Does Keto Accelerate Heart Disease? What the New Study Didn’t Tell You | Simon Hill, Msc, Bsc

The Proof with Simon Hill

Simon Hill

Nutrition, Health & Fitness, Self-improvement, Education

4.9 • 2.9K Ratings

🗓️ 24 June 2025

⏱️ 50 minutes

🔗️ Recording | iTunes | RSS

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Summary

In this solo episode, I unpack the controversial new KETO-CTA study and why its conclusions about cholesterol, ApoB, and ketogenic diets aren’t as clear as they seem. We break down what the study really found, how it was communicated, and what it means if you (or someone you care about) is following a high-fat, low-carb diet with elevated LDL-C. With expert commentary from Dr. Alan Flanagan, we explore: Who Lean Mass Hyper-Responders (LMHRs) are Why the study isn’t actually a “trial” The missing data on plaque progression and what was left out What non-calcified plaque volume (NCPV) tells us Whether this study really challenges ApoB’s role in heart disease Why communication matters and how headlines can mislead What this means for keto diets, cardiovascular risk, and informed decisions If you found this valuable, please share it or leave a review. Every share helps the truth cut through the noise. Intro: Can You Be “Healthy” with Sky-High LDL on Keto? (00:00) What the Keto CTA Study Was Trying to Prove (01:36) The Problem: This Wasn’t Actually a Clinical Trial (03:57) APOB Focused, But Not Pre-Registered: Red Flag #1 (07:58) Real Plaque Progression Numbers: 4x Faster Than Healthy Controls (09:16) So… Does ApoB Matter or Not? (17:50) How the Study Was Communicated to the Public (26:03) What the Headlines Should Actually Say (37:05) Final Thoughts from Dr. Carvallo and Dr. Flanagan (38:06) Key Takeaways (40:37) Want to support the show? The best way to support the show is to use the products and services offered by our sponsors. To check them out and enjoy great savings, visit theproof.com/friends. You can also support the show by leaving a review on the Apple Podcast app and sharing your favourite episodes with friends and family. This episode is brought to you by: 38TERA Consider 38TERA's DMN prebiotic supplement a daily multivitamin for your gut. Formulated by yours truly and gastroenterologist Dr Will Bulsiewicz. Use code PROOF for 25% off at checkout. Bragg Bragg Organic Apple Cider Vinegar is raw, unfiltered, and naturally fermented with 100% organic apples, always with the live “Mother” in every bottle. Get 20% off your first order at bragg.com with promo code SIMON. IM8 With 92 nutrients, including Vitamin B12, Iodine, Selenium and Vitamin D, in highly absorbable forms, IM8 Daily Essentials is the perfect all-in-one daily multi-vitamin to ensure you meet your daily micronutrient needs. IM8 is offering an exclusive 10% off your first order with a free welcome kit when you enter the promo code SIMON at checkout on im8health.com LMNT Stay hydrated with LMNT. Get a free Sample Pack of LMNT’s most popular drink mix flavours with any purchase at DrinkLMNT.com/SIMON Find your favourite LMNT flavour, or share with a friend. And if you don’t like it? Full refund, no questions asked. Eight Sleep Upgrade your sleep with the Pod 5 Ultra by Eight Sleep. Clinically validated to deliver up to 1 extra hour of quality sleep per night through temperature control and biometric tracking. Use code THEPROOF for $350 off at eightsleep.com/theproof. Try it risk-free for 30 days, with worldwide shipping. WHOOP Whoop, the most advanced fitness and health wearable available. Your personalised fitness and health coach to recover faster, sleep better, and train smarter. Claim your first month free on join.whoop.com/simon. Simon Hill, MSc, BSc (Hons) Creator of theproof.com Host of The Proof with Simon Hill Author of The Proof is in the Plants Subscribe & Connect: YouTube Apple Podcasts Spotify Instagram: @simonhill X: @theproof Facebook: The Proof with Simon Hill Nourish your gut with my Plant-Based Ferments Guide and download my Two-Week Meal Plan.

Transcript

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0:00.0	You've probably heard the claim, if you're lean and metabolically healthy, high
0:09.9	LDL cholesterol doesn't matter.
0:12.1	In low carb circles, this is more than just a claim.
0:15.2	It's kind of a permission slip.
0:17.3	Go ahead, load up on butter, bacon and ribbyes.
0:20.2	After all, you're in ketosis, right? But here's the
0:22.8	real question. Is that confidence backed by science? Or just wishful thinking wrapped in six-pack
0:29.4	abs. A new study, the keto-c-trial, set out to explore this very question. It followed 100 people
0:36.8	on a long-term ketogenic diet,
0:39.1	all with significantly elevated LDL cholesterol in APOB, using coronary CT angiography to track
0:45.7	changes in their arteries over 12 months. On the surface, the results might seem reassuring. But when you
0:52.4	dig into the data and the way that the data has been
0:55.1	presented, a more complex and very interesting picture starts to emerge. Whether you follow
1:01.9	a ketogenic diet or have high LDL cholesterol yourself, care about someone who does, or I
1:07.4	just generally interested about nutrition and cardiovascular disease, this episode is for you.
1:13.2	With expert insight from my friend, Dr. Alan Flanagan, who co-authored a detailed critique of the study,
1:19.7	will unpack what the research really found, how it's being communicated to the public,
1:24.2	and what it truly means for the keto community. No hype, no hit pieces, just a
1:30.3	clear-eyed, evidence-based look at the very first study to track artery plaque progression
1:35.5	in lean, metabolically healthy people with keto-induced high cholesterol. The study we're unpacking
1:42.5	titled Plark Begets Plark, APOB does not. Longitudinal
1:47.5	data from the Keto-C-T-A trial was published a few months ago in the Journal of American College
	...

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