Nick Norwitz interviews Aseem Malhotra, MD, a consultant cardiologist, on controversial new findings challenging LDL cholesterol’s role as an independent risk factor for heart disease. They discuss data showing that in metabolically healthy individuals, particularly those on ketogenic diets, high LDL levels may not predict atherosclerosis or adverse cardiac outcomes. Malhotra critiques the pharmaceutical-driven narrative around cholesterol and emphasizes the importance of insulin resistance, inflammation, and lifestyle in heart disease pathogenesis. The conversation explores patient cases, clinical trial limitations, and even a provocative experiment where Oreos reduced LDL more than statins, highlighting the need for a paradigm shift in cardiovascular risk assessment.