Observational data can’t prove causation, but they do make a compelling case for harm with high-animal-fat, low-carb diets.
NEW ORLEANS, LA—Bad news for devotees of popular “Keto” low-carb, high-fat (LCHF) diets: a prospective analysis confirms that this eating pattern is associated with significant increases in LDL cholesterol levels, and also, more worryingly, an increase in adverse cardiovascular events.
“Hypercholesterolemia occurring during a LCHF diet should not be assumed to be benign,” said Iulia Iatan, MD, PhD (St. Paul’s Hospital, Vancouver, Canada), who presented the results of the study here during a featured clinical research session at the American College of Cardiology/World Congress of Cardiology (ACC/WCC) 2023 meeting.
LCHF diets that induce ketosis by relying on a higher consumption of proteins and fats and lower intake of carbohydrates have surged in popularity, with proponents reporting beneficial effects on obesity, diabetes, and epilepsy, said Iatan. In 2021, 16% of American adults said they were following an LCHF diet, and the term “keto” generates well over 3 million monthly internet searches worldwide, she noted. That’s almost twice the number of searches for Weight Watchers, the next most-Googled diet.
But several case reports have shown that following these diets leads to an increase in cholesterol levels across a range of populations, including highly trained athletes, leading some to conclude that hypercholesterolemia may not be as harmful in people who adhere strictly to a ketogenic diet.
“There’s a perception among patients and some members of the public that even though LDL increases, that that is somehow not something you need worry about, because it’s part of the expected metabolic adaptation to the diet,” senior author Liam R. Brunham MD PhD (St. Paul’s Hospital), told TCTMD. “What we’re showing is that this is probably not something you can ignore.”
For the study, Iatan, Brunham, and colleagues turned to the prospective, population-based UK Biobank, extracting roughly a decade’s worth of information on diet, estimated nutrient intake, and blood…