Associations Between Consumption of Ketogenic Diets and Serum Lipoproteins

Paleolithic dietary regime (Paleo diet) has attracted wide public attention in the past few years because of its putative health benefits. This regime differs from other, guideline- recommended dietary patterns. According to the Paleo diet, grains, dairy and industrial nutritional products should be avoided. A few recently published studies indicate that Paleo diet is associated with decreased levels of mean total cholesterol, LDL-cholesterol and triglycerides, and increased HDL-cholesterol, independent of changes in body weight. In a systemic review published recently, authors concluded that the Paleolithic diet resulted in greater short-term improvements in metabolic components, yet they declare that the available data warrant additional evaluations of the health benefits.

While following relatively healthy adults who chose to adopt the Paleo diet (or similar ketogenic diets), we observed unusual elevations in LDL-cholesterol levels in some.

Methods: We examined the association between nutritional intake and metabolic parameters in patients on ketogenic diets. All participants were asked to fill a validated food frequency questionnaire. We obtained lipid profiles at baseline and post initiation of the ketogenic diet.

Results: Eleven Participants (mean age 47 (37-66), 56% women, all non-smokers) followed a ketogenic diet for a mean period of 3 months LDL-cholesterol levels increased by an average of 93% (120 vs. 232 mg/dL, p=0.04, range of on-diet LDL-cholesterol 91-625 mg/dL) HDL- cholesterol levels increased by 26% (54 vs. 68, p=0.04. Participants consumed an average of 20% protein, 44% fat and 36% carbohydrates with a total daily average of 2048 k/cal. We found no correlation between macronutrients and changes in lipid profile.

Conclusions: We found elevated LDL-cholesterol comparable to Familial cholesterolemia. Further research examining the extreme elevation in LDL-cholesterol following consumption of a paleo diet, in larger populations and for a longer period of time, is warranted.