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Can You Do Keto With High Cholesterol

What Does The Keto Diet Do To Your Cholesterol Levels

High Cholesterol on a Ketogenic diet? Dr.Berg on Keto and Cholesterol

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.

Why The Ketogenic Diet Optimizes Cholesterol Levels: The Impact Of Specific Fatty Acids

Now that we know about the effect that the ketogenic diet has on cholesterol levels a finding that seems to contradict everything we thought we knew about cholesterol and fat lets find out how such a high-fat diet actually optimizes cholesterol levels.

The most convincing piece of evidence can be found in a 2003 meta-analysis. In this meta-analysis, researchers compiled the data from sixty trials that quantified the effect that feeding different types of fats to humans had on the total-to-HDL cholesterol ratio . But before we look through the results, we must first understand what this ratio is.

The total-to-HDL cholesterol ratio is found by dividing your total cholesterol level by your HDL-C, and it is essentially the same thing as an LDL-to-HDL cholesterol ratio since most non-HDL cholesterol is LDL cholesterol . The researchers of the 2003 meta-analysis used this ratio because it is a better cardiovascular risk predictor than total cholesterol levels .

Now that we have a superficial understanding of the total-to-HDL cholesterol ratio, lets look at the results of the meta-analysis. The two findings that the researchers highlight most are the effects that lauric acid and stearic acid have on the total-to-HDL cholesterol ratio. Both of these fatty acids improved the total-to-HDL cholesterol ratio more favorably than carbohydrates .

Because of these findings, we can infer that the low-carb, high-fat diet optimizes cholesterol levels for two main reasons:

The Bottom Line On Trying The Keto Diet To Lower Cholesterol

If you have high cholesterol or triglycerides, speak with your medical team first before embarking on a keto diet. If you get the green light, continue to seek their help. There are a lot of popular books out on how to follow a keto diet, but I think patients need additional support and guidance and ongoing conversations about if its working for you, says Ryskamp. Its a tool that someone can use to improve their health, but it may not be the right tool for them, or the right tool the way theyre doing it, she says.

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Does A Keto Diet Cause High Cholesterol

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How Your Body Maintains Cholesterol Levels

Dr. Atkins Advice for those with high cholesterol levels ...

A diet high in cholesterol has almost zero impact on your cholesterol levels because your body is smarter than you think.

Since its such a major producer of cholesterol, your body hustles hard to make sure your cholesterol levels are in constant balance all on their own .

Too much cholesterol hanging around and your body will slow down production, too little cholesterol in your diet and your body will kick production into overdrive.

The 2015-2020 Dietary Guidelines for Americans is the first to get rid of the daily dietary cholesterol limit something many countries eliminated years ago.

So if dietary cholesterol isnt a high risk, and foods with high cholesterol dont build up in your arteries like a clogged shower drain, what causes plaque formation?

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Your Cholesterol Panel On The Keto Diet

When getting a cholesterol panel on keto there are a few points to consider:

How long have you been on the diet? It can take some time for your body to adapt to a ketogenic diet, and it will take time for your cholesterol panel to reflect these dietary changes.

During the first 2-3 months of losing large amounts of weight, which is common on keto, cholesterol can swing both up and down. Once weight loss stabilizes youll get a more accurate read on your levels .

What were your cholesterol levels prior to switching to a ketogenic diet? A single value at one point in time wont give you much information to compare with your keto levels. Serial labs will give you repeat values over time, and this is what you need to make meaningful conclusions

Do you have a genetic condition that may be related to increased cholesterol levels? These conditions include familial hypercholesterolemia, hypothyroidism, as well as chronic inflammation due to autoimmune conditions and lifestyle factors including stress, poor sleep, alcohol use, and smoking.

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The Good And Bad Cholesterol Myth

Youve probably heard of the so-called good cholesterol and bad cholesterol types, but these references arent entirely accurate.

Unlike sugar and salt, which can mingle in your bloodstream, cholesterol is a fat that doesnt mesh well with the watery nature of your blood. For cholesterol to work through your body, it needs to pass through vessels known as lipoproteins.

As their name implies, theyre part fat and part protein. Their sole job is transporting cholesterol to the cells and organs that need it most.

There are five different types of lipoproteins, but the ones you always hear about are low-density lipoprotein , frequently referred to as bad cholesterol, and high-density lipoprotein , which has been labeled as good cholesterol.

To be clear, HDL and LDL are not actual types of cholesterol only what transports cholesterol.

Whats the difference between these two?

Answering Your Questions About How The Keto Diet Impacts Cholesterol

Correcting High Cholesterol and LDL Cholesterol on Keto Diet Dr.Berg

Before diving into more details about the keto diet and cholesterol, lets start by looking at some basic facts about how cholesterol works.

For decades cholesterol has gotten as a bad rap, but in reality cholesterol plays many important roles in the body. For example, cholesterol has functions including:

  • Helping with sex hormone production
  • Forming structures of the brain
  • Supporting cognitive/mental function, including in children and older adults
  • Facilitating absorption of fat-soluble nutrients
  • Ushering nutrients, triglycerides and other compounds into cells to be used for energy

Cholesterol in our body is present in the form of fatty acids that travel through the bloodstream. Whats important to understand about cholesterol is that the balance between LDL and HDL cholesterol is very important. If you have higher LDL, you also want to have higher HDL in order to help clear LDL from the bloodstream.

There are two different types of LDL cholesterol, the type that is often referred to as bad cholesterol: large particle LDL and small particle LDL . Whats the difference, and which one is more dangerous for heart health?

Pattern A carries more fat-soluble nutrients and antioxidants and can actually protect against oxidative stress, while pattern B is more likely to be oxidized and to form plaque buildup in the endothelial lining of the arteries, raising the risk for heart-related problems.

How does the keto diet affect cholesterol levels?

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The Impact Of Carbohydrate Restriction On Hdl Cholesterol

In a recent meta-analysis published in the British Journal of Nutrition by Bueno et al, researchers investigated the impacts of very-low-carbohydrate ketogenic diets on key metrics of cardiovascular health including HDL cholesterol.

The authors defined a VLCKD as a diet lower in 50g of carbohydrates lower than the daily recommended grams of carb consumption clinicians recommend to diabetics. They included 13 randomized controlled studies with a total of 1,415 subjects. All studies took place for at least a full year and all subjects included were over 18 years old and had a BMI of at least 27.5 kg/m2. In each of these studies, VLCKD diets were compared to low-fat diets.

Overall, 12 studies including 1257 patients examined the impact of a VLCKD on HDL cholesterol. When assessing the data, the individuals assigned to a VLCKD achieved an average increase in HDL of 0.12 mmol/L. This was double the average increase in HDL of the low-fat dieters who achieved an average increase in HDL of 0.06 mmol/L. As a result, the authors concluded that carbohydrate-restricted diets confer cardiovascular benefits because they improve levels on HDL in the body.

Key Takeaways: A low-carb diet is an effective method in raising HDL cholesterol when compared to traditional weight-loss diets that emphasize reducing fat intake.

Recommendation: If you need to increase levels of heart-healthy HDL cholesterol, a carbohydrate restricted diet can be an effective tool.

Can You Please Tell Me How Many Snacks We Can Have On The Keto Diet

Can you please tell me how many snacks we can take on the keto diet? And, if we are eating snacks, what is the suggested amount of nuts? Can we take them no more than once a day?

Thanks,

Kiran,

If youre aiming to lose weight, no snacks may be the best option. If you feel you need snacks, you may be better off eating more at your regular meals. But occasionally, a snack may be a decent choice, find our recommendations here.

Best,

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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.

Ketogenic Diet In Diabetes

Can Keto Diet Cause High Cholesterol? Here

One small study had 11 women with type 2 diabetes follow a ketogenic diet for 90 days. After the 90 days, results revealed an increase in HDL cholesterol, a decrease in triglycerides, and no significant changes in LDL cholesterol among participants. Additionally, the study showed decreased body weight and blood pressure.

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Myths Vs Reality: Lowering Cholesterol With A Low Carb Diet

Despite all the research to the contrary, Atkins® low carb diet can be an effective solution to lowering cholesterol. Five hundred years ago, individuals believed the opposite as Atkins allows dieters to consume saturated fats. This mindset belongs to a generation that grew up with the message that eating eggs, meat, and shellfish raises your cholesterol. People were convinced that margarine is a better dietary choice than butter.

We have provided the number two common myths that contribute to why many do not believe Atkins can be a solution for reducing cholesterol. It takes time to change such a mindset, but it happens. Lets take a look at the top two myths related to cholesterol that fuel the misconception that Atkins is unhealthy.

Good And Bad Cholesterol

You have two types of cholesterol in your body: HDL, often called good cholesterol, and LDL, or bad cholesterol.

LDL stands for low-density lipoprotein. It contributes to fatty buildup in your arteries, a condition called atherosclerosis. This can raise your risk of serious cardiovascular problems like a heart attack, a stroke, or peripheral artery disease .

HDL, or high-density lipoprotein, moves LDL cholesterol from your arteries to your liver. There, your body breaks it down and gets rid of it. High levels of HDL help protect against heart attack and stroke.

Triglycerides, the most common type of fat in your body, are related. A high triglyceride level along with high LDL cholesterol or low HDL cholesterol may lead to fatty buildup in the artery walls and a higher risk of heart attack and stroke.

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Stop Being A Keto Caricature

Half a package of cream cheese for a snack.

Dipping an entire stick of pepperoni into homemade alfredo sauce and calling it dinner.

Im not saying cream cheese is bad. Its great. Nor am I suggesting you never eat pepperoni, dipped in alfredo sauce or not. But the amounts are unreasonable. And turning those into regular meals is a bad idea. Theres no reason you cant go keto while eating a hamburger patty or ribeye over a Big Ass Salad. Far more nutrients, far more micronutrients, and it tastes way better.

What Happens To Ldl On Keto Diet

Why High LDL Cholesterol on the Ketogenic Diet? Dr. Berg

A ketogenic diet typically leads to improvements in a range of blood lipids and other markers for cardiovascular health like blood pressure, inflammation, and triglycerides. But the changes to LDL are less predictable and can sometimes go up.

However, studies show that on keto we typically see that even when the total LDL increases, there is a reduction in the small bad LDL, referred to as VLDL or, very low density lipoprotein. This means that most of the increase is in the larger, heart friendlier LDL particles .

Its important to note here that for most people on keto LDL either stays the same or goes down. This finding is reflected in a 2006 study looking at the effects of carbohydrate restriction on LDL cholesterol in a group of 29 men for a 12 week weight-loss intervention found that LDL particle concentrations decreased by 9.6% .

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Ok To Eat Some Carbs If Your Thin And Athletic On Keto Diet

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So Can I Follow Keto Despite Having High Cholesterol

If youre already diagnosed with high cholesterol and would like to give keto a try, its important to let your doctor know this. Theyll monitor your blood lipids closely and help you in determining whether this diet is right for you.

With that said, keto just might be the thing to help you naturally lower your cholesterol and balance out your lipids. This can especially be the case if youre overweight. Thats because studies show that the keto diet leads to weight loss, lower triglycerides, lower LDL cholesterol, and lower blood glucose in overweight adults .

This happens likely because keto has a positive effect on overall metabolic health by triggering weight loss and by boosting metabolic flexibility, i.e. the bodys ability to switch from burning carbs to burning fat.

However, for best results, diet quality matters the most. Make sure that you include plenty of sources of healthy fats in your daily plan like olive oil, nuts, seeds, fish, and avocados. When choosing cooking oils, go for unrefined ones and include plenty of low-carb veggies to get enough fiber fiber lowers cholesterol levels too .” rel=”nofollow”> 13).

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Intro: Keto Diet And Cardiometabolic Risk Factors

Although originally used as a therapeutic approach to reduce seizures in children with intractable epilepsy, nowadays the ketogenic diet is more well-known and broadly used for weight loss and cardiometabolic disease management.

A question frequently asked when considering the implementation of a low-carbohydrate, high-fat diet is whether there are potential negative health outcomes associated with this approach, such as worsening cholesterol levels. Unfortunately, the answer to this question is not cut and dry and is dependent on many potential variables including ethnicity, length of time diet is utilized, amount of carbohydrate intake , level of exercise/activity, and whether the type of fat in the diet is predominately unsaturated or saturated.1-7

Reviews of the literature have shown that in non-epileptic, obese individuals with metabolic dysfunction, as well as in healthy participants, the ketogenic diet has been associated with many positive changes in cardiometabolic biomarkers:1-2

  • Reductions in total cholesterol and triglycerides
  • Increases in HDL cholesterol
  • Increase in size and volume of LDL cholesterol particles
  • Improvements in glucose control and reductions in insulin resistance and diabetes medication use
  • Reduction in 10-year atherosclerotic cardiovascular disease risk score
  • *Variable* changes to LDL cholesterol

Does keto impact cholesterol levels? It depends

The skinny on the keto diet and cholesterol levels

Citations

Bianca Garilli, ND, USMC Veteran

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