Hormonal
In lean individuals with low baseline triglycerides, carbohydrate-restricted diets cause elevated LDL-C and HDL-C through increased hepatic VLDL secretion and lipoprotein lipase (LPL)-mediated turnover, rather than through atherogenic dyslipidemia mechanisms.
If you are lean and keep your triglycerides low while eating low-carb, your LDL might rise significantly. This paper suggests this is likely due to efficient fat burning (high LPL activity) rather than the dangerous type of high cholesterol seen in obesity/diabetes. Monitor your triglycerides and HDL; if TG is low and HDL is high, the high LDL may be less concerning, though long-term cardiovascular outcomes in this specific group require more research.
The Lipid Energy Model (LEM) attempts to explain this metabolic phenomenon by positing that, with carbohydrate restriction in lean persons, the increased dependence on fat as a metabolic substrate drives increased hepatic secretion and peripheral uptake of TG contained within very low-density lipoproteins (VLDL) by lipoprotein lipase, resulting in marked elevations of LDL-C and HDL-C, and low TG.
Why this rating
The paper is a narrative review proposing a model based on existing literature and observational data, not a new randomized controlled trial.
Source
The Lipid Energy Model: Reimagining Lipoprotein Function in the Context of Carbohydrate-Restricted Diets
Nicholas G. Norwitz et al. · Metabolites · 2022
DOI 10.3390/metabo12050460
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