How a Ketogenic Diet May Help Those With Heart Disease: What You Should Know

Researchers say ketones can reduce inflammation and lower oxidative stress. Sasithorn Phuapankasemsuk/Getty Images

Researchers say a ketogenic diet can help people with heart disease by reducing inflammation and lowering oxidative stre…

Researchers say ketones can reduce inflammation and lower oxidative stress. Sasithorn Phuapankasemsuk/Getty Images
  • Researchers say a ketogenic diet can help people with heart disease by reducing inflammation and lowering oxidative stress.
  • Experts say it may be more beneficial to use ketone supplements than going on a keto diet.
  • They add that more research is needed on this topic.

The ketogenic diet is low on carbohydrates and high in fats such as bacon, eggs, and cheese.

Your body then develops chemicals called ketones that send you into ketosis, which means you burn fat for fuel.

That's how you lose weight.

But how could those fatty foods possibly be good for someone with heart disease?

The answer is, it's complicated.

A new report published in the Journal of the American College of Cardiology concludes that ketone bodies can help protect the heart in people with cardiovascular disease.

The scientists researched by reviewing multiple studies. The researchers suggested that using exogenous ketones or ketone supplements could be an alternative to a ketogenic diet.

They also said more studies should be done to assess the impact of using ketones on people at risk of cardiovascular disease.

Ketones vs. keto diet

Experts say there is growing evidence ketones can have a therapeutic effect, but how you get them matters.

“Really what this paper is showing is that a byproduct of the ketogenic diet, ketone bodies, which can come from other means, are beneficial. They can reduce inflammation, reduce oxidative stress, and may be beneficial to the lining of the blood vessels,” said Dr. Andrew M. Freeman, FACC, FACP, a cardiologist and director of the Cardiovascular Prevention and Wellness Program at National Jewish Health in Denver.

“It has been known for a long period of time that ketone bodies seem to exert some positive health effects. The question is can you get ketone bodies in a way that doesn't require you to eat just bacon-wrapped scallops,” Freeman told Healthline.

“And how do you harness the therapeutic potential here? I don't think this paper answers that, but it does give some ideas,” he added.

The report suggests using exogenous ketones or supplements is one way to get them in. Freeman, however, said those are often bitter tasting and can lead to an upset stomach.

“This review article nicely summarizes the implications of using ketone bodies as treatment across a spectrum of cardiovascular disease,” said Dr. Senthil Selvaraj, a senior cardiology fellow at the Perelman School of Medicine at the University of Pennsylvania.

His research team is investigating the use of ketosis in people with heart failure.

“This is a burgeoning field, and many of the studies cited here are early in their lines of inquiry. While I agree that the therapeutic potential for ketone bodies to improve several cardiovascular diseases is real, more data are clearly needed to establish their role,” Selvaraj told Healthline.

Don’t jump to conclusions

Meanwhile, experts are warning consumers not to make hasty diet decisions based on a single report.

“I'm afraid a study like this could potentially make people say, OK… I'm going to go on a ketogenic diet. Then they're going to eat bacon and blocks of cheese and hope for the best,” said Freeman. “They may trade one evil for another. That makes me worried.”

“There are outcomes papers showing long-term ketogenic approaches may not be as beneficial for people as we once thought,” he said. “The exceptions are people with advanced neurologic disease and seizure disorders.”

“There's been data over the years showing that intermittent fasting appears to be emerging as probably beneficial. If you eat your last meal at 5 p.m. and don’t eat breakfast until 8 or 9 or 10 a.m., you may have ketone bodies in your blood naturally,” Freeman explained. “There's even some studies that show that plain black coffee also helps to induce ketone body development.”

“If you do a plant-based ketogenic diet, it could be a very interesting way to get to ketogenesis,” he said.

More research needed

“At this point, the data on ketosis and cardiovascular disease are promising, but not quite ready for prime time,” Selvaraj said. “Many trials are ongoing in this space, but ultimately larger trials across hundreds of patients in each of these diseases will be needed to firmly establish the role of therapeutic ketosis, obtained either by a ketogenic diet or ingesting ketogenic products.”

“We need to figure out how to get people to a therapeutic ketone body development in a way that's safer than the ketogenic diet, which is associated with a whole bunch of harms,” Freeman added. “That's especially true in the patient with heart disease. “