* This week's note builds on last week's note about lean mass hyper-responders. This was the term developed by Dave Feldman to describe lean, fit, metabolically healthy people, who exhibit striking increases in cholesterol when adopting a low-carb diet.
* This week's note examines why cholesterol is observed to rise in these people. It looks at a hypothesis called the Lipid Energy Model, which offers an explanation. It also looks at alternatives proposed by Dr Nadir Ali and Dr Malcolm Kendrick.
* When lean people adopt a low-carb diet, they need to fuel on fat – and ideally dietary fat, as they have little body fat to lose.
* There is much agreement that there seems to be a functional purpose to rising cholesterol and circulating lipids to meet the demand for fuel in lean, low-carb athletic-types.
* The precise mechanism by which this might be happening is the area of debate.
* The most important question to the lean person is – does it matter? If total and LDL-cholesterol (and HDL-cholesterol) rise, when on a low-carb diet, is this of concern?
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