Dr Ford Brewer - PrevMed High Cholesterol DOES NOT Clog arteries (if you are doing THIS) ft. Dave Feldman - Ford Brewer MD MPH (PrevMed Health)
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Aug 24, 2025 
In this engaging discussion, Dave Feldman, an engineer and expert on cardiovascular health, challenges conventional beliefs about cholesterol. He introduces the concept of lean mass hyper-responders and their surprising cholesterol profiles on ketogenic diets. The conversation highlights how LDL levels don't necessarily lead to plaque formation, emphasizing the need for a nuanced view of metabolic health. They also touch on the importance of calcium scoring, the effects of stress on fat accumulation, and the drawbacks of traditional health metrics like BMI.
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Assess Metabolic Health, Not Just LDL
- Do not assume high LDL in a lean person equals metabolic disease; assess HDL, triglycerides, and metabolic markers to judge metabolic health.
- Use a broader metabolic workup rather than treating LDL alone as the sole risk indicator.
Saturated Fat Intake Didn’t Explain ApoB
- The study found no relationship between saturated fat intake and ApoB among participants based on three 24-hour recalls.
- BMI explained LDL/ApoB differences far better than saturated fat intake in their meta-analysis of RCTs.
Baseline CAC Predicts Non-Calcified Plaque Increase
- Higher baseline CAC (coronary calcium) predicted increases in non-calcified plaque volume on follow-up.
- This reinforces that existing calcified plaque is a marker for further atheroma activity even in metabolically healthy people.