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Keto and Cholesterol: The Shocking Facts

Published June 02, 2019 (Revised: August 13, 2019)
<article> <section> <p>You have been following a keto diet and feel great! You have lost a few pounds and your energy is soaring. But, will your high fat diet increase your cholesterol levels—and give you reason to pause? With heart disease as the number one cause of death in the United States, it’s easy to see why our ears may perk up at <i>increasing</i> your fat intake. Maybe your numbers are high and your doctor has already expressed concern about your diet. But we might just all be a bit misinformed about the connection between the keto diet and cholesterol, so let’s set the record straight.</p> </section> <hr class="divider-50 divider-medium mx-auto"> <section> <header>What is Cholesterol? </header> <p>Cholesterol is a wax-like substance with many important functions in the body. It is made primarily by the liver of animals and humans. This means that plants do not have cholesterol. When people talk about cholesterol they are usually referring to the lipid test—recommended every 5 years for most people. These tests typically give you four numbers, these include:</p> <ul> <li>Total Cholesterol: 200 mg/dL or less</li> <li>LDL cholesterol: 70 mg/dL or less</li> <li>HDL cholesterol: 40 mg/dL or more (60 mg/dL is ideal)</li> <li>Triglycerides: 150 mg/dL or less</li> </ul> <p>These numbers are the accepted standard used to make treatment decisions and evaluate your risk for heart disease.<sup>1</sup> But, there is significant controversy over the validity of these numbers and whether it really is beneficial to have cholesterol be so low.</p> <p>The reason is that cholesterol does have many important roles in the body, it is not all bad. It is a major component of all your cell membranes. It helps make hormones and vitamin D. It’s necessary for making bile salts (which digest fat and help absorb nutrients from food).<sup>2</sup> Since cholesterol is so important, your body actually makes most of what it needs on its own. About 80% of cholesterol found in your blood is made by your liver. Only 20% comes from the food you eat, we will see how this is important in a bit.<sup>3</sup> </p> <p>Initial research on heart disease found a connection between arteries clogged by cholesterol plaques and an increased risk of heart attacks. So, it’s no surprise that scientists made the leap that eating foods high in cholesterol would lead to clogged arteries. This is why they recommended limiting or avoiding foods high in cholesterol (i.e. animal foods),to prevent the formation of plaques. Makes sense, right? But, this totally backfired.</p> <p>First, eating foods high in cholesterol doesn’t actually increase the body’s cholesterol. As we mentioned, the liver makes most of the cholesterol found in the body. At least now most experts are on board with that fact. The 2015-2020 <a target="_blank" href="" rel="noreferrer">Dietary Guidelines</a> for Americans eliminated the recommendation to restrict cholesterol in the diet; because there is simply no evidence that dietary cholesterol raises blood cholesterol.<sup>4</sup></p> <p>But, diet does have an impact on cholesterol, just not in the way we originally thought. </p> <picture class="lazy-load"> <source data-srcset="" type="image/webp"> <source data-srcset="" type="image/jpf"> <source data-srcset=""> <img src="" class="img-fluid" alt="cholesterol-testing"> </picture> </section> <hr class="divider-50 divider-medium mx-auto"> <section> <header>What Causes High Cholesterol?</header> <p>Inflammation causes high cholesterol, not dietary cholesterol.<sup>5</sup> <a target="_blank" href="" rel="noreferrer">Inflammation</a> is caused by many different lifestyle and dietary factors. Chronic stress, environmental toxins, and lack of sleep all contribute to inflammation. </p> <p>Diet also plays a major role, but it’s not the fat or cholesterol in your diet that increases inflammation. The culprit is actually refined carbohydrates and sugar. </p> <p>A 2011 study evaluated the impact of soda intake on inflammation, cholesterol, and blood sugar. Subjects were given various amounts of soda daily for a three week trial period. They were told to reduce their overall <a target="_blank" href="" rel="noreferrer">sugar</a> and fructose intake during that time. The study found that those who drank the even low to moderate amounts of <a target="_blank" href="" rel="noreferrer">soda</a> had significantly increased levels of inflammation, higher blood glucose, and more bad LDL cholesterol, when compared to those who did not drink soda.<sup>6</sup> Another study, that used bread instead of soda, found similar results with increased inflammation markers in those who ate the bread.<sup>7</sup></p> <p>The interesting thing about both these studies is that the subjects were all healthy and young. This means that the high carb intake of the bread or soda could significantly alter the metabolism of even a healthy person of a normal weight. </p> <p>All of this research suggests that the culprit of high cholesterol is not dietary cholesterol as once believed, but refined carbohydrates and inflammation. So, what about the keto diet and cholesterol?</p> </section> <hr class="divider-50 divider-medium mx-auto"> <section> <header>Does Keto Cause High Cholesterol? </header> <p>The ketogenic diet is a high fat, low carb diet, opposite from the high carb, low fat diet that is normally recommended for cholesterol management. The evidence has shown that eating a keto diet actually lowers heart disease risk by lowering inflammation.</p> <p>Keto improves cholesterol levels. Increases the size of LDL or “bad” cholesterol particles, so they are fluffy and don’t stick as easily to the artery walls. It raises HDL or “good” cholesterol levels. This in turn improves your LDL to HDL ratio, one risk factor for heart disease. Keto also lowers triglycerides or fats in your blood.<sup>8</sup></p> <p>A 2006 study evaluated the impact of a keto diet on overweight men. After 12 weeks on the diet, the subjects had an 8.9% decrease in their LDL cholesterol, a 12% increase in HDL, and a 38.6% reduction in triglycerides. As you can see, keto may actually benefit cholesterol levels, not increase them.</p> <p>Keto also helps control blood glucose and insulin levels, which lowers the risk of <a target="_blank" href="" rel="noreferrer">diabetes</a>. Improved blood sugar control also helps decrease inflammation even further.</p> <picture class="lazy-load"> <source data-srcset="" type="image/webp"> <source data-srcset="" type="image/jpf"> <source data-srcset=""> <img src="" class="img-fluid" alt="healthy-fats"> </picture> </section> <hr class="divider-50 divider-medium mx-auto"> <section> <header>Keto Cholesterol Tips</header> <p>If you already have high cholesterol, some of this advice may make you nervous, since it goes against what many of us have been led to believe. But, to lower your risk of heart disease, your main focus really should be on lowering overall inflammation and not on how much cholesterol you are eating. Following a healthy keto diet can help you get there.</p> <p>Here are a few of our favorite keto cholesterol tips:</p> <ul> <li>Focus on quality fats. Monounsaturated fats and omega-3s are the healthiest for your cholesterol and heart, regardless of the type of diet you follow. The monounsaturated fats found in nuts, seeds, avocados, and olive oil are the best for helping lower cholesterol levels. Omega-3s found in fish are powerful anti-inflammatories. Keto is a high fat diet, but you can choose fats that help improve cholesterol levels and lower inflammation even more. </li> <li>Avoid low-quality, processed <a target="_blank" href="" rel="noreferrer">vegetable oils</a>. Vegetable oils, such as corn and canola oil, can increase inflammation. Try to limit your intake of these processed foods as much as possible. </li> <li>Choose olive oil or coconut oil to cook with.</li> <li>Eat your veggies. Veggies are high in fiber, which helps lower cholesterol. Be sure to include keto-approved veggies at every meal.</li> <li>Emphasize unprocessed, high quality foods. The more unprocessed foods you can eat that are full of nutrients, the easier it will be for your body to manage inflammation.</li> <li>Limit <a target="_blank" href="" rel="noreferrer">alcohol</a>. Alcohol raises inflammation and triglyceride levels.</li> </ul> <p>So, bring on the bacon and help manage your cholesterol at the same time. </p> <p>Ready to try keto, but afraid of giving up your favorite sweet treats? You don’t have to! Our <a target="_blank" href="" rel="noreferrer">Keto Sweet Treats Cookbook</a> has 77 keto sweet treats so you won’t feel like you are missing a thing.</p> <div class="sub-head">Resources</div> <ol> <li><a target="_blank" href="" rel="noreferrer">Cholesterol test</a></li> <li><a target="_blank" href="" rel="noreferrer">Cholesterol</a></li> <li><a target="_blank" href="" rel="noreferrer">How it’s made: Cholesterol production in your body</a></li> <li><a target="_blank" href="" rel="noreferrer">Dietary Guidelines for Americans</a></li> <li><a target="_blank" href="" rel="noreferrer">Inflammation, not Cholesterol, Is a Cause of Chronic Disease</a></li> <li><a target="_blank" href="" rel="noreferrer">Low to moderate sugar-sweetened beverage consumption</a></li> <li><a target="_blank" href="" rel="noreferrer">High-glycemic index carbohydrate</a></li> </ol> </section> </article>

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