In a randomized controlled trial, simply cutting free and added sugars while keeping whole food carbohydrates produced fat loss, a 10% reduction in LDL cholesterol, no change in ApoB, and no disruption to the gut microbiome.
"Now, in terms of that randomized controlled trial we talked about earlier, simply cutting sugars and refined carbohydrates, well, keeping these whole carbohydrates in your diet, like legumes and root vegetables, the stuff that we think is really good for you, this actually produced a good amount of fat loss, a 10% reduction in LDL cholesterol, and no change in your ApoB, which we saw in the other approaches, and also no disruption to your gut microbiome." (said at 1:03:52)
In the Keto-Med randomized crossover trial (Gardner et al., 2022), participants with prediabetes or type 2 diabetes followed a Mediterranean-plus diet (which eliminated added sugars and refined grains while including legumes, whole grains, and fruits) and a well-formulated ketogenic diet for 12 weeks each. The Mediterranean-plus diet produced meaningful weight loss (-7%) and improved cardiometabolic markers, but LDL cholesterol decreased by 5% (SEM, 5%), not 10%. The 10% figure reflects the increase in LDL cholesterol observed in the ketogenic arm (+10%, SEM, 4%).
- partial: Effect of a ketogenic diet versus Mediterranean diet on glycated hemoglobin in individuals… (The American journal of clinical nutrition 2022)
"Triglycerides decreased more for the WFKD [percentage changes, -16% (SEM, 4%) compared with -5% (SEM, 6%) for the Med-Plus; P = 0.02] and LDL cholesterol was higher for the WFKD [percentage changes, +10% (SEM, 4%) compared with -5% (SEM, 5%) for the Med-Plus; P = 0.01]. Weight decreased 8% (SEM, 1%) compared with 7% (SEM, 1%) and HDL cholesterol increased 11% (SEM, 2%) compared with 7% (SEM, 3%) for the WFKD compared with the Med-Plus, respectively" (abstract, results, passage verified)
pubmedfull study (doi)