Dr. Jeff Graham sits down with Dr. Damon Forbes to explore the emerging concept of "lean mass hyper-responders"— fit, low-carb individuals who present with unusually high LDL levels. They unpack the physiology behind this pattern, discuss how it differs from familial hypercholesterolemia, and review new data on cardiovascular risk. The conversation offers a nuanced look at how metabolism, diet, and lipid transport intersect in precision medicine.