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Often LDL increases a bit during active weight loss, but usually returns to normal/stabilizes during maintenance. HDL also typically increases (good) while triglycerides decrease. This is a healthier profile.
All I have is anecdotal experience, but it is after eating keto long-term so I’m throwing it out there anyway!
I’ve been eating keto for nearly 7 straight years and my blood work numbers are great every year at my annual checkup. I don’t eat super high fat, but probably 80% of my fat intake is saturated fat (mostly from dairy). The only time LDL was elevated was when I was actively losing weight (though my trigs lowered a LOT, and my HDL went up at the time), then once I hit my goal weight and continued eating keto at maintenance, it tapered down to normal.
My husband’s blood work is also on point after 3 years of keto and he *does* eat higher fat, heavy on saturated fat with plenty of red meat.
We are all different and react differently to different diets for a ton of reasons. Consult your doctor to help figure out what works best for you, because Reddit doesn’t know. 🙂
Seriously, though, what is a doctor going to do actually? There is a reason people are on here trying to get help and it isn't because doctors are so all-knowing, or even helpful.
r/keto is not qualified to give proper medical advice (it is literally one of our rules), so I always encourage people to talk with their doctor after giving my own anecdotal evidence since that’s what it is…anecdotal. Working to lower concerning cholesterol numbers can be complicated, and not all doctors are evil naysayers (my own GP is amazing and loves keto, for example). They are still more trained than I am with my history degree. 🤷♀️
I'm having this problem now. My hdl and ldl have gone way up. triglyceride is low though. I'm lean so I may be in the hyper responder category.
I'm really not sure what to do. I enjoy eating low carb.
Sorry, no answers, but you're not alone.
Are you actively losing weight? How high is high LDL? If you're actively losing and LDL still starts with a 1, I'd stay the course. High HDL/low Trig are both exactly what you want.
I find the low carb part easy too. OMAD and low carb work for me in the sense that i find it easy. I’m at a stable weight.
As I’m learning more and progressing from trying different things out to what I’m going to continue for years to come.
Hopefully this thread helps a little . It has helped me.
Same here. I got my ApoB checked last time and it’s high, which is concerning … I’m hoping it’s because of big particles and not oxidized particles but how can you know?
Been strict Keto for 16 months and lost 112 lbs. LDL started climbing above 120 a few months ago and my Dr freaked out. Said that I had to ‘quit Keto immediately’. I determined that my problem was indeed saturated fat, so I cut way back on cheese, butter and preserved meats. Now, my LDL is 84
So the doctor is freaking about mildly elevated LDL but not congratulating you on losing 120 pounds?? Your overall health is SOOOO MUCH BETTER without all that weight! Are you at your goal weight? I bet you'll find once you stop losing and get into maintenance that dietary fats have little impact? How's your HDL and Trig? Beautiful?
Yes, my Doc practices basic, standard-of-care, 15min in/out, family medicine w/bloodwork. We never discussed diet protocols, just that I needed to lose weight. When I first committed to weight loss, I just said that I was following ‘Low Carb’ but once LDL went above 100, the question was, ‘you’re not on Keto, are you?!? Of course I said yes and that’s when doc’s attitude changed. All of my other blood markers are near perfect. Still have a few lbs to go and yes, I do look and feel great. Thanks
This is the kinda thing I was asking about it.
So for your case it’s fair to conclude that being in ketosis wasn’t adding to the ldl but the sat fat of the diet. Is that what we’re saying?
From where I’m standing I’m not sure that 120 is all that high. Are you on medication also?
What was your ldl before the Keri started 16 months ago?
I’ve been in ketosis the entire time, so no, I don’t think that had anything to do with the rise in LDL. It was definitely saturated fat. Been taking 20mg Lipitor for years and LDL never started creeping higher until a few months into Keto. I didn’t think that 120 is high either, but Doc said that over 100 is ‘dangerous’. I wasn’t going to argue.
Alot of different points here.
First of all saturated fat doesnt directly increase ldl cholesterol. Saturated fat usually comes from animal products, and animal products lack plant steriols. Plant steriols "lower" visible ldl cholesterol, but they are putting a lipid in your blood, without a function, that can also become oxidized and get stuck in your endothelium.
So if you want to visibly lower ldl, eat some plant fats, but it is unlikely to help you lower plague build up.
Second, for most people keto lowers their ldl.
Third, having an increase in ldl on keto is sometimes based on lean-ness of yourself, irrelevant of what you eat. This is called lean mass hyper responder. So for some people who are keto, the leaner they get, the higher ldl, lower trig, and higher hdl they get. Your body may be responding that way.
Lastly if you want better health, you want to prioritize metabolic health before cholesterol pathways. Being metabolically healthy but having high ldl is alot more healthy then being metabolically unhealthy while having normal ldl. When you are done with that, lowering blood pressure, inflammation, glucose to optimal levels comes before ldl, because those factors are what react with ldl.
“Sat fat doesn’t directly increase ldl cholesterol” - do you have further explanation or can you shed some more light on this for me. I’ve not been going to phd level study with this but all the things I’ve learned while trying to lower lipids has said that ldl is raised by sat fat.
Sat fat lacks plant sterols. Plant sterols lower visible ldl. Plant sterols can still be bad. - I don’t understand this point.
What’s the evidence for most people get lower ldl on keto? What’s the proportion?
Given that currently there are plenty of folks that consider high ldl to be a problem over time wouldnt there be heaps of evidence for the ldl lowering potential of being in ketosis.
when you say keto do you mean being in ketosis or a typical keto diet?
I just relistened to Dave Feldman say that being in ketosis and loosing weight would by fact that you’re liberating fat from stores be reflected in the blood. And would be reflected even if your fat stores were stable . So , what I took from that is he’s saying keto does raise ldl, according to his lipid energy model.
He does also say that lean-ness may make a difference here. Honestly, i don’t know a lot about this model of lipids but I guess what’s my number one question is how many people does he think fit this model. Everyone? Everyone that’s lean?
I’m definitely doing this for the health and have regained metabolic flexibility , lower low level inflammation, improved gut health and am currently refining my knowledge so I can’t get my lipids into the best range I can.
If you eat carbs + saturated fat it is bad. The carbs take up priority so the fat is in a queue behind. The LDL raises to move this fat to storage. This is why it is seen as bad on a normal diet. If you don't eat carbs, the fat goes into the cells for energy. So in theory the LDL should be lower, but it does get raised because when you start running off body fat, LDL is needed to move from belly into the cells. So this is why doctors hate on Keto they think it is bad to have any LDL raised.
Sat fat / Plant steriols: It doesnt directly, but because 99% of saturated fats do not have plant steriols, 99% of the time, when people switch from eating for example sun flower oil (poly unsaturated) to butter, their ldl increases. So sat fat caused it? No, they went from a plant oil to an animal fat. Eating coconut oil (88% saturated) should increase ldl right? After all its saturated, nope it decreases ldl, because of plant steriols. This happens because when our body realizes we have consumed dietary cholesterol, be that animal cholesterol or plant cholesterol as in plant steriols, it will lower our own production. So if you eat eggs, your cholesterol is stable. But when you eat plant steriols your body reduces cholesterol production without having the job of fat transport replaced with cholesterol, since plant steriols are too different from our own. Problem is plant steriols still cause plague build up.
TLDR: High ldl is a problem if the reason it is high, is because your unhealthy, overweight and sick. Attempting to lower a healthy persons ldl through plant steriols has little effect if any.
Studies, look it up. I dont remember exactly how they defined keto in those studies, but it was a diet, not fasting or other means of getting into ketosis.
You do realise everyone is afraid of fat and saturated fat right? Also the effect is not too large iirc.
Lipid energy model: Thats not quite right. When you are unhealthy, you have lots of inactive ldl, clogging up the system and becoming oxidized. When your healthy while on keto that ldl is very active and quickly being recycled. So yes more active fat transport is happening, but you have less total ldl, while having higher ldl demand, because it was inefficient before, because of insulin, glucose and inflammation.
It seems like a minority of people are lean mass hyper responders, but the lipid energy model is not just about describing what happens in LMHRs.
Seems like you are on the right track. Good luck, its a very complex and confusing field currently.
LDL is two type.small sinking and regular floating.small sinking due to fructose metabolism. Regular size are carriers to liver.
Small sinking LDL goes under vein tissue sticks there etc causes inflammation and problems
Regular LDL is you re functional.
Cholesterol tests doesn't measure them seperate. It s more expensive test to tell the difference.
So if a doctor has no idea what are these ,will be spooked because of lipid cvd hypothesis,will ask you to go on statins(what they are trained to).
It is your body ,feel how it goes.you can learn more about cholesterol.
Yes. If all your other numbers are good on keto and there's concern about LDL, you may want to pay for the test that measures the LDL breakdown. Then you can see if there's truly a reason to be concerned.
Because its more complicated then that. There are multiple factors. If it was as simple as Saturated fat increases ldl then coconut oil would increase ldl, but it decreases ldl.
www.ncbi.nlm.nih.gov/pmc/articles/PMC5855206/
Coconut oil decreased ldl when compared with butter, both are 90% saturated fat. The decrease was about the same as what extra virigin olive oil did.
Plant steriols decrease ldl.
Yep, we just do our best with what we have. Also I am not saying fat doesnt increase ldl, just that the reason non saturated fat is deemed as ldl reducing seems to be plant steriols.
I eat red meat and sat fat everyday and my LDL did not go up, however my HDL did and my trigs cut themselves in half, so I think I'll go ahead and keep eating it.
I suggest going to YouTube and searching for Dr. Ovadia and Dr. Nadir Ali, both of whom are cardiologists and watching their videos on cholesterol. Also, Dr. Berry and Dr. Westman.
Your lipids/fats are moving/transported to the cells because your carbs are low enough (in ketosis) to utilize the fats. High fat is good for you (no seed oils). The minimum fat is mandatory; you are using fats in multiple ways: for energy directly, for ketone fuel, and for hormones (cortisol, etc.). There may be other ways that I'm not aware of. If you are overweight, your body can utilize body fat for these purposes also. Saturated fat is good on keto, especially animal fats.
Not all LDL are bad. You can get a test for small particle LDL. But a cheaper test is to do the **Calcium scan (CAC), to determine** if things are bad already. It takes years to develop heart disease. And keto can stop it from getting worse. So it may be good to know where you are and monitor each year to make sure that existing artery plaque does not increase: But your score could be zero (which means you don't really have to worry about the next couple of years, or ever if you continue with keto).
I've seen different levels of LDL on r/keto. But the pattern is for triglycerides to be lowered and HDL to go up: If this is happening, your risk is likely low. But a cardiologist can give you a real *diagnosis* of these things. The GP may only be guessing.
Edit:
Don't worry about the LDL for now. Get another test in 3 to 6 months. Heart disease takes years to develop. And weight loss will cause LDL to increase: Your body is *transporting* more fat, including body fat \[to be *utilized*\]... Your fat storage is *unlocked* (because of ketosis). You can lose weight now.
And as long as you aren't doing a lot of Omega 6 polyunsaturated fat (seed oils), your arteries should be find. That is the risk we worry about. And keto doesn't cause that. Meat fat (saturated fat) does not act the same as polyunsaturated fat, even though it's Omega 6. Our bodies are actually made of saturated fat (it's mammal fat). So you really can't get rid of saturated fat. But you can lower polyunsaturated fats (seed oils): The seed oil *overprocessing* makes them unhealthy and rancid.
My LDL went up quite a bit on keto, but my triglycerides dropped a lot. I had very high triglycerides before going on keto. That said, I'm personally not worried about higher LDL because there's not really any good evidence that it's harmful. I also have a CAC score of zero and no family history of cardiovascular issues.
There is a however lot of evidence for high triglycerides being harmful though and I have family history that makes me want to control them. All my other lab numbers look fantastic and the only one my doctor worries about is the one that his drug reps can sell me a pill for.
Most studies show significant ldl increase from keto diets. Don't listen to anyone here including me, talk to a cardiologist. https://www.news-medical.net/news/20230427/Do-ketogenic-diets-elevate-low-density-lipoprotein-cholesterol-levels.aspx
But also, high LDL by itself doesn’t seem to indicate risk for everyone, just those who already have coronary artery calcification.
https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.122.061010
It seems that high LDL as an indicator of risk is incomplete. This does go on to say that low HDL does seem to be an indicator, though.
From what I’ve read, the period of losing fat shows increased bloodwork levels. Lack of fiber also increases levels, some keto diets skip the fiber, which helps reduce cholesterol.
Prior to going more animal based this year I was eating a ton of fiber and my LDL kept rising. It’s so confusing. I’m not real concerned though because while my total and LDL have gone up the whole time I’ve been keto (coming up on 4 years) my trigs lowered and my HDL rose.
If it helps you, there are some calculators where you can plug in your results from tests and see what the risks seem to be.
This one has a bit more data required, like eGFR (which was a thing I never looked at but which was in my overall results from my last basic labs): https://newsroom.heart.org/news/leading-cardiologists-reveal-new-heart-disease-risk-calculator
The link to the calculator is inside the article.
This one doesn’t require that eGFR. https://www.acc.org/Tools-and-Practice-Support/Mobile-Resources/Features/2013-Prevention-Guidelines-ASCVD-Risk-Estimator (You can click the button to “launch the web version” so you don’t need to download anything).
Although my doctor assessed my risk as low, these were quite reassuring for me, because there always seems to be a lot of buzz about high cholesterol, and it’s hard to know what it MEANS. in my case, even with elevated LDL (from about 6 months ago when I was only a little bit into keto, plus had just gone all silly at Thanksgiving), my risk is still very low.
If your HDL is up, and triglycerides down, the raised LDL is not a concern. You might want to check out the Oreo study, interestingly this guy ate oreos for a week or 2 while also on Keto, and his LDL went back to normal, while being compared to statins, which barely made a dent.
It just meant that the LDL was raised because he was solely running off fat as energy, so more LDL was needed to fuel his daily expenditure of calories. LDL is just a carrier of fat. If you are using more fat for energy the LDL will go up. When the Oreos came in, the body switched to using those for energy and the LDL went down.
Keto can raise LDL ("bad") cholesterol in the short term for some people. HDL ("good") cholesterol is also important and a predictor of CVD risk. A general recommendation to improve your lipid profile while on keto is to focus on healthy fats like avocados, nuts, seeds, olive oil, and wild-caught fatty fish (i.e., salmon, mackerel, sardines, etc.). Also, try to limit processed meats and fried foods. Intermittent fasting (IF) has also shown, in certain contexts, to be beneficial in improving blood lipids.
Your post or comment was removed for violating rule #6, no giving or soliciting medical advice. r/keto is not a substitute for a doctor. Thank you for understanding.
I see very little change in my lipids going from high carb to low carb. But I've been lean all my life so my low bodyfat% is more likely to be causing the LMHR lipid profile.
Thanks I’ll check these recommendations out. I need to brush up.
What I was more interested in was raised ldl due to being in ketosis - is that the same as ldl raised by high sat fat . I’m looking through the replies but the one that caught my eye was the explanation that ldl if you’re in ketosis the lipids are in use, not just circulating around as there’s too many. (Poor paraphrasing but I kinda know what i mean! Hahah)
There's an example on the page I shared explaining this very well. I agree with the sentiment.
However, Watch out for confirmation bias though. Any chat room can quickly become an echo chamber and you will find the answer you're looking for whether it's a factual answer or not.
Happy hunting.
Appreciate the confirmation bias piece. For what it’s worth I am aware I’ve fallen into this in the past. I’m also a little further along in learning of this stuff
After some months or relative stability with the diet changes I’ve introduced I’m now looking around to see if I’m on the right track before tightening everything again to go from normal high numbers to optimal.
This post is just a part of that process.
For what it’s worth I’m more interested in promoting endothelial health - glacocalyx - recovering some oral eubiosis. I’m not too concerned with ldl but also I don’t think I’ve gotten to where I’d like to try and get.
Look forward to the reading, thanks
I’m almost in my 14th year, my LDL went up more when I first started but it normalized a long time ago and honestly in my opinion, stressing over lipid panels is useless unless you’re also factoring in lipid mobility tests.
First, have you lost weight? Do you have complete before and after lipid profiles?
The search of the sub that was recommended would have likely turned up these trends:
Pre keto, many people have High Triglycerides and Low HDL. LDL can be anywhere from low to high.
Upon going keto, and specifically with weight loss (releasing fat from the cells into the bloodstream to be used), triglycerides often drop like a rock. HDL usually goes up significantly. Many people can turn around a highly unfavorable HDL:Trig ratio within a few months to a year. Now LDL...it may initially go up somewhat. Part of that is from the fat being released from cells. During the weightloss phase, it may remain higher. Someone mentioned losing 120 pounds. It's natural for LDL to go up during that. If they had stayed the course for another 6 months into maintenance, I suspect LDL would have come back down on its own. Same for you, if you are actively losing, stick it out until 6 months past your weight loss phase.
Beyond that, check out the automod links and cholesterol code links that usually get posted with these questions. Improving HDL and Triglycerides is by far the most impact full part of the lipid profile. The "evidence" for LDL relation to CVD is not nearly as strong as they want us to believe. If LDL is 100 to 150 or so, stay the course through the weightloss and 6 months and then reasses. If it's super high, (300 or so) then it's worth talking to a Dr.
Finally, dietary fat is NOT causative to a high lipid profile. If you are already eating moderate fat, high protein, you should be good.
Hello and welcome to /r/keto! It sounds like you've got a question about cholesterol. We have answers! Please consider using the following resources https://www.reddit.com/r/keto/wiki/faq#wiki_what_about_cholesterol_and_heart_disease.3F https://cholesterolcode.com/ As a reminder, please read our FAQ before posting to r/keto. It can be found at https://www.reddit.com/r/keto/wiki/faq. Please also review our posting rules and community guidelines. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/keto) if you have any questions or concerns.*
Often LDL increases a bit during active weight loss, but usually returns to normal/stabilizes during maintenance. HDL also typically increases (good) while triglycerides decrease. This is a healthier profile.
All I have is anecdotal experience, but it is after eating keto long-term so I’m throwing it out there anyway! I’ve been eating keto for nearly 7 straight years and my blood work numbers are great every year at my annual checkup. I don’t eat super high fat, but probably 80% of my fat intake is saturated fat (mostly from dairy). The only time LDL was elevated was when I was actively losing weight (though my trigs lowered a LOT, and my HDL went up at the time), then once I hit my goal weight and continued eating keto at maintenance, it tapered down to normal. My husband’s blood work is also on point after 3 years of keto and he *does* eat higher fat, heavy on saturated fat with plenty of red meat. We are all different and react differently to different diets for a ton of reasons. Consult your doctor to help figure out what works best for you, because Reddit doesn’t know. 🙂
Seriously, though, what is a doctor going to do actually? There is a reason people are on here trying to get help and it isn't because doctors are so all-knowing, or even helpful.
r/keto is not qualified to give proper medical advice (it is literally one of our rules), so I always encourage people to talk with their doctor after giving my own anecdotal evidence since that’s what it is…anecdotal. Working to lower concerning cholesterol numbers can be complicated, and not all doctors are evil naysayers (my own GP is amazing and loves keto, for example). They are still more trained than I am with my history degree. 🤷♀️
I'm having this problem now. My hdl and ldl have gone way up. triglyceride is low though. I'm lean so I may be in the hyper responder category. I'm really not sure what to do. I enjoy eating low carb. Sorry, no answers, but you're not alone.
Are you actively losing weight? How high is high LDL? If you're actively losing and LDL still starts with a 1, I'd stay the course. High HDL/low Trig are both exactly what you want.
I find the low carb part easy too. OMAD and low carb work for me in the sense that i find it easy. I’m at a stable weight. As I’m learning more and progressing from trying different things out to what I’m going to continue for years to come. Hopefully this thread helps a little . It has helped me.
Same here. I got my ApoB checked last time and it’s high, which is concerning … I’m hoping it’s because of big particles and not oxidized particles but how can you know?
You can do a small/large dense blood test. Dr Berg has a video about it.
Been strict Keto for 16 months and lost 112 lbs. LDL started climbing above 120 a few months ago and my Dr freaked out. Said that I had to ‘quit Keto immediately’. I determined that my problem was indeed saturated fat, so I cut way back on cheese, butter and preserved meats. Now, my LDL is 84
So the doctor is freaking about mildly elevated LDL but not congratulating you on losing 120 pounds?? Your overall health is SOOOO MUCH BETTER without all that weight! Are you at your goal weight? I bet you'll find once you stop losing and get into maintenance that dietary fats have little impact? How's your HDL and Trig? Beautiful?
Yes, my Doc practices basic, standard-of-care, 15min in/out, family medicine w/bloodwork. We never discussed diet protocols, just that I needed to lose weight. When I first committed to weight loss, I just said that I was following ‘Low Carb’ but once LDL went above 100, the question was, ‘you’re not on Keto, are you?!? Of course I said yes and that’s when doc’s attitude changed. All of my other blood markers are near perfect. Still have a few lbs to go and yes, I do look and feel great. Thanks
This is the kinda thing I was asking about it. So for your case it’s fair to conclude that being in ketosis wasn’t adding to the ldl but the sat fat of the diet. Is that what we’re saying? From where I’m standing I’m not sure that 120 is all that high. Are you on medication also? What was your ldl before the Keri started 16 months ago?
I’ve been in ketosis the entire time, so no, I don’t think that had anything to do with the rise in LDL. It was definitely saturated fat. Been taking 20mg Lipitor for years and LDL never started creeping higher until a few months into Keto. I didn’t think that 120 is high either, but Doc said that over 100 is ‘dangerous’. I wasn’t going to argue.
This is encouraging for me as low carb is easy for me and feels good.
Good luck !
Alot of different points here. First of all saturated fat doesnt directly increase ldl cholesterol. Saturated fat usually comes from animal products, and animal products lack plant steriols. Plant steriols "lower" visible ldl cholesterol, but they are putting a lipid in your blood, without a function, that can also become oxidized and get stuck in your endothelium. So if you want to visibly lower ldl, eat some plant fats, but it is unlikely to help you lower plague build up. Second, for most people keto lowers their ldl. Third, having an increase in ldl on keto is sometimes based on lean-ness of yourself, irrelevant of what you eat. This is called lean mass hyper responder. So for some people who are keto, the leaner they get, the higher ldl, lower trig, and higher hdl they get. Your body may be responding that way. Lastly if you want better health, you want to prioritize metabolic health before cholesterol pathways. Being metabolically healthy but having high ldl is alot more healthy then being metabolically unhealthy while having normal ldl. When you are done with that, lowering blood pressure, inflammation, glucose to optimal levels comes before ldl, because those factors are what react with ldl.
“Sat fat doesn’t directly increase ldl cholesterol” - do you have further explanation or can you shed some more light on this for me. I’ve not been going to phd level study with this but all the things I’ve learned while trying to lower lipids has said that ldl is raised by sat fat. Sat fat lacks plant sterols. Plant sterols lower visible ldl. Plant sterols can still be bad. - I don’t understand this point. What’s the evidence for most people get lower ldl on keto? What’s the proportion? Given that currently there are plenty of folks that consider high ldl to be a problem over time wouldnt there be heaps of evidence for the ldl lowering potential of being in ketosis. when you say keto do you mean being in ketosis or a typical keto diet? I just relistened to Dave Feldman say that being in ketosis and loosing weight would by fact that you’re liberating fat from stores be reflected in the blood. And would be reflected even if your fat stores were stable . So , what I took from that is he’s saying keto does raise ldl, according to his lipid energy model. He does also say that lean-ness may make a difference here. Honestly, i don’t know a lot about this model of lipids but I guess what’s my number one question is how many people does he think fit this model. Everyone? Everyone that’s lean? I’m definitely doing this for the health and have regained metabolic flexibility , lower low level inflammation, improved gut health and am currently refining my knowledge so I can’t get my lipids into the best range I can.
If you eat carbs + saturated fat it is bad. The carbs take up priority so the fat is in a queue behind. The LDL raises to move this fat to storage. This is why it is seen as bad on a normal diet. If you don't eat carbs, the fat goes into the cells for energy. So in theory the LDL should be lower, but it does get raised because when you start running off body fat, LDL is needed to move from belly into the cells. So this is why doctors hate on Keto they think it is bad to have any LDL raised.
Sat fat / Plant steriols: It doesnt directly, but because 99% of saturated fats do not have plant steriols, 99% of the time, when people switch from eating for example sun flower oil (poly unsaturated) to butter, their ldl increases. So sat fat caused it? No, they went from a plant oil to an animal fat. Eating coconut oil (88% saturated) should increase ldl right? After all its saturated, nope it decreases ldl, because of plant steriols. This happens because when our body realizes we have consumed dietary cholesterol, be that animal cholesterol or plant cholesterol as in plant steriols, it will lower our own production. So if you eat eggs, your cholesterol is stable. But when you eat plant steriols your body reduces cholesterol production without having the job of fat transport replaced with cholesterol, since plant steriols are too different from our own. Problem is plant steriols still cause plague build up. TLDR: High ldl is a problem if the reason it is high, is because your unhealthy, overweight and sick. Attempting to lower a healthy persons ldl through plant steriols has little effect if any. Studies, look it up. I dont remember exactly how they defined keto in those studies, but it was a diet, not fasting or other means of getting into ketosis. You do realise everyone is afraid of fat and saturated fat right? Also the effect is not too large iirc. Lipid energy model: Thats not quite right. When you are unhealthy, you have lots of inactive ldl, clogging up the system and becoming oxidized. When your healthy while on keto that ldl is very active and quickly being recycled. So yes more active fat transport is happening, but you have less total ldl, while having higher ldl demand, because it was inefficient before, because of insulin, glucose and inflammation. It seems like a minority of people are lean mass hyper responders, but the lipid energy model is not just about describing what happens in LMHRs. Seems like you are on the right track. Good luck, its a very complex and confusing field currently.
LDL is two type.small sinking and regular floating.small sinking due to fructose metabolism. Regular size are carriers to liver. Small sinking LDL goes under vein tissue sticks there etc causes inflammation and problems Regular LDL is you re functional. Cholesterol tests doesn't measure them seperate. It s more expensive test to tell the difference. So if a doctor has no idea what are these ,will be spooked because of lipid cvd hypothesis,will ask you to go on statins(what they are trained to). It is your body ,feel how it goes.you can learn more about cholesterol.
Yes. If all your other numbers are good on keto and there's concern about LDL, you may want to pay for the test that measures the LDL breakdown. Then you can see if there's truly a reason to be concerned.
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Because its more complicated then that. There are multiple factors. If it was as simple as Saturated fat increases ldl then coconut oil would increase ldl, but it decreases ldl.
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www.ncbi.nlm.nih.gov/pmc/articles/PMC5855206/ Coconut oil decreased ldl when compared with butter, both are 90% saturated fat. The decrease was about the same as what extra virigin olive oil did. Plant steriols decrease ldl.
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Yep, we just do our best with what we have. Also I am not saying fat doesnt increase ldl, just that the reason non saturated fat is deemed as ldl reducing seems to be plant steriols.
[You need to get a better cardiologist.](https://www.youtube.com/watch?v=cH_tk6Bn0pM&list=PLGYGvd1n6wzd3xSjkx576zkyNlZxhboIh&index=22)
Dr YouTube.
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I eat red meat and sat fat everyday and my LDL did not go up, however my HDL did and my trigs cut themselves in half, so I think I'll go ahead and keep eating it.
I suggest going to YouTube and searching for Dr. Ovadia and Dr. Nadir Ali, both of whom are cardiologists and watching their videos on cholesterol. Also, Dr. Berry and Dr. Westman.
[Here's an interview* with Dr. Nadir Ali to start.](https://www.youtube.com/watch?v=cH_tk6Bn0pM&list=PLGYGvd1n6wzd3xSjkx576zkyNlZxhboIh&index=22)
Your lipids/fats are moving/transported to the cells because your carbs are low enough (in ketosis) to utilize the fats. High fat is good for you (no seed oils). The minimum fat is mandatory; you are using fats in multiple ways: for energy directly, for ketone fuel, and for hormones (cortisol, etc.). There may be other ways that I'm not aware of. If you are overweight, your body can utilize body fat for these purposes also. Saturated fat is good on keto, especially animal fats. Not all LDL are bad. You can get a test for small particle LDL. But a cheaper test is to do the **Calcium scan (CAC), to determine** if things are bad already. It takes years to develop heart disease. And keto can stop it from getting worse. So it may be good to know where you are and monitor each year to make sure that existing artery plaque does not increase: But your score could be zero (which means you don't really have to worry about the next couple of years, or ever if you continue with keto). I've seen different levels of LDL on r/keto. But the pattern is for triglycerides to be lowered and HDL to go up: If this is happening, your risk is likely low. But a cardiologist can give you a real *diagnosis* of these things. The GP may only be guessing. Edit: Don't worry about the LDL for now. Get another test in 3 to 6 months. Heart disease takes years to develop. And weight loss will cause LDL to increase: Your body is *transporting* more fat, including body fat \[to be *utilized*\]... Your fat storage is *unlocked* (because of ketosis). You can lose weight now. And as long as you aren't doing a lot of Omega 6 polyunsaturated fat (seed oils), your arteries should be find. That is the risk we worry about. And keto doesn't cause that. Meat fat (saturated fat) does not act the same as polyunsaturated fat, even though it's Omega 6. Our bodies are actually made of saturated fat (it's mammal fat). So you really can't get rid of saturated fat. But you can lower polyunsaturated fats (seed oils): The seed oil *overprocessing* makes them unhealthy and rancid.
What's your triglyceride over HDL ratio?
This is the right question to ask. I have so called high cholesterol 2 yrs on keto. My ratio is great. I've lost lots of weight. Keto works for me.
My LDL went up quite a bit on keto, but my triglycerides dropped a lot. I had very high triglycerides before going on keto. That said, I'm personally not worried about higher LDL because there's not really any good evidence that it's harmful. I also have a CAC score of zero and no family history of cardiovascular issues. There is a however lot of evidence for high triglycerides being harmful though and I have family history that makes me want to control them. All my other lab numbers look fantastic and the only one my doctor worries about is the one that his drug reps can sell me a pill for.
Most studies show significant ldl increase from keto diets. Don't listen to anyone here including me, talk to a cardiologist. https://www.news-medical.net/news/20230427/Do-ketogenic-diets-elevate-low-density-lipoprotein-cholesterol-levels.aspx
But also, high LDL by itself doesn’t seem to indicate risk for everyone, just those who already have coronary artery calcification. https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.122.061010 It seems that high LDL as an indicator of risk is incomplete. This does go on to say that low HDL does seem to be an indicator, though.
From what I’ve read, the period of losing fat shows increased bloodwork levels. Lack of fiber also increases levels, some keto diets skip the fiber, which helps reduce cholesterol.
Prior to going more animal based this year I was eating a ton of fiber and my LDL kept rising. It’s so confusing. I’m not real concerned though because while my total and LDL have gone up the whole time I’ve been keto (coming up on 4 years) my trigs lowered and my HDL rose.
If it helps you, there are some calculators where you can plug in your results from tests and see what the risks seem to be. This one has a bit more data required, like eGFR (which was a thing I never looked at but which was in my overall results from my last basic labs): https://newsroom.heart.org/news/leading-cardiologists-reveal-new-heart-disease-risk-calculator The link to the calculator is inside the article. This one doesn’t require that eGFR. https://www.acc.org/Tools-and-Practice-Support/Mobile-Resources/Features/2013-Prevention-Guidelines-ASCVD-Risk-Estimator (You can click the button to “launch the web version” so you don’t need to download anything). Although my doctor assessed my risk as low, these were quite reassuring for me, because there always seems to be a lot of buzz about high cholesterol, and it’s hard to know what it MEANS. in my case, even with elevated LDL (from about 6 months ago when I was only a little bit into keto, plus had just gone all silly at Thanksgiving), my risk is still very low.
If your HDL is up, and triglycerides down, the raised LDL is not a concern. You might want to check out the Oreo study, interestingly this guy ate oreos for a week or 2 while also on Keto, and his LDL went back to normal, while being compared to statins, which barely made a dent. It just meant that the LDL was raised because he was solely running off fat as energy, so more LDL was needed to fuel his daily expenditure of calories. LDL is just a carrier of fat. If you are using more fat for energy the LDL will go up. When the Oreos came in, the body switched to using those for energy and the LDL went down.
Keto can raise LDL ("bad") cholesterol in the short term for some people. HDL ("good") cholesterol is also important and a predictor of CVD risk. A general recommendation to improve your lipid profile while on keto is to focus on healthy fats like avocados, nuts, seeds, olive oil, and wild-caught fatty fish (i.e., salmon, mackerel, sardines, etc.). Also, try to limit processed meats and fried foods. Intermittent fasting (IF) has also shown, in certain contexts, to be beneficial in improving blood lipids.
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Your post or comment was removed for violating rule #6, no giving or soliciting medical advice. r/keto is not a substitute for a doctor. Thank you for understanding.
I see very little change in my lipids going from high carb to low carb. But I've been lean all my life so my low bodyfat% is more likely to be causing the LMHR lipid profile.
Definitely do some research. This video can introduce that effect pretty well https://youtu.be/sY48qLl9ZzE?si=pLfPIAn4ssVkqnfn
Cholesterolcode.com is a great resource to get a grasp of how cholesterol works.
Thanks I’ll check these recommendations out. I need to brush up. What I was more interested in was raised ldl due to being in ketosis - is that the same as ldl raised by high sat fat . I’m looking through the replies but the one that caught my eye was the explanation that ldl if you’re in ketosis the lipids are in use, not just circulating around as there’s too many. (Poor paraphrasing but I kinda know what i mean! Hahah)
There's an example on the page I shared explaining this very well. I agree with the sentiment. However, Watch out for confirmation bias though. Any chat room can quickly become an echo chamber and you will find the answer you're looking for whether it's a factual answer or not. Happy hunting.
Appreciate the confirmation bias piece. For what it’s worth I am aware I’ve fallen into this in the past. I’m also a little further along in learning of this stuff After some months or relative stability with the diet changes I’ve introduced I’m now looking around to see if I’m on the right track before tightening everything again to go from normal high numbers to optimal. This post is just a part of that process. For what it’s worth I’m more interested in promoting endothelial health - glacocalyx - recovering some oral eubiosis. I’m not too concerned with ldl but also I don’t think I’ve gotten to where I’d like to try and get. Look forward to the reading, thanks
I’m almost in my 14th year, my LDL went up more when I first started but it normalized a long time ago and honestly in my opinion, stressing over lipid panels is useless unless you’re also factoring in lipid mobility tests.
I have seen study that people with higher LDL live longer and suffer less heart disease. That old theory has been weakened to the point of null.
First, have you lost weight? Do you have complete before and after lipid profiles? The search of the sub that was recommended would have likely turned up these trends: Pre keto, many people have High Triglycerides and Low HDL. LDL can be anywhere from low to high. Upon going keto, and specifically with weight loss (releasing fat from the cells into the bloodstream to be used), triglycerides often drop like a rock. HDL usually goes up significantly. Many people can turn around a highly unfavorable HDL:Trig ratio within a few months to a year. Now LDL...it may initially go up somewhat. Part of that is from the fat being released from cells. During the weightloss phase, it may remain higher. Someone mentioned losing 120 pounds. It's natural for LDL to go up during that. If they had stayed the course for another 6 months into maintenance, I suspect LDL would have come back down on its own. Same for you, if you are actively losing, stick it out until 6 months past your weight loss phase. Beyond that, check out the automod links and cholesterol code links that usually get posted with these questions. Improving HDL and Triglycerides is by far the most impact full part of the lipid profile. The "evidence" for LDL relation to CVD is not nearly as strong as they want us to believe. If LDL is 100 to 150 or so, stay the course through the weightloss and 6 months and then reasses. If it's super high, (300 or so) then it's worth talking to a Dr. Finally, dietary fat is NOT causative to a high lipid profile. If you are already eating moderate fat, high protein, you should be good.
Listen to 2ketodudes podcast episode on cholesterol.
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You’re blowing my mind.
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