Keto And Atherosclerosis: What's The Real Connection?

The ketogenic diet is a high-fat, low-carb eating plan that has gained popularity in recent years. While it can lead to rapid weight loss, there are concerns about its impact on cardiovascular health and the potential for long-term consequences. The diet's restriction of carbohydrates and allowance of liberal fat intake, including saturated fats, has sparked debates among cardiologists and health professionals.

The ketogenic diet has been linked to both positive and negative effects on heart health. On the one hand, it can lead to a rapid reduction in weight and favourable biomarker changes, such as lower blood sugar and improved insulin function. However, it also raises LDL cholesterol levels, which is a risk factor for heart disease. The specific foods chosen on the keto diet matter, too. Studies have found that emphasising animal sources of fat and protein increases the risk of developing Type 2 diabetes, while emphasising vegetable sources and reducing refined carbs lowers the risk.

The impact of the keto diet on cardiovascular health may depend on individual factors such as genetics and pre-existing health conditions. For those prone to heart disease, the keto diet may be dangerous and should only be attempted under medical supervision. Overall, while the keto diet may offer some benefits, more research is needed to understand its long-term effects, especially regarding heart health.

The impact of keto on cholesterol and triglyceride levels

The ketogenic diet has been shown to have a positive impact on cardiovascular disease (CVD) risk factors, but its effect on atherosclerosis, the main cause of CVD, is less clear. Atherosclerosis is the build-up of fatty plaques in the arteries, which can lead to chest pain, heart attack, or stroke. While the keto diet can help to reduce some risk factors for atherosclerosis, such as high cholesterol and triglyceride levels, there are also concerns that it may increase these risk factors in certain individuals.

The impact of keto on cholesterol

The keto diet typically involves a significant reduction in carbohydrate intake and a corresponding increase in fat intake. This can have a range of effects on cholesterol levels, including:

• An increase in low-density lipoprotein (LDL) cholesterol, often referred to as "bad" cholesterol. This is because keto diets tend to be high in saturated fat, which can raise LDL cholesterol. However, some studies suggest that the increase in LDL cholesterol on a keto diet may be limited to large LDL particles, which are less likely to cause atherosclerosis than smaller LDL particles.
• An increase in high-density lipoprotein (HDL) cholesterol, often referred to as "good" cholesterol.
• A decrease in very-low-density lipoprotein (VLDL) cholesterol, which is a risk factor for atherosclerosis.

It is important to note that the impact of the keto diet on cholesterol levels may vary depending on individual factors such as familial hypercholesterolemia, hypothyroid issues, and chronic inflammation. For most people, the keto diet appears to have a beneficial effect on cholesterol levels, but for a small subset of the population, it may increase the risk of atherosclerosis.

The impact of keto on triglyceride levels

Triglycerides are another type of blood lipid that can increase the risk of atherosclerosis. The keto diet has been consistently shown to decrease triglyceride levels, likely due to the reduction in carbohydrate intake. This effect has been observed even in people with type 2 diabetes, a condition that is associated with high triglyceride levels.

Overall impact on cholesterol and triglyceride levels

Overall, the keto diet appears to have a positive impact on cholesterol and triglyceride levels for most people, which may help to reduce the risk of atherosclerosis. However, for a small subset of the population, the keto diet may increase the risk of atherosclerosis by raising LDL cholesterol levels. It is important to monitor cholesterol levels while following a keto diet and make adjustments as needed to optimize health outcomes.

How keto affects blood pressure

Research shows that blood pressure is a crucial indicator of your risk of developing cardiovascular diseases. If left untreated, high blood pressure can really take a toll on your heart and vascular health and make serious complications more prevalent.

Fortunately, diet can be used as an effective tool for reducing blood pressure. Evidence shows that keto may be one of the best approaches for managing high blood pressure.

The Impact of Keto on Blood Pressure

• Studies indicate that low-carb diets are more effective than both higher-carbohydrate diets and a low-fat diet coupled with weight loss medication that also lowers blood pressure.
• One study found that a ketogenic Mediterranean diet high in healthy fats, fish, and vegetables may have an even more substantial impact on blood pressure levels. The blood pressure reduction achieved with this dietary approach was similar to the results achieved in trials on the DASH diet (which is a diet specifically designed to help treat and prevent high blood pressure).
• If you’d like to learn more about blood pressure and the keto diet, check out our article titled “Can a Low Carb Diet Lower Blood Pressure?”

The Impact of Keto on Insulin Resistance and Type 2 Diabetes

In general, the risk of heart disease-related death and stroke are twice as high in people with diabetes. This startling statistic can be traced back to two key issues:

• Type 2 diabetics are typically also struggling with several other risk factors for heart disease.
• High blood sugar levels drive inflammation and slow blood flow, which both can accelerate atherosclerosis.

Both of these issues can be addressed with the keto diet. When study subjects with type 2 diabetes followed a low-carbohydrate ketogenic diet, they lost substantial amounts of weight, and their blood sugar and HbA1c levels dropped significantly. Even studies that put healthy individuals on a ketogenic diet found similar improvements.

In fact, many studies suggest that ketogenic diets are more effective in managing and preventing diabetes when compared to low-calorie diets. Altogether, these promising results can be explained in part by the fact that the keto diet:

• Helps us sustain a calorie deficit, which increases insulin sensitivity and lowers blood sugar and HbA1C.
• Helps us lose fat, which reduces inflammation and the production of signaling molecules that can provoke insulin resistance and heart disease.
• Significantly reduces our glycemic load, which helps us regulate blood sugar levels and decrease our insulin needs.
• Stimulates the use of ketones, which can help reduce insulin resistance and inflammation levels.

The Impact of Keto on Wellbeing, Stress, and Depression

Mental health has a significant impact on heart disease risk, directly and indirectly. Directly, through the effects of chronic stress on heart function, and indirectly, by contributing to other risk factors such as high blood pressure, visceral fat accumulation, high blood pressure, high blood sugar levels, and abnormal blood lipid levels.

Although dietary changes may not be the first thing you think of doing when you are trying to improve the psychological aspects of life, diet can have a substantial impact. Take the keto diet for example.

Research indicates that carb restriction may help address mental health on multiple levels:

• By decreasing inflammation throughout the body and brain. Chronic inflammation can lead to poor mental and physical health. Plus, anti-inflammatory practices, such as exercise and consuming omega-3 fatty acids, have been shown to have a strong effect on mental health. Since keto dieting can help reduce inflammation levels, it may have similar effects as well.
• By reducing glutamate toxicity. When there’s too much excitement (caused by the neurotransmitter glutamate) in the brain, that’s known as neurotoxicity. At its worst, neurotoxicity causes seizures as we see in those with epilepsy. Depression and other mood disorders also have links to neurotoxicity. One way to regulate glutamate activity is by decreasing carb intake and increasing ketone use.
• By decreasing health-related stressors. The keto diet provides us with a way to lose weight and improve health at the same time. This can help us feel like we have more control over our health and body composition, resulting in a greater sense of wellbeing.

Although the effects that the keto diet has on mental health have yet to be studied directly, it is reasonable to speculate that this dietary change can have a significant impact on the psychological aspects of our lives as well.

The link between keto, insulin resistance and type 2 diabetes

The link between keto, insulin resistance, and type 2 diabetes

The ketogenic diet has been shown to be an effective tool for managing and preventing type 2 diabetes. This is because the keto diet:

• Helps us sustain a calorie deficit, which increases insulin sensitivity and lowers blood sugar and HbA1C.
• Helps us lose fat, which reduces inflammation and the production of signalling molecules that can provoke insulin resistance and heart disease.
• Significantly reduces our glycemic load, which helps us regulate blood sugar levels and decrease our insulin needs.
• Stimulates the use of ketones, which can help reduce insulin resistance and inflammation levels.

Research has shown that when study subjects with type 2 diabetes followed a low-carbohydrate ketogenic diet, they lost substantial amounts of weight, and their blood sugar and HbA1c levels dropped significantly. Even studies that put healthy individuals on a ketogenic diet found similar improvements.

In fact, many studies suggest that ketogenic diets are more effective in managing and preventing diabetes when compared to low-calorie diets.

The link between keto and insulin resistance

Insulin resistance is a key driver of type 2 diabetes. It is also a major risk factor for heart disease. This is because high insulin levels drive inflammation and slow blood flow, which can accelerate atherosclerosis.

The keto diet has been shown to increase insulin sensitivity and lower blood sugar and HbA1C. This means that the keto diet can help to reduce the risk of heart disease by improving insulin resistance.

The link between type 2 diabetes and heart disease

In general, the risk of heart disease-related death and stroke are twice as high in people with diabetes. This is because type 2 diabetics are typically also struggling with several other risk factors for heart disease.

The keto diet can help to address these risk factors by improving insulin resistance and reducing inflammation. This, in turn, can help to slow or prevent the development of atherosclerosis.

The keto diet can be an effective tool for managing and preventing type 2 diabetes. It can also help to reduce the risk of heart disease by improving insulin resistance and reducing inflammation. However, it is important to monitor your health when making any major dietary change, as a small subset of the population may experience a worsening of blood lipid levels after following a high-fat, low-carb diet.

The effect of keto on mental health and stress

The ketogenic diet has been recognised for its potential physical and mental health benefits. A recent study suggests that a ketogenic diet may also be associated with better mood and mental well-being in the general population. The findings suggest that following a ketogenic diet may be linked with better mental and emotional health in the general population, with benefits increasing over time.

The keto diet may reduce stress, anxiety, and depression. The diet could increase gamma-aminobutyric acid (GABA) levels, promoting calmness and relaxation similar to the effects of benzodiazepines. The diet may also influence neurotransmitters like dopamine and serotonin, which regulate mood, and the gut microbiome, which affects behaviour and stress response.

The keto diet is proven to be beneficial in treating migraines, epilepsy, and Alzheimer's disease. Some of the ways the diet relieves depression include:

• Increasing substances that play critical roles in managing stress, anxiety, and mood. Low levels of these substances are linked to clinical depression.
• Improving mitochondrial function. The mitochondria are the part of our cells that generate energy needed for the cell to function. Mitochondrial dysfunction is linked to depression.
• Decreasing oxidative stress. Ketogenic diets can improve your body's antioxidant activity, helping to reverse some of the damage caused by free radicals in your cells.
• Regulating insulin function. High sugar diets may cause your body to be sugar resistant, causing an increase in weight, heart disease, and depression.
• Decreasing inflammation. A ketogenic diet may inhibit inflammation or improve chronic inflammation.

Issues and considerations

Not everybody adjusts well to ketosis. Sometimes, your body may experience symptoms that are difficult to manage, including headaches, sleep disturbances, cramping, and fatigue. This may lead to depression. The keto diet may also cause problems like nutrient deficiencies, kidney problems, liver issues, constipation, and mood swings.

There is insufficient evidence for the use of the diet in mental disorders, and it is not a recommended treatment option. This diet may not be for everyone, especially those with pre-existing health conditions. Please speak with your doctor before starting any new diet plan.

How keto changes your plant and alcohol intake

The keto diet is a low-carb, high-fat diet that can be challenging to maintain due to the restricted intake of certain foods and drinks. Here's how the keto diet affects your plant and alcohol intake:

Plant Intake on Keto

The keto diet's emphasis on high-fat and low-carb intake may lead to a reduction in plant-based foods, especially those that are starchy or high in natural sugars. This includes fruits, certain vegetables, grains, legumes, and starchy tubers. The restriction of these plant-based foods may impact your fibre, vitamin, and mineral intake, which are essential for a healthy gut and overall well-being. However, it's important to note that the keto diet does not entirely eliminate plant-based foods. Non-starchy vegetables, such as leafy greens, asparagus, broccoli, and cauliflower, are encouraged on the keto diet as they are low in carbohydrates and provide essential nutrients. Additionally, avocados, olives, nuts, and seeds are also plant-based sources of healthy fats that are well-suited for the keto diet.

Alcohol Intake on Keto

Alcoholic beverages can be tricky to navigate on the keto diet. Here's what you need to know:

• Low-carb alcoholic drinks: Pure forms of alcohol like whiskey, gin, tequila, rum, and vodka are free of carbohydrates. Dry red or white wine, extra dry champagne, and light beer also fall into this category, typically containing fewer than 6 grams of carbohydrates per serving.
• Mixers: When it comes to mixers, opt for low-carb options like diet soda, seltzer, diet tonic water, or powdered flavour packets. Regular soda, juice, sweeteners, and energy drinks can quickly add carbohydrates to your drink.
• High-carb drinks to avoid: Cocktails, mixed drinks, and regular beer often contain high amounts of carbohydrates due to their sugary ingredients. A single serving of regular beer can contain upwards of 12 grams of carbs.
• Impact on ketosis: Alcohol can interrupt the state of ketosis as it provides an alternative energy source for your body to burn instead of fat. This can slow down the fat-burning process and potentially hinder your weight loss goals.
• Lowered alcohol tolerance: The keto diet may lead to a decrease in alcohol tolerance due to low glycogen levels. Carbohydrates help manage the feeling of being tipsy by slowing down the metabolization of alcohol. With very few carbs on keto, your body will process alcohol faster, leading to quicker intoxication.
• Health considerations: Even on the keto diet, it's important to consume alcoholic beverages in moderation. Alcoholic drinks, even low-carb options, are rich in "empty" calories and can contribute to weight gain, nutritional deficiencies, and serious health conditions such as liver problems, cancer, and heart disease.

Frequently asked questions