High Cholesterol Keto
What is the Keto Diet?
Before diving into how keto may affect cholesterol, let’s briefly review what the ketogenic diet entails:
Very low in carbohydrates (typically under 50g per day)
High in fat (70-80% of calories from fat)
Moderate protein intake
Goal is to enter nutritional ketosis, where the body burns fat for fuel instead of carbs
The drastic reduction in carbs and increase in dietary fat causes major shifts in the body’s metabolism. This can lead to rapid weight loss and improvements in markers like blood sugar and insulin levels for many people.
Understanding Cholesterol
To evaluate how keto may impact those with high cholesterol, it’s important to understand the different types of cholesterol:
LDL (low-density lipoprotein): Often called “bad” cholesterol. High levels are associated with increased heart disease risk.
HDL (high-density lipoprotein): Known as “good” cholesterol. Higher levels are protective against heart disease.
Triglycerides: A type of fat in the blood. Elevated levels increase heart disease risk.
Total cholesterol: The overall amount of cholesterol in your blood.
When doctors diagnose high cholesterol, they are typically concerned with elevated LDL and triglycerides, as well as low HDL levels.
How Keto May Affect Cholesterol
Research on how the ketogenic diet impacts cholesterol levels has shown mixed results. Some studies indicate keto can improve cholesterol profiles, while others show it may worsen them. Here’s an overview of how keto tends to affect different types of cholesterol:
LDL Cholesterol
Some people experience increased LDL: A subset of keto dieters see their LDL levels rise, sometimes dramatically. This is more common in those who are very responsive to dietary cholesterol.
Others see no change or a decrease: Many people do not see significant changes in LDL, while some even experience a decrease.
Particle size matters: Keto tends to increase the size of LDL particles. Larger, fluffier LDL particles are thought to be less harmful than small, dense particles.
HDL Cholesterol
HDL typically increases: Most studies show keto leads to an increase in protective HDL cholesterol.
Improved HDL/LDL ratio: Even if LDL goes up, the increase in HDL often leads to an improved HDL to LDL ratio, which is associated with lower heart disease risk.
Triglycerides
Significant reductions: Keto diets consistently lead to major reductions in triglyceride levels for most people.
Improved triglyceride/HDL ratio: The combination of lower triglycerides and higher HDL is particularly beneficial for heart health.
Potential Benefits of Keto for High Cholesterol
For some people with high cholesterol, the ketogenic diet may offer several potential benefits:
Weight loss:
Losing excess weight can help improve cholesterol levels. Keto is very effective for weight loss in many people.
Reduced inflammation:
Chronic inflammation is linked to heart disease. Keto diets may help lower inflammatory markers in the body.
Improved insulin sensitivity:
Better insulin function is associated with healthier cholesterol levels. Keto can dramatically improve insulin sensitivity.
Higher HDL cholesterol:
Raising protective HDL levels is notoriously difficult, but keto often accomplishes this.
Lower triglycerides:
Reducing elevated triglycerides is important for heart health, and keto excels at this.
Reduced small LDL particles:
Even if total LDL increases, a shift towards larger LDL particles may be less harmful.
Potential Risks and Concerns
While keto may benefit some people with high cholesterol, there are also some risks to consider:
Increased LDL in some people:
The rise in LDL some experience on keto could potentially increase heart disease risk, though this is debated.
High saturated fat intake:
Keto diets are often high in saturated fat, which some experts believe may negatively impact heart health.
Nutrient deficiencies:
Restricting entire food groups can make it harder to get all necessary nutrients.
Difficulty adhering long-term:
The restrictive nature of keto makes it challenging for many to stick with.
Increased burden on the liver:
Processing high amounts of dietary fat may stress the liver in some people.
Potential for unhealthy food choices:
Some may rely too heavily on processed meats and dairy products high in saturated fat.
Should You Try Keto with High Cholesterol?
Given the mixed research and individual variability in response, there’s no one-size-fits-all answer. Here are some factors to consider:
Consult your doctor:
Always speak with your healthcare provider before making major dietary changes, especially if you have high cholesterol or other health conditions.
Consider your overall health:
Keto may be more beneficial for those who also have issues like obesity, diabetes, or metabolic syndrome.
Get baseline labs:
Have your cholesterol levels checked before starting keto so you can monitor changes.
Focus on healthy fats:
If you try keto, emphasize healthy fat sources like olive oil, avocados, nuts, and fatty fish rather than loads of saturated fat.
Increase fiber intake:
include plenty of low-carb vegetables and consider fiber supplements to support heart health.
Monitor your response:
Have your cholesterol rechecked after 2-3 months on keto to see how your body responds.
Consider a modified approach:
A more moderate low-carb diet may offer benefits with less risk of dramatic cholesterol changes.
Tips for a Heart-Healthy Keto Diet
If you decide to try a ketogenic diet despite having high cholesterol, here are some tips to make it as heart-healthy as possible:
Choose healthy fats:
Focus on monounsaturated and omega-3 fats from sources like olive oil, avocados, nuts, seeds, and fatty fish.
Limit saturated fat:
While some saturated fat is fine, don’t go overboard with fatty meats, butter, and coconut oil.
Eat plenty of low-carb vegetables:
They provide fiber, antioxidants, and other heart-healthy nutrients.
Include lean proteins:
Opt for fish, poultry, and lean cuts of meat rather than only fatty meats.
Consider plant-based protein:
Incorporate foods like tofu, tempeh, and lupini beans for heart-healthy protein options.
Supplement wisely:
Consider fish oil, fiber supplements, and possibly plant sterols to support heart health.
Stay active:
Regular exercise is crucial for heart health and can help improve cholesterol levels.
Manage stress:
Chronic stress can negatively impact cholesterol. Incorporate stress-reduction techniques into your routine.
Monitor electrolytes:
Ensure adequate intake of sodium, potassium, and magnesium to support heart function.
Stay hydrated:
Proper hydration is important for overall health and may help manage cholesterol levels.
Conclusion
The relationship between the ketogenic diet and cholesterol is complex and highly individual. While some people with high cholesterol may see improvements on a keto diet, others could experience negative effects. It’s crucial to work closely with your healthcare provider, monitor your cholesterol levels, and focus on heart-healthy food choices if you decide to try keto with high cholesterol.
Remember that diet is just one piece of the puzzle when it comes to managing cholesterol and heart health. A holistic approach that includes regular exercise, stress management, adequate sleep, and other healthy lifestyle factors is key to long-term cardiovascular wellness.
Ultimately, the best diet for managing high cholesterol is one that you can stick to long-term and that supports your overall health and well-being. Whether that’s a well-formulated ketogenic diet or a different approach will depend on your individual needs, preferences, and response to dietary changes.