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The keto diet has been a popular weight-loss trend for a while now, but new research has emerged that suggests that it may have some serious negative consequences for heart health. According to a recent study presented at the American College of Cardiology’s Annual Scientific Session, following a low-carb, high-fat “keto-like” diet may be linked to higher levels of “bad” cholesterol and double the risk of cardiovascular events such as blocked arteries, heart attacks, and strokes.

The study defined a low-carb, high-fat (LCHF) diet as 45% of total daily calories coming from fat and 25% coming from carbohydrates. The researchers compared the diets of 305 people eating an LCHF diet with about 1,200 people eating a standard diet, using health information from the United Kingdom database UK Biobank, which followed people for at least a decade.

The researchers found that people on the LCHF diet had higher levels of low-density lipoprotein, also known as LDL, cholesterol and apolipoprotein B, a protein that coats LDL cholesterol proteins and can predict heart disease better than elevated levels of LDL cholesterol can. The researchers also noticed that the LCHF diet participants’ total fat intake was higher in saturated fat and had double the consumption of animal sources (33%) compared to those in the control group (16%). After an average of 11.8 years of follow-up – and after adjustment for other risk factors for heart disease, such as diabetes, high blood pressure, obesity, and smoking – people on an LCHF diet had more than two times higher risk of having several major cardiovascular events.

The researchers said that their study “can only show an association between the diet and an increased risk for major cardiac events, not a causal relationship,” because it was an observational study. However, their findings are worth further study, “especially when approximately 1 in 5 Americans report being on a low-carb, keto-like or full keto diet.”

The keto diet has been around since the 1920s when a doctor stumbled on it as a way of controlling seizures in children with epilepsy who didn’t respond to other treatment methods. 

Low-carb diets like keto rely heavily on fats to fill you up. At least 70% of the keto diet will be made up of fat; some say it’s more like 90%. While you can get all that fat from healthy unsaturated fats such as avocados, tofu, nuts, seeds, and olive oil, the diet also allows saturated fats like lard, butter, and coconut oil, as well as whole-fat milk, cheese, and mayonnaise. Eating lots of foods high in saturated fat increases the body’s production of LDL cholesterol, which can build up inside the arteries and restrict blood flow to the heart and brain.

Most health experts say the trendy keto diet, which bans carbohydrates to make your body burn fat for fuel, cuts out healthy food such as fruit, beans and legumes, and whole grains. In the keto diet, you limit your intake of carbohydrates to only 20 to 50 a day – the lower, the better. To put that into perspective, a medium banana or apple is around 27 carbohydrates – the full day’s allowance. “Those food groups that have to be eliminated to achieve ketosis are major sources of fiber in the diet, as well as many important nutrients, phytochemicals, and antioxidants. This is of concern to many health professionals who consider the VLCD or ketogenic diet to be harmful for long-term health,” says Christopher Gardner, a research professor of medicine at the Stanford Prevention Research Center who has conducted clinical trials on the keto diet.

So, while the keto diet may help you lose weight in the short term, it’s important to be aware of the potential risks it poses to your heart health. If you’re looking to make sustainable dietary changes for your health, consider incorporating more whole foods, fruits, vegetables, and whole grains into your diet, while limiting your intake of processed and high-fat foods. Your heart will thank you for it.

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