Keto diet not linked to greater heart disease risk, says new study

decades, high cholesterol has been demonized as a major risk factor for heart disease. However, a groundbreaking new study suggests that the low-carb ketogenic diet may not be as closely linked to cardiovascular disease as previously thought.

The study, led by The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, involved 100 participants who followed a long-term keto diet and developed elevated levels of LDL cholesterol, also known as the “bad” type. Despite the elevated cholesterol levels, all participants were considered metabolically healthy and had been following the diet for an average of five years.

These participants were classified as lean mass hyper-responders (LMHR), indicating that they experienced a significant rise in cholesterol levels due to adopting a carbohydrate-restricted diet. Using advanced cardiac imaging, researchers found that traditional cholesterol markers like ApoB and LDL-C were not associated with changes in plaque levels in the heart’s arteries or with baseline heart disease over a one-year period.

Dr. Bret Scher, medical director of Baszucki Group, which funded the study, emphasized that individuals with elevated LDL due to being in ketosis are not automatically at increased cardiac risk. Instead, the study suggested that existing plaque levels in the arteries were a better predictor of future plaque accumulation than cholesterol levels.

Dr. Nick Norwitz, a study leader and independent researcher at the University of Oxford, highlighted the importance of cardiac imaging, such as a coronary artery calcium (CAC) score, in predicting plaque progression. He suggested that these imaging techniques could be used to individualize care and better assess cardiovascular risk in patients following a low-carb, high-fat diet.

Dr. Ken Berry, a family physician and diabetes specialist, noted that the study challenged conventional wisdom about the role of cholesterol in heart disease. He raised questions about the relevance of high ApoB levels as a predictor of heart attack risk and suggested that cholesterol levels may not be as significant as previously believed.

While the study has important implications for understanding the cardiovascular effects of a ketogenic diet, some experts cautioned that the findings may not be generalizable to all populations. Dr. Bradley Serwer, a cardiologist, pointed out that the study’s limited scope and short duration make it challenging to apply the results to a broader, more vulnerable population.

Despite these limitations, Michelle Routhenstein, a registered dietitian specializing in heart disease, emphasized the importance of individualized care and shared decision-making in evaluating cardiovascular risk. She noted that while the study demonstrated the unique physiology of individuals following a ketogenic diet, it is essential to consider other risk factors like inflammation, insulin resistance, and oxidative stress in assessing heart health.

Overall, the study provides valuable insights into the effects of a ketogenic diet on cardiovascular health and underscores the need for personalized risk assessment in patients following this dietary approach. Researchers hope that future studies will build upon these findings and further elucidate the relationship between cholesterol levels and heart disease risk in different populations.