Paul Saladino MD podcast Why everything you’ve been told about cholesterol is probably wrong! A conversation with Dave Feldman.
May 14, 2019
Dave Feldman, an engineer-turned-lipid researcher behind CholesterolCode.com, discusses how ketogenic and carnivore diets reshape LDL, HDL, and triglyceride patterns. He outlines the lipid energy model, explains why LDL often rises on low-carb diets, and contrasts diet-driven LDL changes with genetic hypercholesterolemia. Short, provocative takes on lipoprotein roles, plaque formation, and interpreting lipids in metabolic context.
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LDL May Reflect Repair Not Cause Injury
- The lipid hypothesis links blood cholesterol levels to causation of atherosclerosis; Feldman and Saladino argue this is an incomplete view.
- They propose LDL often participates in repair (response to injury) rather than being the primary inciting agent of arterial plaque.
Higher LDL Linked To Lower All-Cause Mortality In NHANES
- Population data can show higher LDL associated with lower all-cause mortality after age adjustment, challenging singular focus on LDL.
- Feldman found in NHANES (50+ not on statins) higher LDL groups had lower overall death rates than low LDL groups.
Lean Mass Hyper Responder Phenotype Defined
- The triad of high LDL, high HDL, and low triglycerides often maps to lean, athletic, insulin-sensitive people on low-carb diets.
- Feldman calls this the lean mass hyper-responder phenotype and sees it as distinct from familial hypercholesterolemia and metabolic dyslipidemia.