(P22-028-24) Impact of an 8-Week Well-Formulated Ketogenic Diet on Advanced Lipid Biomarkers Associated With Atherosclerotic Cardiovascular Disease Risk in Healthy Adults

Objectives: This study investigated the impact of an 8-week well-formulated ketogenic diet (WFKD), a ketogenic diet comprised of nutrient-dense foods, on biomarkers indicative of atherosclerotic cardiovascular disease (ASCVD) risk in healthy, community dwelling adults.

Methods: This single-arm, pilot trial recruited 20 non-smokers aged 30-55 in the US for an 8-week WFKD diet intervention. A registered dietitian provided support and continuous education for 8 weeks using a standardized WFKD manual. Mean changes in total cholesterol (TC), LDL-cholesterol (LDL-C), small dense LDL-cholesterol (LDL-small), HDL-cholesterol (HDL-C), Apolipoprotien B-100 (ApoB), triglycerides (TGs) and non-HDL cholesterol (non-HDL-C) from baseline to 8-weeks were analyzed using paired samples t-tests within the total and compliant samples. Compliance was defined as a serum beta-hydroxybutyrate result of 0.5 mmol/L or greater.

Results: Within the total sample (n=19; 43.3 ± 7.8 years; 73.7% females; body mass index (BMI) 27.5 ± 3.67kg/m²), ApoB (12.7 ± 14.72, p=0.001), TC (20.1 ± 38.89, p=0.04), and LDL-C (25.2 ± 27.29, p< 0.001) increased while body weight (-3.4 ± 2.63, p< 0.001) decreased. There was no difference in LDL-small (16.6 ± 98.44, p=0.47), HDL-C (-4.3 ± 13.20, p=0.17), TGs (-12.3 ± 38.48, p=0.18), or non-HDL-C (27.8 ± 36.09, p=0.18). Among compliant participants (n=16; 43.2 ± 8.5 years; 68.8% females; BMI 27.3 ± 3.43), ApoB (14.4 ± 15.14, p=0.002), TC (24.6 ± 40.09, p=0.03), LDL-C (26.9 ± 29.20, p=0.002), and non-HDL-C (30.7 ± 38.64, p< 0.001) increased. Body weight (-3.9 ± 2.58, p< 0.001) decreased. There was no change in LDL-small (19.6 ± 106.21, p=0.47), HDL-C (-4.2 ± 12.95, p=0.22), or TGs (-7.9 ± 38.68, p=0.43).

Conclusions: During an 8-week WFKD, healthy adults showed an increase in ApoB-carrying lipoproteins and LDL-C content, but not the number of highly atherogenic LDL-small particles or TGs. Advanced lipid panel biomarkers should be considered in personalized nutrition when using a WFKD, and larger populations should be investigated to understand the impact of genetic factors and diet quality further.

Funding Sources: This study was funded by the KUMC School of Health Professions Pilot Award grant and supplemented by the KUMC PhD Student Research Award.