A new documentary exploring one of the most debated topics in metabolic health—the rise in LDL cholesterol sometimes seen in people following low-carbohydrate diets—is beginning its global rollout.
In this episode of the LowCarbUSA® Podcast, I spoke with independent researcher Dave Feldman about his new documentary, The Cholesterol Code, which chronicles his research and the ongoing debate surrounding cholesterol and metabolic health.
The movie is being premiered between March 15 and April 15 through multiple theatrical screenings around the world. “If you don’t see one in your community, then sign up to host your own screening in your area.
Dave, an engineer by training who became widely known in the low-carb community through his self-experiments and data-driven investigations, described how the project began with a personal question. “I’m the engineer who started obsessing about his cholesterol when it went sky high on a keto diet,” he said. “Then came about a lot of my self-experiments, which ultimately led to forming the lipid energy model, which is now published.”
That model attempts to explain why some people—particularly those who are lean and metabolically healthy—experience unusually high LDL cholesterol levels when following a ketogenic or very low-carbohydrate diet. These individuals are known as lean mass hyper-responders, a term Feldman coined to describe people who exhibit a distinctive metabolic pattern: very high LDL cholesterol, high HDL cholesterol, and very low triglycerides.
Investigating the Risk Question
While the metabolic explanation for the phenomenon has attracted growing attention, Dave said the larger and more pressing question has always been risk. “How much does the risk of going on a keto diet and then seeing your LDL go up— even if it is for these reasons—actually matter?” he said. “How much could this develop what’s known as atherosclerosis, the building up of plaque in the arteries?”
To explore that question, he launched a crowdfunded research effort through the Citizen Science Foundation. The study recruited 100 individuals identified as lean mass hyper-responders. Participants underwent advanced heart imaging using CT angiography at the Lundquist Institute, allowing researchers to measure plaque in the coronary arteries. “They get a baseline scan, and then one year later they get a follow-up scan,” he explained. “That way we can see the changes of plaque over time—not just individually, but also at a population level.”
From Research Project to Documentary
The documentary The Cholesterol Code captures the unfolding story of that research. According to Dave, filmmaker Jen Eisenhart began documenting the project shortly after the first baseline scan data became available. “They started filming and managed to capture all of this,” he said. “It’s a riveting story and it all comes together in this film.”
The documentary follows not only the scientific investigation but also the real-world experiences of people who adopted low-carbohydrate diets for serious medical conditions Many participants, he said, had experienced life-changing improvements—only to later face anxiety when routine blood tests showed rising LDL cholesterol levels. “They see their cholesterol go up and they go, ‘Is this actually worth it?’” Dave said. “Even if I really respond well to a low-carb diet—even if I’m doing great—my cholesterol goes up. What does that mean?”
The film includes interviews with individuals managing conditions such as type 1 diabetes, bipolar disorder, eating disorders, and inflammatory bowel disease. Their stories are really touching, hats off to Jen Eisenhart and her team. It’s such a great film. I feel those stories were among the most powerful moments in the film. One of the mental-health stories, particularly, just ripped my heart out. She got her life back. She got her children back. And then she was agonizing about whether she should stop because her LDL was going up.
Research Complications and Scientific Debate
The research itself has also drawn attention because of an unexpected analytical complication that arose during the study. Dave explains that a secondary analysis conducted using artificial intelligence–guided plaque imaging software produced results that differed from other analyses of the same scans. “Three of those analyses disagree with this one,” he says. “On top of that, the company that provides that analysis won’t do a quality control check.” As a result, the research team has requested retraction of the paper associated with that analysis while further investigation continues. “That development ultimately strengthened the documentary by extending filming and allowing additional analysis and interviews to be incorporated. The neat thing is this delay did give us a chance to tighten up the movie more.”
Community-Driven Film Screenings
The film is now being released through a community-driven screening model. Viewers can organize or attend screenings through the film’s website, which uses a platform that allows communities to request theatrical showings once a minimum number of tickets are reserved. “If they go to the website, that’s where they can either join an existing screening—of which there are now many across the United States and actually across the world—or they can host their own,” Dave said.
I really encourage listeners to participate. If you don’t see one in your community, then sign up to host a screening and try to activate your community.
Continuing Research
Beyond the documentary, Dave said the work is continuing with additional research initiatives. One upcoming project—currently referred to as the Triad Study—aims to further investigate the metabolic patterns associated with lean mass hyper-responders and their cardiovascular implications. “We’re hoping to close funding on our companion research study,” he said. “The numbers are looking pretty good.”
As debate continues about the role of cholesterol in metabolic health—particularly among people following carbohydrate-restricted diets—Dave believes the conversation must remain grounded in data and open scientific inquiry. For many viewers, the documentary offers both a scientific investigation and a human story about the intersection of metabolic health, medical uncertainty, and personal transformation.
“It’s a great film and it tells a story that a lot of people in this community are living right now.”
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