Summary of May Be Linked to Higher Risk of Heart Attacks and Cardiovascular Disease:
A “keto-like” diet, which involves low carbohydrates and high amounts of fat, may increase the risk of cardiovascular events like chest pain, blocked arteries, heart attacks, and strokes, according to a new study presented at the American College of Cardiology’s Annual Scientific Session. The study found that regular consumption of a self-reported diet low in carbohydrates and high in fat was associated with increased levels of “bad” cholesterol and a higher risk of heart disease. Although elevated LDL cholesterol is a known risk factor for heart disease, the effects of an LCHF (low-carbohydrate, high-fat) diet on risk for heart disease and stroke have not been well studied. The research team analyzed data from the UK Biobank, a large-scale prospective database with health information from over half a million people living in the UK who were followed for at least 10 years.
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A study presented at the American College of Cardiology’s Annual Scientific Session Together With the World Congress of Cardiology has sparked concern over the safety of the “keto-like” diet, which entails eating high amounts of fat and low carbohydrates. The research found that this type of diet can lead to the build-up of “bad” cholesterol in the blood, increasing cardiovascular risks such as heart attacks, blocked arteries, chest pain and strokes. Although the “keto” diet has been popularised as a successful weight-loss diet, it has received criticism for primarily consisting of low carbohydrates and high fats, which can be problematic for long-term health. The study warned that individuals should be cautious of such risks and advised that those considering the diet should consult with a healthcare professional.
Ketogenic diets refer to eating plans that severely limit carbohydrates, causing the body to enter a state of ketosis, in which the body breaks down stored fats to produce energy. The process results in the creation of ketones as a source of energy, hence the name “ketone producing”. The diet recommends that individuals limit carbohydrate intake to as little as 10% of their daily calorie intake, while promoting a high-fat diet. This type of diet has gained significant popularity due to its effectiveness in reducing weight, controlling blood sugar levels and increasing energy. However, the high-fat diet can be difficult to maintain, which, along with the existence of concerns around its long-term effects on health, has led to a growing number of research articles in the field.
Previous studies have shown that ketogenic diets can raise levels of LDL cholesterol, also known as “bad cholesterol” which has long been understood to enhance the risk of heart disease through the build-up of cholesterol in the coronary arteries. The newly presented study adds another layer to this concern through its finding that those on a keto-type diet will also have higher levels of protein which can sit on top of LDL cholesterol and other atherogenic lipoprotein particles, increasing the potential for blockages in the arteries that require opening via stenting procedures.
This study sampled data from the UK Biobank, a large-scale database with health information from over half a million people in the UK, who were tracked for over a decade. The lead author, Iulia Iatan, drew upon a definition of a low-carbohydrate high-fat (LCHF) diet which mirrored keto-style eating, with no more than 25% energy or calories from carbohydrates and over 45% of daily calories from fat. The research suggested that those on this diet who had high levels of LDL cholesterol were the most susceptible to cardiovascular problems. Those who wish to pursue a ketogenic diet have been advised to monitor their cholesterol levels while checking other risks including high blood pressure, diabetes, and smoking.
The study highlights the need to identify specific characteristics or genetic markers that can predict how someone responds to a specific diet. The research also suggests that not everyone responds to an LCHF diet in the same way, and inter-individual differences exist. The study recommended consultation with a medical professional before starting any new diet. The study does have some limitations, as the dietary information provided by participants was only drawn from one point in time, and self-reports of food consumption may not be accurate, although the questionnaire in this study had been validated.
On-going research is needed to ascertain whether or not the association between “keto-like” diets and cardiovascular events is causative, but in the meantime, the study suggests that users should be cautious and consult their healthcare professional to assess any potential significant risks. This research also serves as an encouragement to identify genetic or other markers that may identify patients who are particularly susceptible to such risks.
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