Red Meat & Cholesterol: Separating Fact from Fiction | Dr Kevin Maki

**Dr. Gabrielle Lyon** (0:00)
Welcome to The Dr. Gabrielle Lyon Show, where cutting-edge science meets innovation and practical application for everyone. In today's episode, I sit down with Dr. Kevin Maki, founder and chief scientist for Midwest Biomedical Research. He specializes in the design and conduct of clinical studies in human nutrition, metabolism, and chronic disease risk factor management. Dr. Maki is also adjunct professor and dean's eminent scholar in the Department of Applied Health Science at the Indiana University School of Public Health. He is a master of the National Lipid Association, fellow of the Obesity Society, and of course, fellow of the American Heart Association. Is there anything that this guy has not done? He is also the past president of the National Lipid Association and is the co-editor-in-chief of the Journal of Clinical Lipidology. Dr. Maki has participated in more than 300 clinical trials and observational studies as an investigator, consultant, and statistician, and has published more than 300 scientific papers, books, and book chapters, earned his Ph.D. in Epidemiology at the University of Illinois, which is exactly why I sit down with Dr. Kevin Maki. Please sit down with me in this conversation with Dr. Kevin Maki.
Dr. Kevin Maki, welcome to the show.

**Dr. Kevin Maki** (1:42)
Thank you so much, glad to be here.

**Dr. Gabrielle Lyon** (1:44)
Now, I got to tell you how I decided that you were the perfect person, no pressure, to come on the show. I thought to myself, how can we make sense of all the data out there? There's observational data, epidemiology, randomized control trials, especially when it comes to nutrition research. I don't want to embarrass you, but I'm going to read a little bit about your background because it is impressive. You are founder and chief scientist for Midwest Biomedical Research. You specialize in design and conduct of clinical trials in human nutrition, metabolism, and chronic disease risk factor management. You are an adjunct professor, you're an eminent scholar in the Department of Applied Health Sciences at Indiana University School of Public Health. Also, are you ready for this one? You are former president of the National Lipid Association.

**Dr. Kevin Maki** (2:45)
Yes.

**Dr. Gabrielle Lyon** (2:46)
Then again, the list of accolades, you have published more than 300 scientific papers. You function as both an investigator, consultant, statistician. You are a numbers guy.

**Dr. Kevin Maki** (2:59)
I'm a numbers guy, that's for sure.

**Dr. Gabrielle Lyon** (3:00)
Today, I brought you on because I need help. I need help. The world needs help clearing up some of the confusion.

**Dr. Kevin Maki** (3:09)
I'll do what I can.

**Dr. Gabrielle Lyon** (3:11)
Okay. Now, just to start, tell us a little bit about your background.

**Dr. Kevin Maki** (3:16)
Sure. So, I started out, I'll start when I worked in the VA as a scientist. So I was in the Department of Veterans Affairs. Happy there. Thought I'd worked there for 40 years and retire. Got a new director for the Center who said, we're turning this into a neuroscience center. So he invited me to find other employment. I joined a private research center that was founded by Michael Davidson, a very well-known preventive cardiologist. And then I ran the Human Nutrition and Metabolism Research Unit there for 10 years. And then I left, started my own private research center, which I sold in 2011 Then founded another private research center, sort of co-founded it. And then we sold that in 2021 So we've been busy and we've fortunately been able to do a lot of good in terms of developing pharmaceuticals. And a lot of what we did in pharmaceutical development helped fund the research that was really my passion, which is lifestyle and chronic disease prevention.

**Dr. Gabrielle Lyon** (4:16)
You know, you have published a lot of information on, for example, obviously you're a former president of the Lipid Association, on cholesterol, red meat, the relationship between these things. And before we dive into that, because we have real questions, like is red meat going to raise cholesterol? How much red meat can we have? Just a number of questions. But before we frame those things up, you have pursued a career in epidemiology. Please tell us what that is and tell us how that plays in the nutrition landscape.

**Dr. Kevin Maki** (4:55)
Sure. Well, epidemiology, first of all, the word comes from epidemic. So a lot of people think of epidemiology, they think of infectious diseases, but epidemiological methods can be used to study chronic diseases as well. So that's been my focus. And epidemiology is usually observational research. There are two kinds of observational research. One is sort of descriptive. So let's say you want to learn about the natural history of the evolution from normal glucose tolerance to type 2 diabetes. Well, you can just follow people over time and describe what happens. Then you have analytic epidemiology where you're comparing groups. And so that's most of what people think of in epidemiology. And there are two main kinds of studies, cohort studies. So you take a group of people, you define them on some characteristic, let's say body mass index or a cholesterol level, or smoking, non-smoking, exercise, sedentary. And then you follow them over time to see if there's a relationship between that characteristic and exposure and the development of a disease. And so that's one type. The other type is case control. Those are a different kind of study where you start with people with and without the disease and then you look into their pasts to try and evaluate whether there are factors associated with that disease. So epidemiology is great. Observational research is very helpful for hypothesis generation. It often leads us in the right direction in terms of defining factors that increase or reduce a person's risk of disease. But it doesn't always give you the right answer. Sometimes you get the wrong answer because when you're looking at groups of people, they have self-selected their exposure. So an example I like to use is vitamin E. So in the 1990s, most cardiologists were taking a vitamin E supplement. And that's because we had a lot of observational evidence that people who took vitamin E supplements had lower risk of heart disease. Well, eventually clinical trials were done and people were randomly assigned to receive vitamin E or not. And it turns out that vitamin E was no better than placebo with regard to cardiovascular health.