Accelerated Coronary Calcification with a Ketogenic Diet: A Worrisome Case Study

Following a diet very low in the percent calories from carbohydrates while driving the calories from fat very high can induce the formation of ketone bodies, the so called ketogenic or keto diet. Originally developed as a potential strategy for refractory epilepsy, it has caught on in the public sector and is followed by many individuals. There are few studies looking at cardiovascular markers on this diet and even fewer looking at cardiac events or coronary anatomy. Concern about data from epidemiologic studies reporting on diets described as low-carbohydrate has been expressed due to an association with higher mortality rates. Recently, a metabolic ward study has described a rise in the inflammatory marker hs-CRP and total and LDL cholesterol with a 4 week ketogenic diet achieving only 5% of calories form carbohydrates.

Case Study

A 48 year-old male patient with a family history of heart disease was seen my clinic this week had unusual documentation of his serious entry into the ketogenic diet world and raises concerns over the unknown consequences of this dietary pattern.

The timeline below is presented.

2015: Physical exam total cholesterol 213, HDL 50, LDL 138, triglycerides 123, TSH 0.71, testosterone 348

December 2017: Adopted a strict ketogenic diet while tracking his calories to achieve ketosis and 5% calories from carbohydrates (<25 grams daily) eating…