A Ketogenic Low-Carbohydrate High-Fat Diet Increases LDL Cholesterol in Healthy, Young, Normal-Weight Women: A Randomized Controlled Feeding Trial.

Jonas Burén,Nágila Damasceno,Anna Sjödin,Madelene Ericsson

doi:10.3390/nu13030814

Jonas Burén, Nágila Damasceno + Show 2 more

Open Access

https://doi.org/10.3390/nu13030814

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Journal: Nutrients	Publication Date: Mar 2, 2021
Citations: 47	License type: CC BY 4.0

Affiliation: Umeå University, Universidade de São Paulo

Abstract

Ketogenic low-carbohydrate high-fat (LCHF) diets are popular among young, healthy, normal-weight individuals for various reasons. We aimed to investigate the effect of a ketogenic LCHF diet on low-density lipoprotein (LDL) cholesterol (primary outcome), LDL cholesterol subfractions and conventional cardiovascular risk factors in the blood of healthy, young, and normal-weight women. The study was a randomized, controlled, feeding trial with crossover design. Twenty-four women were assigned to a 4 week ketogenic LCHF diet (4% carbohydrates; 77% fat; 19% protein) followed by a 4 week National Food Agency recommended control diet (44% carbohydrates; 33% fat; 19% protein), or the reverse sequence due to the crossover design. Treatment periods were separated by a 15 week washout period. Seventeen women completed the study and treatment effects were evaluated using mixed models. The LCHF diet increased LDL cholesterol in every woman with a treatment effect of 1.82 mM (p < 0.001). In addition, Apolipoprotein B-100 (ApoB), small, dense LDL cholesterol as well as large, buoyant LDL cholesterol increased (p < 0.001, p < 0.01, and p < 0.001, respectively). The data suggest that feeding healthy, young, normal-weight women a ketogenic LCHF diet induces a deleterious blood lipid profile. The elevated LDL cholesterol should be a cause for concern in young, healthy, normal-weight women following this kind of LCHF diet.

Highlights

There is a resurgence of interest in ketogenic diets [1]
The current trial shows that feeding healthy, young women a ketogenic low-carbohydrate high-fat” (LCHF) diet rich in saturated fatty acids for four weeks results in profound alterations in the blood lipid profile
Food Agency, eating LCHF induced an increase in low-density lipoprotein (LDL) cholesterol, a leading cause of atherosclerosis

Summary

Introduction

There is a resurgence of interest in ketogenic diets [1]. Nutritional ketosis usually occurs when restricting the carbohydrate intake to below 20–50 g per day [2], but there are individual variations [3]. The low amount of carbohydrate in these diets is usually compensated by a high fat content whereas protein is moderate. Under isocaloric conditions the term “low-carbohydrate high-fat” (LCHF) is more appropriate [4]. Alongside its well-documented weight-reducing effects [5,6], recent studies have shown a beneficial impact of ketogenic LCHF diets on cardiovascular risk factors [5]. The typically high intake of saturated fatty acids and low intake of dietary fiber in LCHF dietary regimes increases low-density lipoprotein (LDL) cholesterol, a risk factor for coronary heart disease [7,8]. There is no consensus from recent meta-analyses regarding the relationship between dietary saturated

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