r/ketoscience Apr 07 '25

Citizen Science Plaque Begets Plaque, ApoB Does Not: Longitudinal Data From the KETO-CTA Trial

40 Upvotes

Abstract

Background

Changes in low-density lipoprotein cholesterol (LDL-C) among people following a ketogenic diet (KD) are heterogeneous. Prior work has identified an inverse association between body mass index and change in LDL-C. However, the cardiovascular disease risk implications of these lipid changes remain unknown.

Objectives

The aim of the study was to examine the association between plaque progression and its predicting factors.

Methods

One hundred individuals exhibiting KD-induced LDL-C ≥190 mg/dL, high-density lipoprotein cholesterol ≥60 mg/dL, and triglycerides ≤80 mg/dL were followed for 1 year using coronary artery calcium and coronary computed tomography angiography. Plaque progression predictors were assessed with linear regression and Bayes factors. Diet adherence and baseline cardiovascular disease risk sensitivity analyses were performed.

Results

High apolipoprotein B (ApoB) (median 178 mg/dL, Q1-Q3: 149-214 mg/dL) and LDL-C (median 237 mg/dL, Q1-Q3: 202-308 mg/dL) with low total plaque score (TPS) (median 0, Q1-Q3: 0-2.25) were observed at baseline. Neither change in ApoB (median 3 mg/dL, Q1-Q3: −17 to 35), baseline ApoB, nor total LDL-C exposure (median 1,302 days, Q1-Q3: 984-1,754 days) were associated with the change in noncalcified plaque volume (NCPV) or TPS. Bayesian inference calculations were between 6 and 10 times more supportive of the null hypothesis (no association between ApoB and plaque progression) than of the alternative hypothesis. All baseline plaque metrics (coronary artery calcium, NCPV, total plaque score, and percent atheroma volume) were strongly associated with the change in NCPV.

Conclusions

In lean metabolically healthy people on KD, neither total exposure nor changes in baseline levels of ApoB and LDL-C were associated with changes in plaque. Conversely, baseline plaque was associated with plaque progression, supporting the notion that, in this population, plaque begets plaque but ApoB does not. (Diet-induced Elevations in LDL-C and Progression of Atherosclerosis [Keto-CTA]; NCT05733325)

Graphical Abstract

Soto-Mota, A, Norwitz, N, Manubolu, V. et al. Plaque Begets Plaque, ApoB Does Not: Longitudinal Data From the KETO-CTA Trial. JACC Adv. null2025, 0 (0) .

https://doi.org/10.1016/j.jacadv.2025.101686

Full paper https://www.jacc.org/doi/10.1016/j.jacadv.2025.101686

Video summary from Dave Feldman https://www.youtube.com/watch?v=HJJGHQDE_uM

Nick Norwitz summary video https://www.youtube.com/watch?v=a_ROZPW9WrY. and text discussion https://staycuriousmetabolism.substack.com/p/big-news-the-lean-mass-hyper-responder


r/ketoscience Sep 09 '24

News, Updates, Companies, Products, Activism relevant to r/ks A new LowCarb friendly non-profit has been created called the American Diabetes Society. I just created a new subreddit called r/ADSorg -- Transform Diabetes Care with the American Diabetes Society

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47 Upvotes

r/ketoscience 4h ago

Cancer Creatine supplementation enhances anti-tumor immunity by promoting adenosine triphosphate production in macrophages (2025)

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frontiersin.org
7 Upvotes

r/ketoscience 4h ago

Meatropology - Human Evolution, Hunting, Anthropology, Ethno Present-day admixed genomes reveal prehistoric adaptation to cold, maritime diet, and local pathogens in Patagonia (2025)

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2 Upvotes

r/ketoscience 22h ago

Disease The Interplay between the Gut and Ketogenic Diets in Health and Disease

3 Upvotes

Abstract

The gut plays a central role in translating dietary signals into systemic health effects, making it a key mediator of the ketogenic diet (KD), a high fat, low carbohydrate regimen. This review synthesizes current knowledge on the interaction between the KD and the gut, emphasizing gut-mediated mechanisms as an interface between dietary interventions and systemic health outcomes, spanning gastrointestinal to neurological health. Topics address gut physiology (gut digestion and absorption, epithelial nutrient sensing, gut motility), intestinal immunity (covering innate, adaptive, and antiviral responses), and extracellular to intracellular processes (i.e. mitochondrial function, stem cell fate, and intestinal circadian rhythm). Special focus is given to the gut microbiome, including both bacterial and fungal communities and how the KD modulates them in conditions such as epilepsy, obesity, traumatic brain injury, and multiple sclerosis. Innovative methods for tailoring the KD, including the use of alternative formulations, ketone esters, and microbiome-focused interventions such as prebiotics and probiotics are examined. Strategies to maximize the diet’s benefits while reducing potential side effects are considered. Together, these insights herein offer a comprehensive framework for understanding the interactions between the KD and the gut, a prerequisite

Mu, Chunlong, Jong M. Rho, and Jane Shearer. "The Interplay between the Gut and Ketogenic Diets in Health and Disease." Advanced Science (2025): e04249.

https://advanced.onlinelibrary.wiley.com/doi/pdf/10.1002/advs.202504249


r/ketoscience 1d ago

Metabolism, Mitochondria & Biochemistry Gene-diet interactions help regulate the body’s daily rhythms

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2 Upvotes

r/ketoscience 1d ago

Central Nervous System Dietary Patterns and Brain Aging: Enthusiasm Before Evidence? (2025)

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0 Upvotes

r/ketoscience 1d ago

Obesity, Overweight, Weightloss Metrics of glycemic control but not body weight influence flavor nutrient conditioning in humans (2025)

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1 Upvotes

r/ketoscience 1d ago

Other How Subtle Bacterial Shifts Keep Gut Inflammation at Bay

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1 Upvotes

r/ketoscience 2d ago

Obesity, Overweight, Weightloss Integrated proteomic and metabolomic profiling identifies distinct molecular signatures and metabolic pathways associated with obesity and potential targets for anti-obesity therapies (2025)

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2 Upvotes

r/ketoscience 2d ago

Metabolism, Mitochondria & Biochemistry The gut microbiota changed by ketogenic diets contribute to glucose intolerance rather than lipid accumulation

4 Upvotes

The ketogenic diet (KD) is a popular option for managing body weight, though its influence on glucose and lipid metabolism was still inconclusive. Gut microbiota is modulated by dietary pattens and has been associated with the changes of metabolic homeostasis induced by KD. Here, we found that two types of KDs, KD1 (8.8% carbohydrate, 73.4% fat, 17.9% protein, 5.7 kcal/g) and KD2 (0.4% carbohydrate, 93.2% fat, 6.4% protein, 6.7 kcal/g), induced changes of gut microbiota and its metabolites, contributing to glucose intolerance but not lipid accumulation in mice. Following a 2-week intervention with KDs, mice fed on KD1 displayed symptoms related to obesity, whereas KD2-fed mice exhibited a decrease in body weight but had severe hepatic lipid accumulation and abnormal fatty acid metabolism, while both KDs led to significant glucose intolerance. Compared to the mice fed on a standard chow diet, the conventional mice fed on both KD1 and KD2 had significant shifted gut microbiota, lower levels of short chain fatty acids (SCFAs) and composition alteration of cecal bile acids. By using an antibiotic cocktail (ABX) to deplete most of the gut microbiota in mice, we found the disturbances induced by KDs in lipid metabolism were similar in the ABX-treated mice to their conventional companions, but the disturbances in glucose metabolism were absent in the ABX-treated mice. In conclusion, these findings suggest that ketogenic diets disrupted glucose and lipid metabolism, at least in mice, and highlight the gut microbial culprits associated with KD induced glucose intolerance rather than lipid accumulation.

W Li, M Gong, Z Wang, H Pan, Y Li, C Zhang Frontiers in Endocrinology, 2024•frontiersin.org

https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2024.1446287/pdf


r/ketoscience 3d ago

Lipids Dehydration promotes intracellular lipid synthesis and accumulation (2025)

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9 Upvotes

r/ketoscience 2d ago

Metabolism, Mitochondria & Biochemistry Proteostasis and Unfolded Protein Response Dynamics in Human Neuron and Mouse Glia Co-culture Reveal Cell-Specific Aging Responses (2025)

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2 Upvotes

r/ketoscience 2d ago

Metabolism, Mitochondria & Biochemistry High-fat diet impairs intermediate-term memory by autophagic-lysosomal dysfunction in Drosophila (2025)

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2 Upvotes

r/ketoscience 3d ago

Metabolism, Mitochondria & Biochemistry The mevalonate pathway couples lipid metabolism to amino acid synthesis via ubiquinone-dependent redox control (2025)

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5 Upvotes

r/ketoscience 3d ago

Metabolism, Mitochondria & Biochemistry A prevalent huge phage clade in human and animal gut microbiomes (2025)

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3 Upvotes

r/ketoscience 3d ago

Metabolism, Mitochondria & Biochemistry [AF] A systems approach for elucidating the role of the microbiome in epigenetic cellular memory (2025)

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2 Upvotes

r/ketoscience 3d ago

Metabolism, Mitochondria & Biochemistry Mitochondrial Quality Control in Health and Disease (2025)

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2 Upvotes

r/ketoscience 3d ago

Obesity, Overweight, Weightloss Different association of GDF15 and FGF21 with glycemic status and aging in the context of obesity (2025)

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2 Upvotes

r/ketoscience 3d ago

Central Nervous System Fasting, ketogenic, and anti-inflammatory diets in multiple sclerosis: a randomized controlled trial with 18-month follow-up

18 Upvotes

Abstract

Background

Multiple sclerosis (MS) is the most common inflammatory disease of the central nervous system in young adulthood leading to disability and early retirement. Ketone-based diets improve the disease course in MS animal models and health outcomes in different pilot studies of neurodegenerative diseases.

Methods

We enrolled 105 individuals with relapsing-remitting MS (RRMS) in an 18-month, randomized, controlled study, and randomized them into (1) standard healthy diet (SD) as recommended by the German Nutrition Society, (2) fasting diet (FD) with 7-day fasts every 6 months with intermittent fasting at 6 of 7 days a week or (3) ketogenic diet (KD) with 20–40 g carbohydrates per day. Primary outcome was the number of new MRI lesions after 18 months in the KD and FD compared to SD and compared to baseline. Secondary outcomes included further MRI outcomes, disease biomarkers as well as metabolic, and clinical MS outcomes.

Results

Eighty-one participants completed the study. The primary endpoint number of new T2 lesions after 18 months did not change in any of the groups (SD 0 (0-(-1)), FD 0 (2 − 0), KD 0 (2 − 0)). Secondary endpoints were analyzed exploratorily: Compared to baseline, in the FD group, Neurofilament light chain (NfL) -concentrations were lower at 9 months (-1.94 pg/mL, p = 0.042) and depressive symptoms improved slightly at 18 months (p = 0.079). In the KD group, cognition improved at 18 months (symbol digit modalities test + 3.7, p = 0.020). Cardiometabolic risk markers (body mass index, abdominal fat, blood lipids, adipokines, blood pressure) improved in all three groups at 9 months differently and were partially associated with clinical outcomes in the FD and KD group.

Conclusion

The results suggest beneficial effects of dietary interventions, underscoring their potential as a complementary strategy in the treatment of RRMS. To further clarify the impact of such interventions on the disease course and patient-centered outcomes — such as cognitive function and depressive symptoms —future studies with larger, more homogeneous study populations are warranted.

Bahr, Lina S., Judith Bellmann-Strobl, Daniela A. Koppold, Rebekka Rust, Tanja Schmitz-Hübsch, Maja Olszewska, Jean Stadlbauer et al. "Fasting, ketogenic, and anti-inflammatory diets in multiple sclerosis: a randomized controlled trial with 18-month follow-up." BMC Nutrition 11, no. 1 (2025): 167.

https://link.springer.com/article/10.1186/s40795-025-01156-5


r/ketoscience 4d ago

Other Animal protein not linked to higher mortality risk, study finds

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31 Upvotes

r/ketoscience 3d ago

Other Nutritional Interventions for Enhancing Female Fertility: A Comprehensive Review of Micronutrients and Their Impact (2025)

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4 Upvotes

r/ketoscience 4d ago

Metabolism, Mitochondria & Biochemistry New study finds hidden body fat is linked to faster heart ageing

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ukri.org
13 Upvotes

r/ketoscience 4d ago

Exogenous Ketones Ketone body supplementation into a standard high-carbohydrate diet reduces fecundity, delays larval development, and may induce autophagy in Drosophila melanogaster (2025)

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6 Upvotes

r/ketoscience 5d ago

Metabolism, Mitochondria & Biochemistry Brain neurons are responsible for day-to-day control of blood sugar

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6 Upvotes

r/ketoscience 5d ago

Disease Hemoglobin Reimagined: A Breakthrough in Brain Disease Treatment

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1 Upvotes

r/ketoscience 5d ago

An Intelligent Question to r/ Petition to include recommendations on low-carbohydrate diets in the MAHA Commission Report

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9 Upvotes