{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T10:05:14Z","timestamp":1753869914912,"version":"3.41.2"},"reference-count":10,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,5,20]],"date-time":"2025-05-20T00:00:00Z","timestamp":1747699200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PCN Reports"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>We report a case of a young female with anorexia nervosa (AN) who continued to excessively restrict carbohydrate intake and had persistently high low\u2010density lipoprotein cholesterol (LDL\u2010C) levels even after weight gain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case Presentation<\/jats:title><jats:p>A 12\u2010year\u2010old female was diagnosed with AN. She began losing weight at the age of 10 years and weighed 24.7\u2009kg (body mass index [BMI], 12.8\u2009kg\/m<jats:sup>2<\/jats:sup>; standard weight ratio [SWR], 58.2%) on her first visit to the psychiatry department. Over the next 3 months after this visit, her weight decreased to 21.1\u2009kg (BMI: 11.1\u2009kg\/m<jats:sup>2<\/jats:sup>; SWR: 50.4%), and she was admitted to the pediatric ward, where her LDL\u2010C level was 475\u2009mg\/dL on admission. Upon consuming a diet containing carbohydrates, her weight gradually increased (26.4\u2009kg), and her LDL\u2010C levels decreased (61\u2009mg\/dL). However, her carbohydrate intake decreased after discharge, and her LDL\u2010C levels gradually increased, although her weight was maintained at approximately 30\u2009kg. Her LDL\u2010C level rose to 675\u2009mg\/dL, and her weight decreased to 25.8\u2009kg, necessitating readmission. After admission, her LDL\u2010C level improved to 185\u2009mg\/dL with carbohydrate intake. Her carbohydrate intake gradually decreased after discharge. She stopped eating meat and started eating avocado, tofu, and large amounts of vegetables. Thus, her LDL\u2010C level remained at approximately 100\u2009mg\/dL, but her weight gradually decreased. Therefore, the patient was readmitted to the pediatric ward.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Excessive ketogenic diets may pose some risks for patients with AN, even if they do not lead to weight loss.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pcn5.70124","type":"journal-article","created":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T03:58:24Z","timestamp":1747799904000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Persistent hypercholesterolemia due to weight maintenance via a ketogenic diet in anorexia nervosa: A case report"],"prefix":"10.1002","volume":"4","author":[{"given":"Chizuru","family":"Nohara","sequence":"first","affiliation":[{"name":"Department of Psychiatry NHO Maizuru Medical Center Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1130-052X","authenticated-orcid":false,"given":"Nobutaka","family":"Ayani","sequence":"additional","affiliation":[{"name":"Department of Psychiatry NHO Maizuru Medical Center Kyoto Japan"},{"name":"Department of Psychiatry, Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiharu","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Dainikitayama Hospital Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroyuki","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Palliative Care Mimihara General Hospital Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sumihiro","family":"Yamano","sequence":"additional","affiliation":[{"name":"Department of Psychiatry NHO Maizuru Medical Center Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7683-7825","authenticated-orcid":false,"given":"Teruyuki","family":"Matsuoka","sequence":"additional","affiliation":[{"name":"Department of Psychiatry NHO Maizuru Medical Center Kyoto Japan"},{"name":"Department of Psychiatry, Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,5,20]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1079\/BJN20041151"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/cdn\/nzab144"},{"key":"e_1_2_11_4_1","first-page":"396","article-title":"Low\u2010carbohydrate diets: what are the potential short\u2010 and long\u2010term health implications?","volume":"12","author":"Bilsborough SA","year":"2003","journal-title":"Asia Pac J Clin Nutr"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2019.11.021"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacl.2015.11.010"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/MED.0000000000000764"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.41189"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu11071442"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2024.1392135"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.162.5.679"}],"container-title":["Psychiatry and Clinical Neurosciences Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pcn5.70124","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T12:56:37Z","timestamp":1750942597000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pcn5.70124"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,20]]},"references-count":10,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1002\/pcn5.70124"],"URL":"https:\/\/doi.org\/10.1002\/pcn5.70124","archive":["Portico"],"relation":{},"ISSN":["2769-2558","2769-2558"],"issn-type":[{"type":"print","value":"2769-2558"},{"type":"electronic","value":"2769-2558"}],"subject":[],"published":{"date-parts":[[2025,5,20]]},"assertion":[{"value":"2024-12-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70124"}}