The Significant Impact of High-Fat, Low-Carbohydrate Ketogenic Diet on Serum Lipid Profile and Atherosclerotic Cardiovascular Disease Risk in Overweight and Obese Adults

Background and objectives
Overweight and obesity are becoming more commonplace globally. The ketogenic diet (KD), also known as
the high-fat, low-carbohydrate diet, has become increasingly popular in recent years as a means to lose
weight quickly. This present study aims to examine the clinical effects of ketogenic diets in individuals who
are obese or overweight by evaluating or assessing variations in metabolic parameters associated with lipid
control, the risk of atherosclerotic cardiovascular disease, and other kidney risk indicators.
Methods and subjects
This observational case-control research involved 250 individuals in total and was conducted from May 2023
to January 2024. Of these, 158 were on a ketogenic diet, and 92 adults not following any type of diet were
chosen to serve as controls. The biochemistry parameters of the kidney function test and lipid profile were
measured for the two comparing groups. Data were analyzed for statistical significance using the Student ttest, Mann-Whitney U test, and one-way analysis of variance (ANOVA), followed by a post hoc test (least
significant difference (LSD)). Chi-square tests were employed in the analysis to compare proportions.
Results
Out of 250 participants, there was a 20-80 age range, with their median age being 40 years old. The two
comparing groups' lipid profiles were very different from one another; the cardiovascular risk (triglyceride
(TG)/high-density lipoprotein (HDL)), total cholesterol, low-density lipoprotein (LDL), and triglyceride
levels were all greater in the KD group when compared to the non-KD group. The mean LDL cholesterol
(LDL-C) of the normal-weight participants was 56 mg/dL (p=0.079). Thereafter, it experienced a significant
rise to 97.58 mg/dL and 108.2 mg/dL in those individuals who were overweight and obese, respectively
(p<0.020).
Conclusions
As obesity rates in the populace keep rising, dietary fads such as the ketogenic diet are gaining traction.
Although they could help with weight loss, this study had a notable observation of severe
hypercholesterolemia and increased risk of atherosclerotic cardiovascular disease among the ketogenic diet
participants. Additional research is necessary to ascertain if a ketogenic diet can be sustained over the long
term and how it affects endpoints that are more clinically significant, such as morbidity and mortality due to
obesity.