High cholesterol has had a bad reputation for causing poor heart health, but a new study suggests that the ketogenic diet low in carbohydrates may not be linked to cardiovascular disease.
The study, led by the Lundquist Institute for Biomedical Innovation at the Harbor-UCLA Medical Center in collaboration with multiple institutes researchers, evaluated 100 participants after a long-term keto diet that developed high levels of LDL cholesterol (known as the “bad” type).
In addition to high cholesterol, all participants were “metabolically healthy” and had followed the key diet for an average of five years, according to a press release on April 7.
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All described as LMHR (Hyper responding), indicating people who adopt a diet restricted by carbohydrates and experience a significant increase in cholesterol.
High cholesterol has had a bad reputation for causing poor heart health, but a new study suggests that the ketogenic diet low in carbohydrates may not be linked to cardiovascular disease. (Istock)
Using advanced cardiac images, the researchers found that traditional cholesterol markers (APOB and LDL-C) were not associated with changes in plaque levels in the arteries of the heart or with basal heart disease for a period of one year.
Instead, existing plate levels seemed to be a better predictor of the accumulation of future plaque.
“This population of people, metabolically healthy with elevated LDL due to ketosis, does not have a higher heart risk simply because its LDL is elevated,” said Bret Scher, MD, medical director of Baszucki Group, which provided funds for the study, he told Fox News Digital.
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“Therefore, we should probably move away from LDL and APOB towards vascular images with CAC or CTA for a better risk prediction and inform how or whether to treat someone’s heart risk factors,” added the doctor based in California.
The study findings were published in the Journal of the American College of Cardiology: Advances.
Using advanced cardiac images, the researchers found that traditional cholesterol markers (APOB and LDL-C) were not associated with changes in plaque levels in the arteries of the heart or with basal heart disease for a period of one year. (Istock)
Previous studies have also shown that people who qualify as LMHR have similar levels of coronary plaque to comparable groups that have normal LDL levels, “stressing that LDL increases induced by the ketogenic diet may not indicate a higher risk of coronary plate,” said the researcher.
Dr. Nick Norwitz, study leader and independent researcher at the University of Oxford, said this is the first study that isolated the LDL and APOB very high as risk factors for heart disease.
“All other studies in humans have included populations with metabolic dysfunction or individuals with congenital genetic causes of LDL high,” Digital Fox told Fox News.
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The results seem to contradict what most doctors would have predicted and what doctors are taught in medical training, according to Norwitz.
“While these data do not prove that conventional understanding is ‘incorrect’, they suggest that the conventional model has a large blind spot.”
This is the first prospective essay of its kind in a unique population often labeled as “high risk” by traditional guidelines, said a doctor, raising important questions about how cardiovascular risk is evaluated in the context of low carbohydrate and high diets in fat. (Istock)
According to Norwitz, cardiac images, including a CAC score, have “much more value” than cholesterol levels in the prediction of plate progression.
“Therefore, CAC scores can be used to stratify patients and help individualize care,” Digital Fox told Fox.
Scher said that “ketogenic therapy” can be effective in treating certain metabolic conditions, but some people are afraid to continue a keto diet due to their cholesterol.
“This study provides support that does not necessarily need to stop the diet or treat their cholesterol, rather, they can work with their medical care team for a more individualized and appropriate cardiac study,” he advised.
Raising important questions
Dr. Ken Berry, family doctor and Diabetes specialist In Tennessee, he did not participate in the investigation, but shared his thoughts about what he described as an “innovative” study.
“The study found no association between LDL-C, APOB and the progression of the coronary plate for a year using high resolution TC angiography,” Digital Fox told Fox News.
“On the other hand, the strongest predictor of the progression of the plate was the pre -existing plaque, not the cholesterol levels, which led the researchers to conclude that ‘the plaque begats plate, Apob does not do it’.”
The existing plate levels seemed to be a better predictor of the accumulation of future plaque, although some experts warned that there are limitations. (Istock)
This is the first prospective essay of its kind in a unique population often labeled as “high risk” by traditional guidelines, Berry said, raising important questions about how cardiovascular risk is evaluated in the context of low carbohydrate and high -fat diets in fat.
“The obvious involvement is that if very high APOB levels are not a good predictor of the risk of heart attack in this specific group of people, is it a good predictor in any group of people?” said.
“Or, as I suspect, only the last popular laboratory test that is used to scare away people to eat an adequate human diet rich in saturated fats?”
Possible study limitations
Dr. Bradley Serwer, cardiologist and medical director of Vitalsolution, a company based in Cincinnati that offers cardiovascular and anesthesiology services to hospitals throughout the country, reviewed the study and pointed out some potential limitations.
“The limited scope of the study, which involves a low -risk population during a short duration, makes it difficult to generalize the findings to a broader and more vulnerable population,” Serwer told Fox News Digital.
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“While the objective of the study was to propose a hypothesis regarding the role of cholesterol in the diet, it does not provide definitive evidence in favor or against its importance.”
However, the cardiologist agrees with the conclusions of the authors that the “improved risk stratification tools” are essential to identify people with the highest risk of coronary heart disease.
The effects of a ketogenic diet can be measured using a ketosis meter. “I hope that doctors adopt this research and treat this specific population of people differently from the rest of their patients, understanding the unique physiological state of ketosis and the metabolic benefits it provides,” said a researcher. (Istock)
“As doctors, our main responsibility lies in evaluating each patient individually and collaborating with them through shared decision making to develop the most appropriate long -term care plan,” he added.
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Michelle Routhenstein, a dietitian registered in New York City who specializes in heart disease, said that plate formation is a several steps process that can take years to progress.
“The artery environment must be conducive to plaque formation,” Routhenstein said, who was not part of the study, Fox News Digital.
“This is a remarkable group of humans that demonstrates notable physiology.”
“For example, people with high blood pressure, a subgroup that was excluded from the study, are more prone to endothelial damage that can make APOB more easily deposited on the wall of the artery.”
“If someone already has a plate in the arteries and holds a high level of LDL and Apob, then it can become more plate, as seen in this study.”
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“However, if someone is metabolically healthy, it has no plaque at the beginning and has high levels of Apob and LDL alone, then the environment cannot necessarily cause the plaque for a period of one year.”
Routhenstein pointed out a previous investigation that shows that the high LDL and the APOB for years of someone’s life, typically together with inflammation, insulin resistance and/or oxidative stress, can increase the risk of plate development.
“It is important to keep in mind that many people who are implementing a ketogenic diet and ignore the high levels of LDL and Apob generally do not know that they have the elaboration of the soft plate,” said a dietitian nutritionist. (Istock)
“It is important to keep in mind that many people who are implementing a ketogenic diet and ignore the high levels of LDL and Apob generally do not know that they have soft plate beer,” he added.
“Therefore, advise them to ignore LDL and Apob levels can be harmful, especially in a world where heart disease is so frequent and remains the main cause of death worldwide.”
Looking to the future
Scher said that more researchers hope will be inspired to promote this study and apply it to different populations.
“But for now, I hope that doctors adopt this research and treat this specific population of people differently from the rest of their patients, understanding the unique physiological state of ketosis and the metabolic benefits it provides,” he said.
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In addition to more studies that evaluate the risk in this population, Norwitz said that the team hopes to investigate more thoroughly the mechanisms of the hyper-response phenotype of lean mass (LMHR).
“This is a remarkable group of humans that demonstrates a notable physiology,” he added.
