Variability in Progression: The study found that not all LMHR participants behaved the same way. Some showed plaque progression, some had no progression, and some even showed regression. The average increase of 18.8 mm³ represents the mean across the entire group, which can be influenced by individuals with significant progression.
"Plaque Begets Plaque": A key finding was that individuals who already had existing coronary plaque at the beginning of the study were more likely to show greater or faster plaque progression. This suggests that pre-existing plaque, rather than high ApoB levels within this population, was a stronger predictor of future plaque development.
In essence, the study indicated that while some LMHRs did experience plaque progression, their high ApoB (LDL) levels were not the correlating factor for that progression
It’s important to note that participants were not screened for insulin resistance or underlying inflammation level. These unmeasured factors could mean that some individuals might have fared worse had they not been on a low-carb diet.