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Deciphering the LDL Cholesterol Surge: Unraveling the Mysteries of Low-Carb Diets and the Lipid Energy Model



Many menopausal and postmenopausal women have found weight loss success, improved blood sugar regulation, better moods, sleep and hormonal health with eating low carb. In a recent study, Elevated LDL Cholesterol with a Carbohydrate-Restricted Diet: Evidence for a “Lean Mass Hyper-Responder” Phenotype,” it’s been shown that a small percentage of the population experiences this anomaly. They are the outliers. 

This study is just the beginning of research into a unique population of metabolically healthy people who are lean, fit, follow a low carb lifestyle and have high LDL cholesterol that does not put them at risk for heart disease.


You’re probably reading this and wondering how in the world is that even possible? It sounds like an oxymoron. For decades, we’ve heard the constant messaging that LDL cholesterol is the bad guy and we need to make sure it doesn’t get out of hand otherwise disaster is imminent.

What if LDL cholesterol isn’t the bad guy, depending upon certain circumstances being present? Isn’t that what science is all about? Questioning the status quo and testing these hypotheses in clinical settings to see what evolves for the health and benefit of humanity that does not cause harm or injury. That’s what we’ll be discussing here in this week’s blog post. So…

Let’s dive into the fascinating world of the Lipid Energy Model (LEM) and how it’s changing the game for lean individuals embracing carbohydrate-restricted diets (CRDs). One of the reasons I chose this topic is because I have personally been doing some biohacking on myself with low carb eating for nearly four months now. I’ll be doing some blood work shortly and am interested to see what my metabolic health results will be so stay tuned. 

There is no doubt there will be harsh critics of this study who will disagree no matter how much evidence is presented to the contrary that is logical and reasonable. Some don’t even want to read the study just by the title alone will condemn it because it challenges the status quo and the standard of care in medicine. The authors of the study are brave medical professionals, who in my opinion, are more interested in health care than sick care. Regardless whether this blog post resonates with you or not, it’s important to venture into new territory, as that is exactly how we evolve and improve pressing issues like metabolic health. All humans deserve to have optimum levels of wellbeing.

Unveiling the Lean Mass Hyper-Responder Phenomenon

Picture this: Lean folks adopting CRDs might notice a surprising boost in both LDL-cholesterol (the “bad” one) and HDL-cholesterol (the “good” one), along with lower triglycerides. The plot thickens when we discover that the degree of this lipid makeover is linked to body mass index (BMI). Those with a lower BMI seem to experience more significant increases in both LDL-C and HDL-C. Enter the Lean Mass Hyper-Responders (LMHR), a subset of individuals showing an impressive response to CRDs.

The LEM Unveiled

Now, let’s unravel the Lipid Energy Model. In simple terms, when lean individuals cut back on carbs, their bodies shift gears and become more reliant on fat for energy. This change prompts the liver to release and the body to absorb triglycerides found in very low-density lipoproteins (VLDL) through the action of lipoprotein lipase. The end result? A spike in both LDL-C and HDL-C levels, while triglycerides take a nosedive.

The LEM Unveiled: Decoding the Metabolic Shift

Carbohydrate Restriction and the Fat Energy Shift:

Imagine your body as a versatile machine that can run on different fuels. When lean individuals choose a low-carb lifestyle, it’s like telling their bodies, “Hey, we’re switching from using carbs to burning more fat for energy.” This shift triggers a series of metabolic changes.

The Liver’s Role in the LEM: 

Now, let’s talk about the liver—the metabolic maestro orchestrating this transformation. With fewer carbs coming in, the liver adapts by producing and releasing very low-density lipoproteins (VLDL). Think of VLDL as tiny shuttles carrying triglycerides, a form of fat, through the bloodstream.

Lipoprotein Lipase and the Triglyceride Journey:

As these VLDL shuttles cruise through the bloodstream, they encounter lipoprotein lipase, a crucial player in our metabolic orchestra. This enzyme acts like a traffic cop, allowing cells to pull triglycerides from the VLDL shuttles for energy use. It’s the body’s way of saying, “We’ve got plenty of fat on board—let’s put it to good use!”

Elevating LDL-C and HDL-C:

Now, here’s where the magic—or should I say, the mystery—happens. The increased reliance on fat as a fuel source leads to a surge in low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C). LDL-C is often tagged as the “bad” cholesterol, while HDL-C is the “good” one. Despite their labels, both play vital roles in our body’s function.


Triglycerides Take a Dive:

While LDL-C and HDL-C steal the spotlight, triglycerides (TGs) quietly exit the stage. With cells grabbing triglycerides for energy, their levels in the bloodstream drop. It’s like a trade-off—the body trades triglycerides for an increase in LDL-C and HDL-C.

The LMHR Enigma and Beyond: 

Enter the Lean Mass Hyper-Responders (LMHR), a subgroup showing an extraordinary response to this metabolic dance. Some experience a jaw-dropping surge in LDL-C levels, even exceeding 500 mg/dL. What’s intriguing is that these individuals started with normal LDL-C levels before embarking on the low-carb journey. Genetic tests don’t reveal the usual suspects associated with high cholesterol.

In essence, the Lipid Energy Model paints a vivid picture of how our bodies adapt to carbohydrate restriction, emphasizing the dynamic relationship between fat, cholesterol, and triglycerides. It’s a complex dance, but understanding it gives us valuable insights into the intricate ways our bodies respond to dietary changes.

Results: Unraveling the BMI Connection

The study revealed a fascinating inverse relationship between BMI and LDL cholesterol change. In simpler terms, the lower your BMI, the more significant the increase in LDL cholesterol. It’s like a dance where body mass and cholesterol levels move in opposite directions.

TG (Triglyceride) to HDL Cholesterol Ratio: A Marker of Metabolic Health:

Keep an eye on the TG to HDL cholesterol ratio—it’s a valuable marker of metabolic health. The study found that a low TG to HDL cholesterol ratio predicted larger LDL cholesterol increases. In essence, this ratio serves as a signpost for the body’s positive response to a low-carb lifestyle.

Lean Mass Hyper-Responders: A Unique Phenotype: 

Enter the intriguing category of “lean mass hyper-responders” (LMHR). These individuals boast LDL cholesterol levels of 200 mg/dL or more, HDL cholesterol levels of 80 mg/dL or higher, and TG levels below 70 mg/dL. What’s remarkable is that they share a lower BMI with others, and surprisingly, their LDL cholesterol levels before adopting the low-carb diet were similar to those of other respondents. It’s like a distinct subgroup with its own set of metabolic rules.

Carbohydrate Reintroduction: A Reversal in LDL Cholesterol:

In a compelling case series, the study explored the effects of a moderate reintroduction of carbohydrates. The result? A marked decrease in LDL cholesterol. It’s a reminder that our bodies are dynamic, responding to dietary changes with flexibility.

This additional information not only enriches our understanding of the Lipid Energy Model but also introduces intriguing nuances about how individual factors like BMI and metabolic markers play a role in this metabolic symphony.



The Lipid Energy Model paints a vivid picture of how our bodies respond to a low-carb lifestyle. By understanding the metabolic dance between fat, cholesterol, and triglycerides, we gain valuable insights into the complex interplay of nutrition and our internal systems. As we wrap up this journey into the LEM, remember, there’s always more to explore and uncover in the ever-evolving realm of holistic health and nutrition.



If you are someone who is currently on a statin and want to try eating a low carb diet to improve your metabolic health and possibly get off statins or lower the dosage, it’s highly recommended to have that conversation with your health care provider who is open to partnering with you on this journey. You will likely do blood work semi-frequently to check how you respond to the dietary changes and keep things safe.



The Lipid Energy Model: Reimagining Lipoprotein Function in the Context of Carbohydrate-Restricted Diets

Authors: Nicholas G. Norwitz 1,* , Adrian Soto-Mota 2 , Bob Kaplan 3 , David S. Ludwig 1,4 , Matthew Budoff 5, Anatol Kontush 6,† and David Feldman 3,*,†








blood lipids, cholesterol, HDL, LDL, Lean Mass Hyper Responder, lipase, Lipid Energy Model, lipoprotein lipase, liver, metabolic flexibility, Metabolic pathways, Muscle loss, triglycerides, VLDL

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