Keto Diet Linked to Doubling of Heart Disease Risk

The popular low-carb keto diet has proven to be particularly dangerous for the heart, a new study has found.

Maria Zavialova

Despite its growing popularity and promising guaranteed weight loss, the keto diet is not without its downsides. Similar to its predecessors, like the Atkins diet, not everything is as rosy as it seems. Unbalanced diets like keto can result in serious side effects that cannot be ignored.

Why the keto diet is dangerous

The keto diet, short for the ketogenic diet, is based on consuming foods high in fat that help the body produce ketones. These ketones, a “type of fuel produced by the liver from stored fat,” as described by the Harvard Medical Journal, trigger a state of “ketosis”. During it, the body uses fat instead of carbs from grains, fruits, and vegetables for energy. However, it may take a few days to reach ketosis, and consuming excess protein can disrupt the entire cycle.

Unfortunately, people who consume high-fat, low-carbohydrate diets often experience elevated cholesterol levels. They also had an increased risk of heart attacks and strokes, as evidenced by the recent study. Additionally, adherents of keto diets may face twice the risk of needing procedures to unblock arteries.

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. To our knowledge, our study is one of the first to examine the association between this type of dietary pattern and cardiovascular outcomes.

Iulia Iatan, MD, PhD, lead author of the study, attending physician-scientist at the Healthy Heart Program Prevention Clinic, St. Paul’s Hospital and University of British Columbia’s Centre for Heart Lung Innovation in Vancouver

How the study was conducted

The UK Biobank, a colossal database with information on the health of more than half a million people in the United Kingdom, provided the data for the research team’s analysis. The team monitored these individuals for at least a decade. 70,684 participants answered a one-time survey regarding their dietary intake during the 24 hours preceding the survey, and also gave blood to measure their cholesterol levels. The researchers identified 305 participants who were presently adhering to a diet that was “keto-like” in nature. That means it should consist of no more than 25% of their total daily energy intake from carbohydrates and over 45% from fat. This group was compared to 1,220 individuals of similar age who followed a standard diet. The researchers named the diet “keto-like” as it contained slightly more carbohydrates and less fat than a strict ketogenic diet.

Most of the participants in the study were women (73%), with a tendency towards being overweight and an average age of 54 years. The researchers then tracked the participants’ health status for nearly 12 years.

Conclusions: the keto diet requires special monitoring and examinations

Individuals who adhered to a ketogenic diet had the highest risk of developing cardiovascular issues, along with elevated levels of LDL cholesterol. Throughout the observation period, 9.8% of ketogenic dieters experienced a heart attack, compared to 4.3% of individuals following a standard diet. Consequently, the researchers suggest consulting a doctor before embarking on a ketogenic diet.

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. Before starting this dietary pattern, they should consult a health care provider. While on the diet, it is recommended they have their cholesterol levels monitored. They should also try to address other risk factors for heart disease or stroke, such as diabetes, high blood pressure, physical inactivity and smoking.

Lead author of the study, Iulia Iatan

Although most participants in the study who adhered to a keto-like diet had heightened health risks, some did not. In certain individuals, cholesterol levels remained constant or even decreased, and the underlying causes of this remain unclear. Consequently, the researchers aim to identify specific characteristics or potential genetic markers that could aid in predicting how a person will react to the ketogenic diet.

At present, there is no completely safe substitute for a well-balanced and nutritious diet. The only way to lose weight is through a caloric deficit and physical exercise. This article offers advice from the American Medical Association on ways to improve your health in 2023.

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