Very Low Calorie diets can cause LDL numbers to increase temporarily (Am J Clin Nutr. 1991 Jun;53(6):1404-10. The transient hypercholesterolemia of major weight loss. Phinney SD, Tang AB, Waggoner CR, Tezanos-Pinto RG, Davis PA.).
Abstract
Serum lipoproteins, body composition, and adipose cholesterol contents of six obese women were studied during and after major weight loss by very-low-calorie diets (VLCDs). Subjects started at 168 +/- 11% of ideal body weight, lost 30.3 +/- 3.7 kg in 5-7 mo, followed by 2+ mo in weight maintenance. Serum cholesterol fell from a prediet (baseline) value of 5.49 +/- 0.32 to 3.62 +/- 0.31 mmol/L (P less than 0.01) after 1-2 mo of VLCDs (nadir), after which it rose to 5.95 +/- 0.36 mmol/L (peak, P less than 0.01 compared with nadir and baseline) as weight loss continued. With weight maintenance, serum cholesterol fell to 4.92 +/- 0.34 mmol/L (P less than 0.05 compared with peak). Adipose cholesterol content did not change in peripheral (arm and leg) biopsy sites but rose significantly in abdominal adipose tissue with weight loss. We conclude that major weight loss was associated with a late rise in serum cholesterol, possibly from mobilization of adipose cholesterol stores, which resolved when weight loss ceased.
Here is a second paper on the same issue (Al Dahmani, Khaled Mohammed et al. Transient severe hypercholesterolemia following bariatric surgery treated successfully with increased food intake. Nutrition , Volume 32 , Issue 3 , 394 – 396).
…a case of transient severe hypercholesterolemia after bariatric surgery treated successfully with increased food intake. A 25-y-old policeman who had sleeve gastrectomy for morbid obesity 10 mo previously presented with generalized weakness, constipation, and significant weight loss after severe dietary restriction. All his preoperative and prior investigations were normal. Further investigation revealed severe total and low-density lipoprotein hypercholesterolemia. After all other causes of secondary hypercholesterolemia were excluded, a diagnosis of starvation-induced hypercholesterolemia was made. The patient was therefore started on a normal mixed diet gradually increased to achieve satiation. His dietary intake, body weight, and lipid profile were monitored over a 3-mo period. Eventually his symptoms abated, weight increased, and lipid profile returned back to normal levels. Although dietary management of failed weight loss after bariatric surgery is the main priority for health professionals, this case illustrates the possible harm of severe dietary restriction after surgery and the need for judicious dietary and nutritional management.
