How To Identify Risk Of Developing Heart Disease
Its normal that we start worrying about our health and well-being as we age. This is especially true when it comes to our hearts condition. The older we get, our blood vessels which supply blood to the heart, become less flexible. This makes it harder for blood to move through and plaques may have already accumulated in the artery walls. There are variousways to check if you are indeed at risk of developing heart disease. One way of determining the risks is to understand your CAC score.
As mentioned earlier, one of the substances that block the arteries is calcium. Coronary artery calcium scoring also called a coronary calcium scan, is a test that measures the amount of calcium in the walls of the hearts arteries. It is a way to estimate someones risk of developing heart disease or calculating the probability of a heart attack or stroke. The earlier you take the testand determine your score, the earlier you can come up with a plan on how to reduce or minimize the risk of developing heart disease.
There are a lot ofhealth strategiesyou can adopt in order to protect your heart and live a healthy life. Controlling your blood pressure, keeping your cholesterol levels under control, managing stress, and getting regular exercise can lower the risk of heart disease. But theres one health strategy you can trya ketogenic diet.
So What Foods Should I Eat
Some cleaner keto-friendly food options include:
- Eggs
- Nut butters such as peanut, almond and cashew
- Healthy fats from coconut oil, olive oil and avocado oil
- Avocados
- Non-starchy vegetables including broccoli, tomatoes, mushrooms and peppers
Keto-friendly foods that you can eat, but in moderation, include:
- Red meats
- High-fat dairy products including cream cheese and sour cream
Carbohydrate Moderation Increases Hdl In Healthy Non
The majority of studies assessing the effects of carbohydrate restriction on HDL have been conducted on primarily Caucasian, obese subjects.
In 2006, researchers sought to investigate the relationship between carbohydrate intake and HDL cholesterol in a healthy, diverse population. Scientists examined data from Canadians of South Asian, Chinese, European, and Aboriginal origin from two cross-sectional studies conducted in the late 90s.
They included participants who were 35-75 years of age and who were not born in Canada but had lived there for at least 5 years. Subjects who suffered from moderate to severe medical conditions such as diabetes, heart diseases, and active cancer were not included. Subjects of all different weights and BMIs were included as long as they were considered healthy.
Scientists then randomly selected 619 subjects who met these inclusion criteria and examined their carbohydrate intake and levels of HDL cholesterol.
After adjusting for demographic factors such as age, sex, and ethnicity and lifestyle factors such as smoking, researchers noted that subjects in the lowest third of carbohydrate consumption had significantly higher levels of HDL cholesterol than subjects in the highest third of carbohydrate consumption.
Fewer servings of sugary drinks were also associated with higher levels of HDL. Because of their findings, the researchers attributed differences in HDL concentration to carbohydrate intake.
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Practical Application: How To Interpret The Cholesterol Levels On Your Blood Test Results
The beneficial effects that the ketogenic diet has on cholesterol levels are not guaranteed for everyone. This is why it is important to consult your doctor and get your blood tested to track the results of your dietary changes.
Most of your blood test results, however, may only cause more confusion. Your LDL-C, HDL-C, Total cholesterol, and triglycerides numbers are valuable, but they only provide small pieces to the puzzle of your cardiovascular health. Does this mean that you have to get an advanced cholesterol panel?
Although some doctors may suggest it if you have genetic factors that are actively contributing to your cardiovascular health, an advanced cholesterol panel isnt necessary for everyone. Instead, most people should look for a different blood marker that can be found from the results of a standard blood lipid panel the total-to-HDL cholesterol ratio. Why?
Dr. Chris Masterjohn postulates that this ratio is an accurate marker for the amount of time that LDL particles spend in the blood . This is an important thing to take note of because the LDL particles are more likely to become oxidized and cause atherosclerosis when they are in the blood for longer periods of time. This gives us a deeper explanation of why the authors of the 2003 meta-analysis looked at the total-to-HDL cholesterol ratio rather than total cholesterol levels.
Key Takeaway: Total-to-HDL cholesterol ratio is the best predictor of cardiovascular disease risk on the basic blood lipid panel.
Good Cholesterol And Bad Cholesterol
You will likely hear terms such as HDL and LDL . HDL and LDL are not cholesterol molecules but rather theyre lipoproteins that help transport cholesterol around the body.
HDL: good cholesterol
- HDL High Density Lipoproteins, commonly termed good cholesterol.
- HDL transports cholesterol around the body and collects and returns unused cholesterol back to the liver to be recycled or destroyed, i.e. it helps prevent other cholesterol from accumulating and clogging your arteries
- Some research suggests that HDL may also have anti-inflammatory effects.
- HDL makes up about 20-30% of total cholesterol.
- The higher your HDL, the better. Over 60mg/dL is good.
- There are many things that can lower HDL Type 2 diabetes, not exercising enough, smoking, being overweight.
LDL: bad cholesterol
So, just talking about high/increasing cholesterol or low/decreasing cholesterol is not enough because we need to distinguish between HDL and LDL
A high cholesterol reading in itself is not necessarily bad. If you have a borderline high level of cholesterol for example but much of it is the good cholesterol HDL thats not a problem. What your doctor is looking out for are high levels of LDL and/or high levels of triglycerides.
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What Is Coronary Heart Disease
Our blood does not just irregularly move around our bodies. It is carried by tubes of arteries and veins that are attached to the heart. Our body needs a steady supply of blood to keep it working. The blood delivers oxygen to all the bodys cells. In order for us to stay alive, we need healthy cells. If our oxygen-rich blood doesnt circulate in our body as it should, a person may experience chest pain or discomfort. This is usually one of the common symptoms of coronary heart disease.
Coronary artery disease or sometimes called coronary heart disease is the narrowing of the blood vessels that supply blood and oxygen to the heart. It is caused by the buildup of plaque in the wall of the arteries which reduces the blood flow and in some instances, block it altogether. This condition is called atherosclerosis. Plaque is made from various substances that include calcium, fat, cholesterol, and many more. When the buildup is too much, a person may then experience chest pain and shortness of breath, which might eventually lead to a heart attack.
Consult Your Doctor Before Starting A Keto Diet
Regardless of their health status, all patients should consult their doctor before going on the keto diet.
The reason: to rule out any existing concerns or ailments that could make the approach harmful to their heart or the rest of their body.
A small subset of people appears to experience increased cholesterol levels on a low-carb diet, so a family history of heart disease should be discussed.
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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.
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.
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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.
What Is The Relationship Between Keto And Cholesterol
In short, a well-formulated ketogenic diet will likely increase your cholesterol. The reason for this is that keto emphasizes a large amount of saturated fat in the diet, and high levels of saturated fat will increase cholesterol. Now, because of Ancel Keys, weve be taught that high cholesterol is a problem. However, putting it bluntly, Ancel Keys was wrong. In this meta-analysis of 21 well-formulated studies the conclusion was that there is absolutely no relationship between high levels of cholesterol and heart disease or cardiovascular disease.
In fact, in this study, keto was shown to favorably affect biomarkers such as cholesterol, as they relate to heart disease.
So keto will increase your cholesterol , but increased cholesterol has no scientific causal relationship to any sort of heart disease or cardiovascular disease. In fact, studies like the one above show that keto has BENEFICIAL impact.
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Debunking Ancel Keys Flawed Fatphobia
A lot of what we believe about the link between fat and cholesterol stems from an erroneous statement made by ivy-league researcher Ancel Keys in the mid 20th century.
He claimed heart disease was caused directly by cholesterol build-up on the artery walls, a theory commonly referred to today as the plumbing model in reference to the speculated clogging of arteries.
What Keys proposed was that eating fat, especially saturated fat like lard, butter, and egg yolks, had a direct correlation with heart disease in his Seven Countries study published in 1953.
Whether or not this study was a covert attempt by big sugar and big pharma to stifle growing popularity of the ketogenic diet for therapeutic reasons like diabetes and epilepsy is still unconfirmed but is a widely held opinion among many academics.
Our liver produces cholesterol naturally, so it begins to seem improbable that cholesterols existence in the body is solely negative. After research emerged that the bloods levels of one type of cholesterol, namely HDL-cholesterol, actually correlated with lower instances of heart disease in patients, researchers pointed the finger at the other predominant type of cholesterol, LDL-cholesterol.
This distinction eventually led to the good vs bad cholesterol concept we invest in today, but the idea can very well have been based on a few assumptions. However, its widely become a simple and easy means to explain a complex problem.
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.
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How Can Ketogenic Diet Help You Reduce The Risk Of Heart Disease
If you want to protect your heart, then you need to be mindful of what you eat. Losing even a moderate amount of weight with the help of a keto diet can lower cardiovascular risk factors such as high blood pressure and obesity. Furthermore, in an article published by PubMed Central of the US National Library of Medicine, ketogenic diet results in lower LDL and higher HDL. Low-density lipoprotein is considered to be the bad cholesterol in our body and the high-protein lipoprotein is the good cholesterol that helps protect against heart disease. Our body needs cholesterol for it to work properly. However, too much cholesterol, specifically the LDL in your blood raises the risks of coronary artery disease.
How Keto May Change Your Ldl Cholesterol
The impact of high-fat, very low-carb eating on your LDL isnt as clear. Again, as the AHA says, LDL is the type of cholesterol thats linked to atherosclerosis, which can increase your risk for heart disease and stroke. It may go up, go down, or stay relatively the same. Hypothetically speaking, if you have a normal triglyceride level and are doing keto to lose weight, LDL may remain stable, says Soffer. Similarly, if you have high triglycerides to start and that number decreases on keto, your LDL may still stay put.
The bottom line is that keto alone may not contribute to the cholesterol spike that some people report when starting the diet. Yet if you start eating more saturated fat because youre on keto, then your LDL will likely rise. An increase in saturated fat intake has been shown over and over again to increase LDL, he says.
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Does The Keto Diet Have Benefits For Cardiac Patients
I do not know of any high-quality dietary studies that consistently show ketosis is helpful in human hearts, says Dr. Tang. However, there have been some exciting new data that may point to potential benefits in subsets of heart failure patients. So, our group and others are actively studying this to see if there is any new dietary intervention opportunity for some patients.
Can the keto diet cause heart issues? Dr. Tang fears some people who have heart failure doing a ketogenic diet might have increased risks of:
- A spike in LDL cholesterol.
- Dehydration.
- Kidney failure.
In general, if you have heart failure, youre more likely to develop a blood sugar abnormality. And with keto dieters consuming high levels of fat and protein, its hard to determine when it turns from healthy to harmful.
Recommendations for heart patients on the keto diet
Its possible some patients might benefit from the keto diet, but some might get worse, says Dr. Tang.
Because of the potentially harmful effects of the keto diet on heart patients, Dr. Tang and other heart failure specialists advise taking a less-strict approach.
For heart patients, Dr. Tang recommend:
- Eating a balanced diet that contains complex carbohydrates, unsaturated fats and lean proteins.
- Controlling portions.
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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