A “keto-like” diet high in fat and low in carbohydrates is linked to high cholesterol

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Can a keto-like high-fat, low-carb diet affect cardiovascular health? Image credit: Alejandro Moreno de Carlos/Stocksy.
  • Researchers investigated whether high-fat, low-carb, keto-like diets increase cardiovascular risk.
  • Keto-like diets have been linked to twice as many cardiovascular events as standard diets.
  • More research is needed to confirm the results.

The ketogenic or “keto” diet. it involves consuming about 10% of daily calories from carbohydrates, 30% from protein, and 60% from fat. The diet activates a process called “ketosis”, where the body derives energy from burning fats instead of carbohydrates.

Some studies suggests that a keto diet can help with weight loss, make cancer cells more vulnerable to chemotherapy and radiation, and reduce blood sugar levels among those with diabetes.

Case studiesHowever, it suggests that the keto diet can worsen or cause high cholesterol.

Further studies investigating how the keto diet affects cardiovascular health could inform dietary options for individuals with different health profiles.

Recently, a study led by dr. Iulia Iatanassistant medical scientist at the Prevention Clinic of the Healthy Heart Program, St. Paul’s Hospital and the Heart Lung Innovation Center of the University of British Columbia in Vancouver, Canada, evaluated how the diets low-carbohydrate, high-fat (LCHF), similar to keto diets. , can affect cardiovascular risk.

Research has found that a LCHF diet nearly doubled the risk of cardiovascular events compared to a standard diet.

The study was presented at a conference held jointly by the American College of Cardiology and the World Heart Federation – the ACC Annual Scientific Session together with the World Congress of Cardiology.

For the study, the researchers analyzed the information collected by the Biobank UK for individuals with data on serum lipids, metabolomic markers, and dietary patterns.

All participants recorded their diet in a 24-hour food survey. Among them, 305 meet the criteria for a LCHF diet, defined as consuming less than 25% of daily calories from carbohydrates and more than 45% from fat.

The researchers matched these participants with 1,220 individuals who were considered to have a “standard diet”, and made up the control group. The average age of the participants was 54, and they had an average body mass index (BMI) of about 27 – which puts them in the “overweight” category.

Participants also had their blood drawn to measure their cholesterol levels. The researchers followed the participants for an average of 11.8 years.

The researchers noted that the diet is “keto-like”, due to its higher percentage of carbohydrates and lower levels of fat than a strict ketogenic diet.

During the follow-up period, 9.8% of participants on a LCHF diet versus 4.3% of controls experienced a cardiovascular event, including blockage in the arteries, a heart attack or stroke.

Those on LCHF diets had significantly higher LDL cholesterol levels and apolipoprotein B (ApoB) – a protein indicator of cholesterol levels.

“When people change their caloric intake from carbs to fat, and especially if it is predominantly saturated fat such as from animal products, LDL cholesterol and ApoB will increase. This has been known for decades,” Dr. Liam R. Brunhamassociate professor of medicine at the University of British Columbia, one of the authors of the study, said Medical News Today.

“What our study showed is that the effect is not uniform, but that there is a subgroup of people who will have severe hypercholesterolemia. [abnormally high cholesterol levels] while on a LCHF diet. This is the group in which the greatest increase in cardiovascular risk was observed,” he noted.

Dr. Dana Hunnesassistant professor at UCLA Fielding School of Public Health, who was not involved in the study, said MNT what you do “[t]His type of diet is supposed to be used in the short term, especially in individuals who have seizure disorders or neurological disorders, since ketones can pass through the blood-brain barrier.

“A keto diet is high in saturated fat (typically), animal products, and can raise cholesterol levels and inflammation/stress,” he explained.

“A low-carb, high-fat diet […] It also tends to be high in animal products, saturated fat, and low in carbs and fiber. These properties can increase cholesterol levels and inflammation in the body, and also potentially affect the microbiome and increase the risk of heart disease,” he added.

MNT also spoke with Michelle Routhenstein, a heart health dietitian at Entirely Nourished, a virtual nutrition counseling and consulting private practice. She told us that the study confirms her own observations.

“This study reiterates what I see in my private practice, [as] many individuals come to see me after being on the keto diet for several months with very high LDL and apolipoprotein A levels, two important ones. [factors] that help establish the risk for atherosclerosis,” he said.

“The keto diet can be very high in saturated fat and low in soluble fiber, which has a negative impact on both of these values,” Routhenstein warned.

When asked about the limitations of the study, Dr. Brunham noted that the study shows correlation but not causation.

He added that those on the LCHF and standard diet differed in characteristics such as BMI, obesity and diabetes status, potentially skewing the results.

“In other words, it could be that the people in the UK Biobank who reported consuming a LCHF diet had a higher risk of heart disease not because of the diet, but because people who chose this diet were inherently more at risk. We need other types of studies such as randomized trials to fully understand this,” he noted.

Dr. John P. Higginsa sports cardiologist at the McGovern Medical School at the University of Texas Health Science Center in Houston, not involved in the study, added that additional limitations include that diet and cholesterol levels were captured at only one time point .

He also questioned whether the standard diets were really “standard” or whether they were a healthier group overall.

“This type of study provides new insights to researchers and clinicians, but should not be the basis for public policy,” warned Dr. Brunham.

“Given that there are still many unknowns in the field, a conservative implication would be that patients on an LCHF diet should monitor their lipid levels, and if they develop severe hypercholesterolemia they should consult with a medical professional for risk management cardiovascular,” he added. .

“I’ve been saying this for a while, but our bodies are not meant to live on ketones, and certainly not for a long period of time,” said Dr. Hunnes.

“These findings show that high intake of animal products and fats seem to increase the likelihood or risk of a cardiac event; and yet, this is something that science has agreed upon for decades,” added Dr. Hunnes.

“The Mediterranean diet is Blue zone diets they are mainly [including] whole foods that are plant based. We would be better served – in terms of heart disease and other chronic conditions – to try to eat more like those who live in the Mediterranean or the Blue Zones than a high-fat, high-protein, low-carb diet,” she .concluded.

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