Ldl And Keto: Which Foods Should Be Avoided?

The ketogenic diet is a popular eating plan that involves eating high amounts of fat, moderate amounts of protein, and minimal amounts of carbohydrates. While it can be an effective way to lose weight, some people may find that certain keto foods raise their LDL cholesterol levels. LDL cholesterol is considered bad cholesterol because high levels can increase the risk of heart disease. To prevent this, people on the keto diet should avoid artificial trans fats, processed meats, and fried foods. Instead, they should focus on consuming polyunsaturated and monounsaturated fats found in plant-based oils, fish, and nuts.

Lean mass hyper-responders

LMHRs typically exhibit a marked elevation in LDL cholesterol levels, with some individuals experiencing increases from normal levels to as high as 500-800 mg/dL. This extreme rise in LDL cholesterol has raised concerns about the potential impact on cardiovascular health, particularly in those with a family history of heart disease. As a result, urgent clinical attention and further research are warranted to understand the cardiovascular risk associated with this phenotype.

One hypothesis to explain the LMHR phenomenon is the Lipid Energy Model. This model suggests that in lean, metabolically healthy individuals on a carbohydrate-restricted diet, there is an increase in the secretion of very-low-density lipoprotein (VLDL) by the liver. The subsequent lipoprotein-lipase-mediated remodelling of VLDL leads to an increase in both HDL and LDL cholesterol levels. Additionally, the model predicts that the rate of VLDL remodelling is influenced by energy demands and inversely related to body fat mass.

When managing LDL cholesterol levels in LMHRs, it is important to work closely with a healthcare professional. While lifestyle changes and pharmacological interventions may be considered, the decision should be individualised and based on the patient's preferences and medical history. It is also crucial to monitor LDL cholesterol levels frequently to assess the effectiveness of the chosen approach.

In summary, the LMHR phenotype is a unique metabolic subgroup characterised by extreme increases in LDL cholesterol levels when following a low-carbohydrate, ketogenic diet. Further research is needed to fully understand the underlying mechanisms, cardiovascular risks, and optimal management strategies for this specific population.

Saturated fats

When following a keto diet, it is advisable to consume lean meats and fish, such as salmon, that are rich in omega-3 fatty acids. Avocados, olive oil, nuts, and nut butters are also good sources of monounsaturated fats and can help lower cholesterol levels.

Additionally, certain polyunsaturated fats, like omega-3 fats, may aid in reducing triglyceride levels and increasing HDL ("good") cholesterol. Flax seeds, chia seeds, and walnuts are excellent sources of omega-3s.

It is worth noting that not all saturated fats are unhealthy. Coconut oil, for example, is praised for its high content of saturated fats and is often included in keto diets. However, when it comes to maintaining healthy cholesterol levels, prioritising unsaturated fats is generally recommended.

In summary, while on the keto diet, it is crucial to be mindful of the types of fats consumed. Opting for unsaturated fats found in foods like olive oil and salmon can help maintain healthy cholesterol levels and reduce the risk of cardiovascular disease.

Monounsaturated fats

Some examples of foods rich in monounsaturated fats include:

• Olive oil
• Safflower oil (high oleic)
• Peanut oil and butter
• Nuts (such as almonds, hazelnuts, pecans)
• Avocados
• Seeds (such as pumpkin seeds and sesame seeds)

It is important to note that while monounsaturated fats are a healthier choice, consuming too much fat can lead to weight gain. Therefore, it is recommended to keep total fat consumption, including monounsaturated and polyunsaturated fats, to no more than 25-30% of your daily calories.

Polyunsaturated fats

It is important to note that while polyunsaturated fats are beneficial, consuming too much fat can lead to weight gain. Therefore, it is recommended to keep total fat consumption, including polyunsaturated fats, to no more than 25-30% of your daily calories.

Genetic predisposition

The ketogenic diet is a high-fat, low-carbohydrate diet that has gained popularity as a rapid weight-loss tool. While the diet has been shown to have several health benefits, there are concerns about its impact on cholesterol levels, specifically low-density lipoprotein (LDL) or "bad" cholesterol. Some studies suggest that the keto diet can lead to a modest increase in LDL cholesterol levels, while others show a more significant elevation, particularly in individuals with a genetic predisposition to cholesterol metabolism dysregulation.

It is hypothesized that individuals with a genetic predisposition to cholesterol metabolism dysregulation may experience a more pronounced elevation in LDL cholesterol levels when following a ketogenic diet. This predisposition is associated with specific genetic mutations, such as the LDL-R gene mutation, which can lead to extreme hypercholesterolemia. In a case series, two out of five patients who underwent genetic testing for Familial Hypercholesterolemia were found to have a mutation of the LDL-R gene. This mutation is believed to be associated with elevated LDL cholesterol levels, and the ketogenic diet may exacerbate the underlying dysregulation of cholesterol metabolism.

The impact of the keto diet on LDL cholesterol levels can vary depending on individual factors, including genetics. In the case series mentioned above, the average LDL cholesterol level of the patients increased significantly while on the ketogenic diet. However, when the patients discontinued the diet, their LDL cholesterol levels decreased drastically. This suggests that the diet may have a significant impact on LDL levels, especially in individuals with a genetic predisposition.

It is important to note that the available research on the ketogenic diet and its impact on LDL cholesterol is limited, and more studies are needed to fully understand the relationship between the diet and cholesterol levels, especially in those with a genetic predisposition. Additionally, the long-term implications of the keto diet as a weight-loss regimen are not entirely understood, and it is not recommended by most professional medical societies as a healthy dietary regimen.

Therefore, if you are considering the keto diet, it is essential to consult with a healthcare professional, especially if you have a family history of heart disease or high cholesterol. They can help determine if the diet is safe and appropriate for you and provide guidance on incorporating heart-healthy fats and other nutritional considerations.

Frequently asked questions