What Happens To Your Cholesterol On A Ketogenic Diet
ââFor most people, a ketogenic diet leads to improvements in cholesterol, but there are sometimes transient rises in cholesterol levels during weight loss. During rapid weight loss, cholesterol that you had stored in your adipose tissue is mobilized, which will artificially raise serum LDL as long as the weight loss continues. To avoid being misled by this, the best time to check blood lipids is a couple of months after weight loss ceases. Total cholesterol includes HDL , which usually goes up 10-15% on a ketogenic diet. That said, some people have high calculated LDL cholesterol values even after weight loss stops. If this occurs, you should discuss further diagnostic tests with your doctor. Current research is looking at LDL cholesterol as a mix of different particle sizes, where the small ones are dangerous and the larger ones are not. With a well-formulated ketogenic diet, we see a shift away from the small dangerous LDL even when the total LDL goes up.
The Impact Of Carbohydrate Restriction On Hdl Cholesterol
In a recent meta-analysis published in the British Journal of Nutrition by Bueno et al, researchers investigated the impacts of very-low-carbohydrate ketogenic diets on key metrics of cardiovascular health including HDL cholesterol.
The authors defined a VLCKD as a diet lower in 50g of carbohydrates lower than the daily recommended grams of carb consumption clinicians recommend to diabetics. They included 13 randomized controlled studies with a total of 1,415 subjects. All studies took place for at least a full year and all subjects included were over 18 years old and had a BMI of at least 27.5 kg/m2. In each of these studies, VLCKD diets were compared to low-fat diets.
Overall, 12 studies including 1257 patients examined the impact of a VLCKD on HDL cholesterol. When assessing the data, the individuals assigned to a VLCKD achieved an average increase in HDL of 0.12 mmol/L. This was double the average increase in HDL of the low-fat dieters who achieved an average increase in HDL of 0.06 mmol/L. As a result, the authors concluded that carbohydrate-restricted diets confer cardiovascular benefits because they improve levels on HDL in the body.
Key Takeaways: A low-carb diet is an effective method in raising HDL cholesterol when compared to traditional weight-loss diets that emphasize reducing fat intake.
Recommendation: If you need to increase levels of heart-healthy HDL cholesterol, a carbohydrate restricted diet can be an effective tool.
Ketogenic Diets Impact On V
Provided the research showing an increase in LDL levels in human subjects after a low-carbohydrate diet, what does the research say about extreme carbohydrate restriction on V-LDL and LDL particle count?
In a 2006 study, researchers assessed the effects of carbohydrate restriction on LDL cholesterol in a group of 29 men for a 12 week weight-loss intervention. The subjects ages ranged from 20-69 years their BMIs ranged from 25 kg/m2 to 30 kg/m2.
Their intervention diets consisted of 10% of energy from carbohydrates, 65% of energy from fat, and 25% of energy from protein. Assuming a 2000 kilocalorie diet, this translates to approximately 50 grams of carbohydrates daily.
After the 12 weeks intervention, researchers noted that the concentration of LDL particles decreased by 9.6% from 1180 nmol/L 1180 to 1066 nmol/L. As previously mentioned, lower levels of LDL particles are beneficial to cardiovascular fitness. Additionally, the particle size of LDL increased by an average of 5.2% from 20.75 mm to 21.27 mm.
Researchers also observed that the size of VLDL particle size did not change in either of the groups. However, they noted that the total number of VLDL particles decreased by 19% from 76.2 nmol/L to 61.7 nmol/L. More specifically, large VLDL particles reduced by 40.2% from 3.33 nmol/L to 1.74 nmol/L, medium VLDL particles decreased by 4.8% from 46.2 nmol/L to 44 nmol/L.
From this, we can conclude that a low-carb, ketogenic diet helps you optimize your LDL cholesterol.
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The Basics: What Is Cholesterol
Cholesterol is a waxy substance that is essential for the life of all animals, including humans.2 Cholesterol is found in virtually every cell of your body and is necessary for many bodily functions, including:
- Cell integrity: As an integral part of every cell membrane in the body, cholesterol is required for maintaining cell structure and fluidity.
- Hormone synthesis: Cholesterol is needed to make steroid hormones such as estrogen, testosterone, cortisol, and other related hormones, such as vitamin D3.
- Creation of bile acids: Your liver converts cholesterol into bile acids, which help you absorb fats and the essential fat-soluble vitamins A, D, E and K.
- Myelin formation: The myelin sheath that surrounds and protects nerve cells contains plenty of cholesterol.3
Your body makes most of the cholesterol that is found in your bloodstream. Its primarily produced in the liver.
Dietary cholesterol found in animal foods like eggs, shellfish, cheese, and organ meat makes up a smaller portion of your blood cholesterol pool.
Unlike fat, which contains nine calories per gram, cholesterol has no calories. Because its present in foods in very small amounts, its measured in milligrams instead of grams. Most fatty meats and whole-milk dairy products contain just a little cholesterol, whereas some shellfish and organ meats are high in cholesterol, yet low in fat.
What Happens To Ldl On Keto Diet
A ketogenic diet typically leads to improvements in a range of blood lipids and other markers for cardiovascular health like blood pressure, inflammation, and triglycerides. But the changes to LDL are less predictable and can sometimes go up.
However, studies show that on keto we typically see that even when the total LDL increases, there is a reduction in the small bad LDL, referred to as VLDL or, very low density lipoprotein. This means that most of the increase is in the larger, heart friendlier LDL particles .
Its important to note here that for most people on keto LDL either stays the same or goes down. This finding is reflected in a 2006 study looking at the effects of carbohydrate restriction on LDL cholesterol in a group of 29 men for a 12 week weight-loss intervention found that LDL particle concentrations decreased by 9.6% .
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Why Is My Blood Pressure Or Cholesterol Going Up On Keto
For most people, the ketogenic diet will optimize your blood pressure and cholesterol levels. Unfortunately, this isnt the case for everyone.
When it comes to cholesterol, you will most likely experience an increase in healthy cholesterol that will help prevent heart disease. In other words, if your cholesterol levels go up while you are on the keto diet, this is usually a good thing. To learn more about what happens to your cholesterol levels on keto and how to interpret your cholesterol numbers, check out this article.
On the other hand, if you have familial hypercholesterolemia, then increasing your fat intake will most likely cause your cholesterol levels to rise in an unhealthy way. In this case, you will usually do better with a lower fat diet.
Regarding blood pressure, keto seems to decrease it more than any other diet that has been studied. A low-carbohydrate diet incorporating fats from olive oil along with vegetables and fish characteristic of the Mediterranean Diet may be the best diet for lowering blood pressure. For a deeper look at the research, check out our article on keto and blood pressure.
However, if your blood pressure increases after starting the diet a couple of things may be happening. Here are some of the most common reasons for this phenomenon:
For those that are struggling to adapt to the diet, make sure you are eating enough calories and follow the recommendations in this article.
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!
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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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What Does The Keto Diet Do To Your Cholesterol Levels
The keto diet appears to improve cardiovascular health markers, including cholesterol and triglyceride levels.
Research from 2004 suggests that people with obesity and high cholesterol experience greater weight loss and bigger improvements in triglyceride and HDL levels when on a keto diet than on traditional low fat diets.
Fewer studies point to poor outcomes like increased LDL and decreased HDL levels, and those tend to improve over time. The important thing to remember is that the types of foods you eat really matter.
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Why Might Ldl Cholesterol Go Up On Keto
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Why The Ketogenic Diet Optimizes Cholesterol Levels: The Impact Of Specific Fatty Acids
Now that we know about the effect that the ketogenic diet has on cholesterol levels a finding that seems to contradict everything we thought we knew about cholesterol and fat lets find out how such a high-fat diet actually optimizes cholesterol levels.
The most convincing piece of evidence can be found in a 2003 meta-analysis. In this meta-analysis, researchers compiled the data from sixty trials that quantified the effect that feeding different types of fats to humans had on the total-to-HDL cholesterol ratio . But before we look through the results, we must first understand what this ratio is.
The total-to-HDL cholesterol ratio is found by dividing your total cholesterol level by your HDL-C, and it is essentially the same thing as an LDL-to-HDL cholesterol ratio since most non-HDL cholesterol is LDL cholesterol . The researchers of the 2003 meta-analysis used this ratio because it is a better cardiovascular risk predictor than total cholesterol levels .
Now that we have a superficial understanding of the total-to-HDL cholesterol ratio, lets look at the results of the meta-analysis. The two findings that the researchers highlight most are the effects that lauric acid and stearic acid have on the total-to-HDL cholesterol ratio. Both of these fatty acids improved the total-to-HDL cholesterol ratio more favorably than carbohydrates .
Because of these findings, we can infer that the low-carb, high-fat diet optimizes cholesterol levels for two main reasons:
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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.
What Happens To Your Cholesterol When You Go On A Keto Diet
Even if youre at risk for cardiovascular disease, you still may be a candidate for the popular diet.
For every person who talks up the ketogenic diet, theres another warning about the ill effects on your heart. The worry is that following a very high-fat, moderate-protein, and very low-carbohydratediet will create a subsequent spike in cholesterol levels, which could, in turn, raise your risk for heart disease.
The worry is certainly valid. On the keto diet, each day youre eating up to 80 percent of your calories from fat and sticking with 20 to 50 grams of net carbs, a term used in popular diets, including keto and Atkins but one that is not officially recognized in the medical community. This all means youll be eating a lot of fat per day, and in the name of meeting that quota, that may include unhealthy choices such as butter, coconut oil, and animal fat, all sources of saturated fat, which has been linked to poor heart health, according to the American Heart Association .
But the effect of keto on heart health isnt as straightforward as it sounds. Indeed, the keto diet may not have as detrimental an effect on your cholesterol as some have thought.
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Predicting How Keto May Affect Your Cholesterol Levels
To have an idea if the keto diet may have a negative effect on your cholesterol, consider your starting triglyceride number. According to the Mayo Clinic, triglycerides are another type of lipid in your blood that your body uses for energy high triglyceride and LDL levels can lead to fatty deposits that gum up arteries, notes the American Heart Association. Normal levels are less than 150 milligrams per deciliter . About a quarter of the population has triglyceride levels above 150 mg/dL, which is the threshold to consider elevated triglycerides. This is a large percentage of the population, so its not uncommon, says Soffer.
If you have normal levels, keto is likely safe to try. For people with normal or perfect triglyceride levels, the impact from keto is minimal or none, says Soffer. If, on the other hand, you have insulin resistance,type 2 diabetes, and/or abdominal obesity, and your triglycerides are elevated it may seem like you should shy away from keto, but the opposite may be true, Soffer argues, explaining that the low-carb nature of keto has the potential to decrease insulin resistance and improve triglycerides.
Still, though, the aforementioned Nutrition & Metabolism study involved a mere 34 people so more research, particularly larger, longer-term studies, is needed before scientists can fully understand the true effects of keto on insulin resistance and triglycerides.
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