Hormonal
Individuals who are lean and metabolically healthy (low BMI, low triglycerides, high HDL) experience marked elevations in LDL cholesterol when consuming a carbohydrate-restricted diet, a phenotype termed 'lean mass hyper-responder' (LMHR).
If you are lean and metabolically healthy, a low-carb diet might significantly raise your LDL cholesterol. This does not necessarily mean your heart health is worse, as your other markers (triglycerides, HDL) are likely excellent. If you are concerned, you can moderately increase carbohydrate intake (50-100g/day) to lower LDL, or continue the diet while monitoring other risk factors. Consult a doctor to interpret your full lipid profile in context.
These data suggest that, in contrast to the typical pattern of dyslipidemia, greater LDL cholesterol elevation on a CRD tends to occur in the context of otherwise low cardiometabolic risk.
Why this rating
The evidence is based on a large observational survey (n=548) and a small case series (n=5), lacking randomized controlled trial data for the LMHR subgroup specifically.
Source
Elevated LDL Cholesterol with a Carbohydrate-Restricted Diet: Evidence for a “Lean Mass Hyper-Responder” Phenotype
Nicholas G. Norwitz et al. · Current Developments in Nutrition · 2021
DOI 10.1093/cdn/nzab144
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