For every person who touts the benefits of the ketogenic diet, another warns of its damaging effects on the heart. There are concerns that eating a very high-fat, moderate-protein, and very-low-carb diet may lead to increased cholesterol levels, which could, in turn, increase the risk of heart disease.
This concern is certainly justified. On the keto diet, each day you consume up to 80% of your calories as fat and are content with 20-50 grams of net carbs, a term used in popular diets including the keto diet and the Atkins diet, but which is not officially recognized by the medical community. . All of this means you’re going to be eating a lot of fat a day, and to hit that quota, you can make unhealthy choices like butter, coconut oil, and animal fats, all sources of saturated fat, which have been linked to poor heart health. The goal of keto is to shift your body from a carb-burning state to a fat-burning state, known as ketosis.
But the effect of the keto diet on heart health isn’t as simple as it sounds. Indeed, the keto diet might not have as bad an effect on cholesterol as some thought.
Looking at the data, two things are clear. Considering population studies and clinical trials, the impact of the keto diet on lipids is modest. More often than not, research shows that ketogenic diets cause modest reductions in triglycerides, modest changes in lipoproteins of high density (HDL, or “good”) which protect the heart, and minimal changes in low density lipoprotein (LDL, or “bad”) levels. Some studies show an increase in LDL levels in low or very low carbohydrate diets. (Long-term studies, however, are lacking).
Whether these levels, especially HDL, increase or decrease largely depends on the quality of your keto diet. One of the issues is that there isn’t just one ketogenic diet. There are different ways to track it, and some people pay attention to the types of fats they eat, while others don’t.
In a review, published in Nutrients in May 2017, it is noted that in human studies of normal weight and obese people, keto diets are generally associated with reduced total cholesterol, increased HDL, decreases in triglycerides and reductions in LDL. Meanwhile, other research, the review points out, shows something different: an increase in LDL or no change one way or the other. In the trials where LDL decreased, people ate a diet low in carbohydrates, high in healthy unsaturated fats and limited in unhealthy saturated fats, the authors point out.
A study included in the above review was published in October 2012 in Nutrition and compared a low-calorie diet and a very low-carb, high-fat diet (which would constitute a keto diet) in over 360 overweight participants. and obese. Some of the participants were diabetic, some were not. After about a year, participants in the keto group saw their total cholesterol, triglycerides, and LDL decrease, while their HDL increased.
Predict how the keto diet may affect your cholesterol levels
To find out if the keto diet may have a negative effect on your cholesterol, consider your initial triglyceride levels. Triglycerides are another type of lipid found in the blood that the body uses to produce energy. High levels of triglycerides and LDL can lead to fatty deposits that clog arteries. Normal levels are below 150 milligrams per deciliter (mg/dL).
If your levels are normal, you can safely try the keto diet. For people with normal or perfect triglycerides, the impact of the keto diet is minimal, if any. On the other hand, if you have insulin resistance, type 2 diabetes, and/or abdominal obesity, and your triglycerides are high, you might feel like you should avoid keto, but that may be be the opposite which is true. Indeed, the low carb content of keto can potentially reduce insulin resistance and improve triglycerides.
Recent research also suggests this effect. A small randomized, controlled study, published in August 2020 in Nutrition & Metabolism, examined 34 older adults with obesity for eight weeks. Those on the very low-carb diet lost three times as much visceral fat as the low-fat group. People on a low-carb diet also experienced more improvements in insulin sensitivity, triglyceride levels, and HDL cholesterol.
In this regard, the relationship between triglycerides and HDL cholesterol is another layer. When triglycerides are high, HDL is usually low. If we reverse the scenario, anything that lowers triglycerides will also tend to raise HDL. Remember that HDL is a type of “good” cholesterol that carries some of the LDL from the bloodstream to the liver where it can be metabolized and eliminated. Raising HDL is good for the heart.
How Keto Can Change Your LDL Cholesterol Level
The impact of a high-fat, very low-carb diet on your LDL is not so clear. LDL is the type of cholesterol linked to atherosclerosis, which can increase the risk of heart disease and stroke. It can increase, decrease or remain relatively stable. In theory, if your triglyceride levels are normal and you follow a keto diet to lose weight, LDL may remain stable. Likewise, if your triglyceride levels are high to begin with and decrease with ketosis, your LDL levels may remain stable.
How to follow a keto diet without harming heart health?
One of the downsides of the keto diet is the idea that you can eat all the fat you want. This is not a healthy state of mind. Better to choose fats [insaturées] cardioprotective foods, such as nuts, nut butters, seeds, avocados, and extra-virgin oils, such as olive oil. Likewise, avoid foods high in saturated fat (like butter) as your main sources of fat.
It’s not just the fats that are important, but also maximizing the small amount of carbs you are afforded. It can be difficult to get enough fiber, and you should make sure you eat plenty of low-glycemic vegetables (non-starchy choices like spinach and broccoli). Ultimately, the benefits come from replacing foods, like processed carbs, which experts say harm overall well-being, with heart-healthy foods, like unsaturated fats.
It’s been said time and time again: If you drastically change your diet, including the keto diet, you should talk to your doctor first and make sure that this change is safe for you and your health issues. You should also have your lipid levels checked before and during the keto diet, so your doctor can watch for a cholesterol spike and determine if this diet is healthy for you.
One of the main concerns is that once you stop following the keto diet, you continue to eat a diet high in saturated fat, combined with a typical standard American diet (a high-calorie diet high in grains and refined proteins , but poor in fruits and vegetables). Since the keto diet is very restrictive, most people don’t follow it long term, so watch your diet and plan appropriately when you go off the diet.
The Basics About Trying The Keto Diet To Lower Cholesterol
If you have high cholesterol or triglycerides, talk to your doctor first before embarking on a keto diet. If you get the green light, keep asking for their help. There are plenty of popular books on how to follow a keto diet, but patients need additional support and guidance and ongoing conversations to find out if it works for you.