A recent study examining the effects of ketogenic diets on heart health has ignited a fierce debate in the nutrition and medical communities, the study focused on “Lean Mass Hyper-Responders” (LMHRs) individuals who follow high-fat, low-carb diets and experience elevated LDL cholesterol but exhibit otherwise healthy markers such as low body fat and normal blood pressure. The year-long trial followed 100 such individuals to determine whether their high LDL levels were contributing to plaque build-up in their arteries, a key indicator of heart disease.
The paper concluded there was no clear association between high levels of LDL or apolipoprotein B (ApoB) and arterial plaque progression in these subjects. Lead researcher Adrian Soto-Mota and co-author Dave Feldman, a keto advocate and self-proclaimed citizen scientist, argued that the results challenged long-standing views linking cholesterol to cardiovascular risk. Feldman, who also coined the term LMHR and helped fund the study through his Citizen Science Foundation, publicly promoted the findings as vindication of the ketogenic lifestyle.
However, this bold interpretation has not gone unchallenged. Numerous experts have raised concerns about the study’s methodology, lack of a control group, short timeframe, and potential conflicts of interest. Some critics, including physicians and researchers, believe the study’s conclusions were overstated, possibly misleading both doctors and patients about the dangers of high cholesterol.
Heart Health Backlash and Ethical Concerns
One of the most vocal critics is Dr. Spencer Nadolsky, a physician who initially helped design the study but later distanced himself, citing ethical red flags. He alleged that Feldman had prematurely shared early results to recruit more participants and donations, possibly compromising the objectivity of the research. Nadolsky eventually filed a formal complaint with the institutional review board overseeing the study. Though the board found no ethical violations, the incident deepened skepticism surrounding the research.
Additional scrutiny came from researchers Miguel López-Moreno and José Francisco López-Gil, who published pointing out issues such as selective data reporting and inadequate statistical modeling. Notably, the study failed to initially highlight a significant 42.8% median increase in non-calcified plaque volume one of the key metrics the research was supposed to examine. This omission, later acknowledged as an “oversight” by the authors, cast further doubt on the reliability of the conclusions.
Despite these flaws, the study passed peer review and was published, raising questions about the standards of scientific vetting. UC Berkeley’s Kevin Klatt criticized the paper’s scientific rigor, suggesting it would have been rejected by more stringent journals. He also flagged Feldman’s lack of formal biomedical training and undisclosed personal investment in the keto narrative as problematic.
Public Perception and Lingering Fallout
As the dust settles, the keto debate remains far from resolved. The study’s initial interpretation has already influenced public opinion, bolstered by keto’s popularity and Feldman’s promotional efforts. A forthcoming documentary, “Cholesterol Code,” is set to amplify Feldman’s perspective, and online platforms, including AI tools, are already citing his lipid energy model as a counter-narrative to traditional cholesterol theory and Heart Health.
While the study’s authors now concede their findings support a possible causal role for ApoB in atherosclerosis, the damage may already be done. Experts worry that flawed or misrepresented science, once released into public discourse, is hard to retract. As Klatt put it, entrenched camps on both sides continue to “talk past each other,” with little consensus in sight.
In the complex world of nutrition science, this latest keto study serves as a cautionary tale, Heart Health highlighting how science, when mixed with ideology and insufficient oversight, can spark more confusion than clarity.
