A new study by the Faculty of Medicine. The University of British Columbia (UBC) ) suggests that the ketogenic diet, a popular weight-loss diet that involves consuming low amounts of carbohydrates and high amounts of fats, may pose an increased risk to cardiovascular health. The study found that people who followed a keto-like diet had higher levels of "bad" cholesterol and were twice as likely to experience cardiovascular events such as chest pain, blocked arteries requiring stenting, heart attacks, and strokes.

Key Takeaways:

• A new study led by UBC researchers suggests that "keto-like" diets, high in fat and low in carbohydrates, may increase the risk of cardiovascular problems.

• The study analyzed data from over 500,000 UK Biobank participants, identifying individuals with diets similar to keto (less than 25% calories from carbs, over 45% from fat).

• Compared to the general population, these individuals showed higher levels of "bad" cholesterol (LDL) and a doubled risk of cardiovascular events like heart attack, stroke, and blocked arteries.

• While individual responses vary, the study suggests a concerning trend for those considering keto-like diets.

• Researchers advise consulting healthcare professionals before starting such diets and monitoring cholesterol levels throughout.

• Further research is needed to understand the full impact and individual variability in response to these diets.

Additional Points:

• The study used self-reported dietary information, which can be prone to inaccuracies.

• The study cannot establish a direct causal link between diet and heart problems; further research is needed.

• The prevalence of low-carb/keto diets in the US (1 in 5) highlights the importance of understanding their potential health risks.

The study presented at the American College of Cardiology’s 2023 Annual Scientific Session suggests that a "keto-like" diet, which is low in carbohydrates and high in fat, may lead to higher levels of "bad" LDL cholesterol and an increased risk of cardiovascular events. Conducted by Iulia Iatan, MD, PhD, the study analyzed data from the UK Biobank, focusing on 305 individuals following a low-carb, high-fat (LCHF) diet. These participants were compared with 1,220 individuals on a standard diet. After nearly 12 years of follow-up, researchers found that those on an LCHF diet had significantly higher levels of LDL cholesterol and apolipoprotein B, both linked to heart disease. Moreover, participants on the LCHF diet had more than twice the risk of major cardiovascular events such as heart attacks, strokes, and artery blockages compared to those on a standard diet (9.8% versus 4.3%).

The study also highlights that not everyone responds to LCHF diets in the same way, with cholesterol levels rising for some but remaining stable or even decreasing for others. Despite these findings, the study’s observational nature means it can only show an association, not causation. The study's lead author emphasizes the need for further research to explore the genetic factors influencing individual responses to such diets. Additionally, the study's limitations include reliance on self-reported dietary information at a single point in time. Nonetheless, the findings underscore the importance of monitoring cholesterol levels and consulting healthcare providers when considering a low-carb, high-fat diet due to potential cardiovascular risks.

Diving into the Study's Findings

Led by Dr. Iulia Iatan, a distinguished physician-scientist at UBC's Centre for Heart and Lung Innovation, the research delves into the cardiovascular implications of a keto-like diet. The study, one of the first to scrutinize the correlation between this dietary pattern and heart health, uncovered unsettling revelations. Participants adhering to a diet low in carbohydrates and high in fats exhibited elevated levels of LDL cholesterol, commonly referred to as "bad" cholesterol. More alarmingly, they faced twice the risk of cardiovascular events such as chest pain, blocked arteries, heart attacks, and strokes.

Understanding the Keto Conundrum

Low-carbohydrate, high-fat (LCHF) diets, including the keto diet, operate on the principle of limiting carbohydrate intake to force the body into a state of ketosis. In this metabolic state, the body shifts from using carbohydrates as its primary energy source to breaking down fats. While the keto diet typically suggests restricting carbohydrates to 10% of daily calories, the UBC study broadens the spectrum, defining an LCHF diet as having no more than 25% of total daily calories from carbohydrates and over 45% from fats.

The Research Methodology: Unraveling Insights from the UK Biobank

To fortify their findings, Dr. Iatan and her colleagues turned to the extensive data repository of the UK Biobank. Spanning over half a million participants tracked for a minimum of 10 years, the study utilized self-reported diet questionnaires and cholesterol level assessments to draw correlations. The results illuminated a concerning trend among those on an LCHF diet, where individuals with the highest LDL cholesterol levels demonstrated the greatest vulnerability to cardiovascular events.

Individual Responses to LCHF Diets: Unveiling the Variability

Dr. Iatan emphasizes a crucial aspect—individual responses to LCHF diets are not uniform. While cholesterol levels tend to ascend on average, some individuals experience no change or even a decline. The study's future trajectory involves delving into the intricacies of these inter-individual differences, aiming to identify specific characteristics or genetic markers that forecast an individual's response to such dietary patterns.

Limitations and Implications: A Cautionary Tale

Acknowledging the study's limitations, Dr. Iatan highlights the reliance on participants' one-time dietary information. This nuance underscores the importance of interpreting the findings with caution. The observational nature of the study establishes an association rather than causation, prompting Dr. Iatan to advocate for prospective studies to delve deeper into the relationship between LCHF diets and cardiovascular risks.

Practical Recommendations for Those Eyeing the Keto Journey

In light of the research outcomes, Dr. Iatan urges prospective followers of the keto or LCHF diet to exercise caution. Before embarking on such a dietary shift, consulting with a healthcare provider is paramount. Monitoring cholesterol levels during the diet and addressing other risk factors for heart disease or stroke, such as diabetes, high blood pressure, physical inactivity, and smoking, becomes imperative for those considering the keto plunge.

Conclusion: A Paradigm Shift in Keto Perception

As the popularity of low-carb, high-fat diets continues to surge, the UBC research injects a crucial nuance into the conversation. The once-hailed keto diet, celebrated for its weight-loss prowess, now stands under the scrutiny of potential cardiovascular risks. Dr Iatan's study, with its meticulous approach and reliance on extensive data, urges us to reconsider our assumptions about the long-term impacts of dietary choices.

In a landscape inundated with health-conscious individuals, the UBC research acts as a beacon of caution, steering us away from the allure of quick fixes and prompting a deeper exploration of the intricate relationship between diet and cardiovascular health. As we navigate the ever-evolving realm of nutritional science, the UBC study serves as a reminder that even the most popular trends warrant rigorous scrutiny for a holistic understanding of their implications.

Reference Article

D. (2023, March 7). Popular keto diet may be linked to higher risk of heart disease and cardiac events. UBC Faculty of Medicine. https://www.med.ubc.ca/news/popular-keto-diet-may-be-linked-to-higher-risk-of-heart-disease-cardiac-events/

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