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
As the defending Presidents’ Trophy winners, the New York Rangers were envisioned as a playoff team again in 2024-25. As the team on top of the league standings in early December, similar words could be written about the Minnesota Wild.
And yet, heading into Wednesday night’s matchup between the clubs (7 p.m. ET, ESPN+), nothing is certain about either team’s playoff chances after the pair has gone 8-9-3 in the past 10 games apiece.
The Wild enter the game in a playoff position, and have a 91.0% chance to make the playoffs per Stathletes. A key part of that is the team’s remaining strength of schedule; their remaining opponents have a 46.0% winning percentage, which is the second-easiest path. (Only the New Jersey Devils face a weaker slate in the final stretch.)
Compare that to the Rangers, who have a 27.3% chance, and will begin this game on the outside looking in. New York’s remaining slate is considerably more difficult; a 54.1% opponents’ winning percentage ranks as the second toughest, behind only the Detroit Red Wings.
If the Wild qualify as the first wild card, their likely first-round opponent is the Vegas Golden Knights; if they land in the second wild-card position, their likely opponent is the Winnipeg Jets. Unfortunately, Minnesota went 0-3 against both teams this season.
The Rangers’ more likely outcome as a playoff entrant is as the second wild card, which earns them a matchup against the Washington Capitals; the Caps have won all three games against New York this season. The Rangers could wind up as the first wild card, earning a matchup against the Atlantic Division champ. They went 1-2 against the Toronto Maple Leafs, 0-2 against the Florida Panthers (with one more game coming up on April 14), and 0-1 against the Tampa Bay Lightning (with games coming up on April 7 and April 17).
So, the future isn’t blindingly bright in the playoffs for these teams. But all you need is a ticket in, and unexpected things can happen!
There are just over two weeks left until the season’s end on April 17, and we’ll help you track it all with the NHL playoff watch. As we traverse the final stretch, we’ll provide details on all the playoff races, along with the teams jockeying for position in the 2025 NHL draft lottery.
Points: 80 Regulation wins: 26 Playoff position: N/A Games left: 7 Points pace: 87.5 Next game: vs. LA (Thursday) Playoff chances: 0.4% Tragic number: 7
Points: 62 Regulation wins: 23 Playoff position: N/A Games left: 7 Points pace: 67.8 Next game: @ DAL (Thursday) Playoff chances: 0% Tragic number: E
Points: 51 Regulation wins: 18 Playoff position: N/A Games left: 8 Points pace: 56.5 Next game: vs. COL (Wednesday) Playoff chances: 0% Tragic number: E
Pacific Division
Points: 98 Regulation wins: 42 Playoff position: P1 Games left: 8 Points pace: 108.6 Next game: vs. WPG (Thursday) Playoff chances: 100% Tragic number: N/A
Points: 68 Regulation wins: 25 Playoff position: N/A Games left: 7 Points pace: 74.3 Next game: @ VAN (Wednesday) Playoff chances: 0% Tragic number: E
Points: 50 Regulation wins: 14 Playoff position: N/A Games left: 8 Points pace: 55.4 Next game: vs. EDM (Thursday) Playoff chances: 0% Tragic number: E
Note: An “x” means that the team has clinched a playoff berth. An “e” means that the team has been eliminated from playoff contention.
Race for the No. 1 pick
The NHL uses a draft lottery to determine the order of the first round, so the team that finishes in last place is not guaranteed the No. 1 selection. As of 2021, a team can move up a maximum of 10 spots if it wins the lottery, so only 11 teams are eligible for the No. 1 pick. Full details on the process are here. Matthew Schaefer, a defenseman for the OHL’s Erie Otters, is No. 1 on the draft board.
Duclair played 12 minutes, 15 seconds in the Islanders’ 4-1 loss to the Lightning with zero points and finished at minus-1. He had only four shifts in the third period. It was the third straight game in which Duclair played 12:15 or less. He has averaged 15:03 in ice time this season, his first with the Islanders.
“He was god-awful. He was god-awful. He had a bad game. That’s why I didn’t play him a lot. And he’s lucky to be in the lineup. Sorry if I lose it on him right now, but that’s how I feel,” Roy said.
When asked what he’s seeing in Duclair’s game, the Islanders coach said “it’s an effort thing” for the veteran forward.
“He’s not skating, he’s not competing, he’s not moving his feet. He’s not playing up to what we expect from him,” Roy said.
Duclair has seven goals and four assists in 44 games with the Islanders, skating to a minus-15. The 29-year-old winger is averaging one point per 60 minutes — which would be a career low for the 11-year veteran. Duclair signed a four-year, $14-million free agent contract with the Islanders last summer and has a full no-trade clause through 2026.
New York is winless in its past six games, struggling down the stretch while chasing the final wild-card playoff spot in the Eastern Conference. The Islanders trail the Montreal Canadiens by five points with eight games to play.
VANCOUVER, British Columbia — Vancouver Canucks center Filip Chytil may miss the rest of the season after experiencing a setback in his attempt to return from another concussion.
Coach Rick Tocchet said Tuesday that Chytil has experienced good and bad days trying to work back. The 25-year-old from the Czech Republic has not played since getting concussed when he was hit from behind by Chicago’s Jason Dickinson on March 15.
“He would go out and skate and felt good, the next day not as good,” Tocchet said. “To be honest with you guys, does he play this year? Maybe the odds are against it. Plus you don’t want to put a guy in that type of position. But when a guy has good days and bad days, obviously you’re not going to play the guy.”
Asked if there was concern about Chytil’s hockey-playing career continuing because of his concussion history, Tocchet added he was not sure.
“I talked to him today and he said it was different than his last concussion,” Tocchet said. “The bad days aren’t as bad, so that’s a positive, so I think we’ve got to take the positive approach. Plus he’s got four, five months to rebuild himself, or who knows? We’ve just got to take it day by day with this guy right now.”
Vancouver acquired Chytil in late January as part of the return for trading J.T. Miller to the New York Rangers. Chytil has already had multiple concussions in the NHL and does not turn 26 until September.
The Canucks, who are making a desperate push to make the playoffs, are also not sure about the status of center Elias Pettersson, who has not played since getting injured March 22 against the Rangers. Tocchet said Pettersson was day to day.
Captain Quinn Hughes has missed time for a lower-body injury and winger Brock Boeser was temporarily sidelined by a concussion. All-Star goalie Thatcher Demko missed training camp and the beginning of the season as he worked his way back from a rare knee injury, then went down with another injury in February.
“There’s been a lot of things that’ve hit this team,” Tocchet said. “And you’re looking for culture stuff, right? Who’s all in and who’s not. When you have a lot of guys all buying in, you can withstand some stuff.”
The odds of making a playoff run aren’t in Vancouver’s favor, but everyone on the team is staying committed, Demko said, even as injuries continue to ravage the lineup.
“I think as a group, we’ve been through a lot this year,” Demko said. “It’s obviously not an easy situation right now with some of the guys out, but I feel like our effort’s been there every game. We haven’t mailed it in, we’re not using it as an excuse. We’re showing up every night and giving it a solid effort. So really proud of the guys coming together and trying to get some wins here.