Milly Gaines
The ketogenic diet is a popular, very-low-carb, high-fat, and moderate-protein diet. It is used for weight loss and to improve overall health and well-being. However, the keto diet may not be suitable for people with high cholesterol. This is because the keto diet may affect cholesterol levels, specifically by raising levels of low-density lipoprotein (LDL), or bad cholesterol.
Some studies have shown that the keto diet can lower levels of high-density lipoprotein (HDL), or good cholesterol, while raising levels of LDL cholesterol. Other studies have shown that the keto diet can decrease total cholesterol and LDL cholesterol levels.
The effect of the keto diet on cholesterol levels may depend on the quality of the diet and individual genetic factors. It is important to consult a healthcare professional before starting the keto diet, especially if you have high cholesterol or other risk factors for heart disease.
| Characteristics | Values |
|---|---|
| Effect on cholesterol levels | Some studies suggest that the keto diet can lower levels of high-density lipoprotein (HDL), or "good" cholesterol, but raise levels of low-density lipoprotein (LDL), or "bad" cholesterol. However, other studies have found conflicting results. |
| Effect on weight loss | The keto diet has been shown to be effective for weight loss, but it may not be superior to other weight-loss diets. |
| Effect on appetite control | Low- and very-low-carb diets offer greater benefits for appetite control. |
| Effect on triglycerides | The keto diet has been shown to reduce triglyceride levels. |
| Effect on medication for type 2 diabetes | The keto diet has been shown to decrease the need for medication in people with type 2 diabetes. |
| Effect on blood pressure | The keto diet may lead to changes in blood pressure. |
| Risk factors | The keto diet may not be suitable for people with high cholesterol, fat-induced lipemia, kidney disease, liver disease, familial hypercholesterolemia, or a genetic disorder that influences fat metabolism. |
What You'll Learn
The impact of keto on LDL cholesterol is unclear
The impact of the keto diet on LDL cholesterol is not entirely clear. While some studies suggest that the keto diet can raise LDL cholesterol levels, others indicate that it has no effect or even decreases LDL cholesterol. The National Lipid Association's position statement on low-carb and very-low-carb ketogenic diets notes that research shows keto produces modest reductions in triglycerides, modest changes in HDL ("good" cholesterol), and minimal changes in LDL ("bad" cholesterol) levels. Some studies included in the review showed an increase in LDL on low- or very-low-carb diets, while others showed a decrease.
One possible explanation for the conflicting results is the variation in the types of fats consumed while following a keto diet. Unsaturated fats, such as those found in nuts, seeds, and fatty fish, are associated with lower LDL cholesterol levels, while saturated fats, found in foods like butter, coconut oil, and animal fat, can increase LDL cholesterol. The quality of the keto diet, including the types of fats consumed, may play a significant role in its impact on LDL cholesterol levels.
Additionally, individual factors, such as genetics, may also influence the effect of the keto diet on LDL cholesterol. Some people with a rare genetic condition that affects LDL particle regulation may experience a significant increase in LDL cholesterol levels when following a keto diet. Familial hypercholesterolemia, an inherited condition characterized by high LDL cholesterol levels and an increased risk of premature heart disease, is another important consideration. Only about 10% of people with this condition are aware they have it, so it is crucial to consult a healthcare professional before starting a keto diet, especially if there is a family history of heart disease.
Furthermore, the long-term effects of the keto diet on LDL cholesterol are not well understood. While some studies have shown that LDL cholesterol levels may increase initially, they tend to decrease over time as weight loss continues. Therefore, it is recommended to monitor cholesterol levels for a couple of months after weight loss has stabilized to get a more accurate assessment of the impact of the keto diet on LDL cholesterol.
In summary, while some evidence suggests that the keto diet may raise LDL cholesterol levels, the impact is not clear-cut and can vary depending on individual factors and the types of fats included in the diet. Close monitoring of cholesterol levels and consultation with a healthcare professional are essential to ensure the keto diet is safe and appropriate for each individual.
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Keto may be harmful to those with a genetic mutation that affects LDL regulation
The ketogenic diet is a high-fat, low-carb, and moderate-protein diet that has gained popularity as a rapid weight-loss tool. While the keto diet is advertised as safe, its long-term implications are not entirely understood, and it is not recommended by most professional medical societies as a healthy dietary regimen for weight loss.
The keto diet's high saturated fatty acid content may lead to an increase in total cholesterol and low-density lipoprotein (LDL) cholesterol levels. While previous studies have shown only a modest, transient elevation in cholesterol in the average keto-diet participant without a clear impact on atherosclerotic cardiovascular disease (ASCVD), some individuals may experience a more dramatic elevation in LDL-cholesterol levels.
In a case series published in the American Journal of Preventive Cardiology, researchers identified a group of 17 patients who experienced unprecedentedly elevated LDL-cholesterol levels after initiating a ketogenic diet. Five of these patients underwent genetic testing, and two were found to have a mutation of the LDL-R gene, which is associated with elevated LDL cholesterol levels.
Therefore, while the keto diet may be beneficial for some individuals, it may be hazardous for those with a genetic mutation affecting LDL regulation. It is essential to consult with a healthcare professional before starting any new diet, especially for those with high cholesterol or a family history of heart disease.
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The importance of consulting a doctor before starting keto
Keto is a high-fat, low-carbohydrate diet that can be effective for weight loss and certain health conditions. However, it is important to consult a doctor before starting this or any other diet, especially if you have existing health concerns. Here are some reasons why consulting a doctor is crucial before starting keto:
- Potential health risks: Keto can lead to an increase in "bad" LDL cholesterol, which is linked to heart disease. It may also cause nutrient deficiencies, liver problems, kidney issues, constipation, and fuzzy thinking. These risks are heightened for those with existing medical conditions.
- Individualised advice: A doctor can provide tailored advice based on your health history and current condition. They can assess whether keto is suitable for you and guide you on how to start and maintain the diet safely.
- Medication adjustments: If you are taking medications for high blood pressure or diabetes, it is crucial to consult a doctor before starting keto. The diet may impact your medication needs and dosage.
- Existing health conditions: If you have an ongoing medical issue such as high cholesterol, asthma, diabetes, or joint pain, consulting a doctor is essential. They can advise on how the keto diet may affect your condition and any necessary precautions.
- Pregnancy: If you are pregnant or trying to conceive, it is vital to seek medical advice before starting keto or any restrictive diet.
- Weight concerns: If you feel significantly overweight, a doctor can help assess your current health status and determine if keto is a safe and appropriate approach for you.
- Physical activity: Consulting a doctor can help determine if your current exercise routine is safe and suitable for your fitness level. They can also advise on any necessary adjustments when starting keto.
- Monitoring and adjustments: Regular check-ins with your doctor are important to monitor your health and the impact of the keto diet. They can assess your cholesterol levels, blood pressure, and other relevant biomarkers to ensure the diet is not causing harm.
- Individual variations: Not everyone will respond to keto in the same way. A doctor can help you understand your unique challenges and goals, creating a specialised diet and exercise plan tailored to your needs.
- Long-term sustainability: Keto may be challenging to maintain long-term due to its restrictive nature. A doctor can provide guidance on how to safely incorporate keto into your lifestyle and make any necessary adjustments over time.
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The types of fat consumed on keto may affect cholesterol levels
The types of fat consumed on a keto diet may affect cholesterol levels. The keto diet involves eating high amounts of fat, moderate amounts of protein, and minimal amounts of carbohydrates. The specific daily allowances are as follows: 55–60% of the day's total macronutrients should be fat, and 5–10% should be carbohydrates.
The keto diet's high-fat content can lead to an increase in saturated fat intake, which has been linked to poor heart health and elevated LDL cholesterol levels. However, the impact of the keto diet on cholesterol levels is not clear-cut. Some studies suggest that the keto diet can lower levels of HDL ("good") cholesterol and raise levels of LDL ("bad") cholesterol. In contrast, other studies have found that the keto diet leads to healthier cholesterol levels, with lower triglyceride levels and higher HDL cholesterol levels.
The discrepancy in these findings may be due to differences in the types of fat consumed on the keto diet. When LDL cholesterol levels increased, it was found that participants consumed a higher ratio of saturated to unsaturated fatty acids. On the other hand, when LDL cholesterol levels decreased, participants ate a keto diet high in healthy unsaturated fats and limited in unhealthy saturated fats.
Therefore, it is important to distinguish between different types of fats when considering the impact of the keto diet on cholesterol levels. Replacing saturated fats with unsaturated fats is generally associated with a lower risk of cardiovascular disease.
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The long-term effects of keto are unknown
The long-term effects of the keto diet are unknown. While some studies suggest that the keto diet can lower levels of high-density lipoprotein (HDL), or "good" cholesterol, it may also raise levels of low-density lipoprotein (LDL), or "bad" cholesterol.
The keto diet is a high-fat, moderate-protein, and very low-carbohydrate diet. On the keto diet, individuals consume up to 80% of their calories from fat and stick to 20 to 50 grams of net carbs per day. This means that people on the keto diet eat a lot of fat, which may include unhealthy choices such as butter, coconut oil, and animal fat. These are all sources of saturated fat, which has been linked to poor heart health by the American Heart Association (AHA).
The effect of the keto diet on heart health is not straightforward. While the keto diet may not have as detrimental an effect on cholesterol as previously thought, the impact of the diet on lipids is modest. Research shows that the keto diet produces modest reductions in triglycerides, modest changes in HDL, and minimal changes in LDL levels. However, some studies show an increase in LDL on low- or very-low-carb diets.
The impact of the keto diet on LDL cholesterol is unclear. Hypothetically, if an individual has a normal triglyceride level and is doing keto to lose weight, their LDL may remain stable. Similarly, if someone has high triglycerides that decrease on keto, their LDL may still stay the same.
The keto diet may be harmful to people with a genetic mutation that affects LDL regulation. If these individuals follow a keto diet, their LDL levels can skyrocket. This result does not happen often enough to skew overall results in population studies, but it can be dangerous for those with the genetic predisposition.
While the keto diet may not be suitable for everyone, it is important to note that having high cholesterol does not automatically disqualify someone from trying the keto diet. Doctors will consider the overall picture, including biomarkers like triglycerides, A1C, blood pressure, and body mass index (BMI), to determine if the keto diet is appropriate for an individual.
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Frequently asked questions
The keto diet is likely not the best option for you if you have high cholesterol, especially if you have familial hypercholesterolemia (high cholesterol levels inherited from family). If you have high cholesterol levels and are interested in trying the keto diet, it’s important to ask a healthcare professional whether the diet is suitable for you, based on your particular cholesterol levels and overall health.
The keto diet, short for ketogenic diet, is a popular diet that people use to lose weight and improve their overall health and well-being. It involves restricting your total carbohydrate intake to 20–50 grams per day, which forces your body to shift from using glucose as its main source of energy to using ketone bodies, a type of chemical formed from the breakdown of fat.
The keto diet may affect cholesterol levels, but more research needs to be done to know for sure. Some studies suggest that the keto diet can lower levels of high-density lipoprotein (HDL), or "good" cholesterol, but raise levels of low-density lipoprotein (LDL), or "bad" cholesterol. Other studies have found that the keto diet can improve total cholesterol and HDL cholesterol, with no significant effect on LDL cholesterol levels.
Consuming mostly unsaturated fats, compared to saturated fats, while on a keto diet may improve cholesterol levels, especially LDL cholesterol levels. Unsaturated fats are found in foods such as plant oils like olive, avocado, sunflower, corn, and canola oils; fatty fish, including salmon, sardines, tuna, and mackerel; nuts and nut butters; and seeds, such as flax, sesame, sunflower, and chia.
The keto diet is generally healthful for most people and can even help lower cholesterol levels in the long term. However, the keto diet may not be appropriate for everyone. If you have high cholesterol, it’s important to talk with your healthcare provider before starting a ketogenic diet. They will evaluate your overall health, the medications you take, and other risk factors to advise whether a keto diet is healthy for you.
