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What Happens To Cholesterol Levels On A Keto Diet

How To Follow Keto In A Heart

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

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.

How Can You Determine If Youre At Higher Risk

Well, you can assess the actual presence of calcification in your coronary arteries. The test for this is called the coronary artery calcium scan . Measuring the degree of calcification is a much better way to assess your risk compared to the amount of cholesterol being carried in your blood.

A paper from the journal Atherosclerosisstated that direct assessment of atherosclerosis is more predictive than traditional risk factors and CAC appears to be superior to any other method or risk assessment tool.

It cannot be emphasized enough that high LDL-C, by itself, does not indicate that you have CVD or are at high risk for developing it.And having an LDL-C in the normal range doesnt guarantee protection. In an analysis of over 130,000 patients hospitalized with coronary artery disease, upon admission, nearly half had LDL-C < 100 mg/dL and nearly 18% had LDL-C < 70 mg/dL .

On the other hand, more than half had HDL-C < 40 mg/dL a possible indicator of metabolic syndrome.

Why Fat Source Matters

In this study, there was a substantial 33% decline in postprandial lipemia after a fat-rich meal. Even more significant was the 50% decline in postprandial lipemia in subjects who followed a keto diet plan that was higher in monounsaturated fats.

In contrast to these outcomes, a different study reports that a low-fat , high-carbohydrate diet plan actually increases overall cholesterol and decreases HDL cholesterol. Ironically, low-carb diet plans like the keto diet actually improve cholesterol profiles in nearly all extant literature.

Its interesting to think that your body naturally has a better balance of blood lipids when you eat more fat and fewer carbs. Not sure which fat sources are best for the keto diet? Check out our Ultimate Keto Food List!

Moreover, the substantial decrease in fasting blood lipids from the keto diet is most likely due to a lower VLDL cholesterol synthesis rate.

Moreover, there is a boost in blood fat elimination from high-fat diet plans. This denotes a substantial increase in plasma lipoprotein lipase activity and skeletal muscle LPL activity in human beings. LPL is an enzyme responsible for breaking down fat molecules in your body.

The bulk of research studies report compelling connections between modifications in fasting and postprandial blood lipids. A current research study shows that a high-carb, low-fat dietary program reduces fasting blood lipids, but does not result in a decrease in the postprandial blood lipids.

Read Also: What Foods Help Lower Cholesterol Fast

Evidence Behind The Ketogenic Diet

  • Carbohydrates, which range from 200 to 350 grams per day, make up around 55 percent of the normal American diet in terms of overall calorie consumption.
  • Until recently, the huge potential for carbohydrates to produce negative consequences was largely ignored. A higher sugar intake is linked to a 44 percent higher frequency of metabolic syndrome and obesity, as well as a 26 percent higher chance of developing diabetes mellitus.
  • In a 2012 analysis of all cardiometabolic mortality in the United States, inadequate intakes of 10 dietary variables were linked to 45.4 percent of deaths. The highest rate of expected mortality was linked to:
  • High sodium intake , followed by
  • Low intake of nuts and seeds
  • High intake of processed meats
  • Low intake of omega-3 fats
  • Low intake of vegetables 7.6%)
  • Low intake of fruits
  • High intake of artificially sweetened beverages .
    • The lowest estimated mortality was associated with
  • Low polyunsaturated fats and
  • Unprocessed red meats .
  • Cholesterol Is A Building Block Or Raw Material For A Dizzying Array Of Important Things In Your Body:

    Why is my blood pressure or cholesterol going up on keto
    • Steroid hormones ,

    And thats just the short list. Cholesterol performs critical functions in the immune system and much more.

    Bottom line: even if very high cholesterol is problematic in some wayand thats a matter of debateyou wouldnt want to drive your cholesterol level too low, because that would cause its own host of issues. You definitely need some cholesterol in your body!

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    Youre Still Not Moving Frequently At A Slow Pace

    Ive said it before, and Ill say it again: low level aerobic activity in the form of walking, hiking, easy cycling, or even light rowing is absolutely essential. Theres a reason it forms the base of my Primal Blueprint Fitness pyramid. When you go for a good-sized walk, youre not burning calories. Youre not blasting your abz, bunz, and gunz. Youre not vomiting on yourself from overexertion. Its not exciting. It wont make a good Youtube video set to Linkin Park. But what you will be doing is utilizing those free fatty acids that might be throwing off your lipid panels.

    In one study, patients who walked briskly were far less reliant on cholesterol, blood pressure, and diabetes medications. Those who took the longest walks at the briskest pace were the least likely to have LDL cholesterol high enough to warrant statins. In another, brisk walking was enough to reduce triglycerides and LDL particle count in overweight women.

    Lifting heavy things and sprinting once in awhile are excellent acute stressors that elicit fantastic health and performance benefits, but constant low-level movement is the foundation of it all, especially if youre eating more fat and trying to become a true fat-burning beast.

    Solution: Do I even have to say? This isnt optional. Go for a walk!

    Also Check: Can Keto Cause High Cholesterol

    Pattern A Vs Pattern B Ldl

    A relatively newer concept when it comes to looking at cholesterol is actually the difference between LDL particle sizes. The type of LDL you have in your body actually makes a huge difference in the amount of risk for heart disease that it presents .

    Pattern A LDL actually has a larger particle size. So, one LDL particle that is pattern A is larger than a single particle of LDL that is pattern B. Pattern A LDL also tends to carry more fat-soluble nutrients and antioxidants. These antioxidants protect it from oxidative stress, making them cardioprotective.

    Pattern B LDL, on the other hand, has a much smaller particle size and is much more prone to oxidation. Another thing about pattern B LDL is that it is small enough to enter into the endothelial lining of the artery where it can become oxidized and more likely to form plaque. There is a high association between these small dense particles and cardiovascular disease.

    This means that two individuals with the same LDL, HDL, and Triglyceride levels could have vastly different heart disease risk depending on what type of LDL they are predominantly carrying in their blood. A ketogenic diet has been shown to reduce the number of pattern B LDL particles .

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    What Happens To Ldl Cholesterol On A Ketogenic Diet

    A ketogenic diet typically leads to a broad range of improvements in blood lipids as well as other cardiovascular risk factors such as blood pressure and inflammation. However, the changes we see in total and LDL cholesterol levels are much less predictable than the changes in other blood lipids such as triglycerides and HDL cholesterol. For some people, calculated LDL cholesterol goes down, and for others it goes up, sometimes quite a bit. This tendency for some people to see an increase in their LDL cholesterol has been a focus of research over the last decade because the question remains – âWhat, if anything, does this tell us when assessing oneâs risk of heart disease?â

    One approach to this question has been to examine the variations in the size of the LDL particles in the blood. With a well-formulated ketogenic diet, we see a shift away from the small dangerous LDL even when the total LDL goes up, so most of this increase is in the âgoodâ or âbuoyantâ LDL fraction . Another factor to be taken into account is that during rapid weight loss, cholesterol that you had stored in your adipose tissue is mobilized as the fat cells shrink . This will artificially raise serum LDL as long as the weight loss continues, but it then comes back down once weight loss stops. To avoid being misled by this, the best strategy is to hold off checking blood lipids until a couple of months after weight loss ceases.


    The Effect Of The Ketogenic Diet On Protein

    Why High LDL Cholesterol on the Ketogenic Diet? Dr. Berg
    • A well-formulated ketogenic diet limits protein consumption to less than 1g/lb body weight, unless individuals are doing strenuous activity involving weight training, in which case protein intake can be raised to 1.5g/lb body weight. This is done to prevent the body from producing glucose endogenously through gluconeogenesis.
    • It does not, however, limit fat or total daily calories. People who follow a ketogenic diet lose weight quickly, up to 10 pounds in two weeks or less. This diet has a diuretic impact, thus part of the first weight reduction is attributable to water weight loss, followed by fat loss. Surprisingly, lean body muscle is largely unaffected by this eating regimen. As a nutritional ketosis state is maintained, hunger sensations diminish, and an overall reduction in calorie intake aids in weight loss.

    Because of the intricacy of the mechanism and the absence of long-term research, a general prescription of the ketogenic diet for the prevention of type 2 diabetes mellitus or cardiovascular disease may appear premature, but it is not farfetched for primary weight loss.

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    What Happens To Triglycerides On Keto

    Studies show that on a keto diet, triglycerides generally decrease . This makes sense when considering that triglycerides are a type of stored fat. When youre on keto your body uses fat for fuel leaving less triglycerides to be stored in your fat cells.

    Reduced triglyceride levels decrease the risk of developing chronic diseases including diabetes and cardiovascular disease .

    How To Lower Cholesterol On Keto

    One of the biggest concerns with low-carb diets of all kinds is cholesterol. Most research shows that these types of diets can result in elevated LDL cholesterol while reducing HDL cholesterol â and keto diets arenât an exception. If you already have high cholesterol, you may want to reconsider a keto diet. Better yet, you may want to try out a diet with foods to lower triglycerides.

    For most healthy people with regular triglyceride levels, these changes are mostly considered modest and shouldnât have a significant detrimental impact on your health. However, to play it extra safe, consider consuming more unsaturated fat than saturated fat, especially if youâre concerned with improving your heart health. You may also want to increase your intake of non-starchy, fiber-rich foods that are low on the GI index.

    The keto diet is not for everyone, and before you proceed with any significant diet changes, you should consult your doctor to make sure you can go about it safely. A good way to ensure your health on the keto diet is by monitoring your lipid and cholesterol levels regularly. Everlywell offers a convenient at-home lipid and cholesterol test. With a finger prick sample collection process, you can receive accurate test results that show your total cholesterol levels, HDL cholesterol levels, calculated LDL cholesterol levels, and triglyceride measurements. You can then review these results digitally and gain some useful insights from physicians.

    Read Also: What’s The Normal Level Of Cholesterol

    Keto Diet And Cholesterol: Does It Help Or Hurt

    By Jillian Levy, CHHC

    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.

    Replace Saturated With Monounsaturated Fat

    Can the Keto Diet Mess With Your Cholesterol? Here

    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.

    Recommended Reading: How To Lower Ldl Cholesterol Quickly

    Keto And Cholesterol: What If Your Cholesterol Goes Up While On Keto

    Few things are more controversial than cholesterol on a ketogenic diet. Not the cholesterol in your foodmost people understand its fine to eat egg yolks, bacon, and butterbut the cholesterol in your blood. Should you be worried if your blood cholesterol level goes up on a keto diet? What if it goes up a lot?Lets take a closer look at keto and cholesterol.

    Should You Be Concerned If Your Cholesterol Increases With Low

    This is an emerging area of research that is currently the focus of a great deal of debate and uncertainty.

    Traditionally, experts in the field of lipids and heart disease have viewed elevated LDL cholesterol with concern because it typically reflects a high concentration of LDL particles circulating in the bloodstream.

    Excessive amounts of LDL particles have been found to be associated with the development of atherosclerosis, the underlying cause of heart disease.11

    Despite the associations between high concentrations of LDL particles and heart disease, research has consistently shown that keto diets help reduce many heart disease risk factors in people with diabetes and other insulin-resistant conditions.12

    Granted, trials showing an actual reduction in heart attacks dont yet exist. Will the demonstrated improvement in risk factors result in a net beneficial effect despite increased LDL? That is unknown, but some evidence suggests that it may be the case.13

    The fact that so many risk factors remain stable or improve with carb restriction even if LDL cholesterol levels increase demonstrates the importance of not viewing any one value in isolation. Instead, it may be better to look at the body as a whole system.

    However, some experts urge caution. Prominent lipidologist and vocal lipid educator Dr. Thomas Dayspring states:

    Read Also: What Does High Bad Cholesterol Mean

    So What Should You Do How Do You Eat Keto And Not Raise Your Cholesterol

    Work with your doctor! If youd like to find a keto-friendly doctor near you, search here and here, and keep in mind that if theres no one in your immediate local area, it could be worth a long drive to work with someone who understands the dynamics of cholesterol on a keto diet.

    Its important to have a total picture of your risk, not just one number by itself. If you have elevated LDL-C, consider getting the CAC to see whether you actually have atherosclerosis or not.

    Ask your doctor to walk you through their assessment of your cardiovascular health, taking into account your blood sugar, blood pressure, triglyceride-to-HDL ratio, family history, physical activity, smoking status, and other factors known to affect risk. A treatment plan should not be based on a single measurement in isolation.

    Its also important to understand the risks and benefits of any medications or other therapies your doctor may recommend for you. For example, a recent paper in JAMA Internal Medicine determined that in order to prevent one heart attack, 77 people would need to be treated with a statin drug for 4.4 years.


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