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Diet Doctor Podcast · August 14, 2023 · 48m
A New Study of Elevated LDL on Keto — The Lean Mass Hyper-Responder Phenomenon
Citizen scientist Dave Feldman presents preliminary data from the Lean Mass Hyper-Responder study — investigating why some lean, athletic people on low-carb diets develop very high LDL cholesterol, and whether this represents genuine cardiovascular risk.
Highlights
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Lean mass hyper-responders develop extreme LDL on keto — but their risk profile may differ from typical high-LDL patients
Feldman: lean, athletic, low-carb dieters who develop very high LDL (>200 mg/dL) also show very high HDL (>80) and very low triglycerides (<70). This triad is metabolically distinct from the typical high-LDL patient with metabolic syndrome.•
Context matters in biomarker interpretation — the same LDL number may have different risk implications in different metabolic contexts
Feldman: a single biomarker (LDL-C) may have different risk implications depending on metabolic context — insulin sensitivity, inflammation, particle size, and triglycerides. Treating all high-LDL patients identically may lead to over-treatment or under-treatment.