[medler]

My problem with keto is that most people on it eat so much saturated fat that their cholesterol goes through the roof, and that’s really bad for cardiovascular health.

(Keto communities deal with this by preaching an anti-science, cholesterol-denialist dogma, but that dogma has always been driven by wishful thinking).

[breck]

> My problem with keto is that most people on it eat so much saturated fat that their cholesterol goes through the roof

Dataset needed

[medler]

Here are a couple of studies:

https://www.med.ubc.ca/news/popular-keto-diet-may-be-linked-...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10121782/

[breck]

Ok, thanks for the links. I had time to read the first study you shared. Here is the link to the actual study: https://www.sciencedirect.com/science/article/pii/S2772963X2...

Positives:

- PDF is available!

- Nice formatting

- Very well written, very clear what they did

Negatives:

- Not an experiment. An observational study.

- If I'm reading correctly, they classified someone's diet mostly based on 1 single prior 24 hour food questionnaire. This is a bit...weak.

- The LCHF cohort has significant pre-existing conditions (which they do correct for, but their headline is about the non-corrected number)

- They define LCHF diets as being <100g of carbs a day, and define VLC diets as being <50g a day, but do NOT publish any results for the VLC cohort. Why not?

- They then do NOT publish their data!

- BUT if you dig into their supplementary tables, they DO report that VLCs have lower rates of ASCVD than LCHF.

- They have conflicts of interest: "Dr Brunham has served on advisory boards for Amgen, Novartis, HLS Therapeutics, and Ultragenyx. Dr Iatan has served on advisory boards for Novartis and HLS Therapeutics and receiving honoraria from Novartis and Sanofi. "

Anyway, I give that one a C-. Well executed, but looks like their hands are tied. I would not bet on its associations to reproduce in an experiment.

[medler]

We can pick apart studies all day long, but the link between saturated fat and cholesterol is hard to deny.

Were I you I would get my ApoB checked. If it’s low, then great! Keep doing what you’re doing! But don’t give yourself a heart attack following the latest fad diet.

[breck]

I appreciate the pointers.

I definitely do _not_ understand the first thing about cholesterol and adverse cardiovascular events.

Certainly high on my list of things to be able to model by the end of the year.

I have spent a fair amount of time in the lab (mostly dry, with a little bit of wet lab), so have good foundations, just that's an area I haven't had time to deep dive in yet.

[coldtea]

>My problem with keto is that most people on it eat so much saturated fat that their cholesterol goes through the roof

"In pricinple" or actually measured cholesterol levels? Because the latter doesn't happen.

[medler]

It doesn’t happen for everyone, but most people on a high-saturated-fat diet will see higher measured cholesterol levels. This has been established in many studies. And anecdotally, it happened to me when I was on a low-carb diet