Risks and benefits of very low levels of low-density lipoprotein cholesterol: When less is not necessarily more

Frati, Giacomo; Biondi‐Zoccai, Giuseppe; Versaci, Francesco

doi:10.1016/j.ijcard.2020.03.079

Cited by 1 publication

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“…Cholesterol has a fundamental role in cellular membrane in all cell types, in steroid hormones and bile acid production, which raises a concern that very low cholesterol levels observed in some participants, mostly vegan and vegetarian, might also have a negative impact on health. Very low LDLC and HDLC levels were associated with increased risk for stroke, cataract and all-cause mortality ( 58 , 59 ). Some of our participants had LDLC (19% vegans, 8% vegetarians and 11% omnivorous) and HDLC (22% vegans and 19% vegetarians and omnivorous) levels below RV.…”

Section: Discussionmentioning

confidence: 99%

Habitual low carbohydrate high fat diet compared with omnivorous, vegan, and vegetarian diets

et al. 2023

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BackgroundDietary patterns which exclude whole food groups, such as vegetarian, vegan and low carbohydrate high fat diet (LCHF), are increasingly popular in general public. When carefully planned, all these diets have some known benefits for health, but concerns are also raised in particular for LCHF. The quality of LCHF diet which individuals follow in real life without supervision is not known.MethodsOne hundred thirty healthy individuals with stable body mass following LCHF, vegan, vegetarian and omnivorous diet for at least six months, were compared in a cross-sectional study. Diet was analyzed through 3-day food records and FFQ, anthropometric measurements were performed and serum metabolic biomarkers determined from fasting blood.ResultsParticipants on LCHF diet had the intakes of micronutrients comparable to other groups, while the intakes of macronutrients differed in line with the definition of each diet. The intakes of saturated fats, cholesterol and animal proteins were significantly higher and the intakes of sugars and dietary fibers were lower compared to other groups. Healthy eating index 2015 in this group was the lowest. There were no differences in the levels of glucose, triacylglycerols and CRP among groups. Total and LDL cholesterol levels were significantly higher in LCHF group, in particular in participants with higher ketogenic ratio. Fatty acids intakes and intakes of cholesterol, dietary fibers and animal proteins explained 40% of variance in total cholesterol level, with saturated fatty acids being the strongest positive predictor and monounsaturated fatty acids a negative predictor.ConclusionNone of the self-advised diets provided all the necessary nutrients in optimal levels. Due to the detected increased levels of serum cholesterols, selection of healthy fat sources, higher intake of dietary fibers and partial replacing of animal sources with plant sources of foods should be recommended to the individuals selecting LCFH dietary pattern.Clinical Trial Registration: ClinicalTrials.gov, identifier NCT04347213.

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Section: Discussionmentioning

confidence: 99%