Low Cholesterol Won’t Save You. Measure This Instead.

Name: Low Cholesterol Won’t Save You. Measure This Instead.
Uploaded: 2026-02-02T12:00:00.000Z
Duration: 18 min 41 s
Channel: Nick Norwitz

Nick NorwitzFebruary 2, 202618m

Topics8

Stunning Fact on Low LDL and Atherosclerosis0:00 Optimal LDL Does Not Prevent Atherosclerosis1:00 Controversial Study on Atherosclerosis Prevalence with Optimal LDL2:30 Critics' Points on the Study5:01 What I Am and Am Not Saying7:02 Why This Is Personal9:01 The 'Not Low Enough' Trap11:01 Biomarkers to Track14:01

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37% of people with very low LDL bad cholesterol still have atherosclerosis, plaque in their arteries, despite optimal cholesterol. Despite decades of medical innovation focused on lowering LDL like turning a pig into irony bacon, cardiovascular disease remains a world-leading killer. If you can get heart disease with pristine optimal LDL, and lowering LDL further hasn't erased the cardiovascular disease epidemic, why are we still doubling down? Why insist on making one number the whole story? Why miss the cardiovascular forest for a stupid little cholesterol shrub? Playing devil's advocate, maybe we just haven't gotten LDL low enough. These questions will be tackled, plus what to measure instead.

Very low LDL cholesterol levels did not prevent atherosclerosis: 12% relative difference, not nothing, but pitiful payoff. Long list of risk factors carry far greater consequence than LDL alone. This is a clear systemic problem. Why this is personal: loved one of a friend suffered a heart attack. LDL doesn't belong in the center of the room; it deserves far less attention.

Newsletter at staycuriousmetabolism.com for details, references, early access to data digests. Community is top three overall bestseller in science globally. Offers master class on cholesterol-lowering drugs and guide to why this is divisive. About information, not prescriptions.

Roadmap

Chapter 1: What happens when LDL cholesterol is optimal. Chapter 2: What critics say. Chapter 3: What I'm saying and not saying. Chapter 4: Why this is personal. Chapter 5: The not low enough trap. Chapter 6: Biomarkers you should track.

Review of paper in journal Atherosclerosis: prevalence of atherosclerosis in adults with optimal LDL cholesterol <70 mg/dL (group mean 57, super low). Some question if atherosclerosis can develop at all with LDL <70 mg/dL. Punchline: 37% of individuals with LDL <70 (mean 57) still had evidence of atherosclerosis. Specifically, 30% had positive coronary artery calcium score; 18% in highest quartile for carotid intima-media thickness (thickness of carotid arteries to brain), some overlap. Not even coronary CT angiography for soft plaque; 37% probably underestimates actual plaque burden.

To be fair, 37% is modestly lower than overall population prevalence of 49% (12% relative difference). But pitiful payoff for driving LDL to very low levels. Landscape changing: new drugs lowering LDL, total cholesterol, ApoB lower while risk factors like insulin resistance, obesity, diabetes persist.

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Low Cholesterol Won’t Save You. Measure This Instead.

Stunning Fact on Low LDL and Atherosclerosis00:00

Optimal LDL Does Not Prevent Atherosclerosis01:00

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