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By Bhavana Kunkalikar Apr 27 2023 Reviewed by Lily Ramsey, LLM

In a recent study published in the American Journal of Preventive Cardiology, researchers explored the impact of ketogenic dieting on low-density lipoprotein (LDL) cholesterol levels.

Study:  Dramatic elevation of LDL cholesterol from ketogenic-dieting: A Case Series . Image Credit: SewCreamStudio/Shutterstock.com Background

Due to the escalating obesity levels, the ketogenic (keto) diet has been studied as a potential remedy for overweight patients' deteriorating weight gain, cardiovascular outcomes, and insulin resistance.

Though popular as a comparatively safe, non-pharmaceutical therapy, the long-term effects of the keto diet for weight loss are not fully understood, and most professional medical societies do not advise this regimen.

Some individuals on a ketogenic diet may experience a significant rise in low-density lipoprotein (LDL) cholesterol levels due to its high saturated fatty acid content. About the study

In the present study, researchers described a cohort of patients whose LDL-cholesterol levels rose to an unprecedented level after beginning a ketogenic diet.

The team evaluated medical records of patients who presented to Cardiology for a hyperlipidemia diagnosis after lipid panel blood work revealed an LDL cholesterol level of 190 mg/dL or more. The charts of these patients were cross-referenced to involve the words "keto" or "ketogenic".

The physician's notes were manually inspected for the patient's dietary routines to confirm that these terms were correctly applied. Almost 17 patients consuming a high-fat, low-carbohydrate diet (called the ketogenic diet) were detected and evaluated via chart review.  Results

Eleven patients were male, and six were female. The mean age at hyperlipidemia assessment was 46 years. The ethnicity of 14 patients was Caucasian, while one was Lebanese, one was Asian, and one was Hispanic.

Two patients reported a history of documented coronary artery disease, one had prior ST-elevation myocardial infarction (STEMI), and another reported coronary artery calcifications. Also, ten patients revealed a family history of hyperlipidemia and atherosclerotic coronary disease. Three patients fulfilled the criteria for familial hyperlipidemia established by the Dutch Lipid Clinic Network. Related StoriesNew VA Medical Center program to help veterans with atherosclerotic cardiovascular diseaseReversing infertility in sterile mice by reducing high-circulating cholesterol with a bacterial proteinLDL cholesterol levels reduced by oral PCSK9 inhibitor in phase 2 trial

The patient's body-mass index (BMI) ranged from 14.83 to 43.87 kg/m2, averaging 27 kg/m2. Only one patient had xanthelasmas, while the others did not. No patients displayed additional physical manifestations of hyperlipidemia, such as tendinous xanthomas or corneal arcus.

The cohort's average LDL cholesterol at baseline was 129 mg/dL. Almost three patients presented with no basal LDL cholesterol levels before recruitment. During an average of 12.3 months on a low-carbohydrate and high-fat diet, the mean LDL cholesterol was 316 mg/dL.

Thirteen patients who stopped dieting and received a lipid panel after almost nine months had an average LDL cholesterol level of 142.7 mg/dL. Seven of these thirteen patients who underwent follow-up laboratory testing could change their LDL cholesterol through dietary modification alone without altering their exercise routine. Statin medications were prescribed to eight patients. At follow-up, one of the patients continued the ketogenic regimen.

In seven and ten patients, Apolipoprotein A1 (Apo A1) and Apo B were collected, respectively. The mean Apo A1 concentration was 149.4 mg/dL, and the mean Apo B concentration was 191 mg/dL.

Furthermore, no acute atherosclerotic cardiovascular disease (ASCVD) events have been recorded while these patients were on the ketogenic diet. Five patients were evaluated genetically for familial hypercholesterolemia. Two patients were discovered to have an LDL-R gene mutation. Conclusion

The study findings showed patients who followed the ketogenic diet for 12.3 months displayed a mean elevation in LDL cholesterol of 187 mg/dL, accounting for a 245% increase.

When patients stopped consuming the ketogenic regimen, their LDL cholesterol levels were reduced by a mean of 174 mg/dL, or 220%. Further research is necessary to comprehend this heightened response's causes and long-term medical importance. Journal reference:

Schmidt, T. et al. (2023) "Dramatic elevation of LDL cholesterol from ketogenic-dieting: A Case Series", American Journal of Preventive Cardiology, 14, p. 100495. doi: 10.1016/j.ajpc.2023.100495.https://www.sciencedirect.com/science/article/pii/S2666667723000363?via%3Dihub

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Counter-terrorism police investigating after two women injured in Leeds

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Counter-terrorism police investigating after two women injured in Leeds

Counter-terrorism police are investigating after an incident involving a crossbow and a firearm left two women injured in Leeds.

Police were called to Otley Road at 2.47pm on Saturday to reports of a “serious incident involving a man seen with weapons”, West Yorkshire Police said.

Officers arrived at the scene to find two women injured – and a 38-year-old man with a self-inflicted injury. All three were taken to hospital, with the man held under arrest, but their injuries are not believed to be life-threatening.

“Two weapons have been recovered from the scene, which were a crossbow and a firearm,” Counter Terrorism Policing North East said in a statement.

The incident happened on the ‘Otley Run’ pub crawl, with one venue saying it was closed for the evening due to “unforeseen circumstances”.

Officers guard one of the crime scenes in Leeds
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Officers guard one of the crime scenes

Officers inside the cordon in Leeds
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Officers inside the cordon in Leeds

Counter Terrorism Policing’s statement added: “Due to the circumstances surrounding the incident, Counter Terrorism Policing North East have taken responsibility for leading the investigation with the support of West Yorkshire Police.

“Extensive enquiries continue to establish the full circumstances and explore any potential motivation.”

Home Secretary Yvette Cooper described it as a “serious violent incident” and said she was being kept updated by police.

“Thank you to the police and emergency services for their swift response,” she said. “My thoughts are with the victims and all those affected by this attack.”

This breaking news story is being updated and more details will be published shortly.

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Wrexham promoted for third season in a row under Ryan Reynolds and Rob McElhenney

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Wrexham promoted for third season in a row under Ryan Reynolds and Rob McElhenney

Wrexham AFC have been promoted for the third season in a row.

The North Wales-based side has gone from the National League to the Championship in just three seasons, under its Hollywood owners Ryan Reynolds and Rob McElhenney.

Wrexham were second in the table and had a run of eight games unbeaten ahead of their match against Charlton Athletic on Saturday, which they won 3-0.

Wrexham's James McClean lifts the trophy after the Sky Bet League One match at SToK Racecourse, Wrexham. Picture date: Saturday April 26, 2025.
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Wrexham’s James McClean lifts the League One trophy. Pic: PA

Wrexham's Dan Scarr celebrates with the fans on the pitch after Wrexham won promotion to the Sky Bet Championship after the Sky Bet League One match at SToK Racecourse, Wrexham. Picture date: Saturday April 26, 2025. PA Photo. See PA story SOCCER Wrexham. Photo credit should read: Martin Rickett/PA Wire...RESTRICTIONS: EDITORIAL USE ONLY No use with unauthorised audio, video, data, fixture lists, club/league logos or "live" services. Online in-match use limited to 120 images, no video emulation. No use in betting, games or single club/league/player publications.
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Wrexham’s Dan Scarr celebrates with the fans on the pitch after Wrexham won promotion to the Championship. Pic: PA

It is the first time any club has been promoted for three consecutive seasons within the top five tiers of English football.

The third oldest association football club in the world, Wrexham AFC was bought by Reynolds and McElhenney in 2020, and has since been the subject of a Disney+ documentary, Welcome To Wrexham.

Reynolds, wearing a Wrexham sweatshirt, and McElhenney were pictured celebrating each goal, and after the game, as the fans came onto the pitch at the SToK Cae Ras (Racecourse Ground) to celebrate the victory with the players.

Wrexham co-owners Rob McElhenney (left) and Ryan Reynolds (right) and Ryan's wife Blake Lively before the Sky Bet League One match at SToK Racecourse, Wrexham. Picture date: Saturday April 26, 2025.
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Wrexham co-owners Rob McElhenney (L) and Ryan Reynolds and Ryan’s wife Blake Lively, before the match. Pic: PA

Both stars came onto the pitch after the supporters returned to the stands.

More on Ryan Reynolds

Speaking to Sky Sports, McElhenney praised those behind the scenes, referring to “so many that don’t get the credit they deserve, people who aren’t talked about”.

Reynolds said bringing success back to the club “seemed like an impossible dream” when they arrived in North Wales in 2020.

Wrexham's Sam Smith celebrates in front of the fans on the pitch after Wrexham won promotion to the Sky Bet Championship after the Sky Bet League One match at SToK Racecourse, Wrexham. Picture date: Saturday April 26, 2025. PA Photo. See PA story SOCCER Wrexham. Photo credit should read: Martin Rickett/PA Wire...RESTRICTIONS: EDITORIAL USE ONLY No use with unauthorised audio, video, data, fixture lists, club/league logos or "live" services. Online in-match use limited to 120 images, no video emulation. No use in betting, games or single club/league/player publications.
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Wrexham’s Sam Smith celebrates in front of the fans after Wrexham won promotion to the Championship. Pic: PA

He put the three promotions down to “the coaching staff, the greatest dressing room” and an “all for one, one for all” attitude throughout the club, adding he was “speechless with their commitment and their emotion”.

As for the mouth-watering prospect of another promotion to the promised land of the Premier League, the pair agreed it was “for tomorrow”, before ending the interview with a joint mic-drop.

Veteran striker Steven Fletcher said, “as soon as I came to this club, I knew it was something special. We want to go again. We’ll reset in the summer, take a break and go again”.

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Direct action group Just Stop Oil holds final protest, claiming it has been ‘successful’

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Direct action group Just Stop Oil holds final protest, claiming it has been 'successful'

“It has been a success.”

Just Stop Oil (JSO) insists it’s been “successful” – as its members ceremoniously hang up their orange high-vis vests during a march in central London.

Since the group formed three years ago, it’s drawn attention and criticism for its colourful, controversial protests, which ranged from disrupting sporting events to throwing soup on Vincent van Gogh’s Sunflowers, and climbing on gantries over the M25. It sprayed orange paint over Stonehenge, and cost police forces tens of millions of pounds.

Those days are now behind it; to the relief of many.

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As a few hundred activists marched through London on Saturday, blocking roads as they went; taxi drivers blared their horns and football fans shouted abuse from the pavement.

The PA News Agency filmed the moment a white minivan seemed to drive towards a group of protesters blocking the road.

Protesters shouted “I’m being pushed back!” to police, while the driver could be heard shouting “What about my right to get home?” to the officers gathered.

But JSO never set out to be popular. And it believes its tactics – though hated – have been successful; thanks to the new Labour government’s commitment to not issue new oil or gas exploration licences.

That’s why, it says, its ceasing direct action.

JSO hangs up its high vis jackets in central London on Saturday
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JSO hangs up its high-vis jackets in central London on Saturday

A washing line of high-vis jackets signifies JSO's disbanding
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A washing line of high-vis jackets signifies JSO’s disbanding

“This moment marks the success of the JSO campaign – our demand was to end new oil and gas licences and that is now government policy.

“As a result of which four billion barrels of oil are being kept under the North Sea. The campaign has reached a natural end.”

Dr Oscar Berglund, senior lecturer in international public and social policy, disagrees that JSO is disappearing because it’s been “successful”.

He told Sky News policing strength and public perception might have more to do with it.

“They have very low levels of popularity. About 17% of the British population are kind of broadly supportive of what Just Stop Oil do. And that’s too low to recruit.

“It’s difficult to recruit members to something that is that unpopular, and then that a lot of people for good reason I think have kind of stopped believing in that kind of disruption as a means to achieve meaningful change.”

Group triggers specific new protest laws

One thing it did change is the law.

Policing commentator Graham Wettone tells us: “Obstruction of the highway, obstruction of rail networks for example, these are specific offences now.

“It’s given the police more tactics, more methods, more offences they can consider, even stopping and searching somebody who may have something to either lock themselves on or glue themselves to something.”

A JSO activist holds a picture of an imprisoned colleague
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A JSO activist holds a picture of an imprisoned colleague

Emma Smart was held in prison for her activism with both Insulate Britain and Just Stop Oil.

“The high-vis might be going away,” she tells me, “but we aren’t.”

“These people aren’t going anywhere, we are still committed, dedicated, terrified by the failings of this government and governments around the world.”

JSO activists throw orange paint at van Gogh's sunflowers
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JSO activists throw orange paint at van Gogh’s sunflowers

Orange smoke set off by JSO protesters at Stonehenge
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Orange smoke set off by JSO protesters at Stonehenge

She hopes for a time of reflection before it returns in a new form but says the need for climate activism is stronger than ever.

She also believes that while most people dislike JSO tactics, it still raises awareness of the cause and might even push people to more moderate campaign groups.

Just Stop Oil came behind other, similarly controversial climate campaign groups like Insulate Britain and Extinction Rebellion, and as it says goodbye, its disruptive methods have been seized upon by other organisations like the Pro-Palestinian Youth Justice.

The infamous Just Stop Oil orange vests might be going away, but the individual activists, their cause and campaign tactics feel here to stay.

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