Thread by @realDaveFeldman

1/ Yes, the topic of a "hyper-response" with high #LDL #Cholesterol (LDLc) on #keto has been coming up a lot this summer, particularly for #LMHRs -- and that's a good thing. More discussion and research desired!

I'll try to unpack the key differences in 3 standing hypotheses...

https://twitter.com/MathieuChiasson/status/1553629554329223169

2/ Conventional: higher LDLc "hyper-response" (HR) mainly due to higher consumption of saturated fat (SF)

@DrNadolsky hypothesis: HR due to higher SF, but also genetics

Me: HR affected by many things, but generally more influenced by Lipid Energy Model (LEM) than SF or genetics

3/ Starting with a few key influences we all agree on...

These things likely have a significant detectable increase on LDL compared to reverse:

1) Swapping unsaturated fat with SF
2) Reducing fiber
3) Less resistance training

4/ The question of genetics is an interesting one, and I definitely think many SNPs impact lipid levels. Some impact these levels a lot, but they are very rare.

This brings us to the major difference between my friend and colleague @DrNadolsky's hypothesis and mine...

5/ I commonly predict if I could choose the cohort (lean, metabolically healthy, more aerobic than resistance training) and the dietary intervention (very low carb, high fat, carnivore-ish diet), then I believe the majority would demonstrate a #LMHR-like phenotype.

6/ I think @DrNadolsky would take me up on this bet as, per retweet above, the expectation is that this response is predominantly genetic influenced (such as via ABCG8 hyper-absorption,etc) and should be rare to observe emergence of this HR, including in my suggested design above

7/ Hopefully we'll get to test this "gym hypothesis" in time to see if indeed there is emergence of the #LMHR profile across a varied genetic cohort.

(As an aside, I love when something is this distinctive and testable. Should be fun when we really get something solid together)

8/ [Addendum] -- @DrNadolsky has corrected me that he is considering other aspects beyond higher consumption of saturated fat -- but the rare gene interaction is still very much central to the hypothesis.

Still testable to the experiment described above...