Dhru Purohit Show
This Study Shocks Cardiologists: LDL and ApoB May Not Predict Heart Disease Risk in Healthy People with Dr. Nick Norwitz
07 Apr 2025
This episode is brought to you by LMNT and Lumebox. The mainstream narrative around LDL cholesterol has long claimed that high LDL is always harmful—no matter the individual or their overall health status. The traditional view holds that elevated LDL levels directly increase the risk of cardiovascular disease, regardless of metabolic health. Today’s guest, Dr. Nick Norwitz, shares groundbreaking research that further explains why plaque buildup progresses and how it can lead to heart disease. Today on The Dhru Purohit Show, Dhru sits down with Dr. Nick Norwitz to explore a groundbreaking study on LDL cholesterol and its implications for cardiovascular health. Dr. Norwitz dives into the role of diet, individual risk factors, and the significance of plaque progression while also addressing lifestyle influences and practical strategies for heart health. He also shares insights on the limitations of current testing methods, the impact of microplastics on cardiovascular health, and the growing gut health crisis. Dhru and Dr. Norwtiz emphasized the need for personalized nutrition, informed decision-making, and a balanced perspective between scientific research and real-world experience. Dr. Nick Norwitz is a researcher, educator, and passionate advocate for metabolic health whose mission is to “Make Metabolic Health Mainstream.” He earned a PhD in Metabolism from the University of Oxford and is now completing his MD at Harvard Medical School. Nick’s drive in this field stems from his personal battle with severe Inflammatory Bowel Disease, which he overcame through a ketogenic diet after conventional treatments failed. His journey has fueled a deep commitment to challenging outdated thinking around health, and he’s known for his infectious curiosity and dedication to teaching. In this episode, Dhru and Dr. Norwitz dive into: Dr. Norwitz’s landmark study (00:41) How the study fits into people’s diets and lifestyles (06:04) Plaque progression in individuals with existing buildup (14:45) Lifestyle factors that contribute to continued plaque progression (16:30) How to assess your personal risk (20:55) Dhru’s personal story and testing journey (30:00) The worst diet and lifestyle habits for heart health (38:27) The impact of carnivore and ketogenic diets on gut health (45:01) Vegetables, fiber, and insights on the omnivore diet (1:02:40) The aspartame study and what it means for humans (1:07:58) Seed oils and their effects on the body (1:23:00) Final thoughts and where to follow Dr. Norwitz (1:34:52) Also mentioned in this episode: Plaque Begets Plaque, Not ApoB, JACC Journals Metabolic Mind YouTube Study from Italy on Microplastics in Cardiovascular Events For more on Dr. Norwitz, follow him on Facebook, Instagram, X/Twitter, YouTube, LinkedIn, Threads, and his Website, and subscribe to his Newsletter. This episode is brought to you by LMNT and Lumebox. Right now, LMNT is offering my listeners a free sample pack with any purchase. Head over to drinkLMNT.com/dhru today. Lumebox is offering my community $260 off their FDA-registered portable Red Light device! That's over 40% off! Go to thelumebox.com/dhru and get your Red Light device. Learn more about your ad choices. Visit megaphone.fm/adchoices
Full Episode
Dr. Nick Norwitz, a pleasure to have you on the podcast. I'm a huge fan of your work. I've been trying to get you on for a little while, so I'm grateful that you're here today. And we have some exciting news for our audience. Today, you're here to talk about a first of its kind, groundbreaking study that will give us massive insights into into a few areas that have all come together.
The carnivore diet, the low carb diet, high LDL, ApoB, and whether or not certain risk factors lead to poor cardiovascular health and even increase our risk of heart attack. So let's talk about this study, who you did it with and why it matters.
We had a bunch of other things we were going to talk about. We decided we actually found out this morning our paper got accepted. So we're kind of pivoting. You had a lot of enthusiasm in that opening. I hope I can deliver. But this is truly an exciting moment with this paper getting accepted because it is a first of its kind study.
It's been one that my colleagues and I, Dave Feldman and Adrian Sotomayor, have been expending blood, sweat and tears on for a few years. And I really have to give most of the credit to Dave Feldman. This started with him. He's, if you don't know him, an outsider, an engineer who had this provocative question. We'll get into it.
Delved into lipidology, became obsessed with it, crowdfunded a clinical trial and executed on it. And we've been working on this area of research. We've had like 10 papers on it over the past couple of years.
But this is really the landmark study because what we did, what the team did was take this group of people that turned lean mass hyper responders, these people who go low carb and see their LDL go through the roof, like sky high levels and followed them
over the course of one year with high resolution CT angiography to look not just for calcified plaques, but also non calcified plaque to see does plaque progress in this population that conventional wisdom would say is that super, super high risk their LDL levels are 200, 300, 400, 500. Sometimes it's close to 600. We had one person in this trial with an LDL of 591.
So do they have plaque progression like conventional wisdom would predict? And if there is plaque progression at a population level, what actually is the major risk factor? What drives the progression? And I'll just give you the headline. There was no or minimal progression in the majority of people.
On a population level, there was a tiny bit of progression, something called percent atheroma volume increased by 0.8%, which is pretty modest at a population scale. And the really critical thing is in addition to most people having no or minimal progression, you had to ask what predicts progression? Is it this LDL cholesterol that we always hear about or the associated marker ApoB?
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