Short Summary
Main recommendation: Focus on reversing the largest heart attack risk factors shown in Dr. Ken Berry's hazard-ratio chart, starting with type 2 diabetes, by adopting a very low carbohydrate "proper human diet" such as a ketogenic or carnivore diet. According to Berry, this approach also addresses metabolic syndrome, high blood pressure, and obesity, while LDL cholesterol is a comparatively minor risk factor.
Key Points
- According to Berry, citing a 2021 chart in the British journal Open Heart by Professor Noyes, type 2 diabetes carries a hazard ratio of 10.71 for coronary heart disease, the largest of the factors shown.
- Metabolic syndrome (high triglycerides, high blood pressure, large waist circumference, and related markers) is ranked second, and hypertension, obesity, and smoking also rank above elevated LDL.
- Among lab markers, Berry says lipoprotein insulin resistance (hyperinsulinemia) has the highest hazard ratio, followed by high triglycerides.
- According to Berry's chart, elevated LDL cholesterol has a hazard ratio of 1.38, which he describes as approaching background noise, and he argues that doctors focused on LDL/statins often neglect blood sugar, insulin, and blood pressure.
- Berry describes inflammatory markers such as hsCRP as a tiny risk compared with diabetes, metabolic syndrome, hypertension, and obesity.
Details Worth Noting
- Concrete instructions: - Berry's recommendation: Prioritize the largest bars on the chart in order. First, reverse type 2 diabetes until hemoglobin A1c returns to normal. Second, address insulin resistance or metabolic syndrome, which Berry says a very low carbohydrate diet fixes together. Third, lower blood pressure toward normal, which Berry says a ketogenic or carnivore diet can do, and reduce obesity and stop smoking. Berry says to set aside LDL concerns if any of these larger risk factors are present, though viewers should still consult their own doctor.
- Berry says that a "real whole food" ketogenic or carnivore diet, not keto treats, cookies, cakes, or pies, is what lowers these markers, and that people taking two or three blood pressure medications have seen blood pressure improve on such diets (his claim, based on his clinical experience).
- Berry says family history of premature coronary heart disease has a hazard ratio of 1.5, which is much smaller than diabetes and, unlike diet-related factors, is not something a person can change.
- Berry says smoking should be stopped, but he ranks it below type 2 diabetes, metabolic syndrome, hypertension, and obesity.
- Berry says that if a type 2 diabetic has an hemoglobin A1c of 6.5 to 7.0 while on medications, doctors who focus on LDL and statins are ignoring the largest risk factor.
- Berry notes that the hazard ratio figures come from the chart he displays, and he mentions that this is medical content from a physician's perspective, not professional individualized medical advice.
Bottom Line
Berry's chart argues that controlling blood sugar, insulin, triglycerides, and blood pressure matters far more for heart attack risk than LDL cholesterol alone. Berry suggests viewers with diabetes or metabolic syndrome discuss these priorities with their own clinician.





