight junctions off when the endothelial cells are dying excessively and turning over these tight junctions got loose her and ldls move across diffuse across The story isn't paper showing what damages your endothelium and drives LDL across C-reactive protein at once familiar with that oxidized LDL again oxidant induction reactive oxygen oxygen species lipopolysaccharide from infections. Aniki course that causes an immune reaction tnf-alpha an old
favor any insult to the endothelial cells pretty much I've walked leads to a lot of these things happening, right? Go figure this kind of stuff. Nearly there proteoglycans are hair-like structures in your arterial wall and here LDL particles can get trapped found and then get further oxidized and become a problem. So you'd want to know well what would drive particles to have an affinity and get trapped here much more that would be a big deal. Wells from the literature blood from heart
attack patients blood from insulin resistant patient's blood from type 2 diabetics people with small dents oxidized LDL LDL, what's higher a PS3 content protein content intimately type 2 diabetes and other inflammatory conditions and type 1 diabetic mice I don't like most experiments but here they are a diabetic mice vs. Control and they wanted to investigate exactly what I'm talking about and they found that with the same level of cholesterol in the diabetic mice vs. Control. It was eight times more LDL bound to the proteoglycans. So it's telling us something Way
Beyond the number of particles that's influencing this process and for me this list for cover a lot of it. Final on Magic HDL all the low carbers little too high HDL think we're going to live forever. Now. You know how I hate is a good indicator, but it doesn't speak to what's really going on, but I'll show you but those hdls and Eeveelution re crucial role to remove cholesterol from the wall deck builds up there and if it's all such as quick as it's coming in, you don't have much of a problem. But if you're putting a lot in
there and your HDL is screwed and you're not taking it as you're going to get a build up right as basic Mass transfer mass balance. So this paper was fascinating one of my favorites and what they did is they took a whole load of people and they took their HDL didn't just measure the concentration like the blood test. They actually measure the HDL functionality and how much cholesterol it could take hours of atherosclerosis macrophage. So they found the health of it. Person High HDL and gave it a score. So when they looked at the future of these people
tracked over many years having a high HDL classic men 35% lower heart attacks familiar with this. but when they looked at who had the heart attacks versus their hey HDL function the health It was a 70% lower future heart attacks for the people with the very functional HDL. And a 90% lower stroke price for the people with the function of HDL sometimes Association and the drugs didn't work. But that's all Ds. This is the real story on HDL. How do you screw up your HDL if you really want to go in and mess it up and make a non-functional. pretty easy actually
just do some of that stuff. nice So we've got five layers here on theramore which decide whether LGL is relevant and the really important these layers as you can imagine and this is a system with the problem of atherosclerosis in engineering you look at the whole system and you rack and stack the most important components and you generally tackle all of them. But in our world sadly does the sum of myopic view staring in of LDL numbers or LDL attributes now, it's understandable. There are drugs which lower
LDL Ox LDL and old are problematic small dense LDL and they do improve outcomes, but I'll show you something from a very recent study. LDL lowering drugs in people with a high CAC score with demonstration disease showed a lowering of events over 12 years In fairness. So those drugs can help those people if they're not going to take other routes to fixing their problem. Putting people with C A C 0 and even up to a hundred. The drugs gave no benefits whatsoever. And there's a large numbers of people in this stage.
So the 2018 guidelines tanksley have enshrined calcification scanning to make medication judgments on middle risk people to actually find out whether they're going to benefit from meds or not. And that's a step forward. So the Crux of the matter we spent 50 years with the media and governments on everyone in health staring at cholesterol still are right at the risk off. Not addressing the elephant no room found more Rich causes. Okay in our Target list an inflammatory drivers, I put an astrix on
because that includes many inflammatory disease is an autoimmune diseases. Rocco piazza's ER your risk for heart attacks 10 times more than any other blood marker. So is a lot of things in this list of reroute causes. The irony is that these real real causes damage the layers that in turn a low cholesterol to get the kudos for heart disease and the bigger irony is that the ultra focus on class trans fats has generated for 50 years these kinds of headlines. These are from the last couple of weeks because low carb diets
are seen to be threatening to raise fast raise cholesterol are dangerous. This is the very latest heart rhythm disorders. I haven't even read it yet. But I know when I'm going to see Association of travel, I'm sure. And has Priyanka showed earlier this firefest. I mean you couldn't make it up but they did make it up because apparently will guide that's the Gated. I'm Barilla pasta got a PR Company to set this train in motion. So you would know whether to laugh or cry. The problem with this for all of us is that all of this media has a chilling effect
on applying low carb or keto and because the majority of our adult population are now essentially diabetic. We need low carb and keto to fix the real root causes or contribute greatly to effects and these people are standing in our way. So we just need to keep answering them. We got back to the quality adjusted life years. How do you push up to that green line? How do you get all the gold stuff rice the grandchildren all laugh? Why you target the most important root causes earlier in life and you do Juju diligence, you have to take responsibility
for your own health, right? We can give pointers but these tanks you focus on these things and you resolved them low carb is an incredibly useful tool. It's not magic. But in the population does after we currently have it's a great tool. It will go a long way. With apologies to Dari I say eliminate industrial seed oils and processed foods, which have to tryout industrial seed oil is refined carbs and sugars three of the worst things for your future long-term help. She get them out of the way. You got fish and healthy fats and only get three maybe cod
liver oil lot of extra vitamins nutrient-dense foods without potassium magnesium, K2, you know, all these things are very important for the proper functioning of the human machine. Can you get healthy sewn exposure? We are sold a line of BS about the song you got nitric oxide. You got vasodilation you get vitamin D. You get order photo products generated in the song. We're not even sure what they do, but we know Eeveelution is Insidious, so they were made for a reason you don't burn but you got healthy song. David Bobak my boss did all
this on more and he stopped at Scouts calcification advancing over Last 5 Years. I'll I'm sure he's going to get himself well up to that green line and he could have easily languished I disappear down at the red line. My father was a super smart man, but he didn't have the knowledge that we have today. And also there were massive amounts of misinformation all through the airwaves back in his time. He did have the advantage of having good healthy meals. My mother was a great cook. He didn't smoke and he hardly ever drank and he was not over $5 apiece by any means now
your blood pressure in the forties. So in retrospect Kofi rice with the beginnings of diabetic dysfunction, On the negative side of The Ledger blood pressure heart attack fear. He always ate the margarine banish the Bolter the eggs and the other things were a fear rice whole grain healthy whole grain for your heart your dime rice lot of that went down. Plastic food pyramid Fair generally because that's what everyone was being told at the time including him and he would not really question as elders and betters in other fields. He was
quite conservative in that way and I'll let you know that she had a taste for coffee Suites and he would have eaten quite a few in his glove box on those long commute So In fairness sugar to do would have got in there but also In fairness we were never told back down to Sugar drove heart disease. It was just a bad teeth. So that was more misinforming. They're worried about eggs and sugar. Bottom lines middle-aged middle risk no brainer loves you got to look at for the calcium scan. If you're a middle-aged person for me is a no-brainer to check what's actually going on inside
if you're very low-risk in your blow of probably not needed because if all of them are called you are very low-risk maybe not needed if you're high risk in her blow. You don't need this kind cuz you need to take action anyway, but the middle risk majority find out what's going on if your lowest score congratulations, you got to keep an eye on her blood's a low score is not a guarantee going to make sure you watch out for home in the signs. I need to follow the rules. I didn't go through them here. I did a brief summary which Apollo the rules on six or seven years later. He got a quickie
scan. Just check nothing untoward has gone wrong. If you get a high score very different matter, especially if you're not expecting one, you know, if you're very overweight smoker got a high school or you just say, okay. I'm verifying the expected but what if you're like David are millions Mothers who are slim and apparently fit and they don't smoke and they go into got a 400 they find out they have a massive problem. You know, you got to look at a lot of blood markers down and you need expert help to interpret those cuz you're looking for a special calls. Not the usual one. Medications may
be appropriate in a high score to stabilize disease in the short-term at least until you work out what's going on and you're going to have to really follow the rules. If you have a high score cuz you're a high-risk patient. You're going to have to move on down the Paraiso in other words. Look at things beyond the usual go things we do because you've got a lot of steak, right you have to take responsibility. I may be 2 years later. You got to call the keishin scan because you need to know what your vector or your trajectory is. How do you slow the progression? Is it still going up quite a
few missed? What do you need to do? I'm finally I would say two middle-aged middle. Rest people know your score know what's going on inside and take the personal responsibility to learn what the correct true cause actions are to secure your future and to make sure you do see the grandchildren grow up. Thank you.
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