What Are The Dangers Of The Keto Diet
If you are on diabetic medication that causes low blood sugar, those meds may need to be adjusted within a few days, Condon said. There are heart-healthy sources of fat, however if that person is not educated on heart-healthy sources of fat, they may consume excessive amounts of saturated fats that can increase your risk of heart disease, Condon said.
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.
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How Much Sodium And Cholesterol Do You Consume On Keto
There are no specific guidelines for how much sodium and cholesterol should be consumed while following a ketogenic diet.
The Dietary Guidelines for Americans recommends that healthy adults consume less than 2,300 milligrams of sodiumequal to about 1 teaspoon of table saltper day. The dietary guidelines do not list specific limits on dietary cholesterol, as recent research has shown that dietary cholesterol doesnt have as much of an effect on blood cholesterol as once thought.
However, it is important to note that many foods high in cholesterol are also high in saturated fat and, in effect, may increase the risk of heart disease due to the saturated fat content. Two exceptions to this are eggs and shrimp. Because of this correlation, it might be wise to limit the amount of foods you take in that are high in both dietary cholesterol and saturated fat while following keto.
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.
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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.
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.
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How Does Keto Or Low
In some people who follow keto or low-carb diets, blood total cholesterol goes up little, if at all. Some even experience a drop in LDL cholesterol after starting low carb. However, others experience an increase in both LDL and HDL cholesterol levels.11 Or, there is an increase only in HDL cholesterol resulting in an improved LDL/HDL ratio.12
One meta-analysis of randomized trials reported that people eating a low-carb diet, on average, experience a reduction in both total LDL and small LDL particles, as well as an increase in the peak LDL size.13
A rise in cholesterol during keto or low-carb eating may be related to losing weight. Although cholesterol levels often drop during the first 2-3 months of losing large amounts of weight, there can be a later rise in cholesterol that persists until weight stabilizes. Once weight loss ceases, cholesterol levels tend to come back down.14
Therefore, it could make sense to wait until someones weight has been stable for a few months before assessing cholesterol levels.
For an estimated 5 to 25% of people whether weight loss occurs or not LDL cholesterol goes up significantly in response to very-low-carb diets, sometimes by 200% or more. Many of these folks seem to belong to a group that Dave Feldman at Cholesterol Code refers to as lean mass hyper-responders .15 These often healthy people are sometimes shocked to discover that their LDL cholesterol has soared above 200 mg/dL after going keto.
Answering Your Questions About How The Keto Diet Impacts Cholesterol
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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What To Do If A Low
Low-carb and ketogenic diets are incredibly healthy.
They have clear, potentially life-saving benefits for some of the worlds most serious diseases.
This includes obesity, type 2 diabetes, metabolic syndrome, epilepsy and numerous others.
The most common heart disease risk factors tend to improve greatly, for most people .
According to these improvements, low-carb dietsshould reduce the risk of heart disease.
But even if these risk factors improve on average, there can be individuals within those averages that experience improvements, and others who see negative effects.
There appears to be a small subset of people who experience increased cholesterol levels on a low-carb diet, especially a ketogenic diet or a very high fat version of paleo.
This includes increases in Total and LDL cholesterol as well as increases in advanced markers like LDL particle number.
Of course, most of these risk factors were established in the context of a high-carb, high-calorie Western diet and we dont know if they have the same effects on a healthy low-carb diet that reduces inflammation and oxidative stress.
However it is better to be safe than sorry and I think that these individuals should take some measures to get their levels down, especially those who have a family history of heart disease.
Fortunately, you dont need to go on a low-fat diet, eat veggie oils or take statins to get your levels down.
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Is The Keto Diet Safe
The keto diet could cause low blood pressure, kidney stones, constipation, nutrient deficiencies and an increased risk of heart disease. Strict diets like keto could also cause social isolation or disordered eating. Keto is not safe for those with any conditions involving their pancreas, liver, thyroid or gallbladder.
Kleinman said someone new to the keto diet can also experience whats called the keto flu with symptoms like upset stomach, dizziness, decreased energy, and mood swings caused by your body adapting to ketosis.
Keto May Harm People With A Genetic Mutation That Affects Ldl Regulation
Where things get possibly dangerous is if youre one of the people who has an inherited genetic mutation that affects the way LDL particles are regulated. If these individuals follow a keto diet, their LDL levels can skyrocket, says Soffer. This result doesnt happen often enough to skew overall results in population studies, but what matters most is the effect the diet has on your individual health. Its a long-recognized phenomenon that hasnt been published well, he says, adding that the genetics that drive this response arent completely understood.
You may not be aware that you have a preexisting genetic mutation, also called familial hypercholesterolemia . In fact, as the AHA notes, for people with FH, only 10 percent know they have it. Being aware of your family history, including members who have had a heart attack at a young age, is important and can help point your provider in the right direction. In some instances, research shows that a low-carb diet may actually be beneficial for those with FH who also have insulin resistance, suggests an analysis published in BMJ Evidence-Based Medicine in July 2015. This is not something to tease out on your own. Instead, its just another reason why you should talk to your doctor about a dietary change, particularly if you have other health conditions, like high cholesterol.
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Ldl And Carbohydrate Restriction: What Is The Relationship
Lets go back to the research assessing how the low-carb, high-fat diets such as the ketogenic diet affect your LDL levels. In the meta-analysis by Bueno et al., low-carb diets were shown to increase HDL twice as much as low-fat diets after randomized controlled interventions. It also showed that there was a small increase in LDL-C in low-carb subjects compared to low-fat diet subjects who experienced no increase.
The research study by Brinksworth et. al also showed that low-carb diets yielded greater increases in HDL cholesterol when compared to a low-fat diet.
Key Takeaways: Some research suggests that high-fat, ketogenic diets can increase LDL-C by a small amount.
Is The Keto Diet Healthy
Wellness Dietitian Mary Condon, RN, LDN, said the keto diet may result in weight loss and lower blood sugars, but its a quick fix. More often than not, its not sustainable. Oftentimes weight gain may come back, and youll gain more than what you lost, Condon said.
Condon said you should always consult your primary care doctor before starting any new diet.
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Replace Some Saturated Fats With Monounsaturated Fats
In the largest and highest quality studies, saturated fat is not linked to increased heart attacks or death from heart disease .
However if you have problems with cholesterol, then it is a good idea to try to replace some of the saturated fats you are eating with monounsaturated fats.
This simple modification may help to bring your levels down.
Cook with olive oil instead of butter and coconut oil. Eat more nuts and avocados. These foods are all loaded with monounsaturated fats.
If this alone doesnt work, then you may even want to start replacing some of the fatty meat you are eating with leaner meat.
I cant emphasize olive oil enough quality extra virgin olive oil has many other benefits for heart health that go way beyond cholesterol levels.
It protects the LDL particles from oxidation, reduces inflammation, improves the function of the endothelium and may even lower blood pressure (
Is Keto A Good Choice If You Have Both High Cholesterol And High Blood Pressure
If you have high cholesterol and high blood pressure, its important to talk with your doctor before deciding to go on a ketogenic diet. Your doctor will take your specific circumstances into consideration, such as overall health, the medications you take, and other risk factors, before approving a keto diet.
With some studies showing keto may potentially improve cholesterol and blood pressure levels, it might be worth asking your healthcare professional about it.
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My Cholesterol Is Very High Should I Come Off Lchf Diet
I started the LCHF diet in September, thanks to your website. Ive lost almost 14 pounds so Im very happy with that, but I had my bloods done last week and my cholesterol has come back very high, at 10, and apparently my bad cholesterol was high as well. It was around 5 previously. I was on a statin and after watching some videos and reading up on them, I came off my statin about two months ago. My doctor wants me to go on a statin and a low-fat diet but I feel great on LCHF. Is there any advice you could give me?
Thanks,
Hi Ber!
Whether you need a statin or not is something we cant tell you we cant and we should not, offer personalized medical advice here.
In general, stopping taking statins appears to result in a significant increase in cholesterol on its own.
Cholesterol levels can rise quite a bit for a minority of people who try keto. However, the cholesterol profile usually improves, e.g. the good cholesterol usually goes up the most, this is connected to a lowered risk by itself. For more on the topic see this guide.
Best,Andreas Eenfeldt