Health
Low-carb keto diet may not raise heart disease risk, new study suggests
High cholesterol has long gotten a bad rap for causing poor heart health — but a new study suggests that the low-carb ketogenic diet may not be linked to cardiovascular disease.
The study, led by The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center in collaboration with researchers across multiple institutes, assessed 100 participants following a long-term keto diet who developed elevated levels of LDL cholesterol (known as the “bad” type).
Other than the elevated cholesterol, all participants were “metabolically healthy” and had followed the key diet for an average of five years, according to an April 7 press release.
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They all qualified as LMHR (lean mass hyper-responder), which indicates people who adopt a carbohydrate-restricted diet and experience a significant rise in cholesterol.
High cholesterol has long gotten a bad rap for causing poor heart health — but a new study suggests that the low-carb ketogenic diet may not be linked to cardiovascular disease. (iStock)
Using advanced cardiac imaging, the researchers found that traditional cholesterol markers (ApoB and LDL-C) were not associated with changes in plaque levels in the heart’s arteries or with baseline heart disease over a one-year period.
Instead, existing plaque levels seemed to be a better predictor of future plaque accumulation.
“This population of people — metabolically healthy with elevated LDL due to being in ketosis — are not automatically at increased cardiac risk simply because their LDL is elevated,” Bret Scher, MD, medical director of Baszucki Group, which provided funding for the study, told Fox News Digital.
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“Therefore, we should likely shift away from LDL and ApoB and toward vascular imaging with CAC or CTA for better risk prediction and informing how or if to treat someone’s cardiac risk factors,” added the California-based doctor.
The study findings were published in the Journal of the American College of Cardiology: Advances.
Using advanced cardiac imaging, the researchers found that traditional cholesterol markers (ApoB and LDL-C) were not associated with changes in plaque levels in the heart’s arteries or with baseline heart disease over a one-year period. (iStock)
Previous studies have also shown that people qualifying as LMHR have similar levels of coronary plaque to otherwise comparable groups that have normal LDL levels, “underscoring that ketogenic diet-induced LDL increases may not indicate a higher risk of coronary plaque,” the researcher said.
Dr. Nick Norwitz, a study leader and independent researcher at the University of Oxford, noted that this is the first study to isolate very high LDL and ApoB as risk factors for heart disease.
“All other human studies have included populations with metabolic dysfunction or individuals with congenital genetic causes of high LDL,” he told Fox News Digital.
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The results seem to contradict what most clinicians would have predicted and what doctors are taught in medical training, according to Norwitz.
“While these data do not prove the conventional understanding is ‘wrong,’ per se, they do suggest the conventional model has a large blind spot.”
This is the first prospective trial of its kind in a unique population often labeled ‘high-risk’ by traditional guidelines, one doctor said, raising important questions about how cardiovascular risk is assessed in the context of low-carb, high-fat diets. (iStock)
According to Norwitz, cardiac imaging, including a CAC score, has “far more value” than cholesterol levels in predicting plaque progression.
“Thus, CAC scores can be used to risk-stratify patients and help individualize care,” he told Fox News Digital.
Scher noted that “ketogenic therapy” can be effective in treating certain metabolic-related conditions, but some people are afraid of continuing a keto diet because of their cholesterol.
“This study provides support that they do not necessarily need to stop the diet or treat their cholesterol — rather, they can work with their healthcare team for a more individualized and appropriate cardiac workup,” he advised.
Raising important questions
Dr. Ken Berry, a family physician and diabetes specialist in Tennessee, was not involved in the research but shared his thoughts on what he described as a “groundbreaking” study.
“The study found no association between LDL-C, ApoB and progression of coronary plaque over one year using high-resolution CT angiography,” he said to Fox News Digital.
“Instead, the strongest predictor of plaque progression was pre-existing plaque, not cholesterol levels — leading researchers to conclude that ‘plaque begets plaque, ApoB does not.’”
Existing plaque levels seemed to be a better predictor of future plaque accumulation, although some experts cautioned that limitations exist. (iStock)
This is the first prospective trial of its kind in a unique population often labeled ‘high-risk’ by traditional guidelines, Berry said, raising important questions about how cardiovascular risk is assessed in the context of low-carb, high-fat diets.
“The obvious implication is that if very high ApoB levels is not a good predictor of heart attack risk in this specific group of people, then is it a good predictor in any group of people?” he said.
“Or is it, as I suspect, just the latest popular lab test being used to scare people away from eating a proper human diet rich in saturated fat?”
Potential study limitations
Dr. Bradley Serwer, a cardiologist and chief medical officer at VitalSolution, a Cincinnati-based company that offers cardiovascular and anesthesiology services to hospitals nationwide, reviewed the study and pointed out some potential limitations.
“The study’s limited scope, involving a low-risk population over a short duration, renders it challenging to generalize findings to a broader, more vulnerable population,” Serwer told Fox News Digital.
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“While the study’s objective was to propose a hypothesis regarding dietary cholesterol’s role, it does not provide definitive evidence for or against its significance.”
The cardiologist does, however, agree with the authors’ conclusions that “improved risk stratification tools” are essential for identifying individuals at higher risk of coronary artery disease.
The effects of a ketogenic diet can be measured using a ketosis meter. “I hope doctors will embrace this research and treat this specific population of people differently from the rest of their patients, understanding the unique physiologic state of ketosis and the metabolic benefits it provides,” a researcher said. (iStock)
“As physicians, our primary responsibility lies in evaluating each patient on an individual basis and collaborating with them through shared decision-making to develop the most appropriate long-term care plan,” he added.
Michelle Routhenstein, a New York City registered dietitian who specializes in heart disease, noted that plaque formation is a multistep process that can take years to progress.
“The environment of the artery needs to be conducive to plaque formation,” Routhenstein, who was not part of the study, told Fox News Digital.
“This is a remarkable group of humans demonstrating remarkable physiology.”
“For example, individuals with high blood pressure, a subgroup that was excluded from the study, are more prone to endothelial damage that can cause apoB to deposit more readily in the artery wall.”
“If someone already has plaque in the arteries and sustains an elevated level of LDL and apoB, then it can develop into more plaque, as seen in this study.”
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“However, if someone is metabolically healthy, has no plaque at baseline, and has elevated apoB and LDL levels alone, then the environment may not necessarily cause plaque to form over a one-year period.”
Routhenstein pointed to prior research showing that high LDL and apoB over years of someone’s life, typically coupled with inflammation, insulin resistance and/or oxidative stress, can increase the risk of plaque development.
“It is important to note that many people who are implementing a ketogenic diet and are ignoring high LDL and apoB levels typically do not know they have soft plaque brewing,” said a dietitian nutritionist. (iStock)
“It is important to note that many people who are implementing a ketogenic diet and are ignoring high LDL and apoB levels typically do not know they have soft plaque brewing,” she added.
“Therefore, advising them to ignore LDL and apoB levels can be harmful — especially in a world where heart disease is so prevalent and remains the leading cause of death globally.”
Looking ahead
Scher said he hopes that more researchers will become inspired to further this study and apply it to different populations.
“But for now, I hope doctors will embrace this research and treat this specific population of people differently from the rest of their patients, understanding the unique physiologic state of ketosis and the metabolic benefits it provides,” he said.
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In addition to more studies assessing risk in this population, Norwitz said the team hopes to further investigate the mechanisms of the lean mass hyper-responder (LMHR) phenotype.
“This is a remarkable group of humans demonstrating remarkable physiology,” he added.
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In a dramatic turn of events that’s captured the attention of animal lovers worldwide, Punch — the young macaque at a zoo in Japan famous for his inseparable bond with a stuffed orangutan toy — has reached a major milestone in his journey toward social integration.
On Thursday, visitors and staff at the Ichikawa Zoological and Botanical Garden witnessed a breakthrough: Punch was seen cuddling with and hitching a ride on the back of a fellow macaque.
Punch’s story began with hardship. He was abandoned by his mother shortly after his birth in July 2025 — and to ensure his survival, zookeepers stepped in to hand-rear the primate.
On Jan. 19, 2026, the zoo officially began the process of reintegrating Punch into the “monkey mountain” enclosure.
The transition was initially fraught with tension.
Punch’s story began with hardship when he was abandoned by his mother shortly after he was born. To help him, zookeepers gave him a stuffed toy that he began dragging around everywhere he went. (David Mareuil/Anadolu via Getty Images)
As a hand-reared infant, Punch was bullied and ignored by the established group of monkeys.
He was often seen huddled alone with his orange plush companion while the rest of the troop interacted.
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In an official statement released Feb. 27, the Ichikawa Zoological and Botanical Garden detailed the meticulous care behind this process.
Previous viral videos showed Punch bullied by the rest of the troop, running to his plushy toy for comfort. (David Mareuil/Anadolu via Getty Images)
“From an animal welfare perspective, our primary goal is to reintegrate Punch with the troop,” the zoo said.
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The strategy involved nursing Punch within the enclosure, so the troop could recognize him as one of their own, and pairing him with a gentle young female macaque prior to his full release to build his confidence.
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The latest footage, captured by X user @tate_gf, suggested the zoo’s patience is paying off.
The video shows Punch seeking physical contact not from his toy, but from another monkey — eventually climbing onto its back for a vital social behavior for young macaques: the “piggyback ride.”
The zoo’s strategy appears to be paying off: Punch, shown at far left, was recently seen riding on the back of a fellow macaque. (David Mareuil/Anadolu via Getty Images)
While Punch still carries his stuffed toy for comfort during moments of perceived danger, the zoo remains optimistic about his progress.
The organization cited the successful 2009 case of Otome, another hand-reared macaque who eventually outgrew her stuffed toy, successfully integrated — and went on to raise four offspring of her own.
The zoo has had crowds coming to see Punch, with hundreds of people lining up to get inside to see the young star, according to reports.
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“I’m hoping Punch has a good life like everybody else does, and think he’s a cute little guy,” one person commented online.
“Such a precious baby,” another person wrote.
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This story discusses suicide. If you or someone you know is having thoughts of suicide, please contact the Suicide & Crisis Lifeline at 988 or 1-800-273-TALK (8255).
Artificial intelligence has been touted as a boon to healthcare, but a new study has revealed its potential shortcomings when it comes to giving medical advice.
In January, OpenAI launched ChatGPT Health, the medical-focused version of the popular chatbot tool.
The company introduced the tool as “a dedicated experience that securely brings your health information and ChatGPT’s intelligence together, to help you feel more informed, prepared and confident navigating your health.”
But researchers at the Icahn School of Medicine at Mount Sinai have found that the tool failed to recommend emergency care for a “significant number” of serious medical cases.
The study, published in the journal Nature Medicine on Feb. 23, aimed to explore how ChatGPT Health — which is reported to have about 40 million users daily — handles situations where people are asking whether to seek emergency care.
Artificial intelligence has been touted as a boon to healthcare, but a new study has revealed its potential shortcomings when it comes to giving medical advice. (iStock)
“Right now, no independent body evaluates these products before they reach the public,” lead author Ashwin Ramaswamy, M.D., instructor of urology at the Icahn School of Medicine at Mount Sinai in New York City, told Fox News Digital.
“We wouldn’t accept that for a medication or a medical device, and we shouldn’t accept it for a product that tens of millions of people are using to make health decisions.”
Emergency scenarios
The team created 60 clinical scenarios across 21 medical specialties, ranging from minor conditions to true medical emergencies.
Three independent physicians then assigned an appropriate level of urgency for each case, based on published clinical practice guidelines in 56 medical societies.
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The researchers conducted 960 interactions with ChatGPT Health to see how the tool responded, taking into account gender, race, barriers to care and “social dynamics.”
While “clear-cut emergencies” — such as stroke or severe allergy — were generally handled well, the researchers found that the tool “under-triaged” many urgent medical issues.
The team created 60 clinical scenarios across 21 medical specialties, ranging from minor conditions to true medical emergencies. (iStock)
For example, in one asthma scenario, the system acknowledged that the patient was showing early signs of respiratory failure — but still recommended waiting instead of seeking emergency care.
“ChatGPT Health performs well in medium-severity cases, but fails at both ends of the spectrum — the cases where getting it right matters most,” Ramaswamy told Fox News Digital. “It under-triaged over half of genuine emergencies and over-triaged roughly two-thirds of mild cases that clinical guidelines say should be managed at home.”
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Under-triage can be life-threatening, the doctor noted, while over-triage can overwhelm emergency departments and delay care for those in real need.
Researchers also identified inconsistencies in suicide risk alerts. In some cases, it directed users to the 988 Suicide and Crisis Lifeline in lower-risk scenarios, and in others, it failed to offer that recommendation even when a person discussed suicidal ideations.
“ChatGPT Health performs well in medium-severity cases, but fails at both ends of the spectrum.”
“The suicide guardrail failure was the most alarming,” study co-author Girish N. Nadkarni, M.D., chief AI officer of the Mount Sinai Health System, told Fox News Digital.
ChatGPT Health is designed to show a crisis intervention banner when someone describes thoughts of self-harm, the researcher noted.
OpenAI launched ChatGPT Health, the medical-focused version of the popular chatbot tool, in January 2026. (Gabby Jones/Bloomberg via Getty Images)
“We tested it with a 27-year-old patient who said he’d been thinking about taking a lot of pills,” Nadkarni said. “When he described his symptoms alone, the banner appeared 100% of the time. Then we added normal lab results — same patient, same words, same severity — and the banner vanished.”
“A safety feature that works perfectly in one context and completely fails in a nearly identical context … is a fundamental safety problem.”
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The researchers were also surprised by the social influence aspect.
“When a family member in the scenario said ‘it’s nothing serious’ — which happens all the time in real life — the system became nearly 12 times more likely to downplay the patient’s symptoms,” Nadkarni said. “Everyone has a spouse or parent who tells them they’re overreacting. The AI shouldn’t be agreeing with them during a potential emergency.”
Fox News Digital reached out to Open AI, creator of ChatGPT, requesting comment.
Physicians react
Dr. Marc Siegel, Fox News senior medical analyst, called the new study “important.”
“It underlines the principle that while large language models can triage clear-cut emergencies, they have much more trouble with nuanced situations,” Siegel, who was not involved in the study, told Fox News Digital.
ChatGPT and other LLMs can be helpful tools, a doctor said, but they “should not be used to give medical direction.” (iStock)
“This is where doctors and clinical judgment come in — knowing the nuances of a patient’s history and how they report symptoms and their approach to health.”
ChatGPT and other LLMs can be helpful tools, Siegel said, but they “should not be used to give medical direction.”
“Machine learning and continued input of data can help, but will never compensate for the essential problem – human judgment is needed to decide whether something is a true emergency or not.”
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Dr. Harvey Castro, an emergency physician and AI expert in Texas, echoed the importance of the study, calling it “exactly the kind of independent safety evaluation we need.”
“Innovation moves fast. Oversight has to move just as fast,” Castro, who also did not work on the study, told Fox News Digital. “In healthcare, the most dangerous mistakes happen at the extremes, when something looks mild but is actually catastrophic. That’s where clinical judgment matters most, and where AI must be stress-tested.”
Study limitations
The researchers acknowledged some potential limitations in the study design.
“We used physician-written clinical scenarios rather than real patient conversations, and we tested at a single point in time — these systems update frequently, so performance may change,” Ramaswamy told Fox News Digital.
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Additionally, most of the missed emergencies happened in situations where the danger depended on how the condition was changing over time. It’s not clear whether the same problem would happen with acute medical emergencies.
Because the system had to choose just one fixed urgency category, the test may not reflect the more nuanced advice it might give in a back-and-forth conversation, the researchers noted.
ChatGPT Health is designed to show a crisis intervention banner when someone describes thoughts of self-harm. (iStock)
Also, the study wasn’t large enough to confidently detect small differences in how recommendations might vary by race or gender.
“We need continuous auditing, not one-time studies,” Castro noted. “These systems update frequently, so evaluation must be ongoing.”
‘Don’t wait’
The researchers emphasized the importance of seeking immediate care for serious issues.
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“If something feels seriously wrong — chest pain, difficulty breathing, a severe allergic reaction, thoughts of self-harm — go to the emergency department or call 988,” Ramaswamy advised. “Don’t wait for an AI to tell you it’s OK.”
The researchers noted that they support the use of AI to improve healthcare access, and that they didn’t conduct the study to “tear down the technology.”
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“These tools can be genuinely useful for the right things — understanding a diagnosis you’ve already received, looking up what your medications do and their side effects, or getting answers to questions that didn’t get fully addressed in a short doctor’s visit,” Ramaswamy said.
“That’s a very different use case from deciding whether you need emergency care. Treat them as a complement to your doctor, not a replacement.”
“This study doesn’t mean we abandon AI in healthcare.”
Castro agreed that the benefits of AI health tools should be weighed against the risks.
“AI health tools can increase access, reduce unnecessary visits and empower patients with information,” he said. “They are not inherently unsafe, but they are not yet substitutes for clinical judgment.”
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“This study doesn’t mean we abandon AI in healthcare,” he went on. “It means we mature it. Independent testing and stronger guardrails will determine whether AI becomes a safety net or a liability.”
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