Will Keto Diet Raise Cholesterol

Will Keto Diet Raise Cholesterol – Even if you are at risk for cardiovascular disease, you may still be a candidate for the popular diet.

For every person talking about the ketogenic diet, there is another warning about the bad effects on your heart. The concern is that a diet high in fat, moderate in protein, and very low in carbohydrates will lead to a subsequent spike in cholesterol levels, which in turn could increase the risk of heart disease.

Will Keto Diet Raise Cholesterol

The concern is certainly justified. On the keto diet, you eat up to 80 percent of your calories from fat each day and stick to 20 to 50 grams of net carbs, a term used in popular diets including keto and Atkins, but one that is not officially recognized in the medical community. (To calculate net carbs, subtract fiber and sugar alcohols from total carbs, per Atkins.) This all means eating a lot of fat every day, and in the name of hitting that quota, that can include unhealthy choices like butter, coconut oil, and animal fat. These are all sources of saturated fat that have been linked to poor heart health, according to the American Heart Association (AHA). (The purpose of keto is to switch your body from a carb-burning state to a fat-burning state, called ketosis.)

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But keto’s effect on heart health isn’t as simple as it sounds. In fact, the keto diet may not have as much of a detrimental effect on your cholesterol as previously thought.

“When you look at the data, a few things are clear. When you look at population studies and clinical trials, the effect of the keto diet on lipids is modest,” says Daniel Soffer, MD, an internist and lipidologist at Penn Medicine in Philadelphia. . Dr. Soffer is a member of the National Lipid Association, an organization dedicated to the management of lipid problems. In October 2019, the National Lipid Association published a statement on low- and very-low-carbohydrate ketogenic diets and their relationship with lipids and published it in the Journal of Clinical Lipidology (PDF). Most often, he says, research shows that keto produces modest reductions in triglycerides, modest changes in heart-protective high-density lipoproteins (HDL, or “good”) and minimal changes in low-density lipoproteins (LDL, or “bad”). ).levels. Some studies, the review notes, show an increase in LDL on low- or very-low-carbohydrate diets. (However, long-term studies are lacking.)

Whether these numbers – especially HDL – increase or decrease depends largely on the quality of your keto diet. “One problem is that there is no one-size-fits-all ketogenic diet. There are different ways to follow it, and some people watch the types of fat they eat, others don’t,” says Soffer.

According to him, a previous article noted that in studies of normal-weight and obese people, keto diets were generally associated with lower total cholesterol, higher HDL, lower triglycerides, and lower LDL. At the same time, other research shows, the review shows, something else: an increase in LDL or no change. In the studies that lowered LDL, people ate a low-carbohydrate diet high in healthy unsaturated fat and limited in unhealthy saturated fat, the authors point out.

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An earlier study included in the above article compared a low-calorie and very-low-carb, high-fat diet (which makes up the keto diet) in more than 360 overweight and obese participants. Some of the participants had diabetes, some did not. After about a year, those in the keto group saw a decrease in total cholesterol, triglycerides, and LDL, while HDL increased.

To get an idea of ​​whether the keto diet may have a negative effect on your cholesterol, consider your initial triglyceride count. According to the Mayo Clinic, triglycerides are another type of blood lipid that your body uses for energy; high levels of triglycerides and LDL can lead to fatty deposits that clog arteries, notes the AHA. Normal levels are less than 150 milligrams per deciliter (mg/dL). “About a quarter of the population has triglyceride levels above 150 mg/dL, which is the threshold for considering elevated triglycerides. This is a large percentage of the population, so it’s not unusual,” says Soffer.

If you have normal levels, keto is probably safe to try. “For people with normal or perfect triglyceride levels, the impact of keto is minimal or nonexistent,” says Soffer. If, on the other hand, you have insulin resistance, type 2 diabetes and/or abdominal obesity, and your triglycerides are elevated—it seems like you should stay away from keto, but the opposite may be true, Soffer explains. that the low-carb nature of keto has the potential to reduce insulin resistance and improve triglycerides.

Research suggests this effect as well. A small randomized controlled trial published in August 2020 in Nutrition & Metabolism looked at 34 older adults with obesity for eight weeks. Those on a very low-carb diet lost 3 times more visceral fat compared to the low-fat group; The low-carb diet also had greater improvements in insulin sensitivity, triglyceride levels, and HDL cholesterol.

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Speaking of which, the relationship between triglycerides and HDL cholesterol adds another layer. When triglycerides are high, HDL is usually low, notes the AHA. Flip that script and “anything that lowers triglycerides will also raise HDL,” says Soffer. Remember, HDL is the type of “good” cholesterol that carries LDL from the blood to the liver, where it can be metabolized and discarded, according to the AHA—so increasing HDL is ultimately good for your heart.

The study only included 34 people—so more research (especially larger, long-term studies) is needed before scientists can understand the true effects of keto on insulin resistance and triglycerides.

A larger group of studies of 567 people with diabetes, drawn from more than 13 studies in a November 2020 meta-analysis in Nutrition & Diabetes, found that the ketogenic diet lowered fasting blood sugar and—in eight studies—also lowered HbA1c levels ( a measure of average blood sugar over time). On average, HbA1c fell by about 1.5 percent; the authors point out that research suggests that a 1 percent reduction in HbA1c reduces the risk of heart attack by 14 percent.

But in general, when it comes to using keto for fat or weight loss, the research is mixed. One big caveat: There isn’t enough data to show whether keto can produce long-term results. As a previous review pointed out, weight loss on keto peaks after five months, followed by slow weight regain. And a meta-analysis of 38 studies in the December 2020 issue of Nutrients comparing low-carb diets to low-fat diets concluded that they all have different effects on the body, but only in the short term. Low-carb diets were associated with greater weight loss (about 3 pounds) and better HDL and triglyceride numbers compared to high-fat diets. On the other hand, low-fat diets lower LDL and total cholesterol more effectively. However, these results were only applicable in the short term, and the small number of studies that looked at results after two years found that the results were no longer significant, possibly because people had difficulty with it in the long term.

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The effect of a high-fat, very-low-carb meal on your LDL is less clear. Again, as the AHA says, LDL is the type of cholesterol associated with atherosclerosis, which can increase the risk of heart disease and stroke. It can increase, decrease or stay relatively the same. Hypothetically speaking, if you have normal triglyceride levels and you’re doing keto to lose weight, your LDL may stay stable, Soffer says. Similarly, if you have high triglycerides to begin with and that number drops on keto, your LDL may still remain.

The bottom line is that keto alone cannot contribute to the cholesterol spikes that some people report when they start the diet. But if you start eating more saturated fat because you’re on keto, your LDL is likely to go up. Increasing saturated fat intake “has been repeatedly shown” to raise LDL, Soffer says.

Things are likely to get dangerous if you are one of the people who have an inherited genetic mutation that affects the way LDL particles are regulated. “When these individuals follow a keto diet, their LDL levels can skyrocket,” says Soffer. This result does not occur often enough to change the overall results in population studies, but what is most important is the effect of diet on your individual health. “It’s a long-recognized phenomenon that’s not well publicized,” he says, adding that the genetics driving this response are not fully understood. (The APOE gene may be one, but probably not the only one, he says.)

You may not be aware that you have a preexisting genetic mutation, also called familial hypercholesterolemia (FH). In fact, according to the AHA, only 10 percent of people with FH know they have it. Being aware of your family history, including members who had a heart attack at a young age, is important and can help steer your provider in the right direction. In some cases, research shows that a low-carb diet may be beneficial for those with FH who also have insulin resistance, a previous analysis said. This is not something to soothe yourself. Instead, it’s just another reason

Pdf) Long Term Effects Of Ketogenic Diet In Obese Subjects With High Cholesterol Level

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