The ketogenic diet, or “keto” for short, has gained popularity in recent years as a weight-loss method. This diet involves a high-fat, low-carbohydrate, and moderate-protein intake, with the goal of inducing a state of ketosis in the body, where it burns fat for fuel instead of carbohydrates. However, a new study suggests that following a keto-like diet may be linked to a higher risk of heart attacks and cardiovascular disease.

The study, published in the Journal of the American College of Cardiology, followed over 4,000 participants for a period of 10 years. The participants were divided into four groups based on their self-reported dietary patterns: a “healthy” plant-based diet, a less-healthy plant-based diet, a “healthy” low-carbohydrate diet, and a less-healthy low-carbohydrate diet.

The researchers found that participants who followed a less-healthy low-carbohydrate diet, which closely resembled a keto diet, had a 32% higher risk of developing cardiovascular disease and a 50% higher risk of experiencing a heart attack, compared to those who followed a healthy plant-based diet

Here are some key takeaways from the study

What did the study find?

The study in question was a large observational study that followed over 4,000 middle-aged adults over a period of 25 years. The researchers tracked the participants’ diets using food questionnaires and assessed their cardiovascular health through medical exams and medical records.

The study found that participants who followed a low-carbohydrate diet that was high in animal-based proteins and fats, and low in plant-based foods, had a significantly higher risk of developing cardiovascular disease and experiencing a heart attack. Specifically, compared to those who followed a healthy plant-based diet, participants who followed the less-healthy low-carbohydrate diet had a 32% higher risk of developing cardiovascular disease and a 50% higher risk of experiencing a heart attack.

The study authors noted that the higher risk of cardiovascular disease and heart attack associated with the less-healthy low-carbohydrate diet may be due to the high levels of saturated fat and cholesterol in animal-based foods, which can contribute to the development of atherosclerosis and other cardiovascular problems. They also pointed out that a healthy plant-based diet, on the other hand, is rich in fiber, vitamins, minerals, and other beneficial nutrients that can help protect against cardiovascular disease.

It’s worth noting that this study was observational and cannot prove causation, only association. Additionally, the study did not specifically investigate the ketogenic diet, but rather a less-healthy low-carbohydrate diet that shared some similarities with the keto diet. Nonetheless, the findings suggest that following a healthy plant-based diet may be a better choice for cardiovascular health than a less-healthy low-carbohydrate diet.

Why might a keto-like diet increase the risk of cardiovascular disease?

High saturated fat intake: A keto-like diet is often high in saturated fat, which is commonly found in animal products such as meat, butter, and cheese. Saturated fat has been linked to an increased risk of heart disease, as it can raise LDL cholesterol levels and contribute to the buildup of plaque in the arteries. While some studies have suggested that saturated fat may not be as harmful as once thought, most health organizations still recommend limiting its intake.

Low fiber intake: A keto-like diet typically restricts carbohydrates, which can lead to a lower intake of fiber. Fiber is important for heart health, as it can help lower LDL cholesterol levels and reduce inflammation in the body. Additionally, a lack of fiber can lead to constipation and other digestive issues, which may indirectly contribute to heart disease.

Increased LDL cholesterol: A low-carbohydrate, high-fat diet can lead to an increase in LDL cholesterol levels, which is a risk factor for heart disease. While some people may experience a decrease in LDL cholesterol on a keto-like diet, others may see an increase, depending on factors such as genetics and the types of fats consumed.

Reduced insulin sensitivity: A keto-like diet can cause a decrease in insulin sensitivity, which may increase the risk of developing type 2 diabetes. Diabetes is a known risk factor for heart disease, as it can lead to damage to the blood vessels and an increased risk of heart attack and stroke.

Lack of variety: A keto-like diet can be restrictive in terms of food choices, which may lead to a lack of variety in the diet. This can result in a deficiency of certain nutrients, such as vitamins and minerals, which are important for overall health and may have an impact on heart health as well.

What are the implications of the study?

The researchers analyzed data from over 400,000 people and found that those who followed a low-carbohydrate, high-fat diet like keto had a 23% higher risk of cardiovascular disease and a 14% higher risk of heart attacks compared to those who followed a moderate carbohydrate diet.

While the study does not prove cause and effect, it does highlight the importance of considering the potential long-term health effects of any diet before adopting it as a long-term lifestyle change. It’s also important to note that the study focused on a specific type of low-carbohydrate diet and may not be representative of all low-carbohydrate diets.

It’s worth noting that not all low-carbohydrate diets are the same, and the health effects can vary depending on the type and quality of the foods consumed. For example, a low-carbohydrate diet that emphasizes whole foods like vegetables, fruits, nuts, and seeds may have different health effects compared to a low-carbohydrate diet that emphasizes processed and high-fat foods.

It’s also important to consider individual health factors and preferences when choosing a diet. Consulting with a registered dietitian or healthcare provider can help determine the best dietary approach for an individual’s specific needs and health goals.

What are some healthier alternatives to a keto-like diet?

Mediterranean diet: The Mediterranean diet is based on the traditional eating habits of people living in countries bordering the Mediterranean Sea, such as Greece, Italy, and Spain. This diet emphasizes a high intake of fruits, vegetables, whole grains, nuts, seeds, and olive oil, as well as moderate consumption of fish, poultry, and dairy products. Red meat and processed foods are limited. The Mediterranean diet has been shown to improve heart health, reduce the risk of type 2 diabetes, and lower the risk of certain cancers.

DASH diet: The DASH (Dietary Approaches to Stop Hypertension) diet was developed to help people lower their blood pressure. This diet emphasizes a high intake of fruits, vegetables, whole grains, and low-fat dairy products, as well as moderate consumption of lean protein sources such as fish, poultry, and legumes. Red meat, sugary foods, and high-fat dairy products are limited. The DASH diet has been shown to reduce blood pressure and improve heart health.

Whole-foods, plant-based diet: A whole-foods, plant-based diet emphasizes a high intake of fruits, vegetables, whole grains, legumes, nuts, and seeds, and limits or eliminates animal products, processed foods, and added sugars. This diet has been shown to improve heart health, lower the risk of type 2 diabetes, and reduce the risk of certain cancers.

It’s worth noting that while these dietary patterns may not be as restrictive as a keto-like diet, they still require some level of adherence and may not be suitable for everyone. It’s important to consult with a healthcare professional before making any significant changes to your diet.

Conclusion

While the keto diet has gained popularity as a weight-loss method, this new study suggests that following a keto-like diet may be linked to a higher risk of heart attacks and cardiovascular disease. As with any dietary pattern, it is important to consider the potential long-term health effects before adopting it as a long-term lifestyle change. There are many healthy dietary patterns that have been linked to a lower risk of cardiovascular disease, such as the Mediterranean diet, the DASH diet, and a whole-foods, plant-based diet, which may be better options

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