Cardiovascular Disease

The impact of carbohydrate restriction-induced elevations in low-density lipoprotein cholesterol on progression of coronary atherosclerosis: the ketogenic diet trial study design

🔬 Ketogenic Diet and Cardiovascular Health in Lean-Mass Hyper-Responders (LMHR) 🥑

Recent research focuses on lean-mass hyper-responders (LMHR) who experience significant increases in LDL-C while following a carbohydrate-restricted ketogenic diet. This study aimed to evaluate whether these LDL-C elevations impact atherosclerosis progression in otherwise metabolically healthy individuals.

→ Objective: Assess plaque progression over 1 year in 100 metabolically healthy LMHR subjects on a ketogenic diet with LDL-C ≥190 mg/dl.

→ Methods: 80 LMHR subjects with LDL-C ≥190, HDL-C ≥60, and triglycerides ≤80 mg/dl were matched 1:1 with subjects from the Miami Heart Study (MiHeart). Primary analysis included Coronary Artery Calcium (CAC), Total Plaque Score (TPS), Total Stenosis Score (TSS), and Segment Involvement Score (SIS) from coronary CT angiography.

→ Results:

• Mean age of LMHR cohort: 55.3 ± 10.3 years, 59% male.
• Mean LDL-C of 272 ± 91 mg/dl (max LDL-C 591 mg/dl).
• No significant difference in total CAC score, TPS, TSS, and SIS between LMHR and MiHeart subjects.
• No significant correlation between LDL-C levels and CCTA plaque metrics.

Conclusion: After an average of 4.7 years of carbohydrate restriction-induced LDL-C elevation, metabolically healthy LMHR individuals did not exhibit a greater atherosclerotic burden than matched controls with lower LDL-C levels. 🔥