One of the ketogenic diet's major perceived drawbacks is an increase in LDL, or so-called bad cholesterol. A new study, though, says that this cholesterol spike doesn't fit the conventional science in terms of its disease-causing ability.
The ketogenic diet – an eating plan that emphasizes fat and protein over carbs – has certainly had its fair share of pluses and minuses added to its balance sheet over the years.
For example, a 2020 study showed that the diet could positively impact our gut microbiome, with a follow-up study in 2023 demonstrating that the gut changes it induces could protect against epileptic seizures. Also, a study last year suggested that the diet might ward off the cognitive decline seen in the early stages of Alzheimer's disease. Keto diets have also shown the potential to enhance chemotherapy; improve memory; and even fight the flu in mouse models.
On the negative side, in 2023 the keto diet was called to task because of its impact on the environment, with a study showing that a typical keto diet generates nearly four times the amount of carbon dioxide for every 1,000 calories as a vegan diet. Last year, another study showed that a low-carb diet like keto could spike the risk of developing type II diabetes by 20%. But perhaps the biggest checkmark the keto diet gets in its "cons" column is the fact that it causes an increase in LDL cholesterol, a protein and fat molecule that can lead to the buildup of plaque in arteries, increasing heart attack and stroke risk.
But a new study from a range of institutes including The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center has shown that the spike in LDL seen in adherents of the keto diet does not necessarily lead to heart disease, especially if they have otherwise healthy biomarkers.
The team followed 100 metabolically healthy people who stuck to the keto diet for a year. The people they used in the study were all considered Lean Mass Hyper-Responders (LMHRs), meaning that they saw elevated levels of LDL cholesterol in their blood, as well as elevated levels of a high-cholesterol marker known as apolipoprotein B (ApoB). However, these individuals also had low triglycerides, low blood pressure, low body mass index, low insulin resistance, and high levels of HDL, often called "good" cholesterol.
So in other words, even though they had high levels of "bad" cholesterol in their blood, they were, in fact, quite healthy after a year of following a keto plan. The study also could not establish any risk of increased heart disease in the patients despite their LMHR status.
They did, however, find that patients who already had plaque in their arteries were those most likely to have more plaque build-up. This led them to conclude that pre-existing plaque, rather than diet, was a stronger predictor of future plaque-related cardiovascular issues and they say that this factor, more than levels of LDL or ApoB, should be used to assess heart disease risk in the future for patients who are otherwise healthy.
Their research has been published in the Journal of the American College of Cariology: Advances.
Source: The Lundquist Institute via EurekAlert
