Keto diet cholesterol – is there a relationship between the two terms?
You may have heard that the keto diet can help with weight loss. This is mostly because it slashes your carb intake to a maximum of 20-50 grams of carbohydrates per day (or thereabouts) and increases fat intake initiates ketosis. This carb restriction allows the body to turn to fat as the primary source of energy. Using calories from fat is ideal for long-term weight loss.
But researchers are also looking at how the keto diet may affect your cholesterol. The concern comes from the fact that the keto diet emphasizes high fat, moderate protein intake, and low carb foods which can inevitably result in spiked cholesterol levels. This obviously raises a person’s risk of heart disease.
This concern is valid because you’re eating a lot of fat per day, and, in order to fulfill the daily recommended quota, making many unhealthy choices. These may include eating coconut oil, butter, and animal fat – all of which are sources of saturated fat that have been linked to poor heart health.
The Safety Factor You Should Know About Keto Diet Cholesterol
For the general population, low-carb, high-fat diets are safe and healthy – unless they are at risk of having liver diseases, familial hypercholesterolemia, and liver diseases. Most people are not aware that they have familial hypercholesterolemia – a genetic condition. It is important to be aware of your family history, including family members who have had a heart attack at a young age. with type I diabetes and metabolic disorders should consult dietitians before a keto diet.
Individuals with high cholesterol levels should consult a healthcare professional or a nutritionist to decide if a diet high in fat content is suitable for them, based on their overall health and cholesterol levels. It is worth pointing out that a growing body of research suggests that the keto diet can lower LDL (bad) cholesterol levels and total cholesterol.
With that said, the low-carbohydrate diets have been known to increase both total and LDL cholesterol levels in the short run.
Good and Bad Cholesterol Explained
The body has two types of cholesterol: HDL – also known as the ‘good’ cholesterol, and LDL – or the bad cholesterol.
HDL stands for high density lipoprotein. It moves dense LDL cholesterol from the arteries to the liver. This is where the body breaks LDL down to clear it from the system. High levels of heart-healthy HDL cholesterol are useful for protecting against cardiovascular disease and heart attack.
LDL, or low density lipoprotein, can increase a person’s risk of atherosclerosis, a condition that leads to fatty buildup in the arteries. This can increase a person’s risk of serious cardiovascular health problems such as peripheral artery disease (PAD), heart attack, and stroke.
The most commonly found type of fat in our body is triglycerides. A high triglyceride level along with a high LDL cholesterol or low HDL cholesterol can lead to fatty buildup in the artery walls and increase the risk of stroke and heart attack.
The Keto Diet
When you follow the keto diet, you eat lots of:
- Meat and poultry
- Fish
- Shellfish
- Eggs
- Oils
- Green vegetables (low carb)
- Leafy vegetables
- Avocado
- Cheese
- Berries – including raspberries, blackberries, and blueberries
- Seeds
- Nut butter
You generally avoid:
- Starchy vegetables
- Honey and syrup
- Sweetened yogurt
- Chips
- Vegetable oils
- Grains such as crackers, cereal, pasta, rice, and bread
- Juices (can spike blood sugar)
- Baked goods (including the gluten-free variety)
A diet with whole foods is better than one loaded with processed foods. This can result in several beneficial effects such as:
- Body fat loss
- Blood sugar control
- Blood pressure control
- Lower triglycerides
- Satiety and fullness
- And other positive effects
Keto Diet Cholesterol Adjustments That Can Be Made
The bottom line is that if you are predisposed to high blood cholesterol levels, then you may have to make adjustments to your keto diet to prevent it from raising your cholesterol levels. This means avoiding trans fats, fried foods, and processed meats because they can raise your risk of heart disease.
Include monounsaturated fats into your diet instead of saturated fats. Good sources of fat include olive oil, nuts, nut butter, and avocados. In addition, you can eat foods rich in omega-3 fats and certain polyunsaturated fats to lower your triglyceride levels and raise your HDL (good) cholesterol levels. Good sources of omega-3s include flax seeds, fatty fish, walnuts, and salmon.
Finally, you can prioritize food groups that are high in fiber, low in carbs. Examples of fiber rich foods include berries, low carb veggies, nuts, and seeds. The increased intake of fiber has been shown to lower total cholesterol levels.
Anorexia and High Activity Levels
Anorexia patients are known for their high levels of cholesterol, despite having very low levels of dietary cholesterol. This is especially true for anorexics who binge on high blood lipids. Starvation also affects individuals, particularly women, on a hormonal level.
In fact, high cholesterol is a well known side effect of starvation in both men and women. Some experts believe that starvation results in the down regulation of the thyroid (which can raise cholesterol content; this will be discussed below).
Problems with the Thyroid Gland
The most common cause of high cholesterol is a dysfunctional thyroid gland and has nothing to do with how much cholesterol an individual eats. The thyroid regulates our hormonal system – which includes everything from sex hormones to metabolism. The thyroid also regulates cholesterol in the bloodstream, especially LDL cholesterol, and when the thyroid is not producing enough hormones, the total cholesterol levels can rise.
This condition is known as hypothyroidism and contributes to increased cholesterol concentrations in the blood because T3, a thyroid hormone, stimulates the production of LDL receptors, which pull LDL cholesterol out of the bloodstream and into the cells )(where it is used for various functions including the production of other hormones).
Low levels of T3, and fewer LDL receptors, can increase the levels of LDL cholesterol in the bloodstream and increase a person’s risk for heart disease.
The Keto Diet and Hypothyroidism
Thyroid hormones play an important role in gluconeogenesis. Cutting down on carbohydrate intake can affect how the converts T4 (the inactive thyroid hormone thyroxine) to T3 (triiodothyronine’s active form).
Staying in ketosis for too long can also lead to inflammation due to the higher levels of acidity because of the production of ketone bodies. Inflammation is a problem with people who struggle with hypothyroidism. So switching to an acidic American diet may result in undesirable effects.
Making Adjustments to the Keto Diet
While it’s true that the keto diet has many benefits for the body, there is no one-size-fits-all solution. Some modifications to very-low-carbohydrate ketogenic diets may be helpful for you depending on your situation. You should discuss this with your nutritionist and healthcare provider.
Here are a few suggestions.
Incorporate Foods That Can Reduce Inflammation
Leafy green veggies are great at reducing inflammation and helping the body become slightly more alkaline. Consider adding spinach, kale, and other leafy greens to your diet. Adding more vitamin D and omega-3 fatty acids will play an important role in reducing inflammation in the body.
Increased Your Consumption of Water
Drinking water has a major impact on your mental clarity, energy levels, weight, and overall health. Try to increase your consumption of water – especially if you are a heavy drinker of coffee and alcohol. Hydration is known for preventing an unhealthy rise in cholesterol levels.
You can also drink plant-based smoothies (low in carbs) to maintain an ideal cholesterol level.
Improve Stress Management
Stress affects cholesterol levels. When a person goes through stress, their body produces more cortisol – a stress hormone. Studies have found that high levels of cortisol, along with other stress hormones such as adrenaline and glucagon, can increase blood sugar levels.
This can increase total cholesterol levels in the body – including HDL and LDL cholesterol. Moreover, high-stress levels can increase blood sugar levels that could prevent a person from entering a state of ketosis. It is highly recommended to utilize stress management techniques such as sleeping more often, engaging in relaxing activities, and dissociating from anything that could trigger stress.
Reduce Exposure to Environmental Toxins
Studies have found a possible link between toxins in the air and higher cholesterol. These toxins can have an adverse impact on our hormone systems with undesirable effects on reproductive, immunological, and neurological health. It is strongly suggested to avoid eating conventional fruits and veggies sprayed with pesticides and herbicides because they may impact hormonal balance.
Combine Keto Diet with Intermittent Fasting
To put it simply, intermittent fasting is when you eat only during certain hours of the day and fast during the others. The easiest method is to fast for 16 hours, giving you an 8 hour window to eat healthy (preferably the keto diet). The period of time for fasting can vary.
Combining the keto diet and intermittent fasting can result in major health benefits and metabolic improvements. These include lower cholesterol and increased body weight loss. Check out this guide for more information on intermittent fasting and an overall balanced diet.
Unraveling the Risks of the Keto Diet
The keto diet has benefits – but it isn’t without its side effects. These may include the following health conditions:
- Fatigue
- Headache
- Constipation
- Muscle cramps
- Changes in blood pressure
- Keto flu (a collection of symptoms that appear a few days after the ketogenic diet)
- Weakness
- Dizziness
- Sleeplessness
- Poor performance at the gym
- Constipation
- Vomiting
- Bad breath
Some experts suggest that the keto diet may not be ideal for everyone. For example, people who have fat induced lipemia may have to avoid the keto diet. This is because high triglyceride levels could result in pancreatitis (the swelling of the pancreas).
Keto Diet Cholesterol: Looking at the Big Picture
If the relationship between cholesterol and the keto diet seems complicated: that’s because it is. The body is a complicated system with various interconnected parts. Hormonal fluctuations, starvation, metabolic diseases, environmental toxins, and thyroid problems are all related and it’s difficult to pin down one of them as the reason for high cholesterol levels.
This is why it doesn’t make sense to try lowering cholesterol with drugs, when there are so many factors that can be controlled.
Lifestyle factors such as macronutrient intake, stress, and even lack of sleep, can be indicators of high cholesterol. Explaining these causes is not the scope of this article, but it should be clear that a keto diet is probably not the only factor contributing to higher levels of cholesterol. Increased cholesterol on the keto diet isn’t a reason to discontinue the diet plan.
In most cases, the problem of high cholesterol isn’t related to macronutrient intake, but rather a combination of various other factors.
From the perspective of keto dieters, this means that the logical response to high cholesterol is to figure out the root cause of it, and take action accordingly.
For a more thorough analysis, we recommend speaking with your doctor or nutritionist about the relationship between the keto diet and cholesterol.
Keep Monitoring Your Health Markers
If you believe that you are at risk of high cholesterol, then we recommend consulting with your doctor frequently to monitor your triglyceride levels. This may be inconvenient but your doctor will alert you if they notice that the LDL cholesterol levels are rising.
Some experts have suggested a litmus test to see if a high-fat diet is ideal for them or not. More clinical trials and randomized trials are needed to make informed decisions about the cardiovascular risk of this popular diet.
The idea is to measure your body’s triglyceride levels. Normal levels of triglycerides are 150 milligrams per deciliter (mg/dL). Higher than 150 mg/dL is considered ‘elevated triglycerides’. If you have normal levels of triglycerides, then keto is most likely safe for you to try.
And if you have elevated cholesterol levels and insulin resistance, you may want to avoid the carbohydrate-restricted diet.
In any case, we strongly suggest working with a health care provider to monitor your health markers and cardiovascular risk factors.
A Word on LDL Hyper Responders
It is worth noting that understanding the relationship between LDL and the keto diet can be complex. Some individuals may notice a significant spike in their LDL – by over 50%. They are known as LDL hyper responders, first coined by Dave Feldman. The effect may be even more dramatic for lean athletes.
The term LDL hyper responder was first coined by Dave Feldman, a software engineer and ‘keto enthusiast’. When Dave first started a keto diet in 2015, he noticed his blood lipids spike significantly. After extensive research, he proposed a lipid energy model to explain why people undertaking a low carb diet may notice an increase in LDL.
Dave believes that LDL increases because of a physiological adaptation to support the use of fat as energy. To summarize, Dave believes that healthy individuals who start a low carb diet will notice an increase in LDLL levels because of an increased liver flux of FFA.
However, Dave’s research is a controversial subject in the nutrition space. Some experts believe that Dave makes erroneous assumptions about his LMHR hypothesis. It is worth mentioning that Dave does not provide peer-reviewed literature to support his hypothesis. He makes his speculations from a series of personal experiments, studies on rodents, and anecdotes.
The scientific community is unanimous, based on peer-reviewed studies, that lower LDL is better for reducing cardiovascular health and saving lives. Both the CDC and the American Heart Association teach that LDL increases the risk of heart diseases.
Always consult with your doctor before making any dietary changes, especially if you have a high risk of cardiovascular diseases.
