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keto-like diet may be linked to heart attack and stroke.

keto-like diet may be linked to heart attack and stroke.

Researchers looked into whether high-fat, low-carb diets similar to the ketogenic diet raise cardiovascular risk.

Diets that resembled ketosis were associated with twice as many cardiovascular events as regular diets.

The findings need to be confirmed by other research.


Around 10% of daily calories should come from carbohydrates, 30% from protein, and 60% from fat according to the ketogenic or “keto” diet. The diet causes a condition known as “ketosis,” in which the body starts using fat for energy instead of carbohydrates.

According to some research, a ketogenic diet may aid in weight loss, increase the susceptibility of cancer cells to chemotherapy and radiation treatment. Also, it lower blood sugar levels in diabetics. Yet, case studies indicate that the ketogenic diet may aggravate or fuel elevated cholesterol.

Further research on the impact of ketogenic diets on cardiovascular health may help people choose the right diet for their health profile.

Recent research examined the potential effects of low-carbohydrate, high-fat (LCHF) diets. These are similar to keto diets, on cardiovascular risk under the direction of Dr. Iulia Iatan, an attending physician-scientist at the Healthy Heart Program Prevention Clinic, St. Paul’s Hospital, and the University of British Columbia’s Centre for Heart Lung Innovation in Vancouver, Canada.

According to the study, as compared to a conventional diet, an LCHF diet nearly doubled the risk of cardiovascular events. The study was presented at the ACC Annual Scientific Session along with the World Congress of Cardiology. Its a conference co-hosted by the American College of Cardiology and the World Heart Federation.


In order to conduct the study, the researchers examined data gathered by the UK Biobank for individuals. Theyincluded information on food habits, metabolomic indicators, and blood lipid levels.

In a 24-hour food survey, all participants had tracked their dietary habits. 305 of them met the requirements for an LCHF diet. This is known as getting more than 45% of daily calories from fat and less than 25% from carbohydrates.

1,220 people who were deemed to be on a “regular diet” and made up the control group were matched with these participants by the researchers. The average age of the participants was 54 years. They were classified as “overweight” because of their mean body mass index (BMI), which was around 27.

What is a Ketogenic diet?

Ketogenic diets are low-carb diets (such as the Atkins diet). The goal is to get more calories from protein and fat and less from carbohydrates. The carbs that are easy to digest, like sugar, soda, pastries, and white bread, are the ones you cut back the most on.  

By reducing carbohydrate intake drastically, fat is replaced. When you reduce carbs, your body enters a state called ketosis. As a result, your body burns fat extremely efficiently for energy. Additionally, it converts fat into ketones in the liver, which can supply energy to the brain. Diabetes and insulin levels can be reduced significantly by ketogenic diets. In addition, the increase in ketones has some health benefits.

Low-carb, high-fat diets and cardio risk

“LDL cholesterol and ApoB will increase when people switch their caloric intake from carbohydrates to fat, especially if the saturated fat comes primarily from animal products. Dr. Liam R. Brunham, associate professor of medicine at The University of British Columbia and one of the study’s authors, told Medical News Today that this has been known for decades.

“What our study revealed is that the effect is not consistent, but that there is a segment of individuals who would experience severe hypercholesterolemia [abnormally high cholesterol levels] when on an LCHF diet. This is the category in which the largest rise in cardiovascular risk was found, the expert added.

Although she was not engaged in the study, Dr. Dana Hunnes, an assistant professor at UCLA’s Fielding School of Public Health, told MNT that “[t]his type of diet is supposed to be utilised short-term, primarily in those who have seizure disorders or neurological diseases as ketones can pass across the blood-brain barrier.”

“A keto diet is strong in saturated fats (usually), animal products, and may boost cholesterol levels as well as cause inflammation and stress,” she said.

“A low-carb, high-fat diet […] similarly tends to be low in carbohydrates and fibre and high in animal products and saturated fats. These characteristics might affect the microbiome, raise cholesterol levels and inflammation in the body, and raise the risk of heart disease, she added.

Keto worries

Michelle Routhenstein, a nutritionist who specialises in heart health and runs the online private practise Completely Nourished, was also interviewed by MNT. She informed us that the study supports her own findings.

“This study confirms what I see in my private practise, [as] many people come to me after being on the ketogenic diet for several months with very high LDL and apolipoprotein A levels, two crucial [factors] that contribute create risk for atherosclerosis,” she said.

Routhenstein issued a warning: “The keto diet can be quite high in saturated fat and low in soluble fibre, which negatively influences both of these parameters.

keto diet and risks to our heart health

According to Yu-Ming Ni, M.D., a cardiologist with MemorialCare Heart and Vascular Institute at Orange Coast Medical Center’s Non-Invasive Cardiology, ketogenic diets, or “keto,” are diets that are high in fat and low in carbohydrates—so low in carbohydrates, in fact, that it causes your body’s metabolism to break down fat and turn it into energy. The ability of keto diets to burn fat has been researched as a weight loss strategy, he continues. Several studies have revealed that high-fat, low-carb diets often result in worse cardiovascular outcomes than plant-based, high-carb, low-fat diets. This has raised a lot of controversy. This study expands on those findings.

So, precisely how can a ketogenic diet impact your heart health? It turns out that there is higher inflammation with keto diets in general. High fat diets are often more inflammatory, and Dr. Ni adds that inflammation is a crucial element in controlling cardiovascular health and disease. “We clearly have evidence of the pro-inflammatory characteristics of red meat or processed meat diets.”

In general, ketogenic diets raise your cholesterol as well. This is primarily because the foods you are consuming already have high cholesterol levels, but Dr. Ni also points out that long-term adherence to a high-fat, low-carb diet can have an impact on your cholesterol levels. He says that “high cholesterol is the number one factor that causes attacks and strokes to develop.”

Study limitations 

Dr. Brunham pointed out that the study reveals association but not causation when questioned about the study’s flaws.

Those following the LCHF diet and those following the normal diet had different BMIs, obesity rates, and diabetes statuses, he continued, potentially skewing the results.

In other words, it’s possible that individuals in the UK Biobank who reported eating an LCHF diet had a higher chance of developing heart disease due to their genetic makeup rather than the diet itself. To truly comprehend this, we would need more sorts of research, such randomised trials, he said.

Additional limitations of the study include the fact that diet and cholesterol levels were only recorded at one time point, according to Dr. John P. Higgins, a sports cardiologist at McGovern Medical School at The University of Texas Health Science Center at Houston who was not involved in the research.

Additionally, he questioned if people who follow standard diets are indeed following a “standard” diet or whether they are generally a healthier population.


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