Paul Saladino MD podcast 52. Cholesterol: Friend or Foe? With the Paleo Cardiologist, Dr. Jack Wolfson
Jun 9, 2020
Dr. Jack Wolfson, a board-certified cardiologist turned integrative "Paleo Cardiologist," focuses on lifestyle-rooted prevention. He explores cholesterol's immune roles and why very low LDL can be harmful. They discuss better lipid markers, sunshine versus vitamin D pills, metabolic health and COVID risk, and how pharmaceuticals and training shape modern medicine.
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Use ApoB ApoA And Inflammation Over Total LDL
- Stop being LDL‑myopic: order ApoB/ApoA ratio, triglycerides, Lp(a) and inflammation markers instead of just total LDL.
- Wolfson recommends ApoB/ApoA, hsCRP, phospholipase A2 and oxidized LDL to assess true cardiometabolic risk.
HDL Context Changes LDL Risk
- HDL level/context dramatically modifies the relationship between LDL and coronary risk: high HDL blunts risk even with higher LDL.
- Saladino shows Framingham stratified by HDL (ApoA) where high HDL nullifies LDL-associated CAD risk.
Check HDL Function Not Just HDL Level
- Test advanced HDL functionality (cholesterol efflux capacity) when available because HDL quantity can be misleading.
- Wolfson mentions emerging commercial tests and suggests this metric will better predict HDL protective capacity.
