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

• Published in: Nutrients Vol. 13; no. 3; p. 814
• Main Authors: Burén, Jonas, Ericsson, Madelene, Damasceno, Nágila Raquel Teixeira, Sjödin, Anna
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 02-03-2021; MDPI
• Subjects: Amino acid sequence; Apolipoprotein B; Apolipoproteins; Blood; Carbohydrates; Cardiovascular disease; Cardiovascular diseases; Cholesterol; Diet; Diet intervention; Dietary fat; Dietary fiber; Fatty acids; Female; Food; Health risks; High carbohydrate diet; High fat diet; Intervention; Lipids; Lipoproteins; Low carbohydrate diet; Low density lipoprotein; Low fat diet; Nutrient deficiency; Nutrition research; Proteins; Risk analysis; Risk factors; Saturated fatty acids; Women; United States > US; Switzerland; Sweden; diet intervention; cardiovascular disease; saturated fatty acids; female; dietary fat; lipoproteins
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu13030814

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 (
< 0.001). In addition, Apolipoprotein B-100 (ApoB), small, dense LDL cholesterol as well as large, buoyant LDL cholesterol increased (
< 0.001,
< 0.01, and
< 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.