{"version":1,"type":"rich","provider_name":"Libsyn","provider_url":"https:\/\/www.libsyn.com","height":90,"width":600,"title":"Dave Feldman on Cholesterol Code & Why the Science Isn\u2019t Settled Yet: Ep 127","description":"When Dave Feldman first walked into a LowCarbUSA\u00ae event in 2016 carrying a laptop full of lab results, few people could have predicted where that moment would lead.  \u201cI\u2019m approaching everyone with my computer,\u201d Feldman recalls, \u201cbecause I\u2019m doing these self-experiments\u2014getting blood work\u2014and I\u2019m trying to figure out why my cholesterol numbers were doing what they were doing.\u201d  What started as a personal puzzle became The Cholesterol Code, a global research effort, a nonprofit scientific foundation, and now a forthcoming documentary film. In this episode of the LowCarbUSA Podcast, host Doug Reynolds sits down with Feldman to trace that journey\u2014and to explain why the next chapter will take center stage at the Symposium for Metabolic Health in Boca Raton, January 23\u201325, 2026 The Question That Wouldn\u2019t Go Away Dave\u2019s original question was deceptively simple: Why do some metabolically healthy, lean people see their LDL cholesterol rise dramatically on a ketogenic diet?  Over time, he noticed a consistent pattern. These individuals didn\u2019t just have high LDL\u2014they also tended to have high HDL, low triglycerides, and excellent metabolic health. In 2017, he coined a name for this group: Lean Mass Hyper-Responders (LMHRs). But identifying a pattern wasn\u2019t enough.  \u201cEven if the lipid energy model proves correct,\u201d Dave explains, \u201cdoes that mean having higher LDL on a ketogenic diet carries higher cardiovascular risk?\u201d  Answering that question required something far more difficult than a blog post or a hypothesis: a prospective imaging study. Building a Study When No One Will Fund One Dave spent years trying\u2014and failing\u2014to convince established institutions to study this population.  \u201cThere\u2019s not a lot of funding to study metabolically healthy people with sky-high LDL,\u201d he says dryly. \u201cThe interest is usually in people who already have multiple cardiovascular risk factors\u2014which confounds everything.\u201d  So in 2019, he made a radical decision. He founded the Citizen Science Foundation, a public charity created for a single purpose: to fund independent research, with no money going to salaries or overhead.  \u201cWe raised $200,000,\u201dDave says, \u201cand paid a research center to do the study.\u201d  By late 2021, recruitment was underway. One hundred lean, metabolically healthy ketogenic individuals underwent coronary CT angiography (CTA) scans to assess plaque in their coronary arteries, with follow-up scans roughly one year later. What the Data Actually Showed The early findings were striking.  When Dave\u2019s cohort was matched against participants from the Miami Heart Study, there was no statistically significant difference in coronary plaque, despite Dave\u2019s group having LDL levels less than twice as high.  \u201cIn fact,\u201d he notes, \u201cour group trended toward lower plaque.\u201d But the most important finding emerged as more analyses were completed:  \u201cThere was no association between ApoB or LDL and plaque progression,\u201d Dave says. \u201cWhatever your LDL level was, it did not correspond with how plaque developed.\u201d  What did matter? Baseline plaque. \u201cWhether you\u2019re low-carb or not,\u201d he explains, \u201cthe more plaque you have at baseline, the more likely you are to see progression. That\u2019s consistent with the existing literature.\u201d When One Dataset Didn\u2019t Make Sense Then came the controversy.  An AI-based quantitative analysis from a company called Cleerly showed plaque progression that appeared inconsistent\u2014not only with Dave\u2019s other data, but with decades of prior research.  \u201cAll of the scans showed progression,\u201d he says. \u201cNo regression. Not even noise.\u201d  For an engineer, that raised immediate red flags.  \u201cIf a bathroom scale is off by a quarter pound,\u201d Dave explains, \u201cyou expect wobble.  Below the noise floor, measurements go up and down.  But this dataset showed only one direction.\u201d Later, when Dave gained access to the anonymized data, he identified multiple anomalies and requested a blinded quality-control reanalysis.  That request was declined.  \u201cI don\u2019t assume wrongdoing,\u201d he emphasizes. \u201cBut when something looks implausible, the response should be course correction.\u201d  Instead, he sought independent confirmation.  A second AI company, HeartFlow, conducted a fully blinded analysis\u2014and its results aligned with every other analysis except Cleerly\u2019s.  \u201cThree out of four analyses agree,\u201d he says. \u201cCleerly is the outlier.\u201d Why This Matters Beyond One Study The implications extend far beyond a single dataset.  Dave believes this episode exposes a deeper issue in nutrition and cardiovascular science: how dominant theories shape interpretation.  \u201cThe lipid hypothesis has a gravitational pull,\u201d he says. \u201cIt affects what people expect to see\u2014and what they question.\u201d  As I put it, Dave has repeatedly taken the LowCarbUSA stage to announce findings that challenge assumptions\u2014and each time, the conversation moves forward.  \u201cIf we want better answers,\u201d Dave says, \u201cwe have to do better science.\u201d The Documentary\u2014and What Comes Next All of this has reshaped his upcoming documentary, The Cholesterol Code. Originally slated for release last year, the film has been expanded to include the scientific and human story behind these findings.  \u201cWe couldn\u2019t release it without covering what happened,\u201d he explains. \u201cIt\u2019s part of the truth.\u201d  For the first time anywhere, the official trailer for the film will be shown at the LowCarbUSA Symposium in Boca, immediately following Dave\u2019s talk.  Attendees will also be invited to help bring the film to live screenings around the world.  \u201cThe world premiere of the trailer will be at your conference,\u201d Dave told me.  \u201cThat alone is worth coming for.\u201d Why You\u2019ll Want to Be There One full day of the Boca symposium is dedicated to cardiovascular health, and Dave is one of the central voices shaping that conversation. Whether you attend in person or via live stream, this is a rare opportunity to engage directly with research that is still unfolding\u2014and with the scientist who helped drive it. As Dave puts it: \u201cThe work just needs to get done,  and in Boca, it will." Learn more and reserve your in-person or virtual seat for the Boca Symposium for Metabolic Health (January 23\u201325, 2026) ","author_name":"LowCarbUSA Podcast","author_url":"https:\/\/www.lowcarbusa.org\/","html":"