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HDL

High-Density Lipoprotein Cholesterol

HDL (High-Density Lipoprotein) is often called 'good cholesterol,' but this oversimplifies what it actually is. HDL isn't cholesterol itself—it's a transport particle that carries cholesterol and other substances from your tissues back to your liver for recycling or disposal. Higher HDL levels are generally associated with lower heart disease risk, which is why it earned the 'good' label. Low HDL (below 1.0-1.3 mmol/L) combined with high triglycerides is a strong indicator of insulin resistance and metabolic problems. Low-carb and keto diets typically raise HDL levels significantly, which is one marker of improved metabolic health.

  Article (2)

  Research (6)

5-Year effects of a novel continuous remote care model with carbohydrate-restricted nutrition therapy including nutritional ketosis in type 2 diabetes: An extension study

A L McKenzie, S J Athinarayanan, Van Tieghem MR, B M Volk, C G Roberts, R N Adams, J S Volek, S D Phinney, S J Hallberg

Diabetes research and clinical practice 2024

A 5‑year very‑low‑carb, remote‑care program for type 2 diabetes showed durable benefits: 20% remission among completers, 33% reached HbA1c <6.5% with no meds or only metformin, alongside less medication and improved heart‑risk markers.

Dietary carbohydrate restriction as the first approach in diabetes management: Critical review and evidence base

Richard D. Feinman, Wendy K. Pogozelski, Arne Astrup, Richard K. Bernstein, Eugene J. Fine, Eric C. Westman, Anthony Accurso, Lynda Frassetto, Barbara A. Gower, Samy I. McFarlane, Jörgen Vesti Nielsen, Thure Krarup, Laura Saslow, Karl S. Roth, Mary C. Vernon, Jeff S. Volek, Gilbert B. Wilshire, Annika Dahlqvist, Ralf Sundberg, Ann Childers, Katharine Morrison, Anssi H. Manninen, Hussain M. Dashti, Richard J. Wood, Jay Wortman, Nicolai Worm

Nutrition 2015

This paper argues that restricting carbs should be the first-line diet for diabetes because it quickly lowers blood sugar, improves key health markers, and often reduces medications—without proven long‑term harms comparable to drugs.

Insights from a general practice service evaluation supporting a lower carbohydrate diet in patients with type 2 diabetes mellitus and prediabetes: a secondary analysis of routine clinic data including HbA1c, weight and prescribing over 6 years

David Unwin, Ali Ahsan Khalid, Jen Unwin, Dominic Crocombe, Christine Delon, Kathy Martyn, Rajna Golubic, Sumantra Ray

BMJ Nutrition, Prevention & Health 2020

Lower‑carb guidance in a UK GP practice led to 46% drug‑free type 2 diabetes remission and 93% normalization of prediabetes, with significant drops in HbA1c, weight, BP, and triglycerides.

Low Carbohydrate Dietary Approaches for People With Type 2 Diabetes—A Narrative Review

Sean D Wheatley, Trudi A Deakin, Nicola C Arjomandkhah, Paul B Hollinrake, Trudi E Reeves

Frontiers in Nutrition 2021

Low-carb diets match or beat low-fat for Type 2 diabetes—often cutting meds and improving HbA1c—without evidence of increased cardiovascular risk.

Small Dense Low-Density Lipoprotein-Cholesterol Concentrations Predict Risk for Coronary Heart Disease

Ron C Hoogeveen, John W Gaubatz, Wensheng Sun, Rhiannon C Dodge, Jacy R Crosby, Jennifer Jiang, David Couper, Salim S Virani, Sekar Kathiresan, Eric Boerwinkle, Christie M Ballantyne

Arteriosclerosis, Thrombosis, and Vascular Biology 2014

Small, dense LDL exposes hidden heart risk: it predicts events even when LDL looks “normal.”