Ketogenic Diet Study Insights by Dr. Budoff

Oct 21, 2024

Lecture Notes: Discussion with Dr. Budoff

Introduction

  • Dr. Budoff's study is currently ongoing and more than halfway enrolled.
  • The data is exciting but preliminary.
  • Importance of maintaining normal healthcare and relationships with physicians.

Study Focus

  • Investigating individuals on a ketogenic diet rich in saturated fats, high animal protein, low fiber.
  • Participants have LDL cholesterol in the top percent of U.S. population, posing high cardiac risk.

Participant Demographics

  • Total Participants: 64
  • Average Age: 53 years
  • Age Distribution: Two-thirds are 50 and older
  • Gender: 66% male

LDL Cholesterol Levels

  • Before Diet: Mean LDL of 135
  • Current Mean LDL: 233, in the top 10% of the top 1% in the U.S.
  • Duration on Diet: On average, 4 years

Key Findings

  • Despite high LDL levels, two-thirds have calcification of zero and no total plaque score.
  • Detection Method: Coronary calcium scan plus CT angiogram.
  • Remaining third have plaque scores between 1 and 8 (maximum possible score: 45).
  • Participants mostly show low risk of atherosclerosis.

Exclusions and Observations

  • Excluded patients with diabetes and other risk factors.
  • Low levels of risk were observed despite high LDL levels.
  • Found one participant with heterozygous FH; excluded from study.

Implications for Lipid Energy Model

  • Supports the metabolic-centric model for understanding lipid levels.
  • Highlights the need for confirmatory studies to solidify findings.

Future Research Directions

  • Possibility of expanding research to larger groups and longer durations.
  • Emphasizes need for confirmatory studies.
  • Encourages continued participation to achieve full cohort enrollment.

Comparison with Miami Heart Study

  • Miami Heart Study uses a similar methodology for CT and calcium scanning.
  • Offers parallel data for comparison, excluding high LDLs from ketogenic diet or FH.
  • Aims to assess the prevalence of plaque in similar populations and the role of LDL in cardiovascular risk.

Takeaways

  • 🎓 The study focuses on 64 participants with high LDL cholesterol on a ketogenic diet, currently over half enrolled.
  • 🩺 Participants are advised to continue regular healthcare and consult their doctors, emphasizing the study's preliminary nature.
  • 🍖 The ketogenic diet typically involves high saturated fats and low fiber, raising concerns about heart health due to high LDL levels.
  • 📊 Despite an average LDL level of 233, two-thirds of participants show zero calcification and no detectable plaque, indicating low cardiovascular risk.
  • 🚨 Only one participant in the study had a genetic predisposition (heterozygous familial hypercholesterolemia), surprising given the high LDL levels.
  • 🔬 Ongoing research aims to confirm findings; a larger confirmatory study is suggested to solidify results and conclusions.
  • 🌍 Miami Heart study comparisons will help contextualize data and assess cardiovascular risks associated with LDL levels in similar populations.
  • 📅 Continued enrollment is vital for robust data to provide clearer insights into the long-term effects of the ketogenic diet on heart health.