Keen on keto? Study gives low-carb, high-fat dieters something to chew on

Got any patients following a ketogenic diet? A University of British Columbia study presented March 5 at the American Congress of Cardiology’s annual scientific session underlined the risk of cardiovascular disease from low-carbohydrate, high-fat food regimens known commonly as the keto diet and championed by a number of doctors in Canada. “Our study found that regular consumption of a self-reported diet low in carbohydrates and high in fat was associated with increased levels of LDL cholesterol, or ‘bad’ cholesterol, and a higher risk of heart disease,” a UBC article quoted lead author Dr. Iulia Iatan, a physician-scientist at the university’s Centre for Heart Lung Innovation. “To our knowledge, our study is one of the first to examine the association between this type of dietary pattern and cardiovascular outcomes.” Dr. Iatan, who also works in the Healthy Heart Program Prevention Clinic at St. Paul’s Hospital in Vancouver, concluded that "Hypercholesterolemia occurring during a low-carb, high-fat diet should not be assumed to be benign.” The study, which defined a low-carb, high-fat diet as one with no more than 25% of total daily calories from carbs—slightly higher than a strict keto diet—and more than 45% from fat, looked at data from the UK Biobank, which contains health information from more than 500,000 United Kingdom residents. Read: Nutrition Wars: Is there such a thing as the best diet? The biobank followed participants for more than 10 years, who completed a self-reported diet questionnaire, along with blood tests to check their cholesterol levels. After an average of 11.8 years of follow-up, 9.8% of participants on the low-carb, high-fat diet experienced one of the events included in the composite event endpoint: angina, myocardial infarction, coronary artery disease, ischemic stroke, peripheral arterial disease, or coronary/carotid revascularization. By comparison, only 4.3% of participants considered to be on a standard diet experienced any of these cardiovascular events. “Among the participants on an LCHF diet, we found that those with the highest levels of LDL cholesterol were at the highest risk for a cardiovascular event,” Dr. Iatan said. “Our findings suggest that people who are considering going on an LCHF diet should be aware that doing so could lead to an increase in their levels of LDL cholesterol.” Read: Short-term fasting reduces tumour growth among cancer patients: study The takeaway for healthcare practitioners? It’s a good idea to monitor the cholesterol levels of patients on low-carb, high-fat diets, and to address other risk factors for heart disease or stroke. These risk factors include diabetes, high blood pressure, physical inactivity and smoking. Dr. Iatan cautioned that not everyone on a low-carb, high-diet is at risk. “On average, cholesterol levels tend to rise on this diet, but some people’s cholesterol concentrations can stay the same or go down, depending on several underlying factors,” Dr. Iatan said. “There are inter-individual differences in how people respond to this dietary pattern that we don’t fully understand yet. One of our next steps will be to try to identify specific characteristics or genetic markers that can predict how someone will respond to this type of diet.” Another notable aspect of the study is that participants provided dietary information at only one point in time. Also the observational nature of the study can show only a link between the diet and a higher risk for major cardiac events, but not causal relationship. However, Dr. Iatan said the findings merit further research in prospectively designed studies, especially when approximately one in five Americans report being on a low-carb, keto-like or a full keto diet. Read: Parkinson’s disease drug may help teens with type 1 diabetes

Keen on keto? Study gives low-carb, high-fat dieters something to chew on

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