Carbohydrate Restriction-Induced Elevations in LDL-Cholesterol and Atherosclerosis: The KETO Trial
Authors' conclusion
Coronary plaque in metabolically healthy individuals with carbohydrate restriction-induced LDL-C ≥190 mg/dL on KETO for a mean of 4.7 years is not greater than a matched cohort with 149 mg/dL lower average LDL-C. There is no association between LDL-C and plaque burden in either cohort.
Study context
- Population
- Lean metabolically healthy lean mass hyper-responder (LMHR) and near-LMHR individuals on ketogenic diet (mean 4.7 years), matched for age, gender, race, hyperlipidemia, hypertension, smokingmatched 1:1
- Exposure
- KETO vs matched Miami Heart (MiHeart) controls with lower low-density lipoprotein cholesterol (LDL-C)
- KETOn = 80
- Outcome
- Coronary plaque burden (CAC score and CCTA total plaque score)
Methodological detailsmatched 1:1, KETO: matched mean age 55.5 years, mean LDL-C 272 (maximum 591) mg/dl, mean 4.7-year duration on KETO
- Matched 1:1
- KETO: matched mean age 55.5 years, mean LDL-C 272 (maximum 591) mg/dl, mean 4.7-year duration on KETO
Main finding
As reported in the abstract
Coronary plaque burden
| Group | Value | CCTA total plaque score | CCTA total plaque score IQR |
|---|---|---|---|
| KETO | median 0 (IQR 0–56) | 0 [IQR: 0-2] | |
| MiHeart | median 1 (IQR 0–49) | 0-4 |
Value
KETOmedian 0 (IQR 0–56)
MiHeartmedian 1 (IQR 0–49)
CCTA total plaque score
KETO0 [IQR: 0-2]
MiHeart— not stated in the abstract
CCTA total plaque score IQR
KETO— not stated in the abstract
MiHeart0-4
- KETO vs MiHeart: P = 0.520 — CAC score
- KETO vs MiHeart: P = 0.357 — CCTA total plaque score
Observational data: associations, not effects.
Further findings
- No correlation between LDL-C level and CCTA coronary plaque
Original publication
Carbohydrate Restriction-Induced Elevations in LDL-Cholesterol and Atherosclerosis: The KETO Trial. JACC Adv. Published 28 August 2024. doi:10.
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