Long-term use of ketogenic diet appears to raise LDL cholesterol levels and also doubles the risk of an adverse cardiovascular event
In a study presented at the American College of Cardiology (ACC) Scientific Session/World Congress of Cardiology (WCC) 2023, researchers discussed how use of a ketogenic diet increased levels of LDL cholesterol and the risk of an adverse cardiovascular event.
A ketogenic diet (KD), also referred to as a low carbohydrate, high fat (LCHF) diet, contains high amounts of fat (55 to 60%), 30 to 35% protein and 5 to 10% carbohydrate. Overall, it seems that a KD plays appears to play a significant therapeutic role in various cardiometabolic diseases and there is certainly evidence of a benefit when used as an intervention for overweight patients with type 2 diabetes. However, despite these advantages, others have raised concerns that a KD has the potential to exacerbate or cause hypercholesterolaemia in patients with or without underlying genetic hyperlipidaemia.Nevertheless, whether a KD over time gives rise to adverse cardiovascular events is unclear given the absence of long-term data. The study presented at ACC/WCC tried to answer this question and researchers used information from data held in the UK Biobank and identified individuals meeting their their definition of a KD diet, i.e., no more than 25% of total daily calories from carbohydrates and more than 45% from fat. These individuals were then matched to a group who self-reported eating a normal diet. The main outcome of the study was the effect of a KD on serum lipids whereas a secondary outcome was the composite incidence of adverse cardiovascular events (e.g., angina, myocardial infarction, coronary artery disease, ischaemic stroke, peripheral arterial disease, or coronary/carotid revascularisation.)
Ketogenic diet outcomesA total of 305 participants eating a KD diet were matched with 1220 eating a standard diet. The mean age of the sample was 54 and 73% were women and the mean body mass index (BMI) of 27.7 compared to 26.7 on the standard diet.
However, after adjustment for cardiovascular risk factors, e.g., diabetes, hypertension, obesity, and smoking, researchers found that 9.8% of those on a KD and 4.3% on a standard diet experienced an adverse cardiovascular event (adjusted hazard ratio, aHR = 2.18, 95% CI 1.39 – 3.43, p < 0.001).
Despite these findings, the authors did acknowledge the limitations of their study in that the information was self-reported and based on a single time-point. They also noted how not everyone responds to a KD in the same way.Source
‘Keto-Like’ Diet May Be Linked to Higher Risk of Heart Disease, Cardiac Events. ACC Anywhere
