Tuesday Feb 24, 2026

Why Your Doctor Is Missing the #1 Heart Disease Risk Factor | Dr. Bret Scher

In this episode, preventive cardiologist Dr. Bret Scher—medical director of Metabolic Mind and the Coalition for Metabolic Health—joins the show for a wide-ranging conversation on why mainstream cardiology has been getting heart disease prevention wrong. After years of practicing conventional medicine, Dr. Scher had his worldview upended when he discovered the power of low-carb and ketogenic diets to reverse the metabolic dysfunction driving most cardiovascular disease. We explore why LDL alone doesn't tell the full story, what ApoB reveals that your standard lipid panel misses, and why metabolic health—not just cholesterol—may be the most important predictor of heart disease risk.

We also dig into the real trade-offs of GLP-1 drugs, why they shouldn't replace lifestyle interventions, and the groundbreaking field of metabolic psychiatry—where ketogenic diets are being used to treat bipolar disorder, schizophrenia, and major depression by addressing energy dysfunction in the brain. Dr. Scher shares how the Coalition for Metabolic Health is pushing to reshape dietary guidelines and medical training to prioritize metabolic health, and why the newly updated Dietary Guidelines for Americans finally acknowledging low-carb diets marks a turning point. Whether you're navigating your own heart health, questioning the standard medical advice, or curious about the link between metabolic health and mental health, this conversation is packed with insights you won't hear in a typical doctor's visit.

Timestamps

00:00 The Shift in Dietary Perspectives

02:45 Understanding Patient Responses to Low Carb Diets

05:37 The Push for Mainstream Acceptance of Low Carb Diets

08:36 Reevaluating Heart Disease Prevention

11:37 The Role of Cholesterol in Heart Health

14:48 Dietary Interventions for Metabolic Conditions

17:45 Navigating Cholesterol Levels and Medications

22:20 The Role of GLP-1 Drugs in Weight Management

28:16 Understanding Metabolic Psychiatry

35:40 Advocacy for Metabolic Health Policy

40:00 Key Takeaways for Improving Health