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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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California judge rules DAO members liable under partnership laws

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California judge rules DAO members liable under partnership laws

A16z Crypto’s Miles Jennings posted on X that the ruling is a “huge blow” to decentralized governance. 

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Thousands of farmers to descend on Downing Street to protest against inheritance tax changes

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Thousands of farmers to descend on Downing Street to protest against inheritance tax changes

Thousands of farmers from across the UK are expected to gather outside Downing Street today – in the biggest protest yet against the government’s changes to inheritance tax rules.

The reforms, announced in last month’s budget, will mean farms worth over £1m will be subject to 20% inheritance tax from April 2026.

Farmers say that will lead to land being sold to pay the tax bill, impact food security and the future of British farming.

The Government insists it is “committed” to the farming industry but has had to make “difficult decisions”.

Farmers from Scotland, Northern Ireland, Wales and England will arrive in London to hear speeches from agricultural leaders.

Sky News understands TV presenter and farm owner Jeremy Clarkson, Conservative Party leader Kemi Badenoch and Lib Dem leader Ed Davey will also address crowds.

Protestors will then march around Parliament Square.

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A sign in a field by the M40 near Warwick, protesting the changes to inheritance tax (IHT) rules in the recent budget. Pic: PA
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A sign in a field by the M40 near Warwick, protesting the changes to inheritance tax rules in the recent budget. Pic: PA

‘It’s really worrying’

“It’s unfortunate, as Labour had originally said they would support farmers,” said fourth-generation farmer Will Weaver, who is attending today’s rally.

His 500-acre cow and sheep farm in South Gloucestershire has been in his family since 1939.

“We’ve probably buried our head in the sand a little bit. I think, back of a fag-packet rough estimates, tax is going to be north of half a million [pounds].”

The government is keen to stress that farmers will get a decade to pay the bill – but that comes as little comfort to Will: “It’s more than our profit in any year that we’ve had in the last 10 years. Dad’s saying we’ll have to sell something. I don’t know if we’ll be able to raise that sort of money through a mortgage. It’s really worrying.”

As anger grows, there continues to be disagreement between the National Farmer’s Union and the Government over how many farms will actually be impacted by the change.

The Treasury says only the wealthiest estates, around 500 of them, will have to pay under the new rules – claiming 72% of farms won’t be impacted.

But farmers say that calculation is incorrect – citing that DEFRA’s own figures show 66% of farms are valued at over £1m and that the government has undervalued many estates.

At the same time as the rally, the NFU is addressing 1,800 of its members in Westminster before they lobby MPs.

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The president of the National Farmers’ Union says farmers are feeling

‘Understanding has been betrayed’

Max Sealy represents the NFU Dairy Board in the South of England.

“We have a detailed job to do to explain why this is wrong not just for farming, not just for the countryside and not just for our families, but for the economy in general,” he said.

“This is a bad tax – it’s been badly implemented because it will affect growth productivity in the country.”

He told Sky News Labour made promises to farmers ahead of the election.

“Both Steve Reed and Keir Starmer came to our conference two years ago and told us farming wasn’t a business like any others and that he understood the long-term nature of farming – that understanding has been betrayed,” he said.

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And the government say:

In a joint statement, Chancellor Rachel Reeves and Secretary of State for Environment, Food and Rural Affairs Steve Reed said: “Farmers are the backbone of Britain, and we recognise the strength of feeling expressed by farming and rural communities in recent weeks. We are steadfast in our commitment to Britain’s farming industry because food security is national security.

“It’s why we are investing £5bn into farming over the next two years – the largest amount ever directed towards sustainable food production, rural economic growth and nature’s recovery in our country’s history.

“But with public services crumbling and a £22bn fiscal hole that this Government inherited, we have taken difficult decisions.

“The reforms to Agricultural Property Relief ensure that wealthier estates and the most valuable farms pay their fair share to invest in our schools and health services that farmers and families in rural communities rely on.”

A Met Police spokesperson said it was “well prepared” for the protest and would have officers deployed to ensure it passes off “safely, lawfully and in a way that prevents serious disruption”.

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Fintech unicorns are watching Klarna’s debut for signs of when IPO window will reopen

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Fintech unicorns are watching Klarna's debut for signs of when IPO window will reopen

Hiroki Takeuchi, co-founder and CEO of GoCardless. 

Zed Jameson | Bloomberg | Getty Images

LISBON, Portugal — Financial technology unicorns aren’t in a rush to go public after buy now, pay later firm Klarna filed for a U.S. IPO — but they’re keeping a watchful eye on it for signs of when the market will open up again.

Last week, Klarna made a confidential filing to go public in the U.S., ending months of speculation over where the Swedish digital payments firm would list. Timing of the IPO is still unclear, and Klarna has yet to decide on pricing or the number of shares it’ll issue to the public.

Still, the development drew buzz from fintech circles with market watchers asking if the move marks the start of a resurgence in big fintech IPOs. For now, that doesn’t appear to be the case — however, founders say they’ll be watching the IPO market, eyeing pricing and eventually stock performance.

Hiroki Takeuchi, CEO of online payments startup GoCardless, said last week that it’s not yet time for his company to fire the starting gun on an IPO. He views listing as more of a milestone on a journey than an end goal.

“The markets have been challenging over the last few years,” Takeuchi, whose business GoCardless was last valued at over $2 billion, said in a CNBC-moderated panel at the Web Summit tech conference in Lisbon, Portugal.

“We need to be focused on building a better business,” Takeuchi added, noting that “the rest will follow” if the startup gets that right. GoCardless specializes in recurring payments, transactions that come out of a consumer’s bank account in a routine fashion — such as a monthly donation to charity.

Lucy Liu, co-founder of cross-border payments firm Airwallex, agreed with Takeuchi and said it’s also not the right time for Airwallex to go public. In a separate interview, Liu directed CNBC to what her fellow Airwallex co-founder and CEO Jack Zhang has said previously — that the firm expects to be “IPO-ready” by 2026.

“Every company is different,” Liu said onstage, sat alongside Takeuchi on the same panel. Airwallex is more focused on becoming the best it can be at solving friction in global cross-border payments, she said.

An IPO is a goal in the company’s trajectory — but it’s not the final milestone, according to Liu. “We’re constantly in conversations with our investors shareholders,” she said, adding that will change “when the time is right.”

‘Stars aligning’ for fintech IPOs

One thing’s for sure, though — analysts are much more optimistic about the outlook for fintech IPOs now than they were before.

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“We outlined five handles to open the [IPO] window, and I think those stars are aligning in terms of the macro, interest rates, politics, the elections are out the way, volatility,” Navina Rajan, senior research analyst at private market data firm PitchBook, told CNBC.

“It’s definitely in a better place, but at the end of the day, we don’t know what’s going to happen, there’s a new president in the U.S.,” Rajan continued. “It will be interesting to see the timing of the IPO and also the valuation.”

Fintech companies have raised around 6.2 billion euros ($6.6 billion) in venture capital from the beginning of the year through Oct. 30, according to PitchBook data.

Jaidev Janardana, CEO and co-founder of British digital bank Zopa, told CNBC that an IPO is not an immediate priority for his firm.

“To be honest, it’s not the top of mind for me,” Janardana told CNBC. “I think we continue to be lucky to have supportive and long-term shareholders who support future growth as well.”

He implied private markets are currently still the most accommodative place to be able to build a technology business that’s focused on investing in growth.

However, Zopa’s CEO added that he’s seeing signs pointing toward a more favorable IPO market in the next couple of years, with the U.S. likely opening up in 2025.

That should mean that Europe becomes more open to IPOs happening the following year, according to Janardana. He didn’t disclose where Zopa is looking to go public.

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