What Does A Cholesterol Test Mean
Its these differences in molecule sizes that allows us to measure the different kinds of lipoproteins. So when you hear someone refer to their HDL or LDL numbers, they are talking about the number of HDL or LDL molecules in their blood. In general, more HDL is good. In general, less LDL is good.
But, hang on, remember that there are two sizes of LDL particles: particle A and particle B .
The standard cholesterol test does not measure LDL particle sizes . It only measures TOTAL amounts . But with no insight into the actual lipoprotein sizes, the LDL number isnt necessarily an accurate representation.
The problem with this is that its the B particles that cause the biggest problems. Remember, since particle B molecules are very small, they are the ones that get stuck in nooks and crannies of the arterial and vascular walls. Having more B particles will be bad. But, having more A particles wont necessarily be bad. But if all you get is the TOTAL LDL , you have no idea of your actual particle composition. So its possible that a high LDL number, without any context or further testing is not a problem at all.
The solution is pretty simple. Request an LDL-P test to get an idea of your LDL particle makeup.
HDL, since its considered a good cholesterol lipoprotein, is okay if its higher in number.
Keto And Cholesterol: How The Ketogenic Diet Affects Your Heart Health
Everyone knows that keto favorites like bacon and butter are bad for your cholesterol and heart health, right?
According to the American Heart Association, the key to improving cholesterol levels involves swapping out your fatty foods for heart-healthy foods like oatmeal, fiber-based cereal, whole-grain toast, and orange juice. This is the biggest argument against the ketogenic diet, but it is a topic commonly misunderstood and backed by unscientific and bias data.
In order to understand your cholesterol levels, how they affect heart health, and where the ketogenic diet fits into it all, lets break down the facts about cholesterol piece-by-piece.
The Framingham Heart Study
The Framingham Heart Study in Massachusetts gave a shocking revelation of cholesterols connection with heart disease. So it showed that 40% of those who had a heart attack actually has a cholesterol level lower than 200. Further, those who have less than 180 total cholesterol levels has 300% more chance of getting a stroke. Finally, low cholesterol levels are linked to poor cognitive functions for people of old age.
Theresno direct correlation between cholesterol and diseases mentioned as per thestudy. Where is really the problem? Answers are found on what composescholesterol.
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Replace Saturated With Monounsaturated Fat
Keto is a high-fat diet. Because of this, going Keto entails eating more butter, animal fat, coconut oil, and other sources of saturated fat than most people otherwise would.
And as we covered earlier, higher intakes of saturated fat are well understood to raise cholesterol levels. Thats why Keto and high cholesterol often go hand in hand.
One way to mitigate high cholesterol on Keto? Replace saturated fats with monounsaturated fats.
The best sources of monounsaturated fats are olives, avocados, and nuts. Instead of a fatty ribeye, you have a chicken and spinach salad drenched with olive oil. Instead of cooking with butter, you cook with avocado oil. You get the idea.
What Is Ldl And Why Is It Bad
LDL, or low density lipoprotein, is often referred to as bad cholesterol.
The primary role of LDL is to carry cholesterol and triglycerides to cells for energy and to repair the damage.
Recent science is showing that the most important cholesterol marker is the LDL particle number . This is a measurement of how many LDL particles are floating around in your bloodstream .
Yet most standard blood tests only measure your LDL-c, or how much cholesterol the LDL particles you carry around. Its important to compare your LDL-p and LDL-c numbers. If LDL-c is high and LDL-p is low then you probably dont have anything to worry about .
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Is The Keto Diet Healthy For Your Heart
It seems like almost everyone is trying the keto diet, and there are many stories of rapid weight loss out there. But we wondered about eating all that fat most keto diet regimens recommend you get 80 percent of your calories from fat is that healthy for your heart?
The short answer is no, Severson says. Even if you choose all healthy fats, like olive oil and fish, youll still end up eating more saturated fat than is safe and healthy.
Most people arent eating the healthiest version of the diet anyway. So many people think its about eating bacon and meat, but often they are eating too much protein to be on a true ketogenic diet. Its about fat, not protein, says Severson.
Moreover, what youre not eating can also increase your risk of heart disease. When you avoid whole grains, legumes, and fruit, you lose a lot of the dietary fiber that helps protect your heart.
While individual results of the diet can vary widely in different people, most people will see a rise in their cholesterol level, even if they lose weight. For people with a history of heart disease or high cholesterol, this can be especially dangerous.
Dietitians and researchers also dont have enough data yet to know exactly how the keto diet could impact people over the long term.
Remind Me: How Does Keto Work
The ketogenic diet is a very low carbohydrate, high fat diet that was developed to help children and adults experiencing epileptic seizures. Its now used to help people reach a number of health goals, including weight loss.
The diet requires getting roughly 5 to 10 percent of your daily calories from carbohydrates, 15 to 20 percent from protein, and a whopping 70 percent from fat. Severely restricting carbohydrates forces your body to burn fat for energy instead.
Research has shown that the keto diet has several health benefits, at least in the short term. Most notably, folks on the diet have experienced significant weight loss, improved blood sugar, and improved cardiovascular health .
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How Does Keto Affect Your Arteries
How the keto diet affects your arteries depends on your individual health and the types of fats consumed while on the diet. Saturated fats have been shown to negatively affect your cholesterol levels mainly by increasing your LDL cholesterol levels. This can contribute to plaque buildup in your arteries.
However, unsaturated fats have the opposite effect on heart health by decreasing LDL cholesterol and increasing HDL cholesterol levels. This can improve your heart health, decreasing your risk of heart attack and stroke.
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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How Genetics Plays A Part
While the ketogenic diet may be safe for most people, it might not be healthy for others to follow. A ketogenic diet could increase LDL cholesterol levels in some people at high risk for heart attack and stroke.
In particular, people with an inherited condition called familial hypercholesterolemia should always consult with their healthcare provider before trying a ketogenic diet. Familial hypercholesterolemia is marked by very high LDL cholesterol levels and an increased risk of premature heart disease. The American Heart Association has state that only 10% of people with familial hypercholesterolemia are aware they have it.
Additionally, some people have a rare genetic condition that affects how LDL particles are regulated, causing high LDL cholesterol levels. The genetics causing this response isnt completely understood, but the APOE gene, which provides instructions for making a protein called apolipoprotein e, may be one of several factors involved. People who have this inherited genetic condition should avoid the keto diet.
Butter Bacon And Fat: The Truth About Keto And Cholesterol
How can eating a diet rich in butter, red meat, cheese, eggs, and bacon not raise your cholesterol levels? Thats like saying eating a whole pint of ice cream wont raise your blood sugar levels, right? Far from it. As it turns out, the keto and cholesterol combo could be a good thing.
You see, a low-carb diet like keto will change your lipid profile but maybe not in the way you expect.
When you know exactly how cholesterol works in your body, you may see keto in a whole new light. Youll also probably need to rethink everything you thought you knew about cholesterol.
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Ketogenic Diet In Diabetes
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.
How Do Cholesterol Levels Affect Heart Health
Based on the previous information, it may seem obvious that LDL is bad for heart health and HDL is good, but these values often given during blood tests do not paint the whole picture.
The total amount of cholesterol in HDL and LDL particles holds little value what really matters is the particle size or how many LDL particles are in the blood and how big they are.
Larger LDL particles are more beneficial because smaller LDL particles are more likely to get into the arterial walls and lead to plaque formation.
This is why a standard blood test can give very little information as to a persons actual heart health. Next time you are at your doctors office, ask for an NMR lipoprofile instead of a traditional blood panel. This type of cholesterol test not only gives total LDL and HDL values but also provides the particle number and size for further analysis.
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What Happens To Hdl Levels On A Keto Diet
Though eating fat doesnt affect blood cholesterol levels in a standard carb-heavy diet, when carbs are restricted and fat becomes the basis of your diet, HDL levels ultimately improve.
So on a keto diet eating fat does affect your cholesterol levels, just in the opposite way weve been told!
Supporting these observations, A 2017 review of human and animal studies found keto diets to be generally associated with reductions in total cholesterol, increases in HDL decreases in triglycerides, and reductions in LDL .
A 2020 high quality randomized control study of 34 older adults with obesity found that over 8 weeks participants on the keto diet lost three times the body fat compared with a group eating a low-fat diet. The keto group also had greater improvement in insulin sensitivity, triglyceride levels, and HDL cholesterol
A 2013 meta-analysis of 12 high quality studies involving more than 1200 participants investigating the impact of very-low-carbohydrate ketogenic diets vs. low fat diets, found that the average increase in HDL particles in the low carb group was double that of the low fat group .
Taken together these findings all affirm that differences in HDL are due to carbohydrate intake, not fat intake.
How To Maintain Healthy Cholesterol On Keto
We still dont know the best diet for high cholesterol, but the data suggests that Keto can improve cholesterol profiles in obese people and those with diabetes. Its a promising drug-free therapy for these populations.
But what if your LDL spikes onKeto? Some people say not to worry about it. That other risk markers are more important. That high cholesterol alone doesnt cause heart disease.
Maybe theyre right. We dont have good long-term data on otherwise healthy people that develop high LDL on Keto.
But since high LDL is a well-established heart disease risk factor in other populations, its probably wise to play it safe. Beyond consulting with your doctor to manage your cholesterol, be mindful of these 3 dietary considerations:
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How To Follow Keto In A Heart
One of the draws of a keto diet is the idea that you can eat any and all fat that you want. Thats not a healthy mindset to step into. I recommend patients choose cardioprotective fats, like nuts, nut butter, seeds, avocado, and extra virgin oils, such as olive oil, says Ryskamp. Similarly, avoid foods that are high in saturated fat as your primary fat sources.
Its not just fats that are important, but maximizing the small amount of carbohydrates youre allowed. Getting enough fiber can be a challenge, and youll want to make sure youre eating plenty of low GI-index veggies . Ultimately, the benefits come from replacing foods, like processed carbs, that experts believe are detrimental to overall wellness, with those that are heart-healthy, like unsaturated fats, she says.
Its been repeated over and over: If youre drastically changing your diet which includes going keto you need to talk to your doctor first and make sure its safe for you and your individual health concerns. You also want to get your lipids checked before and during keto, so your doctor can watch for a cholesterol spike and determine if this is a healthy diet for you.
One of the biggest concerns, says Soffer, is that once you come off keto, you continue eating a high-saturated-fat diet in combination with a typical Standard American Diet . Because keto is highly restrictive, most people dont stay on it for the long haul, so watch your diet and plan appropriately when you go off the diet.
What Do You Eat
Because the keto diet has such a high fat requirement, followers must eat fat at each meal. In a daily 2,000-calorie diet, that might look like 165 grams of fat, 40 grams of carbs, and 75 grams of protein. However, the exact ratio depends on your particular needs.
Some healthy unsaturated fats are allowed on the keto diet like nuts , seeds, avocados, tofu, and olive oil. But saturated fats from oils , lard, butter, and cocoa butter are encouraged in high amounts.
Protein is part of the keto diet, but it doesn’t typically discriminate between lean protein foods and protein sources high in saturated fat such as beef, pork, and bacon.
What about fruits and vegetables? All fruits are rich in carbs, but you can have certain fruits in small portions. Vegetables are restricted to leafy greens , cauliflower, broccoli, Brussels sprouts, asparagus, bell peppers, onions, garlic, mushrooms, cucumber, celery, and summer squashes. A cup of chopped broccoli has about six carbs.
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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.