What To Eat If Your Cholesterol Is Rising On The Keto Diet
If the standard keto diet is impairing your cholesterol levels, there are several adjustments you can make to improve heart health without giving up on keto living.
The most effective change is to replace most of your saturated fat intake with minimally-processed sources of monounsaturated and polyunsaturated fats. This simple shift will decrease your consumption of foods that can impair cholesterol levels while emphasizing fats that tend to have a positive effect.
The easiest way to reduce your saturated fat intake is by limiting these foods:
- Coconut oil
- Fatty cuts of red meat
- Dark chocolate
Eat the following keto-friendly foods instead:
- Protein sources lower in saturated fat fish, seafood, poultry, and eggs
- Fats/oils high in monounsaturated fats extra virgin olive oil, avocado oil, and duck fat for cooking and dressings
- Nuts and seeds macadamia nuts, brazil nuts, pecans, flaxseeds, and chia seeds are the lowest carb options
- High-fat fruits avocados and olives
- Full-fat cheese*
- MCT oil* for a fat and ketone boost
*Though these are high in saturated fat, studies have shown that they dont increase LDL levels.
Essentially, this is a variation of a ketogenic Mediterranean diet that emphasizes cholesterol-optimizing foods. To learn more about this approach and follow a simple keto meal plan, read through our guide to Mediterranean keto.
Effect Of Saturated Fat
A review of low-fat diets versus low-carb, high-fat diets greater than 12 months long looked at the effects on cholesterol levels in overweight or obese people.
Researchers found that decreases in total cholesterol and LDL cholesterol levels were significantly more noticeable in those following low-fat diets. In contrast, an increase in HDL cholesterol and a reduction in triglyceride levels were more apparent in high-fat-diet participants.
Whether cholesterol increases or decreases largely depends on how the very-low-carbohydrate ketogenic diet is followedparticularly with the types of fats consumed.
The study authors further found that in high-fat diets, decreased total cholesterol levels were associated with lower intake of saturated fat and higher polyunsaturated fat intake. In comparison, increased HDL cholesterol was related to a higher intake of monounsaturated fat.
Lower saturated fat intake was marginally related to lower LDL cholesterol levels. Additionally, increased triglyceride levels were associated with higher intakes of carbohydrates.
If You Have High Cholesterol Should You Avoid Keto
Having high cholesterol doesnt automatically disqualify you from keto. Were seeing really good cardiovascular results from a keto diet, says Susan Ryskamp, RDN, clinical dietitian at Michigan Medicines Frankel Cardiovascular Center in Ann Arbor.
Doctors will want to look at the overall picture with the goal of improving biomarkers like triglycerides, A1C, blood pressure, and body mass index . On keto, if patients lose weight, get their BMI closer to, if not under 30 , and these biomarkers improve, we feel theyre at less of a cardiovascular risk, says Ryskamp.
If a patient has severely elevated triglyceride levels upwards of 1,000 mg/dL then Ryskamp would likely suggest another diet first. But a triglyceride level of 300 may still be a go, with close monitoring and frequent lipid checks. Most of the patients I see can safely go on keto, she says.
The fact is, says Ryskamp, people start down the road to heart disease in different ways , and cardiovascular patients respond uniquely to treatment. Not everyone will want to go on keto, but it may be recommended for some, she says. As a Clinical and Scientific Debates on Atherosclerosis points out, keto is not the only option. Other diets are as effective, more sustainable and safer, the authors write. The AHA still recommends a plant-based diet high in fruits, vegetables, legumes, whole grains, and lean vegetable or animal protein.
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Keto And Cholesterol: A Ketogenic Diets Connections With Cholesterol
About 32% of men and 13% of women in the US suffer from low levels of HDL cholesterol. Additionally, the majority of Americans do not have HDL cholesterol levels high enough to decrease the risk of cardiovascular illness.
As chronic conditions such as diabetes and cardiovascular illness increase in prevalence worldwide, scientists have evaluated methods to increase levels of HDL cholesterol. For many years, physicians have used drugs called statins to increase HDL .
Recently, scientists have looked at utilizing dietary interventions as cost-effective methods to optimize HDL cholesterol and prevent the onset of cardiovascular diseases. Below we document three research studies examining low-carb and ketogenic diets effects on HDL.
What Does The Keto Diet Do To Your Cholesterol Levels
The keto diet appears to improve cardiovascular health markers, including cholesterol and triglyceride levels.
Research from 2004 suggests that people with obesity and high cholesterol experience greater weight loss and bigger improvements in triglyceride and HDL levels when on a keto diet than on traditional low fat diets.
Fewer studies point to poor outcomes like increased LDL and decreased HDL levels, and those tend to improve over time. The important thing to remember is that the types of foods you eat really matter.
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Ketogenic Mediterranean Diet With Phytoextracts
An Italian study in 2019 looked at 106 overweight or obese people who ate a diet known as the ketogenic Mediterranean diet with phytoextracts and took a daily multivitamin supplement over six weeks. Subjects were allowed to consume unlimited calories in a diet made up of green vegetables, olive oil, fish, meat, and other high-quality proteins, along with specific food supplements and herbal extracts.
The results showed a significant decrease in body mass index , total cholesterol, LDL cholesterol, triglycerides, and blood glucose levels. There was also a significant increase in HDL cholesterol levels.
How A Keto Diet May Influence Cholesterol
There has been some research done on low-carbohydrate diets and their effects on cardiovascular health. It can be hard to draw specific conclusions on the topic, though, because many of the studies are short term , are of a small sample size, and examine different variations of very-low-carb diets.
Nevertheless, we are starting to understand a little bit more about how very-low-carbohydrate, or ketogenic, diets may affect cholesterol levels. Below is a summary of some of the research studies.
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Consider Swapping Saturated Fats For Unsaturated Fats
For some, making small changes like the ones listed above wont be enough to produce a meaningful change in LDL. Instead, they may need to reduce saturated fat from all sources and replace it with mono- and polyunsaturated fats. In practice, that means less beef, cheese, and cream and more fish, macadamia nuts, avocados, and olive oil.
Liquid polyunsaturated fats, such as seed oils, remain a point of contention. This is because observational studies show a small cardiac benefit, but randomized, controlled trials show they can reduce LDL but may increase both cardiovascular events and risk of dying.8 Furthermore, mechanistic data suggest seed oils can increase oxidation and inflammation, although clinical trials havent shown this.9 See more in our evidence-based guide to vegetable oils.
Another option is to switch to a vegetarian or vegan keto/low-carb diet, which is typically lower in saturated fat. You can find more details in our guides on vegetarian and vegan low-carb diets.
Many people find that reducing or eliminating saturated fats while still remaining on a LCHF diet successfully lowers LDL cholesterol. The more pressing question is if this is a sustainable eating pattern. The answer is highly individualized and requires personal experimentation.
Predicting How Keto May Affect Your Cholesterol Levels
To have an idea if the keto diet may have a negative effect on your cholesterol, consider your starting triglyceride number. According to the Mayo Clinic, triglycerides are another type of lipid in your blood that your body uses for energy high triglyceride and LDL levels can lead to fatty deposits that gum up arteries, notes the American Heart Association. Normal levels are less than 150 milligrams per deciliter . About a quarter of the population has triglyceride levels above 150 mg/dL, which is the threshold to consider elevated triglycerides. This is a large percentage of the population, so its not uncommon, says Soffer.
If you have normal levels, keto is likely safe to try. For people with normal or perfect triglyceride levels, the impact from keto is minimal or none, says Soffer. If, on the other hand, you have insulin resistance,type 2 diabetes, and/or abdominal obesity, and your triglycerides are elevated it may seem like you should shy away from keto, but the opposite may be true, Soffer argues, explaining that the low-carb nature of keto has the potential to decrease insulin resistance and improve triglycerides.
Still, though, the aforementioned Nutrition & Metabolism study involved a mere 34 people so more research, particularly larger, longer-term studies, is needed before scientists can fully understand the true effects of keto on insulin resistance and triglycerides.
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Cutting Through The Fat: What Are Lipids And Cholesterol
Before we can examine the research, we need to understand the roles fat, cholesterol, and carrier molecules called lipoproteins play in the body.
Fats, also known as lipids, are a diverse group of molecules with a non-polar characteristic that repels water. This means that you if you put a fat in water, they will not mix.
In the human body, fats are most commonly found in the bloodstream in one of two forms. The first is triglycerides, a fatty acid that stores energy for later use.
These long molecules can be broken down into other fatty acids and glycerol to create fuel for the body. Glycerol can further be broken down and converted into glucose. Elevated levels of triglycerides in your blood can increase your risk of developing diabetes, cardiovascular illnesses, and other life-threatening diseases.
The other important class of lipids in the body is a waxy substance called cholesterol. These molecules have a variety of functions in your body such as building hormones including estrogen and testosterone, maintaining the integrity of cell membranes, and aiding in the absorption of vitamins.
Your body produces all the cholesterol you need in the liver and other cells throughout the body. Cholesterol is also obtained by consuming animal-based foods such as poultry, dairy, and red meat. Typically, 75% of the bodys cholesterol is produced endogenously while the other 25% is ingested from external sources.
Ketogenic Diet: Is The Ultimate Low
- By , Contributor
Recently, many of my patients have been asking about a ketogenic diet. Is a ketogenic diet safe? Would you recommend it? Despite the recent hype, a ketogenic diet is not something new. In medicine, we have been using it for almost 100 years to treat drug-resistant epilepsy, especially in children. In the 1970s, Dr. Atkins popularized his very-low-carbohydrate diet for weight loss that began with a very strict two-week ketogenic phase. Over the years, other fad diets incorporated a similar approach for weight loss.
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Will A Keto Diet Lower Triglycerides And Cholesterol
No, keto diets have been shown to increase cholesterol levels. The Mediterranean diet, however, has been shown to lower cholesterol levels and reduce the risk of cardiac events.
The Mediterranean diet promotes eating vegetables, fruits, whole grains, and healthy fats daily eating fish, poultry, beans, and eggs weekly reducing portions of dairy and limiting red meat.
Ketogenic Diet In A Crossfit Group
Studying healthy people, a 12-week investigation looked at the effects of a ketogenic diet in people who regularly trained in CrossFit. Twelve people participated in the study involving the high-intensity, interval-training workout. Five of the study participants were in the control group and continued eating a regular diet, while seven people followed a ketogenic diet.
The study concluded that changes in HDL cholesterol and triglycerides were not significant and were similar among participants in both groups. In contrast, LDL cholesterol increased nearly 35% in those following the keto diet along with CrossFit.
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The Importance Of Ongoing Monitoring
People who follow the keto diet should consult their doctors to arrange .
If a doctor notices that LDL cholesterol levels are rising, the diet may no longer be appropriate.
People with high levels of fats, such as cholesterol and triglycerides, in their blood have an increased risk of developing cardiovascular disease.
People with high cholesterol should adopt a lifestyle that reduces these levels. This is because high cholesterol is associated with cardiovascular disease.
The keto diet emphasizes high amounts of fat, but not all fats have equal value. For example, replacing saturated fats with unsaturated fats is associated with a lower risk of cardiovascular disease, according to the 20152020 Dietary Guidelines for Americans .
Saturated fats occur in foods such as cookies, cakes, and other snacks. Coconut oil, butter, and ghee contain high levels of saturated fats, whereas extra virgin olive oil and margarine are higher in monounsaturated and polyunsaturated fats.
Fish such as salmon, tuna, and cod can be an excellent source of protein, and they contain unsaturated fat, such as omega-3 fatty acids, which can be beneficial for the body.
People with high cholesterol who follow the keto diet can snack on certain nuts and seeds that are generally low in carbs and rich in fiber and protein. Chia seeds have a higher content of polyunsaturated fats.
The Difference Between Dietary And Blood Cholesterol
Although it may sound like common sense that eating a high-fat low-carb diet filled with cholesterol-rich foods would raise blood cholesterol levels, thats not the way it actually works.
Your body expertly regulates your blood cholesterol by controlling how much cholesterol it makes. When you eat more cholesterol, your body makes less. When you eat less cholesterol, your body makes more.
Because of this regulating ability, studies show that foods high in dietary cholesterol have very little impact on blood cholesterol levels in most people . This is why for most people, high-cholesterol keto foods do not negatively impact your blood cholesterol levels.
A 2012 study in Nutrition compared a low-calorie diet to a low-carb, high-fat diet among 360 overweight and obese participants. After one year, participants on the keto diet saw their total cholesterol, triglycerides, and LDL decreased, while HDL rose. HDL is often referred to as good cholesterol.
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Add These Foods To Lower Ldl Cholesterol
Different foods lower cholesterol in various ways. Some deliver soluble fiber, which binds cholesterol and its precursors in the digestive system and drags them out of the body before they get into circulation. Some give you polyunsaturated fats, which directly lower LDL. And some contain plant sterols and stanols, which block the body from absorbing cholesterol.
1. Oats. An easy first step to lowering your cholesterol is having a bowl of oatmeal or cold oat-based cereal like Cheerios for breakfast. It gives you 1 to 2 grams of soluble fiber. Add a banana or some strawberries for another half-gram. Current nutrition guidelines recommend getting 20 to 35 grams of fiber a day, with at least 5 to 10 grams coming from soluble fiber.
2. Barley and other whole grains. Like oats and oat bran, barley and other whole grains can help lower the risk of heart disease, mainly via the soluble fiber they deliver.
3. Beans. Beans are especially rich in soluble fiber. They also take a while for the body to digest, meaning you feel full for longer after a meal. That’s one reason beans are a useful food for folks trying to lose weight. With so many choices from navy and kidney beans to lentils, garbanzos, black-eyed peas, and beyond and so many ways to prepare them, beans are a very versatile food.
4. Eggplant and okra. These two low-calorie vegetables are good sources of soluble fiber.
The Effects Of A Ketogenic Diet On Ldl Cholesterol Levels
In the study that Arroll conducted, at the National Centre for Complementary and Integrative Medicine at the University of Sydney, she and her colleagues, Dr. David Colquhoun, and Professor of Epidemiology Dr. Thomas Burbridge, divided 53 adults into two groups.
People in the first group were advised to follow a low fat diet for 6 months and then to follow a ketogenic diet for another 6 months. They were encouraged to avoid simple carbohydrates, fried foods, refined sugars, and alcohol.
They were also advised to avoid meat for 6 months.
The participants in the second group were told to follow a low fat diet for 6 months but were encouraged to eat meat for up to 3 months of that period.
Since meats do not have as high of a fat content.
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Keto Diet Can Improve Cholesterol Levels Among Obese And Overweight Adults
Dietary cholesterol derives mainly from fat included in food, thus many people believe eating a high-fat diet would normally result in increased levels of cholesterol. Nonetheless, many studies have shown that low-carbohydrate, high-fat diets can actually decrease levels of cholesterol and consequently reduce the risk of cardiovascular diseases.
Low-carbohydrate versus Low-fat Diet
A randomised, controlled clinical trial among 120 overweight adults with high levels of cholesterol compared the effects of a ketogenic diet against a low-fat diet. After 24 weeks, the group following the keto diet reported greater weight loss and declines in the triglyceride levels and higher increases in the HDL cholesterol levels compared to the low-fat group .
Similar results were reported by a telemedical guided weight loss program among 200 overweight adults, where triglyceride and HDL-cholesterol levels were lower at month 6 in the keto diet group compared to the low-fat group. The conclusion was that a low-carb diet has more benefits in reducing cardiovascular risks compared to the low-fat diet .
Another randomised study among 132 severely obese adults in Philadelphia also demonstrated a greater decrease in triglyceride levels and less decline in HDL cholesterol levels among the group following a low-carbohydrate diet compared to the low-fat diet group .
Ketogenic Diet Alone