Welcome back to the Diet Doctor podcast. I'm your host, Dr. Brett Scher. I'm not sure there's

anything in lipidology right now that's more controversial than elevated LDL in the setting

of a low-carb diet and is it harmful or not. And we're going to get into a little bit about

that topic today. Specifically, there is a new

paper that's come out that we're going to do a deep dive on. And this paper specifically has to

deal with the lean mass hyper-responder phenotype, or this group of people who see a dramatic rise

in their LDL after starting a low-carb diet. And the paper is titled,

Elevated LDL cholesterol with a carbohydrate-restricted diet,

evidence for lean mass hyper-responder phenotype.

And we're fortunate enough to be able to speak with four of the authors,

Nick Norowitz, Adrian Sodomoto, Dave Feldman, and Dr. Trocalation.

So we're going to speak with all of them to get their

insight about this paper. But I really think this is an important topic because the paper kind

of defines a whole population that before was not well defined. You know, Dave Feldman coined

this term, lean mass hyperresponder way back in 2017, but there was no scientific exploration of it right

it was his experience it was anecdotes coming in well this paper is the first to sort of synthesize

it and say okay this is what this patient population with these people look like and so it was let's talk about the study a little bit.

It was a web survey of almost 600 people.

And they had to have, they had to be eating less than 130 grams of carbohydrate per day

and not beyond lipid lowering medication.

And they just had to have lipid values before and after starting a low carb diet.

And interestingly, their mean LDL before starting low-carb diet was 135, 146 mean and median,

...