Can You Do Keto With High Cholesterol Safely and Effectively? What You Need to Know
Is It Safe to Do Keto With High Cholesterol?
💡 It can be safe, but you need to be careful and work with your doctor. If you have high cholesterol, your doctor should check your levels regularly. Eating healthy fats like olive oil and nuts, and having regular checkups, can help lower risks and keep your heart safe while on keto.
Have you wondered if you can try the popular keto diet when you already have high cholesterol? It’s a common concern. The keto diet is high in fat and low in carbs, so many people ask how it affects cholesterol and heart health.
Starting a keto diet with high cholesterol requires careful planning and medical supervision, as ketogenic diets can lower triglyceride levels and increase “good” HDL cholesterol, although the effect on “bad” LDL cholesterol can vary and may increase with high saturated fat intake.
Since everyone’s body reacts differently, regular checkups are key to tracking your cholesterol and heart health. Many people use the keto diet to lose weight, but if you have high cholesterol, it’s important to know how it might affect you.
This guide breaks down how ketogenic diets interact with cholesterol, helping you decide if keto is a safe and smart choice for your heart health.
Table of Contents
- Understanding the Keto Diet
- What You Need to Know About Cholesterol
- Can You Do Keto With High Cholesterol
- How Keto Can Affect People with High Cholesterol
- Health Considerations for Keto with High Cholesterol
- Strategies for Doing Keto with High Cholesterol
- Frequently Asked Questions
- Final Thoughts
Understanding the Keto Diet
The ketogenic diet is a very low-carb eating plan that changes how your body gets energy. By cutting down carbs a lot, your body starts burning fat for fuel instead of sugar. This process is called ketosis.
This dietary change is more than just cutting out sugar; it involves a complete shift in your macronutrient intake. Most of your calories will come from fat, with moderate protein and very few carbs.
Understanding these core principles is the first step in exploring how ketogenic diets might affect your cholesterol. Now, let’s look closer at how this eating style works and what foods are typically involved.
Core Principles of Ketogenic Eating
This very low-carbohydrate diet changes your body’s fuel source from carbohydrates to fat. The ketogenic diet has been studied as a way to help with weight gain, insulin resistance, and heart health problems.
By limiting carbs to 20–50 grams per day, your body enters ketosis, breaking down fat into ketone bodies. This state helps reduce fat mass and sets keto apart from other low-carb diets.
To maintain ketosis, you need to eat about 70-80% of your calories from fat, 10-20% from protein, and only 5-10% from carbs. It’s best to do this under medical supervision, especially if you have health issues.
Common Foods Included and Avoided
When following a keto diet, focus on eating high-fat, low-carb foods. Choose healthy unsaturated fats like avocados, olive oil, nuts, and seeds. Fatty fish such as salmon and tuna provide good protein and healthy fats.
On the other hand, you should avoid foods high in carbs and sugar. This means cutting out bread, pasta, rice, potatoes, sugary snacks, sodas, and most fruits because they can stop your body from staying in ketosis.
To build a heart-healthy keto plate, include healthy fats like olive oil, avocado oil, nuts, and seeds; lean proteins such as fatty fish, chicken, and lean meats; low-carb vegetables like spinach, broccoli, cauliflower, and bell peppers; and moderate amounts of full-fat dairy like cheese, butter, and cream.
It’s important to limit processed meats and artificial trans fats, which can negatively impact heart health, and choose whole foods instead of processed “keto” snacks.
What You Need to Know About Cholesterol
Cholesterol is a waxy substance in your blood and cells that your body needs to build healthy cells, hormones, and vitamin D. Your body makes all the cholesterol it needs, but you also get some from certain foods. However, having too much cholesterol can be harmful to your health.
When you have too much cholesterol in your blood, it can build up in your arteries. That’s why it’s important to watch your total cholesterol, including low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides.
Types of Cholesterol: LDL, HDL, and Triglycerides
HDL is the “good” cholesterol that helps clear the “bad” LDL cholesterol from your arteries, keeping your heart healthy. High LDL can cause plaque buildup in arteries, increasing heart disease risk.
Triglycerides are fats in your blood used for energy, but having too many can raise your heart disease risk, especially if your LDL is high or HDL is low.
Your total cholesterol is the sum of LDL, HDL, and triglycerides.
How Cholesterol Impacts Heart Health
Your cholesterol levels have a direct impact on your heart health. High levels of LDL cholesterol are a major risk factor for cardiovascular disease. Over time, this “bad” cholesterol can accumulate on the inner walls of your arteries, forming hard deposits called plaque.
This plaque buildup stiffens and narrows the arteries, restricting blood flow to your heart and other organs. This can lead to serious health issues, including chest pain (angina), heart attack, and stroke. The higher your LDL, the greater your risk of heart disease.
Having high levels of HDL cholesterol is good for your heart. HDL acts like a cleaner, picking up extra LDL cholesterol in your blood and carrying it away.
This helps stop plaque from building up and keeps your arteries clear. That’s why keeping a good balance between LDL and HDL is important to lower your risk of heart disease and keep your heart healthy.
Can You Do Keto With High Cholesterol?
The connection between ketogenic low-carbohydrate diets and high cholesterol is complex, and the effects can vary greatly depending on your individual health.
Research shows that for some people, a keto diet can improve cholesterol, but for others, it may raise “bad” cholesterol, alter gut microbiome composition, and reduce beneficial gut bacteria.
This may lead to long-term health issues like irritable bowel disease, increased intestinal infections, and weakened immune function.
However, the effects of keto on cholesterol vary by individual. Factors like genetics, fat types consumed, and starting cholesterol levels influence how keto impacts you.
Considering both short- and long-term effects is important to understand keto’s impact on cholesterol.
Short-Term Effects on Cholesterol Levels
When you start a low-sugar diet, your triglyceride levels usually drop quickly because you eat very few carbohydrates, which lowers the liver’s production of triglycerides.
Researchers also found that the keto diet caused significant changes in lipid metabolism and how your body uses fats and energy in muscles, shifting from burning sugar to burning fat for fuel.
At the same time, HDL (“good”) cholesterol levels often rise. This happens as you replace carbs with fats, including both saturated and unsaturated types. For many, these initial changes are viewed as positive indicators of improved heart health.
An older but notable study found that a low-carb sugar-restricted diet led to more significant reductions in triglycerides and higher HDL levels compared to a low-fat moderate-sugar diet after six months. However, the response of LDL cholesterol can be unpredictable in the short term.
These conflicting results highlight that initial responses are highly individual and require close monitoring to ensure your total cholesterol doesn’t shift into a dangerous range.
Long-Term Risks and Benefits of Keto for Cholesterol
Looking at the ketogenic diet over the long term, the effects on cholesterol are mixed. Some studies show that benefits like lower triglycerides and higher good HDL cholesterol can last.
Many people also lose weight, which helps with other issues like diabetes and high blood pressure.
However, the main worry for people on keto long-term is that their LDL (bad) cholesterol might stay high. Some studies show LDL goes down over time, but others say it stays high. High LDL over a long time increases the risk of heart disease.
While low-carb diets can help with weight loss, they are not always better than other diets in the long run. This uncertainty makes ongoing medical supervision crucial.
If your LDL cholesterol stays high, your doctor might suggest whether you should keep following the diet or try other treatments for lowering cholesterol.
Also, many people find it hard to stick with the keto diet long-term, which could reduce any health benefits you might have gained.
How Keto Can Affect People with High Cholesterol
For individuals already dealing with high cholesterol, the ketogenic diet’s influence on LDL and HDL cholesterol levels is a primary concern.
The diet’s high-fat nature can trigger different responses based on your body’s unique makeup, including any genetic predisposition you might have.
Some people may see a favorable shift, with HDL levels rising and triglycerides falling. However, others might experience a sharp spike in LDL , increasing their cardiovascular risk factors.
LDL Cholesterol Changes on Keto
The effect of a ketogenic diet on LDL cholesterol is debated. For some people, LDL stays the same or goes down, especially if they lose weight. But many people see their LDL go up, often because of eating more saturated fats like butter and fatty meats. Choosing unsaturated fats instead can help lower LDL.
Genetics also play a key role; some people are predisposed to higher LDL on a high-fat diet due to genes or familial hypercholesterolemia. Regular monitoring and a personalized approach are essential, as responses vary greatly between individuals.
Potential Improvements in HDL and Triglycerides
Research shows that ketogenic diets increase HDL (“good”) cholesterol and lower triglycerides, which helps reduce heart disease risk.
Eating fewer carbs lowers triglyceride production, while healthy fats from olive oil, avocados, nuts, and fatty fish raise HDL levels.
A 2019 study of women with type 2 diabetes found that 90 days on a ketogenic diet increased HDL and decreased triglycerides, without changing LDL. Improving the ratio between these markers is strongly associated with lower cardiovascular risk.
Heart Health Considerations for Keto with High Cholesterol
If you have high cholesterol, you need to be careful when starting the keto diet. High LDL cholesterol is a big concern because it increases the risk of heart disease.
While some health markers may get better, it’s important to be aware of the risks. If the diet isn’t managed well, it could increase your chance of heart problems. That’s why keeping track of your health and working with a doctor is essential.
Monitoring Cardiovascular Risks
When following a ketogenic diet with high cholesterol, it’s very important to regularly check your heart health. You should focus on your cholesterol levels, including LDL, HDL, and triglycerides. But it’s also important to monitor other factors to get a full picture of your heart disease risk.
Your healthcare provider should regularly check your blood pressure and blood sugar levels. While the keto diet can sometimes improve these, especially with weight loss, any negative changes should be addressed right away.
By closely monitoring these important health measures, you and your doctor can see if the keto diet is helping or harming your heart. This way, you can make changes to your diet or treatment plan quickly to reduce the risk of heart problems and keep your heart safe.
Your doctor will monitor bloodwork—including cholesterol, triglycerides, A1C, and blood pressure—to track improvements or catch issues like high cholesterol levels early. This helps reduce cardiovascular risk.
Checkups also allow for adjustments to your plan, guidance on food choices, and management of side effects. This collaborative approach keeps your health journey both safe and personalized.
Strategies for Doing Keto with High Cholesterol
If you have high cholesterol but want to try the keto diet, you can take steps to do it more safely. The key is to make it a heart-healthy plan that supports your health. This means making smart choices beyond just cutting carbs.
To safely follow keto with high cholesterol, focus on eating heart-healthy fats, staying active, and keeping in touch with your doctor. These steps can help you lose weight while protecting your heart.
Choosing Heart-Healthy Fats and Foods
To follow keto with high cholesterol, the type of fat you eat matters immensely. Instead of relying on saturated fats, prioritize unsaturated fats, which are known to support heart health. This dietary change can help manage your cholesterol levels while you remain in ketosis.
Focus on eating foods high in healthy fats like olive oil, avocados, nuts, and seeds. Fatty fish such as salmon provide omega-3s that help lower triglycerides and raise good cholesterol (HDL). Try to limit saturated fats found in butter, processed meats, and full-fat dairy.
Some heart-healthy foods to include in your low-carb plan are avocados, olive oil, nuts like almonds and walnuts, seeds such as chia and flax, fatty fish like salmon and mackerel, and low-carb vegetables to provide enough fiber.
Frequently Asked Questions
Should People with High Cholesterol Avoid Keto Altogether?
Not necessarily. For some, ketogenic diets can improve certain risk factors of high cholesterol levels. However, due to the potential for increased LDL cholesterol and risks associated with genetic predisposition, it’s not suitable for everyone. A discussion with your doctor about creating a modified, healthy diet plan is the best approach.
Does Keto Impact the Need for Cholesterol Medication?
It might, but it depends. Some people may see better cholesterol levels and need less medication. But if LDL cholesterol goes up a lot, your doctor may suggest starting or continuing cholesterol medicine to protect your heart.
Final Thoughts
Navigating the keto diet with high cholesterol means being careful and informed. By understanding how keto works and keeping an eye on your cholesterol levels, you can make food choices that support your heart health.
It’s important to choose heart-healthy fats and work closely with your doctor to make sure your diet supports your health. Regular checkups help track how your body responds to the changes.
If you want advice that fits your unique health needs, talk to a trusted medical provider. They can guide you safely through your keto journey.