Does the Keto Diet Affect Cholesterol?

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People who follow a ketogenic or keto diet eat large amounts of fat, moderate amounts of protein and minimal amounts of carbohydrates. Some data suggest that following this diet may affect cholesterol levels.

In particular, the daily keto diets for fats, proteins and carbohydrates are as follows:

fat: 55-60% of the total macronutrients for the day
protein: 30-35%
carbohydrates: 5-10%
Some studies have shown that a keto diet can lower high-density lipoprotein (HDL) or “good” cholesterol levels, but increase low-density lipoprotein (LDL) or “bad” cholesterol levels. For this reason, the keto diet may not be suitable for everyone.

For example, health professionals may advise people with high cholesterol not to follow the keto diet.

In this article, learn more about the keto diet and its effects on cholesterol. We also describe safety considerations.

What does the Study Say?

An older study in the Annals of Internal Medicine divided participants into a keto diet group and a low-fat group.

During the study, people in both groups lost more fat than non-fat. However, their LDL cholesterol levels do not change.

Those in the keto diet lost weight, had more significant reductions in triglyceride levels, and had higher levels of HDL cholesterol. HDL levels tend to rise when people replace carbohydrates with saturated, monounsaturated and polyunsaturated fats.

It is important to note that the researchers followed the participants for only 6 months. As a result, it is not clear whether or how their cholesterol levels changed later.

The authors mention that in previous studies, researchers have found conflicting results.

For example, they cite a study in which participants who followed the keto diet for 2 months had a mean increase in LDL cholesterol levels of 0.62 millimoles per liter (mmol / L). Another study showed a 0.26 mmol / L reduction in LDL cholesterol levels after 6 months.

An additional study followed people who followed either a keto diet or a low-fat diet for 1 year.

This was a follow-up study of a previous project. The results of an earlier study suggest that the keto diet leads to more weight loss and healthier cholesterol levels in obese people after 6 months.

The researchers noted that after 1 year, participants after the keto diet still had lower triglyceride levels and higher HDL cholesterol levels than those after the low-fat diet. They also found that people in both groups lost the same amount of weight on average.

However, given that all participants in these studies were obese, the results may not apply to people without it.

Recent research continues to lead to conflicting results. Studies from 2016 show an increase in LDL cholesterol and a decrease in HDL cholesterol associated with the keto diet.

A 2018 document reports the opposite, suggesting that the keto diet may raise HDL cholesterol levels.

Risks of the Keto Diet

Some people who follow a keto diet may experience:

muscle cramps
changes in blood pressure
keto flu

Keto flu is a collection of minor, short-term symptoms that some people experience when they start a keto diet. These symptoms include:

difficult to tolerate exercise

Safety Considerations

Several studies suggest that the keto diet may affect cholesterol levels.

When people consume low amounts of carbohydrates, the liver produces less triglycerides, which may be involved in raising HDL cholesterol levels.

However, the keto diet can increase LDL cholesterol levels in some people. As a result, the diet may not be suitable for everyone.

It may not be suitable, for example, for people with fat-induced lipemia. This condition leads to very high levels of fat in the blood.

If a person with fat-induced lipemia follows a keto diet, their triglyceride levels may continue to rise, which can lead to pancreatitis. Usually people with lipemia should follow a low fat diet.

People who want to lose weight should talk to a doctor to determine an appropriate diet.

When considering recommending a keto diet, physicians should consider the risks with potential benefits, which may include rapid weight loss, decreased triglyceride levels, and elevated HDL cholesterol levels.

The Importance of Ongoing Monitoring

People who follow the keto diet should consult their doctors to arrange frequent monitoring of cholesterol and triglyceride levels in the blood.

If a doctor notices that LDL cholesterol levels are rising, the diet may no longer be appropriate.

People with high levels of fats, such as cholesterol and triglycerides, have an increased risk of developing cardiovascular disease in their blood.

Foods to Eat and Avoid

People with high cholesterol should adopt a lifestyle that lowers these levels. This is because high cholesterol is associated with cardiovascular disease.

The keto diet emphasizes large amounts of fat, but not all fats have the same value. For example, replacing saturated fats with unsaturated fats is associated with a lower risk of cardiovascular disease, according to the 2015-2020 American Dietary Guidelines.

Saturated fats are found in foods such as cookies, pastries and other snacks. Coconut oil, butter and warm oil contain high levels of saturated fat, while olive oil and extra virgin margarine have a higher content of monounsaturated and polyunsaturated fats.

Fish – such as salmon, tuna and cod – can be an excellent source of protein and contain unsaturated fats, such as omega-3 fatty acids, which can be beneficial to the body.

People with high cholesterol who follow the keto diet can eat some nuts and seeds for breakfast, which are usually low in carbohydrates and rich in fiber and protein. Chia seeds have a higher content of polyunsaturated fats.

Vegetables, fruits and legumes are excellent sources of nutrition. However, anyone who follows a keto diet should be aware of the carbohydrate content of these foods.

People on a keto diet may consume milk and products containing it, but may want to choose low-fat versions if they have high cholesterol.


Some studies show that following a keto diet is an effective and quick way to lose weight.

However, people may find the keto diet difficult to follow. In this case, they may want to consult a doctor or nutritionist.

Studies show that the keto diet leads to significant weight loss among obese people. However, researchers need to study the diet further to determine the long-term health effects.

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