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Cardiology has become obsessed with the mantra “lower is better.” Lower LDL, lower ApoB, and you're going to be better off. This simple tagline misses the forest for a stupid little cholesterol shrub. It’s well known that intervening to lower LDL and ApoB doesn’t necessarily result in better overall... outcomes for the whole person, even in circumstances where cardiovascular risk might be reduced. It's therefore incredibly sad when "certain cardiologist experts" (heavy quotes there) make false claims like: "people with a PCSK9 loss of function mutation have very low LDL-C and live 15-20 years longer than those who don't. And we have meds now that cause that effect." That nonsense I could forgive. What is far more troubling is that there's a general failure to challange problematic (and sometimes outright false) narratives like this provided they align with the status quo, even when the status quo has failed public health miserably. We need to broaden the aperture of the discussion because the "science is not settled." Below is an excerpt from this morning video on the lipid marker linked to longevity (not LDL or ApoB): 🚨Then, of course, watch The Cholesterol Code movie on Amazon and leave a review! #CholesterolCodeMovie Dave Feldmanshow more

Nick Norwitz MD PhD

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Why Are We Still Playing "Cholesterol Uno?" 🤔👇 (85 sec clip, link to full video below) "When faced with data showing that “optimal” LDL-C levels fail to prevent atherosclerosis, the final retreat is almost always the same: the LDL-C just wasn’t low enough. “Lower is better” the mantra goes. If a mean LDL of 57 mg/dL isn’t sufficient to make atherosclerosis an orphan disease, then the solution must be 40. Or 30. Or 20. Or even 10 mg/dL. Heck, let’s just try to hit zero like we’re playing cholesterol Uno… What this reflexive response reveals is the profound keyhole thinking that has come to dominate conventional cardiology Medicine has become so siloed and sub-specialized that success is often defined within the narrow boundaries of a single biomarker or organ system, rather than in terms of whole-person health. It is entirely possible—at least in theory—that taking a sledgehammer to LDL-C and ApoB, driving them as close to zero as possible, could further reduce cardiovascular events. But that framing dodges the far more important question: what are we trading? Because LDL-lowering therapies are not benign."

Why Are We Still Playing "Cholesterol Uno?" 🤔👇 (85 sec clip, link to full video below) "When faced with data showing that “optimal” LDL-C levels fail to prevent atherosclerosis, the final retreat is almost always the same: the LDL-C just wasn’t low enough. “Lower is better” the mantra goes. If a mean LDL of 57 mg/dL isn’t sufficient to make atherosclerosis an orphan disease, then the solution must be 40. Or 30. Or 20. Or even 10 mg/dL. Heck, let’s just try to hit zero like we’re playing cholesterol Uno… What this reflexive response reveals is the profound keyhole thinking that has come to dominate conventional cardiology Medicine has become so siloed and sub-specialized that success is often defined within the narrow boundaries of a single biomarker or organ system, rather than in terms of whole-person health. It is entirely possible—at least in theory—that taking a sledgehammer to LDL-C and ApoB, driving them as close to zero as possible, could further reduce cardiovascular events. But that framing dodges the far more important question: what are we trading? Because LDL-lowering therapies are not benign."

Nick Norwitz MD PhD

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Cardiology Has an LDL Obsession. What to Measure Instead... 🔗New video: 👇1 min clip on LDL vs Insulin Resistance The landscape of atherosclerosis is changing. New drugs are lowering LDL, total cholesterol and ApoB lower and lower, while larger risk factors like insulin resistance, obesity, and diabetes persist. If you want a comparison, lipoprotein insulin resistance score (LP-IR). Because 1.0 is risk neutral, insulin resistance score is a more than 14X more powerful predictor of new coronary heart disease than LDL. But we know who gets all the attention. Answer: [See Clip] That’s not proportional medicine Do you agree? For more nuances see the video linked above. cc Benjamin Bikman Dave Feldman

Cardiology Has an LDL Obsession. What to Measure Instead... 🔗New video: 👇1 min clip on LDL vs Insulin Resistance The landscape of atherosclerosis is changing. New drugs are lowering LDL, total cholesterol and ApoB lower and lower, while larger risk factors like insulin resistance, obesity, and diabetes persist. If you want a comparison, lipoprotein insulin resistance score (LP-IR). Because 1.0 is risk neutral, insulin resistance score is a more than 14X more powerful predictor of new coronary heart disease than LDL. But we know who gets all the attention. Answer: [See Clip] That’s not proportional medicine Do you agree? For more nuances see the video linked above. cc Benjamin Bikman Dave Feldman

Nick Norwitz MD PhD

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LDL Cholesterol Saves Lives! What a fantastic example of cherry picking! Yes this person is right, in ELDERLY people, all cause mortality is greater amongst those with low LDL cholesterol… but WHY? And why didn’t he bring up all cause mortality with LDL levels amongst those who are not elderly? Oh because he doesn’t like that data. This is a textbook example of reverse causality. LDL Cholesterol is not protecting people from disease, but rather people with wasting diseases like cancer are more likely to be resistant to wasting if LDL is not low, indicating that they are not emaciated. But if we zoom out of the elderly and look at lifelong LDL exposure & the risk of mortality, it tells a very different story. Lifelong LDL cholesterol exposure has a LINEAR association with increased mortality, especially from cardiovascular disease (CVD) (PMIDs: 23083789, 38241044, & 30694319). In fact, reduced LDL exposure early in life throughout adulthood can reduce the chance of mortality from CVD by up to 3 times! Gee I wonder why he didn’t mention that. Additionally, the unremarkable results from many statin trials comes from the fact that often these are prescribed after a CVD event or later in life when someone has already done significant damage to their blood vessels. But even with that being the case we do see a clinically significant benefit in lowering the risk of mortality with statin use (PMIDs: 36233511 & 37368941). That said, statins can have some side effects & are not appropriate for everyone & you should speak to a cardiologist about your options if you have high LDL But this is a textbook example of carnivore zealots trying to do f***ery with science & giving you a 3rd of the info to try to trick you into believing their nonsense

LDL Cholesterol Saves Lives! What a fantastic example of cherry picking! Yes this person is right, in ELDERLY people, all cause mortality is greater amongst those with low LDL cholesterol… but WHY? And why didn’t he bring up all cause mortality with LDL levels amongst those who are not elderly? Oh because he doesn’t like that data. This is a textbook example of reverse causality. LDL Cholesterol is not protecting people from disease, but rather people with wasting diseases like cancer are more likely to be resistant to wasting if LDL is not low, indicating that they are not emaciated. But if we zoom out of the elderly and look at lifelong LDL exposure & the risk of mortality, it tells a very different story. Lifelong LDL cholesterol exposure has a LINEAR association with increased mortality, especially from cardiovascular disease (CVD) (PMIDs: 23083789, 38241044, & 30694319). In fact, reduced LDL exposure early in life throughout adulthood can reduce the chance of mortality from CVD by up to 3 times! Gee I wonder why he didn’t mention that. Additionally, the unremarkable results from many statin trials comes from the fact that often these are prescribed after a CVD event or later in life when someone has already done significant damage to their blood vessels. But even with that being the case we do see a clinically significant benefit in lowering the risk of mortality with statin use (PMIDs: 36233511 & 37368941). That said, statins can have some side effects & are not appropriate for everyone & you should speak to a cardiologist about your options if you have high LDL But this is a textbook example of carnivore zealots trying to do f***ery with science & giving you a 3rd of the info to try to trick you into believing their nonsense

Layne Norton, PhD

89,928 Aufrufe • vor 1 Jahr

Why do some people with crazy high LDL-C and ApoB develop no plaque in their arteries, while others – including those with far lower LDL and lower ApoB – do develop plaque? 🫀- featuring Thomas Dayspring So, let’s tackle one possible explanation centered around the following term: “Transcytosis.” ✋Quick Definition & Analogy Transcytosis is the process whereby a cell – in this case, the endothelial cells lining your arteries – sucks up something from outside (here, an LDL particle containing cholesterol), passes that something through its interior, and then out the other side. By way of analogy, think of your artery wall like an exclusive nightclub. Some particles get waved in VIP-style. Others get stuck outside. But what if LDL wasn’t just passively slipping through a hole in the wall, but was actually being escorted through by a bouncer? That is - more or less - transcytosis. #LDL #ApoB #heartdisease #cholesterol #LEM #LMHR #HDL #hearthealth #insulinresistance #metabolichealth #cholesterolcode #staycurious Dave Feldman Adrian Soto-Mota LipoFan Austin Dudzinski, PharmD, BCACP

Why do some people with crazy high LDL-C and ApoB develop no plaque in their arteries, while others – including those with far lower LDL and lower ApoB – do develop plaque? 🫀- featuring Thomas Dayspring So, let’s tackle one possible explanation centered around the following term: “Transcytosis.” ✋Quick Definition & Analogy Transcytosis is the process whereby a cell – in this case, the endothelial cells lining your arteries – sucks up something from outside (here, an LDL particle containing cholesterol), passes that something through its interior, and then out the other side. By way of analogy, think of your artery wall like an exclusive nightclub. Some particles get waved in VIP-style. Others get stuck outside. But what if LDL wasn’t just passively slipping through a hole in the wall, but was actually being escorted through by a bouncer? That is - more or less - transcytosis. #LDL #ApoB #heartdisease #cholesterol #LEM #LMHR #HDL #hearthealth #insulinresistance #metabolichealth #cholesterolcode #staycurious Dave Feldman Adrian Soto-Mota LipoFan Austin Dudzinski, PharmD, BCACP

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"The Higher Your Cholesterol The Longer You Live" "If you have Low Cholesterol, be very afraid." Cardiologist Dr. Jack Wolfson / Natural Heart Doctor shares the latest research on the critical importance of Cholesterol for vibrant health. "The Higher the LDL Cholesterol, The Lower Your Risk of Dying." "The LDL Paradox: Higher LDL-Cholesterol is Associated with Greater Longevity" Lead Authors: Uffe Ravnskov & Dr Aseem Malhotra 👇👇👇Link to Study👇👇👇 "The worry over Total Cholesterol & Heart Attack risk is a fallacy from the 60s & 70s" "Cholesterol is critically important, that's why all animals have it, that why breast milk has it, that's why eggs contain it because that's how a chicken comes to life." "Do not fear total Cholesterol, in fact for people older than 60, the higher the total Cholesterol, the longer they live." "LDL has many important roles in the body. Cholesterol itself, Triglycerides, fat soluble Vitamins, CoQ10 heart protection & optimal immune function."

"The Higher Your Cholesterol The Longer You Live" "If you have Low Cholesterol, be very afraid." Cardiologist Dr. Jack Wolfson / Natural Heart Doctor shares the latest research on the critical importance of Cholesterol for vibrant health. "The Higher the LDL Cholesterol, The Lower Your Risk of Dying." "The LDL Paradox: Higher LDL-Cholesterol is Associated with Greater Longevity" Lead Authors: Uffe Ravnskov & Dr Aseem Malhotra 👇👇👇Link to Study👇👇👇 "The worry over Total Cholesterol & Heart Attack risk is a fallacy from the 60s & 70s" "Cholesterol is critically important, that's why all animals have it, that why breast milk has it, that's why eggs contain it because that's how a chicken comes to life." "Do not fear total Cholesterol, in fact for people older than 60, the higher the total Cholesterol, the longer they live." "LDL has many important roles in the body. Cholesterol itself, Triglycerides, fat soluble Vitamins, CoQ10 heart protection & optimal immune function."

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In conversation with Andrew D. Huberman, Ph.D., Peter Attia explains why ApoB should be treated as a causal driver of heart disease, not just a risk marker: “There is no ambiguity that ApoB is causally related to atherosclerosis.” “LDL cholesterol or ApoB, causally related to atherosclerosis. Well, if that’s true, and I haven’t seen a credible argument that it’s not.” “If a risk is causal and it is modifiable, it should be modified regardless of the risk tail and duration.” “The earlier you start, the less aggressive you need to be, the less damage that’s there already.”

In conversation with Andrew D. Huberman, Ph.D., Peter Attia explains why ApoB should be treated as a causal driver of heart disease, not just a risk marker: “There is no ambiguity that ApoB is causally related to atherosclerosis.” “LDL cholesterol or ApoB, causally related to atherosclerosis. Well, if that’s true, and I haven’t seen a credible argument that it’s not.” “If a risk is causal and it is modifiable, it should be modified regardless of the risk tail and duration.” “The earlier you start, the less aggressive you need to be, the less damage that’s there already.”

Huberman Lab Clips

212,256 Aufrufe • vor 1 Jahr

Joe Rogan’s guest Gary Brecka dismantled one of the most profitable narratives in modern medicine — the “good vs bad cholesterol” myth. For decades, pharma-backed health campaigns have pushed the idea that LDL is the bad cholesterol and HDL the good, persuading millions to take statins to lower LDL at all costs. But according to Brecka and cardiologists like Dr. Aseem Malhotra, this simplistic model ignores the real biology. What actually matters, Brecka explains, is particle size. When triglycerides rise — often due to high-sugar, high-glycaemic diets and insulin resistance — LDL particles shrink. Smaller particles (the “BBs”) can penetrate arterial walls, become oxidized, and trigger inflammation. Large, buoyant LDL particles (the “basketballs”) do not. Two people can have the same total cholesterol, but vastly different cardiovascular outcomes — depending on triglyceride levels, insulin sensitivity, and inflammation markers like C-reactive protein. Brecka emphasizes that cholesterol isn’t the villain; it’s the firefighter showing up to the fire — a response to inflammation, not the cause of it. Cardiovascular health, he argues, should focus on the metabolic picture: – Fasting insulin – Blood glucose and A1C – Triglyceride-to-HDL ratio – C-reactive protein Not simply on driving LDL numbers down with lifelong statin use. Brecka even noted that in his work processing death claims for centenarians, he never came across one who didn’t have elevated LDL levels — raising serious questions about whether low cholesterol truly equals longevity. This challenges decades of medical orthodoxy and billions in drug sales. But the evidence is catching up: metabolic dysfunction, not LDL itself, is the real culprit behind atherosclerosis.

Joe Rogan’s guest Gary Brecka dismantled one of the most profitable narratives in modern medicine — the “good vs bad cholesterol” myth. For decades, pharma-backed health campaigns have pushed the idea that LDL is the bad cholesterol and HDL the good, persuading millions to take statins to lower LDL at all costs. But according to Brecka and cardiologists like Dr. Aseem Malhotra, this simplistic model ignores the real biology. What actually matters, Brecka explains, is particle size. When triglycerides rise — often due to high-sugar, high-glycaemic diets and insulin resistance — LDL particles shrink. Smaller particles (the “BBs”) can penetrate arterial walls, become oxidized, and trigger inflammation. Large, buoyant LDL particles (the “basketballs”) do not. Two people can have the same total cholesterol, but vastly different cardiovascular outcomes — depending on triglyceride levels, insulin sensitivity, and inflammation markers like C-reactive protein. Brecka emphasizes that cholesterol isn’t the villain; it’s the firefighter showing up to the fire — a response to inflammation, not the cause of it. Cardiovascular health, he argues, should focus on the metabolic picture: – Fasting insulin – Blood glucose and A1C – Triglyceride-to-HDL ratio – C-reactive protein Not simply on driving LDL numbers down with lifelong statin use. Brecka even noted that in his work processing death claims for centenarians, he never came across one who didn’t have elevated LDL levels — raising serious questions about whether low cholesterol truly equals longevity. This challenges decades of medical orthodoxy and billions in drug sales. But the evidence is catching up: metabolic dysfunction, not LDL itself, is the real culprit behind atherosclerosis.

Camus

210,618 Aufrufe • vor 9 Monaten

LDL and the Problem of Incomplete Framing 🫀 Here's my mini rant... There is long list of risk factors that carry far greater consequence than LDL alone. Take obesity, type 2 diabetes, insulin resistance, elevated blood pressure, chronic inflammation, smoking history. I could go on, but the point is actually really obvious... When LDL cholesterol monopolizes the spotlight, the problem is that the framing is incomplete. Instead, it becomes actively harmful to patients to pull away attention and clinical urgency from factors that matter more than LDL. The spotlight of medicine directs attention and resources, towards what's easiest to monetize and medicalize: LDL cholesterol, a marker that's easy to smash with a drug that makes money. I am NOT making the argument about bad intentions. I'm describing a clear systemic problem, one that perpetuates the broader metabolic health epidemic we continue to find ourselves in, including cardiovascular disease.

LDL and the Problem of Incomplete Framing 🫀 Here's my mini rant... There is long list of risk factors that carry far greater consequence than LDL alone. Take obesity, type 2 diabetes, insulin resistance, elevated blood pressure, chronic inflammation, smoking history. I could go on, but the point is actually really obvious... When LDL cholesterol monopolizes the spotlight, the problem is that the framing is incomplete. Instead, it becomes actively harmful to patients to pull away attention and clinical urgency from factors that matter more than LDL. The spotlight of medicine directs attention and resources, towards what's easiest to monetize and medicalize: LDL cholesterol, a marker that's easy to smash with a drug that makes money. I am NOT making the argument about bad intentions. I'm describing a clear systemic problem, one that perpetuates the broader metabolic health epidemic we continue to find ourselves in, including cardiovascular disease.

Nick Norwitz MD PhD

45,303 Aufrufe • vor 7 Monaten

Might something different be going on for these people than other people who have high LDL cholesterol? Lean mass hyper-responders (LMHR) are defined as having a lean physique, high LDL, high HDL and low triglycerides while on a #Keto diet. Many LMHRs still choose to follow a ketogenic diet to treat conditions like diabetes, insulin resistance, IBS, epilepsy, or mental disorders, and see great benefits to their health. PhD and Harvard Medical School student, Nick Norwitz MD PhD, himself a LMHR, sought an answer. In an N=1 experiment, Nick found that he could lower his LDL cholesterol twice as much with Oreo cookies compared to statins! High #LDL has traditionally been considered a risk factor for heart disease, but do we need to change how we think about LDL for a LMHR? If Oreos can beat statins, should that make us wonder if lowering LDL is the right approach for everyone? Watch the full YouTube interview here: Read the published study:

Might something different be going on for these people than other people who have high LDL cholesterol? Lean mass hyper-responders (LMHR) are defined as having a lean physique, high LDL, high HDL and low triglycerides while on a #Keto diet. Many LMHRs still choose to follow a ketogenic diet to treat conditions like diabetes, insulin resistance, IBS, epilepsy, or mental disorders, and see great benefits to their health. PhD and Harvard Medical School student, Nick Norwitz MD PhD, himself a LMHR, sought an answer. In an N=1 experiment, Nick found that he could lower his LDL cholesterol twice as much with Oreo cookies compared to statins! High #LDL has traditionally been considered a risk factor for heart disease, but do we need to change how we think about LDL for a LMHR? If Oreos can beat statins, should that make us wonder if lowering LDL is the right approach for everyone? Watch the full YouTube interview here: Read the published study:

Metabolic Mind

25,200 Aufrufe • vor 2 Jahren

REDUCE OXIDIZED LDL WITH THIS FAT! LDL cholesterol is not the enemy. Your liver produces it on purpose — to transport hormones, nutrients, and building blocks your body needs. The real problem is oxidized LDL, the damaged form that contributes to arterial plaque. And here’s what most people don’t know: Multiple human RCTs show that high-polyphenol, cold-pressed extra-virgin olive oil can significantly reduce oxidized LDL — in some trials by up to 30%. It’s the polyphenols like hydroxytyrosol and oleuropein that protect LDL from oxidative damage and improve your lipid profile. So the goal isn’t to “eliminate LDL.” The goal is to prevent it from oxidizing. And one of the most powerful tools for that, backed by randomized controlled trials, is single-origin, high-polyphenol extra-virgin olive oil. Upgrade your oils, protect your LDL, protect your heart. #cholesterol #longevity #oliveoil

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"The Higher Your LDL, The Longer You're Going To Live." Dr Aseem Malhotra, Cardiologist "The Greater The Financial Interest In A Given Field, The Less Likely The Research Findings Are to be True." "The Most Lucrative Drug In The History Of Medicine Are Statins." $19 Billion Dollar Profit Industry Totalling 818 Million Prescriptions Annually. "The Benefit Of Statins For Both Low Risk & High Risk Primary Prevention Is ONLY 1%...1 In 100." "There Is No Correlation Between Elevated LDL Level & Events Of Cardiovascular Disease. In Fact, It's The Inverse. There Is A Correlation Between Higher LDL Level & Longevity." "The Higher The LDL, The Longer You're Going To Live, Because It Has A Vital Role In Your Immune System." "Just Because Cholesterol Is At The Scene Of the Crime, Doesn't Mean It's The Perpetrator." LDL serves an important & vital purpose for vibrant health. LDL contains the antioxidants Vitamin E, CoQ10 & Carotenoids that kill off free radicals. This reduces inflammation & oxidative damage, which are the true causes of cardiovascular disease. LDL is a transport molecule delivering cholesterol to repair the cell membrane of the arterial wall. LDL is preventive of disease & immune system protective. Cholesterol is trying to clear the inflammation & put out the fire caused by other lifestyle issues in order to get the body to return to Homeostasis. Atherosclerosis Is An Inflammatory Disease, Not A Cholesterol Disease or A Statin Deficiency. A Fireman shows up to put out a fire. He's not the cause of the fire. Cholesterol shows up to put out the fire of Inflammation in the Arterial Wall. Cholesterol is not the cause of the Inflammation that turns to Plaque. Eliminate The Root of The Inflammation Which Causes The Damage & Atherosclerosis: Industrial Seed Oils Processed Sugar Carbohydrates Insulin Resistance Ultra Processed Foods Smoking Obesity Environmental Toxins Poor Sleep Low Vitamin D Levels Magnesium Deficiency K2 Deficiency Lack of Exercise Stress These Are All Modifiable Risk Factors. Most Chronic Disease Happens Within Us, It Does Not Happen To Us. A low carbohydrate diet prioritizing nutrient dense animal foods, eliminating harmful seed oils & sugar, provides the best healthy cholesterol profile. This approach keeps Triglycerides low & HDL high, which is one of the best biomarkers for heart health. TG/HDL ratio optimally should be less than 2.0 & even better at 1.5 or less. 👇The Higher Your LDL, The Longer You Live👇 👇LDL Paradox: Higher LDL, Greater Longevity👇 👇LDL Does Not Cause Cardiovascular Disease👇 Speakers: Dr Aseem Malhotra & Gary Brecka Video: The Ultimate Human Podcast

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New episode of HARD DRUGS! Should everyone be taking statins? Statins have revolutionised heart disease and they're one of many reasons for the long-term decline in cardiovascular mortality. Clinical trials suggest that the more you reduce LDL cholesterol levels, the more you reduce the risks of heart attacks and strokes, with no signal of harms even at the lowest levels. So scientists recommend the earlier they're taken the better, and the lower LDL levels you reach the better. Statins do have some rare side effects – such as muscle weakness and muscle loss in rare cases – but meta-analyses of RCTs find that most other side effects listed on statins' labels do not actually have higher risks than placebo. In this episode, Jacob Trefethen and I chat about all this and much more! - Why it took almost a century for scientists to come to consensus on "the lipid hypothesis": that higher levels of plasma LDL cholesterol causes higher risks of heart disease and that reducing it saves lives. - Drugs that effectively reduce cholesterol levels beyond the effect of statins, such as PCSK9 inhibitors, most of which are monoclonal antibodies, as well as newer siRNA drugs and the macrocyclic peptide enlicitide, which recently completed phase 3 trials, and Lp(a) drugs. - What the future holds for cholesterol drugs Timestamps: 0:00:00 Introduction 13:35 The decline in heart disease mortality 31:02 Surprising cholesterol trivia 55:40 The lipid hypothesis: 7 lines of evidence for the harms of LDL cholesterol 1:22:15 How cholesterol works 1:30:40 The discovery of statins 1:48:44 Should everyone be on statins? 1:57:10 PCSK9 drugs and beyond 2:22:56 Summary: how we got here and the future of cholesterol drugs Watch, listen, or read wherever you get your podcasts. Spotify: Apple: YouTube: Transcript:

New episode of HARD DRUGS! Should everyone be taking statins? Statins have revolutionised heart disease and they're one of many reasons for the long-term decline in cardiovascular mortality. Clinical trials suggest that the more you reduce LDL cholesterol levels, the more you reduce the risks of heart attacks and strokes, with no signal of harms even at the lowest levels. So scientists recommend the earlier they're taken the better, and the lower LDL levels you reach the better. Statins do have some rare side effects – such as muscle weakness and muscle loss in rare cases – but meta-analyses of RCTs find that most other side effects listed on statins' labels do not actually have higher risks than placebo. In this episode, Jacob Trefethen and I chat about all this and much more! - Why it took almost a century for scientists to come to consensus on "the lipid hypothesis": that higher levels of plasma LDL cholesterol causes higher risks of heart disease and that reducing it saves lives. - Drugs that effectively reduce cholesterol levels beyond the effect of statins, such as PCSK9 inhibitors, most of which are monoclonal antibodies, as well as newer siRNA drugs and the macrocyclic peptide enlicitide, which recently completed phase 3 trials, and Lp(a) drugs. - What the future holds for cholesterol drugs Timestamps: 0:00:00 Introduction 13:35 The decline in heart disease mortality 31:02 Surprising cholesterol trivia 55:40 The lipid hypothesis: 7 lines of evidence for the harms of LDL cholesterol 1:22:15 How cholesterol works 1:30:40 The discovery of statins 1:48:44 Should everyone be on statins? 1:57:10 PCSK9 drugs and beyond 2:22:56 Summary: how we got here and the future of cholesterol drugs Watch, listen, or read wherever you get your podcasts. Spotify: Apple: YouTube: Transcript:

Saloni

734,864 Aufrufe • vor 6 Monaten

Dr. Robert Lustig obliterated 50 years of cholesterol dogma in 41 seconds flat He literally said (watch every word): “If you eat a low-carb diet — keto, paleo, whatever — you reduce carbs/sugar and raise dietary fat. Yes, your LDL will go UP. But it’s the big, buoyant, fluffy LDL. That kind is cardiovascularly NEUTRAL. It’s not the bad guy. The actual bad guy is the small, dense LDL. Statins? They don’t even touch those. So the real question is: Do you want to lower an LDL that doesn’t matter… and in exchange put yourself at risk for chronic hyperglycemia, which absolutely DOES matter? Is that a good trade?” Exact quote ends at 0:41 I’m not telling you what to eat. I’m just asking: Have we been chasing the wrong villain this entire time? Drop your thoughts below — respectfully. Science needs debate, not dogma.

Dr. Robert Lustig obliterated 50 years of cholesterol dogma in 41 seconds flat He literally said (watch every word): “If you eat a low-carb diet — keto, paleo, whatever — you reduce carbs/sugar and raise dietary fat. Yes, your LDL will go UP. But it’s the big, buoyant, fluffy LDL. That kind is cardiovascularly NEUTRAL. It’s not the bad guy. The actual bad guy is the small, dense LDL. Statins? They don’t even touch those. So the real question is: Do you want to lower an LDL that doesn’t matter… and in exchange put yourself at risk for chronic hyperglycemia, which absolutely DOES matter? Is that a good trade?” Exact quote ends at 0:41 I’m not telling you what to eat. I’m just asking: Have we been chasing the wrong villain this entire time? Drop your thoughts below — respectfully. Science needs debate, not dogma.

Camus

146,341 Aufrufe • vor 9 Monaten

💥The response to yesterday's paper has been UNREAL! My phone hasn't stopped buzzing. If you've been under a rock, here are some highlights in <90 sec 👇 🫀Most participants showed no or minimal progression of coronary plaque 🫀Neither ApoB nor LDL exposure predicted plaque progression 🫀But plaque predicted plaque progression What does this mean, in a phrase: "While this paper doesn't disprove the lipid heart hypothesis, it does help expose a major blindspot." There will be a LOT more coming soon... I promise you that... #Cholesterol #LDL #KetoDiet #ApoB #CAC #CCTA #LMHR #LEM #SaturatedFat #HeartHealth #MetabolicHealth cc Dave Feldman Dr Aseem Malhotra Joseph Everett (WIL) Jan Ellison Baszucki Metabolic Mind Also not, this is not a one off. There have been 10+ papers leading to this moment... and we are just getting warmed up... PMID: 40192608, Plaque Begets Plaque. ApoB does not: Longitudinal data from the KETO-CTA trial PMID: 39372369, Carbohydrate restriction-induced elevations in LDL-cholesterol and atherosclerosis: The KETO trial PMID: 38237807, Increased LDL cholesterol in adults with normal but not high body weight: a meta-analysis PMID: 35629964, The Lipid Energy Model: reimagining lipoprotein function in the context of carbohydrate-restricted diets PMID: 35106434, Elevated LDL-cholesterol with a carbohydrate-restricted diet: evidence for a “lean mass hyper-responder” phenotype

💥The response to yesterday's paper has been UNREAL! My phone hasn't stopped buzzing. If you've been under a rock, here are some highlights in <90 sec 👇 🫀Most participants showed no or minimal progression of coronary plaque 🫀Neither ApoB nor LDL exposure predicted plaque progression 🫀But plaque predicted plaque progression What does this mean, in a phrase: "While this paper doesn't disprove the lipid heart hypothesis, it does help expose a major blindspot." There will be a LOT more coming soon... I promise you that... #Cholesterol #LDL #KetoDiet #ApoB #CAC #CCTA #LMHR #LEM #SaturatedFat #HeartHealth #MetabolicHealth cc Dave Feldman Dr Aseem Malhotra Joseph Everett (WIL) Jan Ellison Baszucki Metabolic Mind Also not, this is not a one off. There have been 10+ papers leading to this moment... and we are just getting warmed up... PMID: 40192608, Plaque Begets Plaque. ApoB does not: Longitudinal data from the KETO-CTA trial PMID: 39372369, Carbohydrate restriction-induced elevations in LDL-cholesterol and atherosclerosis: The KETO trial PMID: 38237807, Increased LDL cholesterol in adults with normal but not high body weight: a meta-analysis PMID: 35629964, The Lipid Energy Model: reimagining lipoprotein function in the context of carbohydrate-restricted diets PMID: 35106434, Elevated LDL-cholesterol with a carbohydrate-restricted diet: evidence for a “lean mass hyper-responder” phenotype

Nick Norwitz MD PhD

46,059 Aufrufe • vor 1 Jahr

The Multi-Billion Dollar Lie: How LDL Became "The Bad Cholesterol" In a fascinating exchange on The Joe Rogan Experience, human biologist Gary Brecka deconstructed one of modern medicine's most entrenched narratives: the demonization of LDL cholesterol. Brecka argues the "LDL is bad" story was built on a flawed foundation of isolated science. Researchers observed a correlation—people with heart disease often had high LDL. But, crucially, they didn't solve for the context. What were their insulin levels? Fasting glucose? Inflammatory markers like CRP? The high LDL was often a fellow traveler in a body under metabolic distress from poor diet and lifestyle, not necessarily the sole villain. The proof, Brecka posits, is in the outcomes. If high LDL were a direct cause of mortality, then forcibly lowering it with statins should significantly extend life. "Lo and behold," he states, "we see no extension of mortality." So why does the narrative persist? Brecka points to a trillion-dollar industry and the rigid "Standard of Care." Physicians are trained and financially incentivized to operate within this box. The standard of care for high LDL is a statin. To practice outside of it risks their license, malpractice coverage, and career. Who defines this standard? Brecka is unequivocal: "Pharma dictates that that's the standard of care. They also dictate the reimbursement rates." The system, he explains, creates a herd mentality. It's not that doctors are trying to cause harm; they are practicing within a system designed to maintain a specific protocol, one that is incredibly profitable and legally protected. The conversation is a powerful reminder that true health requires looking at the whole system, not just an isolated biomarker. What are your thoughts on the role of standard of care in modern medicine?

The Multi-Billion Dollar Lie: How LDL Became "The Bad Cholesterol" In a fascinating exchange on The Joe Rogan Experience, human biologist Gary Brecka deconstructed one of modern medicine's most entrenched narratives: the demonization of LDL cholesterol. Brecka argues the "LDL is bad" story was built on a flawed foundation of isolated science. Researchers observed a correlation—people with heart disease often had high LDL. But, crucially, they didn't solve for the context. What were their insulin levels? Fasting glucose? Inflammatory markers like CRP? The high LDL was often a fellow traveler in a body under metabolic distress from poor diet and lifestyle, not necessarily the sole villain. The proof, Brecka posits, is in the outcomes. If high LDL were a direct cause of mortality, then forcibly lowering it with statins should significantly extend life. "Lo and behold," he states, "we see no extension of mortality." So why does the narrative persist? Brecka points to a trillion-dollar industry and the rigid "Standard of Care." Physicians are trained and financially incentivized to operate within this box. The standard of care for high LDL is a statin. To practice outside of it risks their license, malpractice coverage, and career. Who defines this standard? Brecka is unequivocal: "Pharma dictates that that's the standard of care. They also dictate the reimbursement rates." The system, he explains, creates a herd mentality. It's not that doctors are trying to cause harm; they are practicing within a system designed to maintain a specific protocol, one that is incredibly profitable and legally protected. The conversation is a powerful reminder that true health requires looking at the whole system, not just an isolated biomarker. What are your thoughts on the role of standard of care in modern medicine?

Camus

79,123 Aufrufe • vor 9 Monaten

Dr. Paul Saladino reveals why the standard belief about LDL cholesterol is failing your heart health "Why do humans only develop atherosclerosis in arteries and not veins? The same amount of LDL cholesterol is circulating in my veins as in my arteries. It's a contiguous system. Veins don't develop atherosclerosis, only arteries" "Arteries are much more muscular because they must carry more pressure. When there's more pressure, there's more denuding of the endothelium, which means there's more damage just by being an artery because the pressure in there is higher" "My argument is apoB-containing particles like LDL are not atherosclerotic. You need endothelial damage to initiate atherosclerosis. Maybe they're arriving to the scene of the damage as part of the healing process—are they the firemen or are they the arsonist?"

Dr. Paul Saladino reveals why the standard belief about LDL cholesterol is failing your heart health "Why do humans only develop atherosclerosis in arteries and not veins? The same amount of LDL cholesterol is circulating in my veins as in my arteries. It's a contiguous system. Veins don't develop atherosclerosis, only arteries" "Arteries are much more muscular because they must carry more pressure. When there's more pressure, there's more denuding of the endothelium, which means there's more damage just by being an artery because the pressure in there is higher" "My argument is apoB-containing particles like LDL are not atherosclerotic. You need endothelial damage to initiate atherosclerosis. Maybe they're arriving to the scene of the damage as part of the healing process—are they the firemen or are they the arsonist?"

Health Almanac

14,371 Aufrufe • vor 1 Monat

"The Higher Your LDL, The Longer You're Going To Live." Cardiologist Dr Aseem Malhotra & Study Co-Author. "The Greater The Financial Interest In A Given Field, The Less Likely The Research Findings Are to be True." "The Most Lucrative Drug In The History Of Medicine Are Statins." $19 Billion Dollar Profit Industry Totalling 818 Million Prescriptions Annually. "The Benefit Of Statins For Both Low Risk & High Risk Primary Prevention Is ONLY 1%...1 In 100." "There Is No Correlation Between Elevated LDL Level & Events Of Cardiovascular Disease. In Fact, It's The Inverse. There Is A Correlation Between Higher LDL Level & Longevity." "The Higher The LDL, The Longer You're Going To Live, Because It Has A Vital Role In Your Immune System." "Just Because Cholesterol Is At The Scene Of the Crime, Doesn't Mean It's The Perpetrator." Cholesterol is trying to clear the inflammation & put out the fire caused by other lifestyle issues in order to get the body to return to Homeostasis. Atherosclerosis Is An Inflammatory Disease, Not A Cholesterol Disease or A Statin Deficiency. A Fireman shows up to put out a fire. He's not the cause of the fire. Cholesterol shows up to put out the fire of Inflammation in the Arterial Wall. Cholesterol is not the cause of the Inflammation that turns to Plaque. Eliminate The Root of The Inflammation Which Causes The Damage & Atherosclerosis: Chronic Stress High Blood Pressure Type 2 Diabetes Obesity Smoking Sugar Consumption Carbohydrates/Insulin Resistance Ultra Processed Foods Seed Oils Environmental Toxins Poor Sleep Low Vitamin D Level Low Magnesium Level Lack of Exercise These Are All Modifiable Risk Factors. Most Chronic Disease Happens Within Us, It Does Not Happen To Us. 👇Dr Aseem Malhotra's Co Authored Analysis 👇 👇Higher LDL, Greater Longevity👇 👇LDL Does Not Cause Cardiovascular Disease👇 👇Full Episode: The Ultimate Human Podcast👇

"The Higher Your LDL, The Longer You're Going To Live." Cardiologist Dr Aseem Malhotra & Study Co-Author. "The Greater The Financial Interest In A Given Field, The Less Likely The Research Findings Are to be True." "The Most Lucrative Drug In The History Of Medicine Are Statins." $19 Billion Dollar Profit Industry Totalling 818 Million Prescriptions Annually. "The Benefit Of Statins For Both Low Risk & High Risk Primary Prevention Is ONLY 1%...1 In 100." "There Is No Correlation Between Elevated LDL Level & Events Of Cardiovascular Disease. In Fact, It's The Inverse. There Is A Correlation Between Higher LDL Level & Longevity." "The Higher The LDL, The Longer You're Going To Live, Because It Has A Vital Role In Your Immune System." "Just Because Cholesterol Is At The Scene Of the Crime, Doesn't Mean It's The Perpetrator." Cholesterol is trying to clear the inflammation & put out the fire caused by other lifestyle issues in order to get the body to return to Homeostasis. Atherosclerosis Is An Inflammatory Disease, Not A Cholesterol Disease or A Statin Deficiency. A Fireman shows up to put out a fire. He's not the cause of the fire. Cholesterol shows up to put out the fire of Inflammation in the Arterial Wall. Cholesterol is not the cause of the Inflammation that turns to Plaque. Eliminate The Root of The Inflammation Which Causes The Damage & Atherosclerosis: Chronic Stress High Blood Pressure Type 2 Diabetes Obesity Smoking Sugar Consumption Carbohydrates/Insulin Resistance Ultra Processed Foods Seed Oils Environmental Toxins Poor Sleep Low Vitamin D Level Low Magnesium Level Lack of Exercise These Are All Modifiable Risk Factors. Most Chronic Disease Happens Within Us, It Does Not Happen To Us. 👇Dr Aseem Malhotra's Co Authored Analysis 👇 👇Higher LDL, Greater Longevity👇 👇LDL Does Not Cause Cardiovascular Disease👇 👇Full Episode: The Ultimate Human Podcast👇

Valerie Anne Smith

204,455 Aufrufe • vor 1 Jahr

What if everything we thought we knew about cholesterol and heart disease risk… doesn’t apply to everyone? In this episode, world-renowned cardiologist Dr. Matthew Budoff unpacks the results of a landmark one-year study tracking 100 lean, metabolically healthy individuals on a ketogenic diet with extremely elevated LDL levels. Dr. Budoff is the Program Director, Director of Cardiac CT, and the endowed chair of preventive cardiology at The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center. In this interview, Dr. Scher and Dr. Budoff further break down the results of his new publication, which used advanced imaging to demonstrate that LDL cholesterol and ApoB levels are not associated with plaque progression in Lean-Mass Hyper Responders following a #ketogenicdiet. 📊 Surprising insights: • Elevated LDL and ApoB did not predict plaque progression • Some participants with LDLs over 500 showed no plaque at all • A few participants even experienced plaque regression • Existing plaque—not LDL-C or ApoB—did predict plaque accumulation in this population Dr. Budoff explains what these results mean for clinicians, for patients using ketogenic therapy as a medical intervention, and for the broader conversation around cardiovascular disease risk. “It is important that clinicians, along with the general public, are made aware that personalized, data-driven approaches to assessing risk should be considered based on individual conditions,” said Dr. Budoff. “The existence of this phenotype suggests that alternative markers or tests should be used to establish metabolic health in some cases.” 🎬 These exciting new findings are featured in Dave Feldman and Jen Isenhart’s upcoming documentary, The Cholesterol Code, the story of how a software engineer conducts a groundbreaking study on an unusual group of people—lean, healthy individuals whose doctors are convinced they’ll die young. Real stories of healing with ketogenic diets provide a blueprint for using food as powerful medicine. Visit to learn more about the film and to be the first to hear about private screenings and the general release in the fall. Expert Featured: Dr. Matthew Budoff Matthew Budoff MD Resources Mentioned: Plaque Begets Plaque, ApoB Does Not Diagnostic and Preventative Cardiovascular Imaging Center CMEs Mentioned: Managing Major Mental Illness with Dietary Change: The New Science of Hope Brain Energy: The Metabolic Theory of Mental Illness Learn more about metabolic psychiatry and find helpful resources at

What if everything we thought we knew about cholesterol and heart disease risk… doesn’t apply to everyone? In this episode, world-renowned cardiologist Dr. Matthew Budoff unpacks the results of a landmark one-year study tracking 100 lean, metabolically healthy individuals on a ketogenic diet with extremely elevated LDL levels. Dr. Budoff is the Program Director, Director of Cardiac CT, and the endowed chair of preventive cardiology at The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center. In this interview, Dr. Scher and Dr. Budoff further break down the results of his new publication, which used advanced imaging to demonstrate that LDL cholesterol and ApoB levels are not associated with plaque progression in Lean-Mass Hyper Responders following a #ketogenicdiet. 📊 Surprising insights: • Elevated LDL and ApoB did not predict plaque progression • Some participants with LDLs over 500 showed no plaque at all • A few participants even experienced plaque regression • Existing plaque—not LDL-C or ApoB—did predict plaque accumulation in this population Dr. Budoff explains what these results mean for clinicians, for patients using ketogenic therapy as a medical intervention, and for the broader conversation around cardiovascular disease risk. “It is important that clinicians, along with the general public, are made aware that personalized, data-driven approaches to assessing risk should be considered based on individual conditions,” said Dr. Budoff. “The existence of this phenotype suggests that alternative markers or tests should be used to establish metabolic health in some cases.” 🎬 These exciting new findings are featured in Dave Feldman and Jen Isenhart’s upcoming documentary, The Cholesterol Code, the story of how a software engineer conducts a groundbreaking study on an unusual group of people—lean, healthy individuals whose doctors are convinced they’ll die young. Real stories of healing with ketogenic diets provide a blueprint for using food as powerful medicine. Visit to learn more about the film and to be the first to hear about private screenings and the general release in the fall. Expert Featured: Dr. Matthew Budoff Matthew Budoff MD Resources Mentioned: Plaque Begets Plaque, ApoB Does Not Diagnostic and Preventative Cardiovascular Imaging Center CMEs Mentioned: Managing Major Mental Illness with Dietary Change: The New Science of Hope Brain Energy: The Metabolic Theory of Mental Illness Learn more about metabolic psychiatry and find helpful resources at

Metabolic Mind

10,423 Aufrufe • vor 1 Jahr

Megyn Kelly’s doctor told her statins should be in the drinking water. Her hormones doctor said absolutely not. So she asked Dr. Paul Saladino for the truth. His take: Cholesterol is essential for brain and hormone health. The real issue isn’t your LDL number in isolation, it’s your overall metabolic health. Even “normal” cholesterol can hide risk if fasting insulin, thyroid, or A1C is off. A 2025 study from The Lundquist Institute (KETO-CTA trial) found that in metabolically healthy people, high LDL cholesterol showed no significant increase in plaque buildup or cardiovascular risk. Metabolic health appears to matter far more than LDL levels alone. What’s your take, are we over-fearing cholesterol and under-focusing on real metabolic health?

Megyn Kelly’s doctor told her statins should be in the drinking water. Her hormones doctor said absolutely not. So she asked Dr. Paul Saladino for the truth. His take: Cholesterol is essential for brain and hormone health. The real issue isn’t your LDL number in isolation, it’s your overall metabolic health. Even “normal” cholesterol can hide risk if fasting insulin, thyroid, or A1C is off. A 2025 study from The Lundquist Institute (KETO-CTA trial) found that in metabolically healthy people, high LDL cholesterol showed no significant increase in plaque buildup or cardiovascular risk. Metabolic health appears to matter far more than LDL levels alone. What’s your take, are we over-fearing cholesterol and under-focusing on real metabolic health?

Camus

316,726 Aufrufe • vor 2 Monaten