I recently joined Dave Feldman's LMHR (Lean Mass Hyper Responder) FaceBook group. Dave's always in search of more data. He put this targeted group up for both information gathering and debate. It is an interesting mix of people with many of us posting lab data, CAC scores, etc. There are approximately 800 members. Most are LMHR -- or at least have very high LDL cholesterol. Some have LDL-C at 300+ or 400+ and don't seem to care -- or even seem proud of it. They've bought into Dave's theory or the generally accepted position that cholesterol doesn't matter for those doing LCHF/keto. However, most members have joined because they and their doctor's are freaking out about their crazy lipid panels after going keto and they are looking for answers. Some members are MDs & RDs just looking to better understand this phenomenon. Unlike here and other "weight loss" oriented groups, many - if not most of the LMHR in that group started Keto for reasons other than losing weight. Many are younger, athletic types. Some are just very lean. My being a 'big loser' makes me sort of an odd duck in that group. At the moment Dave's theory of what makes a LMHR is 1) Not IR (metabolically healthy) and 2) Keto + Lean, Keto + physically active, or both. I think that my activity level and diabetes reversal are the things that 'qualify' me as a hyper responder.

I'm glad to be part of this group. The debate goes on and given my LMHR status I do want to know how this plays out (and contribute if I can). The science is not 100% settled. It wasn't settled when they decided to make fat & cholesterol that bad guy decades ago and it is not settled now. When I do keto my LDL-C doubles. When I eat LCHF right at my keto carb limits my LDL-C falls into a reasonably doctor pleasing range.

My problem is that I do better when I keep my carbs well down into the keto range. As I have chased better LDL-C numbers I find that I'm walking the 'slippery slope' of my carb limits. When my target is 40 to 50 net carbs each day keeping the eating within reason is harder. Frankly, I don't feel as good when I'm eating more carbs. With the exception of that darn LDL-C number, my gut tells me that keto is where I belong. At the moment I'm working on returning to keto. Once the reins are let out it is work to tighten things up again. I want to feel better. I also want to take care of a few pounds that I put on over the summer. My LDL will shoot up again. That's a given. But I will be heating healthy, whole foods and staying active. And I'll keep my head in the game about the latest science regarding the 'associated risks' of high LDL-C. What else can I do? I'd rather error on the side of staying lean and healthy. The way I see it, if I'm going to check out of this life early I'd rather be living a vibrant life up to the day of a massive heart attack than return to the path that I was on. Slow death by obesity, diabetes & alzheimer's certainly looks less appealing. If something new comes up to make me change my mind about keto, I'll consider making changes. But until then I'm returning to a VLC diet - perhaps for good.

Link to Dave's LMHR FB Group