keto cholesterol

Fact-checked by Dr. Anthony Gustin, DC, MS

Written by Lauren Ciccarelli

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How can eating a diet rich in butter, red meat, cheese, eggs, and bacon not raise your cholesterol levels?

That’s like saying eating a whole pint of ice cream won’t raise your blood sugar levels, right?

Not exactly.

See, a low-carb diet like keto will change your lipid profile — but maybe not in the way you expect.

So if you’ve been wondering how a ketogenic diet helps you lose weight and find more energy without raising your cholesterol numbers, today we’ll be taking an evidence-based approach to answer your fears with science.

We’ll explore everything about keto cholesterol through topics like:

When you know exactly how cholesterol works in your body, you may see keto in a whole new light.

And you’ll probably also need to erase everything you know about cholesterol too.

What You Know About Cholesterol is Probably Wrong

Cholesterol is a waxy substance only produced by animals and humans. Plant-based foods like fruits and veggies are cholesterol-free.

When scientists first studying the human heart noticed a correlation between hardened, clogged arteries and an increase in heart attacks, cardiovascular disease, and strokes, they blamed cholesterol because that’s what they found built up as plaque.

Eating foods high in cholesterol, they said, would then in turn give you high cholesterol.

You can see why this might make sense to people who didn’t have access to the world’s knowledge at the touch of a button. When you see congealed bacon grease sitting in a pan, it’s not such a stretch to imagine the same happening in your body.

But this isn’t an accurate picture of how cholesterol truly works.

How Eating Cholesterol Doesn’t Give You High Cholesterol

keto cholesterol

 

Your Body Knows How to Maintain Cholesterol Homeostasis

A diet high in cholesterol has almost zero impact on your cholesterol levels because your body is smarter than you.

Since it’s such a major producer of cholesterol, your body hustles hard to make sure your cholesterol levels are in constant balance all on their own (it’s called cholesterol homeostasis).

Too much cholesterol hanging around and your body will slow down production; too little cholesterol in your diet and your body will kick production into overdrive.

The 2015-2020 Dietary Guidelines for Americans is the first to get rid of the daily dietary cholesterol limit — something many countries eliminated years ago[*].

So if dietary cholesterol isn’t a big deal anymore, and foods with high cholesterol don’t build up in your arteries like a clogged shower drain, what causes plaque formation?

The “Good” and “Bad” Cholesterol Myth

All cholesterol is good cholesterol. But you’ve probably heard of the so-called “good” and “bad” cholesterol types.

See, unlike sugar and salt, which can mingle about in your bloodstream, cholesterol is a fat that doesn’t mesh well with the watery nature of your blood. It’s kind of like how oil and vinegar don’t mix (thanks, osmosis).

For cholesterol to make its rounds throughout your body, it needs to climb into a boat to sail your bloodstream in style.

These vessels are known as lipoproteins.

As their name implies, they’re part fat (lipo-) and part protein. Their sole job is transporting cholesterol to the cells and organs that need it most.

There are five different types of lipoproteins, but the ones you always hear about are low-density lipoprotein (LDL), frequently referred to as “bad” cholesterol, and high-density lipoprotein (HDL), which has been labeled a “good” guy.

To be clear, HDL and LDL are not actual types of cholesterol — only what transports cholesterol.

What’s the difference between these two?

High Density Lipoproteins (HDL): The Ones You Want on Your Team

HDL particles are produced in your liver and intestines and contain more protein than fat. This makes them denser (aka, high-density).

HDL has been crowned “good” cholesterol because it corrals all the cholesterol that’s not being used by your body and brings it all back to your liver. There it will either be recycled or become a poop emoji.

Why is HDL considered “good”?

Because it boasts protective, anti-inflammatory properties that regulate your immune system[*] and protect against certain types of cancer in those with type 2 diabetes[*] and those without[*].

Plus, researchers say your risk of developing type 2 diabetes increases by 4% for every 1 mg/dL drop in HDL cholesterol your body experiences[*]. So that means keeping your HDL high is a serious priority.

Though all this makes HDL sound like a hero, its greatest accomplishment is clearing out LDL particles, or the “bad” cholesterol, from your bloodstream.

Low Density Lipoproteins (LDL): The Ones to Watch Out For

LDL particles deliver nutrients and energy to your cells.

The only problem is that unlike HDL, LDL particles move at a snail’s pace and have a tendency to get stuck in your bloodstream. When this happens, the vulnerable LDL gets attacked by free radicals and starts to oxidize, or break down.

Oxidized LDL is much easier to sneak inside your artery walls.

This then triggers your immune system to go into a full-on inflammatory response, which sends white blood cells to capture all the dangerous oxidized LDL running amok.

Whatever doesn’t get wrangled by good ol’ HDL enters your arteries and starts the process of plaque build up (aka, atherosclerosis).

So does that mean the higher your LDL cholesterol levels, the higher your risks for cardiovascular disease?

Not exactly.

A standard lipid blood test will show you how much cholesterol lives inside the LDL particle, or the concentration, but that’s no longer the best marker for cholesterol health.

Scientists now know it’s not how much cholesterol you have, but your LDL particle number that makes the difference. This number measures how many LDL particles are floating in your bloodstream — and how big they are.

Small LDL particles carry a greater risk factor for heart disease as they can easily penetrate the artery walls and lead to build up[*].

However, if you have mostly large LDL particles, your risks are pretty low because the chances of this happening are much slimmer.

Then there’s very-low-density lipoproteins (VLDL).

These are even smaller, which means they’re much more likely to break into your artery wall, gunk up the operations, and lead to hardened arteries[*].

LDL carries cholesterol around your body whereas VLDL carries triglycerides.

What About Your Triglycerides?

Triglycerides are the most common form of fat in food. They create fuel for your body to use not in the short-term, but in the future.

Here’s how it works:

When your body breaks down carbs, some simple sugars are used quickly by your body for energy. Others cause an excess of sugar to build up in your bloodstream.

Your body then releases insulin to help that sugar get inside your cells and be used. But if your cells don’t need that energy (like if you’re on a Netflix binge), most of it will be converted to triglycerides, which will be stored as fat.

Because your body needs to produce extra triglycerides to deal with your sugar problem, you’re not only adding hard-to-get-rid of storage fat to your body, you’re also building up the levels of triglycerides in your blood.

That’s why elevated triglycerides are often seen as a byproduct of insulin resistance.

In one study, researchers learned that eating sugar and high fructose corn syrup increased triglycerides, VLDL, and decreased LDL particle size while reducing HDL. Conveniently, when the scientists removed sugar from the control diets, a reversal of all of these was seen[*].

An increase in triglycerides can lead to higher cardiovascular risks and metabolic disorders like obesity and type 2 diabetes.

But when you’re on a keto diet, you’ll be replacing triglyceride-raising carbs with good fats that actually boost HDL and increase LDL particle size, which will help your body balance cholesterol naturally again.

A Low Carb Diet Like Keto Can Help You Balance Cholesterol

A high LDL reading isn’t necessarily bad if your particles are large and you have an awesome stockpile of HDL to sweep all the LDL away when it’s not being used.

HDL prevents the accumulation of LDL so you don’t have clogged arteries, which means an increase in cholesterol as HDL particles may be a positive[*].

Here’s the bad news: 32% of men and 13% of women have low HDL numbers[*] so they may not be able to fight off the effects of LDL.

The solution?

A low carbohydrate diet like keto. Yes, even with it’s high fat intake.

Sylvan Lee Weinberg, former president of the American College of Cardiology, said that a low-fat, high-carb diet can no longer be defended by medical organizations because it:

May well have played an unintended role in the current epidemics of obesity, lipid abnormalities, type 2 diabetes, and metabolic syndromes.”[*]

So it’s time for something different. Limiting your fat intake and dietary cholesterol doesn’t work.

When compared to low fat diets, low carb diets have been shown to be effective for boosting HDL while still allowing weight loss[*].

Research continues to show that a ketogenic diet specifically[*]:

  • Increases LDL particle size so they’re less prone to oxidation
  • Raises HDL to deal with LDL before it oxidizes
  • Improves your LDL to HDL ratio
  • Lowers triglycerides and improves your triglyceride to HDL ratio[*

When participants in one study went high-fat, they experienced an average 20.6% increase in their HDL cholesterol levels — nearly four times what those in the low-fat group saw[*].

Another meta-analysis highlighted that low carb ketogenic diets result in significant weight loss, increased HDL, and lower LDL levels over the course of a year[*]

And during a clinical trial of 40 adults with high triglyceride levels, a low-carb, high-fat diet resulted in a 51% decrease in triglycerides and a 13% increase in HDL[*].

While these results are worth getting excited about, what about starting a low-carb diet if you’re overweight, obese, or already have high cholesterol numbers?

Again research shows that low-carb diets cause no harm to your health:

In one study, obese participants lost 10 pounds following a low-carb diet and saw no ill changes to their overall total cholesterol[*].

A long-term trial had overweight participants go keto for 24 weeks. Researchers were pleased to see lower triglycerides, decreased body weight and body mass index, better blood glucose and LDL — and an increase in HDL like a cherry on top of a sundae[*].

And since men are more likely to have atherosclerosis and coronary heart disease than women, a group of scientists examined the effect a keto diet may have on overweight men. After just 12 weeks, the men noticed their LDL decrease by 8.9%, triglycerides reduce by 38.6%, and HDL jump 12%[*].

Seems like it may be better for your health to cut the carbs and start embracing cholesterol.

Worry About Too Many Carbs, Not About Cholesterol

Most of what we know about how cholesterol works has been based on the “standard American diet”, which typically includes high levels of carbs.

As scientists continue to show that low-carbohydrate diets like keto can improve your health and lead to better total cholesterol numbers, we’ll only have more research and results to discuss.

To lower your heart disease risk, boost your HDL and lower your LDL cholesterol, try adding healthy fats like avocado and coconut oil and monounsaturated fat like olive oil to your diet ASAP.

These are keto-approved and excellent for your heart health no matter which diet you ultimately choose.

When you’re finally ready, check out the ultimate startup guide to the ketogenic diet today!

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Responses (15)

  1. My Cholesterol has gone up to thirteen on Keto . My Dr is freaking out.
    He wants me back on Paleo but I feel better on keto.
    I’ve been doing keto for 8 months. My cholesterol was 8 6 month ago.
    Help please.
    Marion

  2. My latest blood work showed great HDL, VLDL, my LDL is just a bit high and my doc is saying we should do something about it. I don’t want to go on cholesterol meds they gave me leg cramps and other side effects I didn’t like. I think if he lets me give it more time that number could come down as well. I’ve lost 23lbs since January when I started Keto, my sugars are back to normal all other blood work is great! I’m going to try to add more of the avocado, coconut and olive oil and see what happens.

  3. I’ve been religiously following the keto diet for 3 months. My blood tests came back today. My triglycerides were cut in half, but my good cholesterol went down a point while my bad cholesterol raised 50 points. So explain that.

  4. I love red wine, 2-3 glasses a night, can I continue this on the Keto diet? just looking for honest experiences and results.

  5. Same here. LDL increased by 62 and now at 170 which is high and concerning. I’m enjoying the Keto, healthy (other than high cholesterol) and active, but is it worth it? FYI high cholesterol is hereditary so I’m sure this also plays a role. How can we decrease it if we are already using healthy fates like coconut oil, olive oil, avocado etc?

  6. Ive been strict keto for over 3 months and have lost 20lbs. I got my test results back yesterday and was shocked to see how my levels had changed: total cholesterol went from 230 to 308!! All the bad went up and all the good went down. But I’ve also heard that it can take a bit longer for cholesterol levels to even out and start going down. Is this true? I don’t want to quit keto because I have another 20lbs to lose, but I don’t want to have a stroke either.

  7. Don,
    I’ve been Keto for over a year now. I’ve lost 60 lbs. I’m off Metformin for type 2 diabetic and my LDL has improved significantly. In my experience, Keto will show some quick results in some but for others it will take longer. It depends on how long you’ve been on the standard American diet. It will take time for your body to fix “self-heal”. Not everyone will have the same results in the same amount of time.

  8. Hi. Glad to see my bad cholesterol is not the only one that’s gone up. The day before I started Keto my bad cholesterol was 93 and my “good” was 107. A month later, I got my blood taken again and my bad had increased to 137 but my good thankfully had only decreased by 2, to 105. The Dr. said that the good news about that was that the “good” cholesterol was the one that protected the heart so nothing needed to be done, as yet. I also have no intention of taking cholesterol meds. Want to go to my grave with as few meds as possible. However, yes, my plan has been to increase eating more “healthy” fats, like Extra Virgin Olive Oil, avacadoes (one a day is prime) and nuts like manademias (which are considered the “wonder nut”). I still eat bacon, butter and eggs but am hoping the increase in healthy fats will show good results in the cholesterol levels. We’ll see.

  9. Mine too went up a hundred points total. My HDL and TRIs are in range but the biggest shocker was my LDL. I’m glad I’m not the only one! I do want to get the particle count which is the LDL-p. This seems like the more concerning value.

    I too will up my good fats and keep going and try not to get discouraged. This Keto diet helped solve my IBS I can’t go back. I’ve tried everything and I’m convinced this is the right path. Just trying to keep the faith in the process and see it through. It all does make sense.

  10. Just from researching that I have been doing, this information seems to make a lot of sense and I may have found some information that is pertinent as to why many of you have experienced a rise in LDL levels. VLDL become LDLs when they drop the triglyceride. So, as we consume less carbs we start to lose triglycerides and the VLDLs start to become LDLs. I am no professional by any means, but as I read that article it made sense as well. It takes a while for some people’s livers to start to get the picture and send out more HDL to round up the LDL and there are things that we can do to aid that process such as adding olive oil and coconut oil to our diets as well as eating purple produce and exercising, but the LDL count will probably rise at first and slowly drop from thereafter. It will probably drop faster if we are taking steps to raise our HDL. The longer our body (liver) has been exposed to an unhealthy diet, the longer it will take to recover from it.

  11. Everyone talks about upping their fats… I do not think that is the key to sweeping LDL out of the system. Upping cruciferous fiberous veggies… the fiber, vitamins and minerals contained in veggies bind with the LDL and move it on out. You would have to eat literally a truck load to make any serious dent in your daily carb allowance since most are very low net carb anyways.

  12. I don’t follow the diet completely. I don’t eat carbs. However, I dont eat recipes with all the butter and cream cheese. I don’t want my cholesterol to go high.

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