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Does a Ketogenic Diet Change Your Lipid Profile


Wrong and outdated health information often causes worry about the healthiness of the ketogenic diet. One of the biggest concerns is: does a ketogenic diet change your lipid profile?

In order to tackle and address these concerns, we’ll be covering what lipid profile means, why it’s included in myths about the ketogenic diet and why you don’t need to worry about most of what you’ve been told.

Lipids and the Ketogenic Diet

The main purpose of the ketogenic diet today is to provide a measurable state of metabolism through nutritional ketosis. There are many benefits of ketosis, including weight loss, better mental clarity, and more energy. These benefits make the ketogenic diet enticing, but what about how it affects lipids in the body?

To understand this, let’s discuss what lipids are and the beliefs surrounding them and the keto diet.

What is a Lipid Profile?

A lipid profile is the measure of fats and fatty substances (lipids) that your body uses as energy. These are usually measured via a lipid panel of blood tests meant to look for any irregularities in your lipid amounts.

Lipids include:

  • Triglycerides
  • Cholesterol
  • High-density lipoprotein (HDL, often know as “good,” cholesterol)
  • Low-density lipoprotein (LDL, often known as “bad,” cholesterol)

The ketogenic diet raises some concerns around the diet negatively affecting one’s lipid profile and increasing their risks of diseases related to high cholesterol or triglycerides. Let’s take a look at these concerns.

Myths About Fat and Cholesterol

Below are some of the myths when it comes to the ketogenic diet and lipid profiles. We’re used to hearing many of these due to bad or old science — and we all know the internet is rampant with poor (and sometimes harmful) information.

Myth: Cholesterol is bad.

A huge misconception about diets that are low-carb and high in animal protein and fat is that they’re bad for your cholesterol. The thought is that eating foods that contain saturated fat and dietary cholesterol lead to elevated blood cholesterol levels, which is bad for health.

This couldn’t be further from the truth. Cholesterol is good! In fact, it’s necessary for living. It’s important for the creation of hormones, vitamins, and other vital substances. It’s crucial for the function of every cell wall in the body.

And we now know that not only does a low-carb/high-fat diet bring better weight loss results, it’s not harmful to heart health as once believed.

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Myth: Low-carb diets raise cholesterol and cause heart disease.

Again, this is the most common rumor about cholesterol regarding a ketogenic or low-carb diet—that the intake of saturated fat and dietary cholesterol will cause heart disease.

But here’s the truth: there is actually no conclusive evidence supporting that diets high in fat or saturated fat lead to heart problems or an increase in cholesterol. People have just been told this for so many years that it’s become accepted as fact.

Healthy saturated fats are actually necessary part of a healthy diet. See these healthy ketogenic diet foods.

Now that we’ve covered the biggest myths, it’s important to understand what is actually true about how the ketogenic diet can affect your lipid profile and your health.

The Truth About the Ketogenic Diet and Lipids

Let’s look at some of the most important facts about the ketogenic diet and its relation to one’s lipid profile:

Lipid Profile Changes on the Ketogenic Diet

The facts show that a well-planned low-carb diet can actually lead to a better cholesterol profile, not a harmful one.

In obese patients, a ketogenic diet has been shown to significantly (within 24 weeks):

If you hear anyone talk about elevated cholesterol from a low-carb diet, that’s likely due to an increase in HDL cholesterol, which is actually beneficial and means a LOWER risk of heart disease because it increases HDL to LDL cholesterol ratio.

Plus, a whole foods, ketogenic diet eliminates sugar-creating foods that can cause inflammation and damage to the arteries. Since your body has less glucose available to make cholesterol, total cholesterol levels will drop.

You can also expect a drop in triglyceride levels, as eating carbohydrates spikes your triglyceride levels — so, a great decrease in carbs means lower triglyceride readings.

What to Eat for a Healthy Lipid Profile

If you’re eating the ketogenic diet for health, which is highly probable if you’re reading this article, be sure you choose healthy ketogenic foods. This means: low-carb, high-fat WHOLE food sources.

It’s easy to make the ketogenic diet a free-for-all of processed meats like bacon, processed oils, and low-carb packaged foods. This is where you can get into trouble with your health. Junk food is junk, no matter what diet you’re following. For good health, including a healthy lipid profile, the quality matters.

Healthy ketogenic foods include:

  • High-quality saturated and monounsaturated fats like olive oil (especially high-quality extra virgin olive oil), coconut oil, nuts (focus on the high-fat varieties), avocados, pasture-raised egg yolks, and fatty fish
  • Proteins like fatty organic beef, dark, fatty poultry, shellfish, and organ meats
  • Low-carb fresh or frozen vegetables like spinach, kale, bok choy, swiss chard, broccoli, onions, bell peppers, and zucchini

If you’re new to the ketogenic diet and want to see the benefits for yourself, we encourage you to get your full lipid profile panel done prior to or at the beginning or starting the diet to compare your blood work results from before and after. That way you can monitor for yourself along with tracking your ketones levels.

Whether the ketogenic lifestyle is new to you or you’re a keto veteran, we hope this information regarding the myths and truths about eating keto and its affects on your lipid profile provides helpful information in your quest for better health.


32 thoughts on “Does a Ketogenic Diet Change Your Lipid Profile

  1. This is a very interesting text, and it really is in accordance with what I’ve read in the last weeks, even some articles are “adamant” suggesting a better lipid profile.

    I’ve done my blood work twice now, and my LDL increased quite considerably. Could it be because I’m losing so much fat? Can my own fat be putting cholesterol in my blood stream?

    thanks in advance!

      1. What is the definition of High Quality fat? I am eating avocado, butter, cream and bacon mostly. My LDL just continues to go UP.. so which of these is not HQ? Help!
        My Trigs are best ever and so is HDL, but LDL is over 5mmol/L

  2. Great article, but some doubts… after 7 weeks of keto diet my lipid profile is something weird for the expected results. My total chol. has increased from 296 to 392 mg/dl, my LDL increase from 173 to 285 , my HDL increase from 45.1 to 69.6 and the triglycerides decrease from 191 to 186… and my insulin is 1.36 uUI/ml

    My keto diet has av average of 74.5% fat , 19.0% proteins and 6.5% carbs.

    Is this normal for this short time of adapting?

  3. I have been on the Keto diet for 5 months, lost 20 pounds. I have reached my desired weight of 114 pounds, I am 65. I just got my lab results and my cholesterol increased to 336 from 200. My HDL is 86 and my LDL is 226 for a total of 336. I have a family history of high cholesterol, I am currently taking statins. I am really concerned, any advice?

    1. Hi Lucy, I would recommend checking out the blogs from experts such as Peter Attia and Ivor Cummins. They explain the ins and outs of cholesterol and the latest research debunking the myths of keto and cholesterol.

  4. I too have been disturbed by my vldl being too high they call it very bad cholesterol and triglycerides are also high..I eat like most who do keto minus greasy meat, and fat bombs. Why is my doc concerned with that even though total cholesterol is good, and will keto cause some to have numbers going the wrong way?

  5. Please help. On strict Keto. 12-15 carbs daily for 3 months but look at my triglycerides!

    Test 6/29 9/29 Ideal
    Chol/HDL Ratio 6.0 4.0 0-5.5
    HDL 32.0 42.0 40-59
    LDL 128 101 0-100
    H1C 13.1 6.6 4.2-5.8
    Glucose 373 94 70-110
    Triglycerides. 181 222 40-200

  6. We have been going Keto/ very low carb for 14 months due to cancer. Lost 35 lbs, all labs are great including inflammation markers with the exception of the total & LDL cholesterol. I understand high cholesterol is considered a myth as far as causing heart disease, but my husband had an MI 10 years ago. He is currently on no statins. We love the Keto diet for obvious reasons, increased energy, weight loss, all great labs. Cholesterol baffling ? Thank you

  7. I went on the Keto diet 2 months ago to lower my triglycerides. They went from 362 to 609 mg/dl although the rest of my numbers look OK. LDL went from 127 to 60. Total cholesterol went from 231 to 190 ; HDL went from 34 to 24. I’m eating healthy whole foods, definitely not a lot of bacon. What do I need to do to get that Tri number down?

  8. Yes what about those of us who when eating a ketogenic diet cholesterol numbers are off the chart and I don’t mean HDL. I am referring to LDL’s, particle numbers and size. What is the reason for this and why does it seem to happen in only a small percentage of people? Any reason to worry?

    1. Hi Nancy, that’s a great question and there could be a number of different explanations. One possibility is that you could be classified as what some people refer to as a “hyper-responder.” Ivor Cummins, Peter Atia, and Dave Feldman are great sources for more in depth information on this topic.

  9. Thanks for this great article. I have started following Low card high fat diet around 3 months ago. In these 3 months, my fasting blood sugar levels have improved towards normal range, reduced approx 9 lb weight and Triglycerides levels improved greatly from 244 to 129. However, when I checked the LDL and HDL numbers, I felt disappointed. LDL reduced only a bit however HDL also reduced instead of increasing. Overall I am feeling happy but would be much helpful if someone can help me to understand the reason for decline in HDL numbers.
    Thanks so much

    1. Hi Gaurav, that is great news to hear about all of the positive improvements in just 3 months! In terms of your HDL and LDL levels, I would recommend checking again in another few months. Don’t be disappointed – your progress so far is phenomenal!

  10. My cholesterol has always been high, but with this kentonic approach, it has sky rocketed up to 325 and my LDL especially 240 from 200. I think possibly the coffee with the cream might have been bad? I am not sure, but do NOt want to take statins. I am woman 69 year.

  11. I have been on this diet for 3 months now. I compared my triglycerides, LDL,HDL, and A1C and they are significantly higher than before. All except for the A1C. I am actually pretty happy to see my sugar level go from 8.2 to 6.9. What can I do to bring my lipids under control?

    1. Hi Soraya, as mentioned in the article, it’s best to focus on a whole-foods based keto diet in order to optimize your health outcomes. Focus on consuming high quality fats and proteins while minimizing anything thats highly processed.

  12. Try adding fiber to your diet with modified citrus pectin and metamucil to lower your cholesterol levels.

  13. Listen to Dr Darren Schmidt and Dr Eric berg. They offer really good informative videos on YouTube. Everything is explained in its entirety.
    Especially on how to do the ketosis dieting correctly. For the men and women who exercise and want to stay muscular as well as living the ketogenic lifestyle, Thomas delauer is the man who knows it all. I hope this helps anyone who is interested in totally sorting out their health. After researching this lifestyle for the past two years these are the three people that make the most sense.

  14. Hi,
    I started strict keto diet 50 days back with 70, 25, 5 macros. Primary reason was to reduce the borderline sugar and cholestrol. My weight is normal but I did reduce by 15 pounds. I got my cholestrol checked recently and worried that I see an increase. Below are the numbers:

    Before Keto cholestrol – HDL=35, LDL=153, Tri=112, Total=210
    After Keto cholestrol – HDL=35, LDL=194, Tri=140, Total=259

    Could you please help me and let me know what is going on. I like to be in keto and blood sugar range is good. Worried that cholestrol is going high. Any remedy please?

    Thank you!

    1. Hi Vik, cholesterol is a very controversial topic these days within the keto community and beyond…we still don’t know exactly what these numbers are telling us (especially in someone following a ketogenic diet). First thing I would recommend is getting another blood test that gives a more comprehensive look…to start off, one that shows the actually particle sizes rather than just the number – you can ask your doctor about getting this done. Also, sometimes reducing the amount of dairy and/or making sure you’re getting it from a high quality source may help bring the numbers down (LDL and Tri) if that’s your goal. Check out some of the info from people like Peter Attia, Ivor Cummins, and Dave Feldman who have done a great deal of research in this area.

  15. My cholesterol increased a lot after 3 months on the keto diet compared to most recent test done 6 months before starting the keto diet. Total cholesterol increased from 144 to 275, LDL increased from 73 to 188, HDL changed from 53 to 59 and triglycerides in 89 to 140. Any advice on what to do? Other information is that I’m taking a statin (10mg Lipitor) and over three months, I lost 15 pounds (5 is probably water). I’m not really overweight, but would like to lose 5-10 more pounds. Also between those two tests I also stopped taking baby aspirin to help reduce acid reflux. My initial thinking is to increase my statin dose and try to use healthier oils.

  16. I have been on Keto for a while now and have had good results physically and with my lab results. I have kept my total carbohydrate intake at 20 or below. It is highly recommended that on a ketogenic diet, you keep your carb intake to 5% or less of total calories. This works out to be an average of 20g net carbs a day. Sometimes I occasionally go over slightly. We are all human. Find a Keto Calculator on line, plug in your numbers and it will give you a guide on how much calories, fats, and protein to consume. Remember, try to keep your carb intake at 20g or less daily for Best Results, that’s the Key !

  17. I’m very happy with my keto diet…. 🙂

    before keto: date july 21, 2017.
    cholesterol 5.4
    HDL 1.0
    LDL 3.3
    triglyceride 2.4

    I’m 53 years old
    date: April 11, 2019
    cholesterol: 8.4
    HDL 1.7
    LDL 6.5
    triglyceride 0.7

    my average blood pressure SYS / DIA – 109/69

  18. I started on a Ketogenic diet on Feb 25th 2019, because my blood sugar was extremely high. My A1C was 14.6. I just turned 59. I compared my results from Feb 25th to July 23rd (5 month period). In addition to the ketogenic diet (I am a pescatarian so I did not eat any meat), I also did Intermittent Fasting (eating twice during an 8 hour period and fasting for 16 hours) and worked out 4-5 days a week(yoga, trampoline and weight training.)

    My weight went from 143 to 125 (I am 5 ft 5 inches)
    My A1C went from 14.6 to 6.6
    My fasting blood sugar went from 284 to 91
    My triglycerides went from 289 to 59
    My total cholesterol went from 285 to 249
    My HDL stayed at 61
    My LDL went from 167 to 176–this is the only thing that went up slightly.

    I went form a size 8 to a size 4. Overall, I have the energy of a 25 year old. I am very happy with my results. I am going to keep on going.

    Hope this helps inspire someone else.

  19. Dr. Gustin, a question: Recent fasting triglycerides through the roof (>900). I’ve been strict keto for over three weeks, but very much yoyo-ing (between keto and, well…not) before that. Do you suppose the yoyo-ing could have caused the spike before this last round? My PCP wants me on fenofibrate, but I do not want to take meds. Any thoughts? Thanks in advance for any insight.

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