Popiolek-Kalisz also noted that a person’s lipid profile is influenced by their carbohydrate intake. With this in mind, she wrote, keto diets have been shown to increase levels of total cholesterol, LDL cholesterol, HDL cholesterol and apolipoprotein B in normal-weight individuals. In obese individuals, meanwhile, the keto diet may help lower total cholesterol or triglyceride levels, but it does not make a significant impact in either direct for HDL or LDL cholesterol levels.
“Lower intake of carbohydrates in ketogenic diets can lead to triglyceride levels reduction, however, significantly increased levels of LDL were also noted,” Popiolek-Kalisz wrote. “What is more, the positive effects of the ketogenic diet on triglyceride levels seem to diminish in longer observations.”
A similar impact is seen on glucose levels and blood pressure. Some studies have found that keto diets may reduce a person’s hemoglobin A1C test levels, for example, but “this effect fades in longer observations.” And while reducing carbohydrate intake can help diabetic patients decrease their systolic blood pressure, the impact appears to fade somewhere between six and 12 months.
“One of the possible reasons for the short-term effect of the ketogenic diet on blood pressure can be increased diuresis as a result of ketosis and rapid weight loss,” Popiolek-Kalisz wrote.
Should heart patients consider the keto diet?
One of the key takeaways from this new analysis is that heart patients appear to be poor candidates for the keto diet.
From a nutritional perspective, keto diets are typically high in saturated fatty acids, red meat and processed foods, which heart-healthy diets limit. Keto diets are also typically low in wholegrain products, fruits and vegetables, three things that heart-healthy diets make a priority.
In addition, Popiolek-Kalisz wrote, individuals on a keto diet typically discontinue the use of SGLT-2 inhibitors, which are regularly prescribed to heart failure patients.
“The last concern, also important for elderly patients, is initial dehydration due to elevated diuresis resulting from ketosis,” Popiolek-Kalisz added. “In elderly patients, this could lead to orthostatic hypotonia, which should be also taken into consideration.”
Click here to read the full analysis.