Research

Macro partitioning

Adherence to a ketogenic-like diet (KLD) results in a transient increase in LDL cholesterol but a sustained improvement in the triglyceride-to-HDL ratio (log(TG/HDL)), indicating a shift toward a less atherogenic LDL profile compared to ultra low-fat diets (ULF).

If you follow a very low-carb diet and see your LDL cholesterol rise, do not automatically assume your heart risk has increased. Look at your Triglyceride-to-HDL ratio; if it has improved significantly, it suggests your LDL particles have become larger and less harmful, which is a positive metabolic shift. Maintain your diet quality by minimizing added sugars and refined grains.

ModerateQualifiesMEDIUM confidence
KLD resulted in a transient but significantly greater increase in LDL-C at 3-months with a concomitant significantly greater reduction in the log(TG/HDL)... At 12-months, LDL-C was similar for KLD and ULF, whereas KLD maintained significantly greater improvements in log(TG/HDL) compared to ULF.
Lucia Aronica et al. · Frontiers in Nutrition · 2023

Why this rating

Secondary analysis of a subset of participants (n=18 vs n=21) from a larger RCT; self-reported dietary data; small sample size limits generalizability.

Source

Weight, insulin resistance, blood lipids, and diet quality changes associated with ketogenic and ultra low-fat dietary patterns: a secondary analysis of the DIETFITS randomized clinical trial

Lucia Aronica et al. · Frontiers in Nutrition · 2023

DOI 10.3389/fnut.2023.1220020

rct · n=609Cited 11×
Read the paper
DOI resolved against Crossref · corpus check 2026-06-10

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