Keto Diet: Good Or Bad For Cholesterol?

The ketogenic diet is a popular, very low-carb, high-fat, and moderate-protein diet. It has been shown to help with weight loss, but its effect on heart health and cholesterol levels is less clear. While some studies suggest that a keto diet may lead to a modest increase in bad LDL cholesterol, others indicate that it can lower LDL cholesterol levels, especially when consuming healthy unsaturated fats. Overall, the impact of the keto diet on cholesterol may depend on various factors, including the quality of the diet, the types of fats consumed, and individual genetic factors.

The effect of keto on heart health

The keto diet is a popular eating regimen that involves a high-fat, moderate-protein, and very low-carbohydrate approach to food. The aim is to shift the body from burning carbohydrates for energy to burning fat, a state known as ketosis. While the keto diet has been touted for its weight-loss benefits, its impact on heart health and cholesterol levels is a topic of ongoing debate and research.

The link between keto, cholesterol, and heart health

Cholesterol levels are a critical factor in heart health. High levels of low-density lipoprotein (LDL) cholesterol, also known as "bad" cholesterol, contribute to fatty buildup in the arteries, increasing the risk of heart attack and stroke. On the other hand, high-density lipoprotein (HDL) cholesterol, or "good" cholesterol, helps remove LDL cholesterol from the arteries, offering protection against cardiovascular events.

The concern with the keto diet is that its high-fat content may lead to a spike in cholesterol levels, particularly LDL cholesterol. This is because the keto diet often includes large amounts of saturated fat, found in foods like butter, coconut oil, and animal fat, which have been linked to poor heart health.

Research findings on keto and cholesterol

Several studies have investigated the impact of keto on cholesterol levels, with varying results. Some research suggests that keto produces modest reductions in triglycerides and minimal changes in LDL cholesterol levels, while having a more positive effect on HDL cholesterol. However, other studies have shown an increase in LDL cholesterol on low- or very-low-carb diets.

The impact of keto on cholesterol levels appears to depend on the quality of the diet and individual genetic factors. A well-planned keto diet that includes heart-healthy, unsaturated fats, such as nuts, nut butter, seeds, avocado, and extra virgin oils, may have a more positive effect on cholesterol levels. Additionally, those with a genetic predisposition, such as familial hypercholesterolemia, may experience a more significant increase in LDL cholesterol on a keto diet.

Recommendations for following keto

While the keto diet may be an option for some, it is crucial to consult with a healthcare provider before starting. This is especially important for those with high cholesterol or other risk factors for heart disease. Close monitoring of cholesterol levels during keto is essential to ensure they do not reach unsafe levels. Additionally, a clear plan for transitioning off the keto diet is important, as most people cannot follow it long-term.

In conclusion, the effect of the keto diet on heart health is complex and depends on various factors. While it may offer some benefits, such as weight loss and improved insulin sensitivity, its impact on cholesterol levels and heart health is still being elucidated. More long-term, large-scale studies are needed to fully understand the effects of keto on heart health and to determine the optimal way to follow this diet for those who choose to do so.

The impact of keto on bad LDL cholesterol

The keto diet is a high-fat, low-carbohydrate diet that has been linked to both positive and negative effects on cardiovascular health. While the diet has been shown to aid weight loss, its impact on cholesterol levels, particularly LDL cholesterol, is still being studied.

The link between keto and LDL cholesterol

The keto diet involves consuming a high proportion of calories from fat (up to 80%) and a very low amount of carbohydrates (less than 50 grams per day). This shift in calorie intake can impact cholesterol levels, including LDL cholesterol, also known as "bad" cholesterol.

Some studies have shown that the keto diet can lead to a modest increase in LDL cholesterol levels. This may be due to the high intake of saturated fats associated with the keto diet, such as butter, coconut oil, and animal fats. These saturated fats have been linked to poor heart health and can contribute to fatty buildup in the arteries, increasing the risk of heart disease and stroke.

However, the effect of keto on LDL cholesterol is not consistent across all individuals. Some studies have found no significant changes or even a decrease in LDL cholesterol levels among participants on a keto diet.

Factors influencing the impact of keto on LDL cholesterol

The impact of the keto diet on LDL cholesterol may depend on various factors:

• Diet quality: The type of fats consumed while on the keto diet is crucial. Consuming mostly unsaturated fats, such as plant oils, fatty fish, nuts, and seeds, can improve LDL cholesterol levels. In contrast, a high intake of saturated fats can lead to increased LDL cholesterol.
• Genetics: Genetic factors may also play a role in how the keto diet influences LDL cholesterol levels. Individuals with an inherited condition called familial hypercholesterolemia have very high LDL cholesterol levels and an increased risk of premature heart disease. Those with this condition should consult with their healthcare provider before considering a keto diet. Additionally, some people have a rare genetic condition that affects how LDL particles are regulated, causing high LDL cholesterol levels.
• Individual health history: The impact of the keto diet on LDL cholesterol may vary depending on an individual's health history. For example, those with insulin resistance, type 2 diabetes, or abdominal obesity may experience different effects on their LDL cholesterol levels compared to healthy individuals.
• Duration of the diet: The long-term effects of the keto diet on LDL cholesterol are still being studied. While some studies have shown positive effects, larger and longer-term studies are needed to fully understand the impact of keto on LDL cholesterol over time.

Recommendations and precautions

Before adopting the keto diet, it is essential to consult with a healthcare professional, especially for those with high cholesterol or other risk factors for heart disease. Regular testing and monitoring of cholesterol levels are crucial to ensure the diet is not causing unsafe changes. Additionally, incorporating heart-healthy, unsaturated fats into the diet is recommended to potentially improve LDL cholesterol levels.

The impact of keto on good HDL cholesterol

The impact of a keto diet on HDL ("good") cholesterol is a topic of interest, with some studies suggesting that it can lead to an increase in HDL levels. This is particularly true when people replace carbohydrates with saturated, monounsaturated, and polyunsaturated fats.

For example, a study published in the Journal of Clinical Lipidology in October 2019 found that the keto diet generally resulted in modest changes in HDL levels. Another study, which monitored people who followed a keto diet for a year, found that they had higher HDL cholesterol levels than those following a low-fat diet.

Additionally, a small randomized controlled study from August 2020 found that older adults with obesity who followed a very low-carb diet experienced improvements in HDL cholesterol levels. Similarly, a study from 2018 reported that the keto diet could raise HDL cholesterol levels.

However, it is important to note that the impact of the keto diet on HDL cholesterol may depend on the quality of the diet and individual factors. Some studies have found conflicting results, with one older study finding no change in HDL levels among participants following a keto diet.

Overall, while the keto diet may have a positive impact on HDL cholesterol for some individuals, more research is needed to fully understand its effects, especially in the long term.

The role of genetics in keto's effect on cholesterol

The ketogenic diet is a high-fat, low-carb diet that has become popular for weight loss. While the keto diet may not have as detrimental an effect on cholesterol as previously thought, it is important to note that its impact on heart health is complex and influenced by various factors, including genetics.

Research suggests that the keto diet can lead to a modest increase in cholesterol levels, particularly high-density lipoprotein (HDL) or "good" cholesterol, and minimal changes in low-density lipoprotein (LDL) or "bad" cholesterol. However, the impact of the keto diet on LDL cholesterol is less clear, and it may vary depending on diet quality and individual factors.

Genetics play a significant role in keto's effect on cholesterol. Some individuals with a genetic predisposition to cholesterol metabolism dysregulation may experience a disproportionate elevation in cholesterol levels when following a ketogenic diet. This is often observed in individuals with a genetic mutation affecting LDL regulation, such as the APOE gene or familial hypercholesterolemia (FH). In these cases, the keto diet can lead to a significant increase in LDL cholesterol levels, which could potentially increase the risk of cardiovascular disease.

It is important to note that only about 10% of people with FH are aware of their condition. Therefore, consulting a doctor before starting the keto diet is crucial, especially for individuals with a family history of heart disease or high cholesterol. Doctors can help determine if the keto diet is safe for an individual's specific health concerns and can monitor for any cholesterol spikes during the diet.

Additionally, the types of fat consumed while on the keto diet are essential. Consuming unhealthy sources of saturated fat, such as butter, coconut oil, and animal fat, may contribute to poor heart health and increased LDL cholesterol levels. Instead, prioritizing heart-healthy, unsaturated fats, such as nuts, seeds, avocado, and extra virgin oils, is recommended.

The importance of fat quality on keto

The ketogenic diet is a high-fat, very-low-carb diet. It involves eating up to 80% of your calories from fat and limiting net carbs to 20-50 grams per day. This means that the quality of the fats you consume is crucial for maintaining good health and achieving your desired results.

Firstly, it is important to understand the different types of fats and their effects on the body. The four main types of fats are saturated fats, polyunsaturated fats, monounsaturated fats, and trans fats.

Saturated Fats

Saturated fats have been associated with an increased risk of heart disease due to their potential to raise cholesterol levels. However, recent studies suggest that not all saturated fats have the same impact on cholesterol. For example, stearic acid, found in meat, has been linked to lower cholesterol levels and reduced plaque build-up. On the other hand, lauric, myristic, and palmitic acids, found in coconut oil and dairy products, can increase cholesterol levels.

Polyunsaturated Fats

Polyunsaturated fats are typically found in vegetable oils and are praised for their health benefits. However, when consumed in high quantities, they can contribute to cancer and heart disease. This is because polyunsaturated fats are less stable and more susceptible to oxidation, which can damage arterial walls and lead to plaque build-up. Omega-3 and Omega-6 polyunsaturated fats are essential for optimal health, but they should be consumed in moderation and obtained from whole food sources like fatty fish, nuts, and seeds.

Monounsaturated Fats

Monounsaturated fats are considered "healthy" fats due to their positive impact on heart health and cholesterol levels. They can be found in olive oil, avocados, peanuts, and peanut butter. Studies show that these fats can improve insulin resistance and optimise HDL/LDL cholesterol levels.

Trans Fats

Trans fats are artificially produced and are known to increase the risk of heart disease. They are often found in highly refined oils and commercially prepared processed foods, such as cakes, cookies, and crackers. It is best to avoid these fats as much as possible.

When following a keto diet, it is crucial to prioritise healthy, natural sources of fat. Avocados, nuts, olive oil, fatty fish like salmon, and full-fat Greek yogurt are excellent choices. These foods provide essential nutrients, support heart health, and promote balanced blood sugar levels. Additionally, it is recommended to limit processed meats, fried foods, and refined vegetable oils, as they may negatively impact your health.

In conclusion, the quality of fat is of utmost importance on a keto diet. By choosing healthy, natural sources of fat and avoiding processed and refined options, you can optimise your health, achieve your desired results, and potentially improve your cholesterol levels. Remember to consult with your doctor or a healthcare professional before starting any new diet, especially if you have existing health conditions.

Frequently asked questions