Carnivore Diet and Cardiovascular Health: New Insights from Dr. Tro Kalayjian

# Carnivore Diet and Cardiovascular Health: Dr. Tro Kalayjian Challenges Established Beliefs with Two New Studies

**by Laurent Glatz – for Athletic Carnivore**

What if some nutritional guidelines continue to exclude animal-based foods even though patients significantly improve their metabolic health by consuming them? This is precisely the question raised by the work of Dr. Tro Kalayjian, an American physician who recently presented particularly compelling results on ketogenic diets, cholesterol, and cardiovascular risk.

Who is Dr. Tro Kalayjian?

Unlike some influencers who make numerous nutritional claims without clinical experience, Tro Kalayjian has a solid medical background. He graduated from Touro College of Osteopathic Medicine in New York in 2011 and completed his internal medicine residency at Greenwich Hospital within the Yale New Haven Health network, where he also served as chief resident.

He holds American board certifications in internal medicine and obesity medicine. He is also a founding member of the Society of Metabolic Health Practitioners, an organization that brings together professionals interested in nutritional interventions for metabolic diseases.

His journey has a unique aspect: he personally struggled with severe obesity. At his heaviest, he weighed approximately 159 kilograms. After several unsuccessful attempts with conventional calorie-restriction recommendations, he turned to a ketogenic diet, with which he reports having lost about 68 kilograms.

Today, he leads **Toward Health**, a U.S.-based medical practice specializing in obesity, type 2 diabetes, and metabolic disorders. His team combines low-carbohydrate nutrition, medical monitoring, behavioral support, and regular biological parameter tracking.

His goal is ambitious: to achieve significant improvements that allow, when possible, the reduction of certain medications.

A Presentation That Raises an Uncomfortable Question

During a presentation aimed at professionals and nutrition enthusiasts in Australia, Kalayjian detailed several scientific publications from his team, including two studies from 2026.

The first, published on September 30, 2026, in the *American Journal of Preventive Cardiology*, focuses on cardiovascular risk. The researchers studied 120 overweight or obese adults enrolled in a care program based on a ketogenic diet and continuous medical support.

The diet emphasized animal proteins and fats, drastically reduced grains, starches, and sugars, and did not impose specific limits on saturated fats. It also allowed certain plant foods, so it was not a strict carnivore diet.

After twelve months, 90 participants had the necessary data for the primary analysis.

And the results deserve close attention.

Cardiovascular Outcomes That Challenge Traditional Recommendations

The team used PREVENT, a risk calculator developed by the American Heart Association to estimate 10-year cardiovascular risk.

Results showed a relative decrease of **29% in estimated atherosclerotic cardiovascular disease risk, 28% in overall estimated cardiovascular risk, and 42% in estimated heart failure risk**.

Participants also lost a median of 12.2% of their initial body weight. Their average systolic blood pressure dropped by 10.7 mmHg, HbA1c decreased by 0.48 percentage points, and triglycerides fell by 34 mg/dL.

Another interesting observation: average LDL cholesterol remained generally stable in this cohort despite no specific restriction on saturated fats.

It is important to distinguish two things. These percentages represent a reduction in calculated risk, not a 29% reduction in actual heart attacks observed. The study is retrospective and lacks a randomized control group. Therefore, it cannot attribute all benefits solely to the diet.

However, this does not diminish the significance of the measured metabolic improvements.

**The real question then becomes: why would a diet that includes a significant amount of animal products automatically be considered detrimental to cardiovascular health, regardless of the observed metabolic response?**

Insulin: A Key Element in the Reasoning

To understand why these results are interesting, one must look beyond fat intake alone.

When a person drastically reduces carbohydrate consumption, they generally reduce post-meal blood sugar spikes and the accompanying insulin secretion demand.

In individuals with insulin resistance, this change can help improve glucose regulation and certain metabolic parameters.

The liver, adipose tissue, and muscles participate in this adaptation. Blood glucose, triglycerides, and sometimes blood pressure can improve, especially when the intervention is accompanied by weight loss.

This rationale explains why low-carb, ketogenic, and carnivore approaches are gaining increasing interest.

Meat, eggs, fish, and other animal foods provide complete proteins and essential nutrients without the carbohydrate loads typical of many grain-based or sugary preparations.

However, a decrease in insulin alone does not predict all long-term cardiovascular effects. Lipoprotein responses, especially particles containing apolipoprotein B, remain an important factor to consider.

A Particularly Interesting Second Study on Cholesterol

Dr. Kalayjian also presented a publication from August 24, 2026, in *Lipids in Health and Disease*, focusing on 14 patients who developed a significant increase in LDL cholesterol on a ketogenic diet.

The researchers studied their response to ezetimibe, a drug that reduces intestinal cholesterol absorption.

In these patients selected for their pronounced response, the median LDL reduction reached 53.2%, compared to the usual reduction of about 18% with this medication alone in the general population.

This study does not claim that all ketogenic diet followers would respond this way: the cases were specifically chosen because a strong response was observed.

Nevertheless, it raises a fascinating hypothesis: **cholesterol metabolism might function differently in some individuals who are highly adapted to carbohydrate restriction.**

The researchers suggest exploring the role of a low-insulin environment on cholesterol absorption and hepatic regulation. The mechanism remains to be demonstrated.

What These Findings Really Mean for the Carnivore Diet

These publications do not prove that an exclusively animal-based diet systematically protects the heart. Participants in the first study followed a ketogenic diet, not necessarily a carnivore one.

However, they reinforce an important idea: **you cannot properly evaluate a nutritional approach by focusing solely on its carbohydrate content or the proportion of animal fats it contains.**

Initial metabolic status, insulin resistance, weight, blood pressure, blood lipids, and individual evolution must all be considered together.

This is precisely where a well-designed carnivore diet can be valuable: it may allow some individuals to drastically reduce carbohydrate exposure, simplify their diet, and improve satiety. But its effectiveness and tolerance cannot be assumed to be the same for everyone.

A person with significant obesity and insulin resistance will not necessarily respond like a lean, highly active athlete who has been adapted to animal fats for several years.

Applying the exact same recommendations to both would be an oversimplification.

The True Lesson from Dr. Kalayjian

What makes his work interesting is not just his advocacy for ketogenic nutrition. It is his commitment to turning clinical observations into verifiable scientific publications.

His results invite serious study of nutritional approaches that deviate from usual recommendations, rather than dismissing them solely because their dietary composition differs.

For Athletic Carnivore, this approach aligns with a core conviction: the success of a nutritional strategy depends not only on the foods chosen but on their compatibility with the individual's actual physiology.

Before changing your diet again, cutting out more foods, or increasing fat intake, the question might be to understand why your body responds the way it does.

**This is precisely the value of personalized analysis: moving beyond general recommendations to identify the parameters that truly matter in your case.**

[Understand Your Metabolic Terrain with Athletic Carnivore](https://athleticcarnivore.fr/)

**And you, do you still judge your diet based on what you were taught to eat, or based on what your own body actually shows you?**

Studies and Scientific References

**Calkins M. et al. (2026)** — *One-year change in PREVENT-estimated cardiovascular risk during telehealth metabolic care centered on a therapeutic ketogenic diet.* American Journal of Preventive Cardiology. Published online September 30, 2026. [DOI: 10.1016/j.ajpc.2026.102087](https://doi.org/10.1016/j.ajpc.2026.102087)

**Gonzalez J. et al. (2026)** — *Increased LDL-C reduction with ezetimibe in ketogenic diet-induced hypercholesterolemia.* Lipids in Health and Disease, 25, article 187. [DOI: 10.1186/s12944-026-03034-w](https://doi.org/10.1186/s12944-026-03034-w)

**American Heart Association** — [PREVENT Cardiovascular Risk Calculator](https://professional.heart.org/en/guidelines-and-statements/prevent-calculator)

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