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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Foods To Eat And Avoid
People with high cholesterol should adopt a lifestyle that lowers these levels. This is because high cholesterol is associated with cardiovascular disease.
The keto diet emphasizes large amounts of fat, but not all fats have the same value. For example, replacing saturated fats with unsaturated fats is associated with a lower risk of cardiovascular disease, according to the 2015-2020 American Dietary Guidelines.
Saturated fats are found in foods such as cookies, pastries and other snacks. Coconut oil, butter and warm oil contain high levels of saturated fat, while olive oil and extra virgin margarine have a higher content of monounsaturated and polyunsaturated fats.
Fish such as salmon, tuna and cod can be an excellent source of protein and contain unsaturated fats, such as omega-3 fatty acids, which can be beneficial to the body.
People with high cholesterol who follow the keto diet can eat some nuts and seeds for breakfast, which are usually low in carbohydrates and rich in fiber and protein. Chia seeds have a higher content of polyunsaturated fats.
Vegetables, fruits and legumes are excellent sources of nutrition. However, anyone who follows a keto diet should be aware of the carbohydrate content of these foods.
People on a keto diet may consume milk and products containing it, but may want to choose low-fat versions if they have high cholesterol.
Keto Diet And Cholesterol: Does It Help Or Hurt
Given the fact that the ketogenic diet is a high-fat, low-carb diet one which emphasizes foods like coconut oil, butter and meat this leaves many people wondering: Is the keto diet bad for your heart? Despite what you might think, the keto diet has actually been associated with improvements in cardiovascular health.
Is the keto diet safe for someone with high cholesterol? Because keto is rich in fats, including saturated fat and cholesterol found naturally in animal-derived foods like eggs and meat, many people will experience an increase in cholesterol after beginning the keto diet. However, studies suggest the connection between the keto diet and cholesterol is actually positive.
Recently, weve come to understand that higher cholesterol isnt always a bad thing, and rather that experiencing chronic inflammation;as well as;elevated triglycerides, due to causes like an overall poor diet, insulin resistance and unhealthy lifestyle, is likely a much bigger threat.
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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.;
The Bottom Line About Cholesterol And The Keto Diet
Cholesterol is essential to key processes in your body.
Low-carb, high-fat diets such as the ketogenic diet, increase the concentrations of heart-healthy HDL cholesterol when compared against standard high-carb diets.;
Carbohydrate restriction in healthy individuals leads to higher levels of HDL cholesterol.;
Low-carb, high-fat diets generally decrease LDL particle concentration and increase the size of LDL cholesterol, which is beneficial for cardiovascular health.
Dangerous VLDL cholesterol concentrations in the blood decrease with a ketogenic diet.
Improvement in the total LDL to HDL cholesterol ratio has been demonstrated when dietary carbohydrates are replaced with fat.
When we weigh all the evidence, the benefits of low carb diets on our cholesterol levels greatly outweigh the negatives for most people.;
However, some people may need to adjust their diets in order to meet optimal cholesterol levels. If you have a genetic predisposition, or a history of elevated cholesterol levels or heart issues, please undertake low carb diets with the supervision of your doctor.;
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Low Density Lipoproteins : The Ones To Watch Out For
LDL particles deliver nutrients and energy to your cells. The only problem is that unlike HDL, LDL particles move at a snails pace and have a tendency to get stuck in your bloodstream. When this happens, the vulnerable LDL gets attacked by free radicals and start to oxidize, or break down.
Oxidized LDL is much easier to sneak inside your artery walls.
This then triggers your immune system to go into a full-on inflammatory response, which sends white blood cells to capture all the dangerous oxidized LDL running amok.
Whatever doesnt get wrangled by good HDL enters your arteries and starts the process of plaque buildup .
So does that mean the higher your LDL cholesterol levels, the higher your risks for cardiovascular disease?
A standard lipid blood test will show you how much cholesterol lives inside the LDL particle, or the concentration, but thats no longer the best marker for cholesterol health.
Scientists now know its not how much cholesterol you have, but your LDL particle number that makes the difference. This number measures how many LDL particles are floating in your bloodstream and how big they are.
Small LDL particles carry a greater risk factor;for heart disease;as they can easily penetrate the artery walls and lead to buildup. However, if you have mostly large LDL particles, your risks are pretty low because the chances of this happening are much slimmer.
Why Is Hdl Considered Good
HDL is considered good because it boasts protective, anti-inflammatory properties that regulate your immune system and protect against certain types of cancer in those with type 2 diabetes;and those without.
Plus, researchers believe your risk of developing type 2 diabetes;increases by 4% for every 1 mg/dL drop in HDL cholesterol;your body experiences. So that means keeping your HDL high is a serious priority.
Though all this makes HDL sound like a plus, its greatest accomplishment is clearing out LDL particles, or the bad cholesterol, from your bloodstream.
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Keto Diet And High Cholesterol: Cholesterol And Modern Science
The hypothesis that consuming saturated fat and high cholesterol foods raise blood cholesterol levels is simply inaccurate. More recent studies completely debunk the outdated and corrupt studies from before the turn of the century.
Our liver naturally produces approximately 75% of our blood cholesterol levels, and the other 25% is through diet. The body regulates cholesterol vigilantly, producing less when dietary intake is higher, and producing more when less is consumed.
Well-designed cholesterol studies highlight that approximately 75% of the populations blood cholesterol levels do not change at all with the introduction of high cholesterol foods into the diet, due to this self-regulating method. The 25% of the population who are hyper-responders, and although their levels do increase, so does the ratio of good to bad cholesterol: meaning that they are not at an increased risk of heart disease.
Keto Diet And High Cholesterol: Finding A Healthcare Practitioner
When dealing with cholesterol or any health issues, its important to find a practitioner that sees the bigger picture. For starters, you want to make sure your physician is testing accurately for cardiovascular markers.
The conventional lipid markers that general practitioner medical doctors test for are not accurate predictors. Physicians testing for relative LDL particle number and lipoprotein are getting much more predictive results when it comes to cardiovascular problems.
Moreover, the story of cardiovascular disease includes an array of factors including family history, inflammatory markers like C-reactive protein, fibrinogen, Lp-PLA2, oxidized LDL, and metabolic markers . Its not as simple as one test and a conclusion.
In other words: find yourself a functional medicine practitioner who goes beyond simply testing for total cholesterol levels. Understanding health and wellbeing requires a whole-person approach, and one test will not predict your likelihood of heart disease.
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Blood Collection And Analysis
All blood samples were obtained with a 21 G butterfly needle from an antecubital vein of the subject. After resting quietly for 15 min in a supine position, blood was collected into EDTA and serum separator vacutainer tubes . EDTA tubes were immediately spun while serum tubes remained at room temperature for 15 min prior to centrifugation to allow clotting to occur. Whole blood was centrifuged , promptly aliquoted into cryostorage tubes, snap-frozen with liquid nitrogen and stored at â80Â°C for later analysis. Frozen samples were thawed only once before the analysis of all variables.
HDL-C and triglycerides were analysed using enzymatic methods on an automated analyser . Total cholesterol was measured using enzymatic colourimetric methods. Plasma LDL-C was determined using a direct method, as well as calculated from the total cholesterol, HDL-C and triglyceride concentrations.
Lipoprotein distribution was conducted by Liposcience using hydrogen nuclear magnetic resonance on a 400 MHz NMR analyser as previously described. Lipoprotein subclasses were grouped based on particle diameters: large very low-density lipoprotein , medium VLDL , small VLDL , intermediate-density lipoproteins , large LDL , medium LDL , small LDL , large HDL , medium HDL and small HDL . The lipoprotein insulin resistance index was calculated from six lipoprotein measures .
What To Do If Cholesterol Worsens On The Keto Diet
If your cholesterol worsens on the keto diet, there are adjustments you can make without giving up a low carb lifestyle:;
- Avoid bulletproof coffee: This refers to adding butter, coconut oil, or MCT oil to your daily cup of coffee.
- Intermittent fasting: Only eat when hungry. While further research is needed to look at the association between time-restricted eating and cholesterol levels, a recent pilot study of time restricted eating showed a reduction in LDL.
- Reduce saturated fat: Adjust the amount of saturated fat, and balance it with more monounsaturated & polyunsaturated fats. Minimally processed sources are essential.;
- Incorporate leaner protein sources such as fish, seafood, poultry, and eggs. Dial back the amount of coconut oil, butter, and ghee, and replace these with extra virgin olive oil and avocado oil.;
- Eat more LDL-lowering keto foods such as low-carb plant foods. These include avocado, dark leafy vegetables, cacao and dark chocolate, ;macadamia nuts, brazil nuts, and pecans. One analysis of 25 studies found that eating two servings of nuts per day reduced LDL cholesterol by an average of 7% . However plant foods contain numerous toxins that can harm your body and cause chronic inflammation, so be aware of the trade-off and closely monitor the effects.;
- Increasing vitamin K2 may help protect heart health by keeping calcium in your bones and out of your arteries.The best sources of vitamin K2 include liver, eggs, grass-fed dairy products, and chicken .
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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.
The Health Food Pyramid Has Promoted Low
From the 1990s to 2005, the pyramid suggested to use fats and oils sparingly, and the updates 2005 pyramid does not mention them at all.
One of the significant problems with our healthcare system is a significant lag between new science and implementation through doctors recommendations. By the time most doctors finish medical school, their knowledge is already out of date, and working physicians simply dont catch up with the latest science because theyre busy.
Food is the building block of our human bodies, providing us with the nutrients we need to survive and thrive. Understanding the critical role that diet plays in generating health is key to thriving, as studies show that over 90% of cardiovascular disease is preventable by diet and lifestyle choices. Its time debunk the myth that cholesterol is caused by fat consumption. This myth has been harming the health of millions of Americans.
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How Can I Lower Cholesterol With Diet
Heart-healthy lifestyle changes include a diet to lower your cholesterol. The DASH eating plan is one example. Another is the Therapeutic Lifestyle Changes diet, which recommends that you
Choose healthier fats.You should limit both total fat and saturated fat. No more than 25 to 35% of your daily calories should come from dietary fats, and less than 7% of your daily calories should come from saturated fat. Depending upon how many calories you eat per day, here are the maximum amounts of fats that you should eat:
|Calories per Day|
|69-97 grams||17 grams|
Saturated fat is a bad fat because it raises your LDL level more than anything else in your diet. It is found in some meats, dairy products, chocolate, baked goods, and deep-fried and processed foods.
Trans fat is another bad fat; it can raise your LDL and lower you HDL . Trans fat is mostly in foods made with hydrogenated oils and fats, such as stick margarine, crackers, and french fries.
Instead of these bad fats, try healthier fats, such as lean meat, nuts, and unsaturated oils like canola, olive, and safflower oils.
Limit foods with cholesterol. If you are trying to lower your cholesterol, you should have less than 200 mg a day of cholesterol. Cholesterol is in foods of animal origin, such as liver and other organ meats, egg yolks, shrimp, and whole milk dairy products.
Eat plenty of soluble fiber. Foods high in soluble fiber help prevent your digestive tract from absorbing cholesterol. These foods include
What Is A Ketogenic Diet
This diet severely restricts carbohydrates, typically providing only 5-10% of calories , compared to the 50% currently recommended. It also includes moderate levels of protein with no restriction of fat .
The idea behind the ketogenic diet is to use fat as a fuel source rather than carbohydrates, which is the bodys preferred source of fuel. This process produces ketones. Ketosis occurs when these ketone bodies accumulate in the blood. Exact quantities of carbohydrates to induce ketosis will vary, as achieving ketosis is highly individualised.
Many types of ketogenic diets exist, but all ban carb-rich foods such as sweet sugary foods, breads, cereals, pasta, rice, potatoes and other starchy vegetables and fruit juices. But also foods like beans and legumes, and most fruits.; Most ketogenic diets allow foods high in saturated fat and cholesterol, such as;fatty cuts of meat, processed meats, lard, butter, cream, and cheese, as well as sources of;unsaturated fats, including nuts, seeds, avocados, plant oils, and oily fish.
As a result, a ketogenic diet can end up being high in saturated fat and cholesterol, and low in foods which we know are cardio-protective e.g. legumes, whole grains, fibre-rich starchy vegetables and most fruits.
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Five Ways To Lower Your Ldl On A Keto Or Low
Has your cholesterol increased on a low-carb diet? Do you fear that you may need to abandon this way of eating and its potential benefits?
Here are five ways you can reduce your total and LDL cholesterol levels while maintaining a keto or low-carb lifestyle. Consider trying them in this order.
1. Avoid Bulletproof coffee
Bulletproof coffee refers to adding butter, coconut fat or MCT oil in coffee. Avoid drinking significant amounts of fat at all when youre not hungry. This alone can sometimes normalize elevated cholesterol levels.23
2. Eat only when hungry
Only eat when hungry and consider adding intermittent fasting. This may reduce cholesterol levels. Although most research on intermittent fasting and LDL reduction come from low-quality observational studies during Ramadan, a recent pilot study of time restricted eating showed a significant reduction in LDL.24 While we need more data, this remains a promising intervention.
3. Eat foods higher in unsaturated fats instead of saturated fats
Foods higher in unsaturated fats include fats like olive oil, fatty fish and avocados. Replacing sources of saturated fat with these foods may be enough to lower LDL cholesterol.
However, remember that many unsaturated oils are highly processed. As with food, we recommend focusing on the least processed oils like olive oil, macadamia oil, and avocado oil.
4. Eat LDL-lowering keto-friendly foods
These low-carb plant foods may help lower cholesterol levels somewhat:
5. Eat more carbs