Rick The-V

Here is the problem with the keto crowd claiming that high LDL doesn't matter if you're lean, eat steak, and work out. In the KETO-CTA study, participants had an average LDL of 242 mg/dL. They were lean, had low triglycerides, high HDL, and were supposedly metabolically healthy. Yet in the blinded reanalysis, 21% had significant progression of coronary atherosclerosis in just ONE YEAR using the prespecified imaging method. Another analysis put that figure at 29%. The original paper was retracted. The revised analysis still found plaque progression. Now compare that with decades of evidence showing that ApoB-containing particles cause atherosclerosis and that lowering LDL reduces cardiovascular events. Being fit is wonderful. Eating well matters. But neither gives you immunity from coronary artery disease. You cannot exercise your way out of a lifetime of elevated ApoB. And steak is not a statin.