OBESITY AND NUTRITION: Edited by Eric C. WestmanReversal of severe hypertriglyceridemia with intermittent fasting and a very-low-carbohydrate ketogenic diet: a case seriesDas, Subrata; McCreary, Jordanb; Shamim, Shariqc; Kalayjian, Trod,eAuthor Information aMount Sinai Morningside-West, Icahn School of Medicine at Mount Sinai bAlbert Einstein College of Medicine cBurrell College of Osteopathic Medicine dYale New Haven Health System, Greenwich Hospital, Greenwich, Connecticut eDr Tro's Medical Weight Loss & Direct Primary Care, New York, USA Correspondence to Tro Kalayjian, MD, Yale New Haven Health System, Greenwich Hospital, Greenwich, CT, USA. Tel: +1 845 397 2873; e-mail: [email protected] Current Opinion in Endocrinology & Diabetes and Obesity: October 2020 - Volume 27 - Issue 5 - p 308-311 doi: 10.1097/MED.0000000000000566 Buy Metrics Abstract Purpose of review To illustrate successful reversal of hypertriglyceridemia using a very-low-carbohydrate ketogenic diet in conjunction with intermittent fasting in two patients. Recent findings Hypertriglyceridemia remains an important component of residual risk for atherosclerotic cardiovascular disease. Current guidelines from the AHA/ACC recommend the initiation of a very-low-fat diet to treat persistently elevated triglycerides, whereas the National Lipid Association argues that a very-low-carbohydrate, high-fat diet is contraindicated in severe hypertriglyceridemia. In contrast, we report resolution of two cases of severe hypertriglyceridemia with implementation of very-low-carbohydrate ketogenic diets and intermittent fasting. Summary Here, we describe two patients who have demonstrated substantial reductions in serum triglycerides, effectively reversing severe hypertriglyceridemia using unconventional dietary methods. Although anecdotal, these cases point to a critical lack of flexibility in current dietary guidelines that hinder their application in clinical practice. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.