ArticleJACC. Advances2024
Carbohydrate Restriction-Induced Elevations in LDL-Cholesterol and Atherosclerosis: The KETO Trial.
Article in JACC. Advances, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Ketogenic diets and cardiovascular health balancing metabolic benefits against lipid-related risk.BMC cardiovascular disorders · 2026Pooled it
- The ketogenic diet is not for everyone: contraindications, side effects, and drug interactions.Annals of medicine · 2026Review
- A Structured Narrative Review of Contemporary Dietary Strategies Following Acute Coronary Syndromes.Journal of cardiovascular development and disease · 2026Review
- Ketogenic Diets and Low-Density Lipoprotein Cholesterol in Adults With Normal Weight: An Emerging Clinical Challenge.Journal of the American Heart Association · 2026Review
- Ketogenic metabolic therapy: low-carbohydrate interventions as novel neuroprotective strategies for cognitive dysfunction in diabetes.Frontiers in aging neuroscience · 2026Review
- Ketogenic therapy as a potential novel treatment approach for PTSD: an integrative review and proposed mechanistic model.Frontiers in psychiatry · 2026Review
- Ketogenic diets and metabolic dysfunction-associated steatotic liver disease: a literature review.Cell & bioscience · 2025Review
- Coronary artery calcification in type 1 diabetes after 10-year ketogenic diet.Journal of applied physiology (Bethesda, Md. : 1985) · 2025Article
- A long-term ketogenic diet causes hyperlipidemia, liver dysfunction, and glucose intolerance from impaired insulin secretion in mice.Science advances · 2025Article
- The Impact of Ketogenic Capacity on Lipid Profile in Individuals with Prediabetes or Newly Diagnosed Type 2 Diabetes.International journal of molecular sciences · 2025Article
- Effect of time restricted feeding with low carbohydrate, high protein and fat diet without calorie restriction on body weight, blood sugar and lipid profile over 6 months: a retrospective cohort study.International journal of obesity (2005) · 2025Article
- Longitudinal Data From the KETO-CTA Study: Plaque Predicts Plaque, ApoB Does Not.JACC. Advances · 2025Article
- Ketone Body Induction: Insights into Metabolic Disease Management.Biomedicines · 2025Review
- Myths and Facts Regarding Low-Carbohydrate Diets.Nutrients · 2025Review
- Weight Reduction with GLP-1 Agonists and Paths for Discontinuation While Maintaining Weight Loss.Biomolecules · 2025Review
- Review
- A pilot study of a ketogenic diet in bipolar disorder: clinical, metabolic and magnetic resonance spectroscopy findings.BJPsych open · 2025Article
- A Case Report on the Metabolic Effects of a Very-Low-Carbohydrate Ketogenic Diet in a Patient WithDiabetes spectrum : a publication of the American Diabetes Association · 2025Article
- Ketogenic diet, adenosine, and dopamine in addiction and psychiatry.Frontiers in nutrition · 2025Review
- Ketogenic diet in clinical populations-a narrative review.Frontiers in medicine · 2024Review
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Increases in low-density lipoprotein cholesterol (LDL-C) can occur on carbohydrate restricted ketogenic diets. Lean metabolically healthy individuals with a low triglyceride-to-high-density lipoprotein cholesterol ratio appear particularly susceptible, giving rise to the novel "lean mass hyper-responder" (LMHR) phenotype. Objectives: The purpose of the study was to assess coronary plaque burden in LMHR and near-LMHR individuals with LDL-C ≥190 mg/dL (ketogenic diet [KETO]) compared to matched controls with lower LDL-C from the Miami Heart (MiHeart) cohort. Methods: There were 80 KETO individuals with carbohydrate restriction-induced LDL-C ≥190 mg/dL, high-density lipoprotein cholesterol ≥60 mg/dL, and triglyceride levels ≤80 mg/dL, without familial hypercholesterolemia, matched 1:1 with MiHeart subjects for age, gender, race, hyperlipidemia, hypertension, and smoking status. Coronary artery calcium and coronary computed tomography angiography (CCTA) were used to compare coronary plaque between groups and correlate LDL-C to plaque levels. Results: The matched mean age was 55.5 years, with a mean LDL-C of 272 (maximum LDL-C of 591) mg/dl and a mean 4.7-year duration on a KETO. There was no significant difference in coronary plaque burden in the KETO group as compared to MiHeart controls (mean LDL 123 mg/dL): coronary artery calcium score (median 0 [IQR: 0-56]) vs (1 [IQR: 0-49]) ( Conclusions: 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. (Diet-induced Elevations in LDL-C and Progression of Atherosclerosis [Keto-CTA]; NCT057333255).
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Registered trials
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