A recent study has stirred up the conversation about high cholesterol and heart health, focusing on the low-carb ketogenic diet. Conducted by The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, the research involved 100 participants who followed a keto diet long-term, leading to elevated levels of LDL cholesterol, often dubbed the “bad” cholesterol. Interestingly, despite these high cholesterol levels, all participants maintained a metabolically healthy status over an average period of five years.
These individuals are categorized as LMHR, meaning they exhibit a significant rise in cholesterol when on a carb-restricted diet. Traditional wisdom often links high cholesterol with heart disease, but this study challenges that notion by utilizing advanced cardiac imaging. The researchers discovered that typical cholesterol markers like ApoB and LDL-C didn’t correlate with changes in heart artery plaque levels or baseline heart disease over the course of one year.
Dr. Bret Scher, the medical director of Baszucki Group, which funded the study, mentioned to Fox News Digital, “This population of people — metabolically healthy with elevated LDL due to being in ketosis — are not automatically at increased cardiac risk simply because their LDL is elevated.” The study suggests a shift in focus from cholesterol levels to more informative measures like vascular imaging for assessing cardiac risks.
The findings were published in the Journal of the American College of Cardiology: Advances. Previous research had also indicated that those classified as LMHR had similar levels of coronary plaque to those with normal LDL levels. This underscores that increases in LDL due to a ketogenic diet might not signal a greater risk of coronary plaque.
Dr. Nick Norwitz, a study leader from the University of Oxford, noted that this study uniquely isolates very high LDL and ApoB as risk factors. He explained to Fox News Digital that past studies included participants with metabolic issues or genetic reasons for high LDL, which this study did not. The surprising results challenge conventional medical training and suggest that the traditional model has overlooked some aspects.
This study is the first of its kind involving a population labeled ‘high-risk’ by standard guidelines. Dr. Norwitz pointed out that cardiac imaging, such as using a CAC score, offers more value in predicting plaque progression than cholesterol levels alone. Such imaging could help tailor care to individual needs.
Dr. Scher remarked on the potential of “ketogenic therapy” in treating metabolic conditions, noting that fear of cholesterol might deter some from continuing the diet. He advised that this study supports working with healthcare providers for a personalized cardiac evaluation rather than discontinuing the diet based on cholesterol concerns alone.
Dr. Ken Berry, not involved in the study, called it “groundbreaking” and emphasized the finding that pre-existing plaque, not cholesterol levels, was the stronger predictor of plaque buildup. This raises questions about the validity of using ApoB levels as a heart attack risk indicator.
Dr. Bradley Serwer, a Cincinnati-based cardiologist, reviewed the study, noting its limitations due to its scope and short duration. He emphasized the need for better tools to identify those at higher coronary disease risk. Despite this, the study’s insights into cholesterol’s role in heart health are notable.
Michelle Routhenstein, a New York City dietitian, highlighted that plaque formation is a complex process, requiring conducive arterial conditions. Although not part of the research, she recognized the study’s portrayal of a unique physiological state in the participants.
