I am stealing Ken's brilliant observation about cholesterol on VLC vs just LowER carbs diets. This was a comment in Research forum:
Now that I am metabolically healthy, when I eat a lower carb diet in the 60 to 100 carb range I get stellar cholesterol numbers. My HDL is high, triglycerides are low and my LDL is in a range acceptable to my doctor. But when I eat a very low carb/keto diet (< 20 net carbs) my LDL-C will more than double -- especially if I'm exercising and actively losing weight. In other words, I'm a cholesterol hyper-responder when I do keto. I still have a stellar Triglyceride/HDL ratio, but my TC and LDL-C are off the charts. This is not uncommon, especially for the lean, athletic type Keto people. Dave Feldman has thousands of members on his Lean Mass Hyper Responder Facebook group and the typical first post by new members is all about how they and/or their doctor's are freaking out about LDL-C at 2 or 3 times the max reference range. Doctors typically see this and think that the patient is a ticking time-bomb desperately in need of statin treatment.
Personally, I'm of the belief that this is a normal function of our body for healthy people who are fueled mostly by fat. My doctor begs to differ. An LDL-C of < 120 mg/dl she will accept. On keto my LDL-C can exceed 250 mg/dl. I had to turn down another hard push for a statin prescription just yesterday. It happens with every visit. So maybe it is good that this study was done on "lower carb" participants. They may have had much different conclusions if they had studied a proper keto diet and a bunch of hyper-responders show up in their sample group.
FYI: Dave Feldman managed to get a study funded with the intent to determine if Lean Mass Hyper Responders are at greater risk for heart disease. The study is just now getting underway. Hopefully we will know more at the conclusion of this study. Here is a link to an interview with Dave about this study.
Discussing the LMHR Study on the DD Podcast
If you or your doctor still care about a high LDL-C, or even a too low Trig and too high HDL (one doctor wondered if HDL was too high
)…Ken's numbers when he eats lowER carb, tracks with what I also saw after 4 months on Ted Naiman's higher protein, more vegetable carbs (50-60 net) LDL lowering foods, lower saturated fats, with a daily TRE eating window but no extended fasting, diet.
Dec 2020…Trig 43, HDL 69, ratio .6. LDL-C 144
Since I was still actively losing weight, a pound or 2 above a healthy BMI, I didn’t pay too much attention to the changes from my years on a very LC diet, eating closer to 20g total carbs than to 60g net carbs. On VLC, I consistently had a Trig/HDL ratio of around .33. Last test on VLC in Feb 2019 was Trig 31, HDL 98, ratio.32.
Now I am curious to see what has happened to my cholesterol, after a year on lowER carb, lower fat, no longer "keto". I call it moderate carb, but Ludwig"s study would still label it low carb. I didn’t realize it at the time, but after only 4 months of following most of these DietDoctor tips to lower numbers, my cholesterol was getting closer to "normal" ranges…if you care and think that important.