A real look at Keto and Cholesterol

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A real look at Keto and Cholesterol

When someone is starting keto or contemplating starting, a concern is almost always cholesterol, saturated fat, and heart disease.  So I wanted to spend some time and take a real look at keto and cholesterol.

It is generally true that the amount of saturated fats that you will consume when starting keto is likely to be higher than what it was before.  But does that really matter?

So I think it is worth taking a moment and clearing up a few things first.

What is Cholesterol?

Let's start with the basics. Cholesterol is essential for life and helps the body. Period. It helps make cell membranes, vitamin D, and quite a few hormones [3].

Cholesterol is made in the body and also comes from the diet. Did you know that 75-85% of the cholesterol in your body is produced by the body and the other 15-25% is from your diet?

Most people talk about Total Cholesterol, HDL, and LDL.  In short, HDL is the good stuff and LDL is the “bad” stuff, or at least that is what we are told. Most people don't understand what HDL or LDL even is. In short, cholesterol is carried around the bloodstream in lipoproteins. These lipoproteins are the HDL and LDL. LDL shuttles the cholesterol to place in the body and HDL shuttles it back to the liver.

While the terms LDL and cholesterol or HDL and cholesterol are used interchangeably, the fact is that LDL and HDL are not cholesterol, but carriers of cholesterol.

The current thinking is this - there are large particle and small particle LDL. The difference is that the small ones are supposedly the yucky, sticky ones that can clog up the pipes.  There is a bit of debate on this - but at the end of the day, these are lipoproteins, not cholesterol. So LDL should not be called "bad cholesterol". If you want to call it bad, then call it a bad lipoprotein.

Now, there are studies out there that can show an (albeit weak) short-term association between saturated fat and raised cholesterol whereas it is much harder to show an association in longer-term studies

Saturated fat

Now let's talk about saturated fat. Saturated fat is the fat primarily found in animal sources. And it is thought to increase the "bad" cholesterol (perhaps they mean the lipoprotein here).

Back in the day, there was a battle between sugar and fat and sugar "won".  I use that term loosely, by the way.  It was "shown" that saturated fats contributed to heart disease. 

The government told Americans that they should decrease saturated fats in their diets. So, what happened?  We listened!  We decreased fats and replaced them with trans fats (oops - we all know what a tragic mistake this was) and crap carbs 

The result?  A huge rise in obesity, Type 2 Diabetes, and heart diseases. 

According to a 2010 study, "... studies showed that there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD"  (CHD -> Coronary Heart Disease, CVD -> Cardiovascular Disease).

Keto and Cholesterol

As we talked about, most people eworry about keto and cholesterol.  I also hear these things as well as that there will be an initial rise, but it will settle down over time.

I wanted to show MY cholesterol numbers 3 months after going Keto and then 6 months after going keto.  I do not have pre-keto numbers, but I can tell you that my pre-keto cholesterol has never been flagged as high.

Keto + 3 months

I have to say that when I got these results back, I did panic just a bit. But I knew a lot less back then.

Luckily I know better now. My total cholesterol was high, HDL was fine, LDL was high, and non HDL was high.

Back then, my first thought was perhaps I was consuming too much saturated fat?  No, no, no.  I had to keep telling myself not to get caught up in the numbers and agenda, and instead, rely on what I know.  This is the typical "raise" after starting keto. And did it really matter?

Just be patient.  Wait 3 months.  

Keto + 6 months

Whew....  check out these beauties as compared to their data rages!  Now, the 102 was flagged, but let's dive a little deeper.  Under 100 is considered OPTIMAL.  100-129 is considered "near optimal".  So, I'm cool! 

My naturopath said she'd be happy to do the test to break down particle size and I said "No need". But I want you to see how my cholesterol is pretty perfect.  AFTER a short-term rise,  a TEMPORARY rise.

What does this all mean?

Don't always believe the stories.  Don't believe the scare tactics. Have your cholesterol taken before keto, at 3 months and at 6 months to put your mind at ease if you need to. I hope that a real look at my personal cholesterol numbers will put things into perspective for you.


[1] https://www.ncbi.nlm.nih.gov/pubmed/20071648 https://www.healthline.com/nutrition/top-9-biggest-lies-about-dietary-fat-and-cholesterol 

[2] https://www.hopkinsmedicine.org/health/conditions-and-diseases/high-cholesterol/cholesterol-in-the-blood

[3] https://www.zoeharcombe.com/2022/05/a-new-look-at-statins-ldl-cholesterol-cvd/

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