The Keto Diet and Cholesterol: Is Eating Low-Carb and High-Fat Really Good for Your Heart?

The low-carb, high-fat keto diet is proven to help people lose weight, manage type 2 diabetes, and improve the symptoms of metabolic syndrome such as high blood pressure and blood sugar levels. It’s safe to say that keto and heart health go hand-in-hand, but when it comes to cholesterol, the ketogenic diet can go both ways. 

The keto diet and cholesterol have a relationship that has the potential to go bad if not kept in balance. But when the relationship is going good, your heart beats with delight. Let’s get to know these two lovebirds and see what makes the relationship tick, shall we?

Cholesterol: An Overview

Your body depends on cholesterol to form cell membranes and tissues, to synthesize vitamin D, hormones, and fat-soluble vitamins, and to manufacture bile acids for digestion. Your liver produces 75% of the cholesterol in blood with the other 25% coming from the foods we eat. 

Unfortunately, upwards of 100 million Americans have high cholesterol, which puts them at risk for heart disease. Cholesterol has the tendency to attach to arteries and form plaque, a life-threatening condition called atherosclerosis. Plaque buildup narrows the arteries, which restricts blood flow and can trigger a cardiovascular event such as a heart attack or stroke.

Needless to say, if you already have high cholesterol and are at risk of heart disease, then it’s understandable to be concerned about the keto diet’s potential to raise cholesterol levels. 

However, it all depends on the type of cholesterol you’re talking about.

The Bad Guys

Most of the cholesterol in the blood is carried by low-density lipoproteins, or LDL cholesterol. LDL cholesterol has the tendency to attach to other substances, such as saturated fats, and plug up the arteries. 

Triglycerides are the byproducts of sugar, alcohol, and excess calories, and they get stored in your fat cells. High triglyceride levels are associated with weight gain and obesity.

Very low density lipoproteins, or VLDLs, are the precursors of LDLs. They carry triglycerides through the bloodstream, and the VLDLs that aren’t cleared away are converted to LDLs.

The Good Guy

High density lipoprotein, or HDL, transports about 33% of the cholesterol in your blood. It does its best to help your heart out by sweeping away excess LDL molecules. The higher your HDL levels, the better off your health.

Your total cholesterol is a measure of the LDL, HDL, and VLDL concentrations in your blood. Having a slightly high total cholesterol reading isn’t a bad thing if it’s HDL increasing the numbers, so physicians tend to put more weight behind the individual LDL, triglyceride, and VLDL outcomes to determine your risk for high cholesterol.

Keto Diet and Cholesterol: The Science

The overarching findings suggest that the keto diet has the potential to lower LDL cholesterol and triglyceride levels while raising HDL cholesterol. 

A study published in Experimental and Clinical Cardiology showed that over the duration of 6 months the keto diet… 

… “decreased the level of triglycerides, LDL cholesterol and blood glucose, and increased the level of HDL cholesterol (1).” 

Another 6-month study published in the Annals of Internal Medicine showed that…

… “During active weight loss, serum triglyceride levels decreased more and high-density lipoprotein cholesterol level increased more with the low-carbohydrate diet than with the low-fat diet (2).”

The same researchers studied the effects of the keto diet compared to those of a low-fat diet over the course of a year and confirmed that the keto diet led to lower bad cholesterol and higher good cholesterol, concluding…

“A low-carbohydrate diet may be beneficial for weight loss and reduction of cardiovascular risk factors (3).”

While these studies suggest that the ketogenic diet is an overall heart helper, the intricacies are a little more refined and depend on the type of fats you eat as well as your genetic response to dietary cholesterol.

The Impact of Dietary Cholesterol 

We now know that cholesterol from the food we eat has only a moderate effect on cholesterol levels…unless your genes put you in the category of individuals called “responders.” If so, your body reacts more dramatically to dietary cholesterol. When a so-called responder eats a food high in cholesterol, such as an egg, cholesterol levels skyrocket. 

If you are at risk for high cholesterol levels, you will want to pay extra attention to daily cholesterol limits.

• 300 mg of cholesterol if otherwise healthy
• 200 mg of cholesterol if at higher risk

Keto and Cholesterol Relationship Advice

The keto diet has the potential to raise your LDL cholesterol because it tends to center on animal products and byproducts, which are high in saturated fats that are known to cling to LDL molecules and raise cholesterol when consumed in excess. 

When embarking on any new diet, it’s important to monitor your health, including your cholesterol levels. You can keep LDL cholesterol levels down while increasing HDL cholesterol by reducing consumption of keto-approved foods high in saturated fat, such as red meat, and boosting your intake of high-fat foods made up of monounsaturated and polyunsaturated fats, like avocados and olive oil. 

There’s no rule that going keto means going heavy on animal products. Check out our tips for following a vegan keto diet.

You can also help lower cholesterol by increasing your fiber intake. Fiber can sometimes take a hard hit on the keto diet. After all, you’re cutting out high-fiber foods like grains and certain fruits and vegetables. Still, it’s possible to get all the fiber you need on the keto diet, so long as you meal plan with diligence. 

High-fiber foods to fill up on include:

• Avocados
• Kefir
• Kimchi
• Sauerkraut
• Nuts and seeds
• Berries
• Green veggies

No matter what diet regimen you follow—intuitive eating, paleo, keto, or other—it’s always about choosing the most healthful, nutrient-dense foods to fuel up your body and mind. When you’re eating healthy and exercising, high cholesterol doesn’t stand a chance!