You may be wondering if keto is right for you considering all the health hubbub it gets. But, you may have also heard keto can increase your LDL! If you have diabetes or a heart condition, an elevated LDL reading may be of particular concern to you. The keto diet does raise LDL for some people, but this may not always be a bad thing.
At-home testing can be a great way to keep an eye on what your LDL levels are doing while on a keto diet. If you find your LDL is rising, there are steps you can take to help lower it.
In brief
- The keto diet has been associated with a significantly elevated LDL in some people
- High LDL can be problematic in some instances, but in others, it is totally fine
- There are heart-healthy ways to lower LDL if needed
- At-home lab testing can help keep you and your LDL levels on track
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The low-down on LDL
To understand LDL, we first have to understand cholesterol:
Snapshot: Cholesterol is a substance either made by your liver or found in your diet in animal foods (like milk or butter). Your body NEEDS cholesterol; you wouldn’t survive without it! You use this waxy compound to keep your cells from falling apart and it plays a huge role in the creation of other substances, including hormones, bile acids, and vitamin D.
In order to serve these functions throughout your body, cholesterol needs to be transported by another molecule because it can’t travel on its own; this is where LDL and HDL come in.
So, what is LDL, in 60 seconds?
HDL and LDL are proteins that carry cholesterol through your blood. LDL simply stands for Low Density Lipoprotein and HDL is High Density Lipoprotein (much easier to say LDL and HDL, agreed?). HDL and LDL latch on to cholesterol to transport it through your blood to be used throughout your body.
To get specific, HDL carries cholesterol in your body back to your liver where it can be broken down and removed. A majority of the cholesterol in your body, however, is circulating as LDL.
LDL has developed the reputation as the ‘bad’ cholesterol while HDL wears the halo of being the ‘good’ cholesterol. This is mainly because higher levels of serum LDL have been linked with an increased risk for illnesses like heart disease and stroke. HDL, on the other hand, actively carries LDL particles back to your liver, helping to reduce the chances LDL will get up to no good.
The reason LDL is associated with a higher risk for heart issues is it contributes to buildup of plaque in your arteries. This build-up can be particularly problematic in and around the heart as it can narrow blood pathways. If your heart isn’t getting enough oxygen through the blood, you may experience chest pain (angina) or a heart attack!
What’s considered ‘normal’ for LDL levels?
Not everyone needs to pay attention to their LDL levels. But, if you know you’re at risk for heart issues (maybe great Uncle Joe had a heart attack one time), it can be a good idea to get tested regularly. Also, if you’re doing the keto diet, you might want to get your levels checked since it can raise LDL; we’ll talk more about that later.
As with any biomarker, there are optimal and suboptimal levels your LDL could be at:
| LDL Cholesterol Level | Category |
| < 100 mg/dL | Optimal |
| 100-129 mg/dL | Near optimal |
| 130-159 mg/dL | Borderline high |
| 160-189 mg/dL | High |
| 190 mg/dL or higher | Very high |
These parameters are general guidelines and should not be considered on their own. An LDL level of 80 mg/dL may be perfectly healthy for one person who has no serious conditions, but that same level could mean danger for a person with diabetes or heart disease.
If you have a family history of chronic disease or struggle with a chronic disease yourself, be sure to speak with your doctor when considering results from an at-home LDL test.
My LDL is higher when I’m on keto - is this normal?
While the keto diet has been shown to improve many markers for health for most people (such as improving blood sugar and insulin levels or promoting weight loss), there is a subset of people for which the keto diet worsens some markers (such as thyroid hormones). Specifically, some people see a significant climb in their LDL cholesterol.
This increase in LDL while on keto occurs frequently enough to have warranted a fair bit of research in the past decade. However, the jury is not totally out on whether or not the keto raise in LDL is bad for your health.
Okay, so keto does affect LDL, but is this bad?
For one, it is puzzling that a diet that seems to improve other markers for a healthy heart would increase levels of a substance that has historically been thought to lead to heart disease.
Research has clarified there are different types of LDL, and the type of LDL that dominates when on a keto diet may not be all that bad for your heart. Small-dense low-density lipoprotein has been linked with a higher risk of coronary heart disease while larger LDL particles are not. It is postulated by many the keto diet increases blood LDL levels, but in a manner that produces the larger particles that don’t build up on artery walls as easily.
Additionally, other research has indicated another reason blood cholesterol levels may increase on the keto diet: Keto promotes weight loss. When your body taps into your fat stores as it is going through ketosis, fat is being broken down which naturally releases cholesterol into your system!
The bottom line: You need to consider your circumstances when assessing your LDL while on the keto diet. If you have significantly elevated LDL levels, you should have your doctor assess your bloodwork to determine the particle size and to see what steps you should take next.
Is keto okay if you have a high LDL?
There is no blanket answer to this question. If you have an extremely high LDL, greater than 1000 mg/dL, for example, you should probably consider using a different diet (and also see your doctor ASAP). But, if your LDL is at 290 mg/DL, you’ve been losing weight, your HDL and triglycerides are in a healthy range, and your blood pressure is improving, the overall benefit of keto may be outweighing the potential downfalls.
Other factors that may impact LDL include age, whether or not you smoke, how physically active you are, how much you weigh, your gender, your family history, and what medications you’re on. With so many potential variables, it is clear everybody is different when it comes to measuring LDL; therefore it is important to consider your personalized health goals, diet choices, lifestyle, and lab results.
Heart-healthy ways to lower LDL while on keto
If your LDL is high while doing keto, there are some natural steps you can take to help lower it:
- Pay attention to the fats you’re eating. While a large portion of your calories will come from fat while on keto, this does not mean you should not use discretion with what types of fat you’re eating. Try to get more unsaturated fats in your diet, such as from seeds, nuts, avocados, and virgin oils. Don’t lean on saturated fats, like beef fat or full-fat dairy, as the foundation of your diet, and stay far, far away from trans fats.
- Keep your fiber intake up. This can be tricky while on the keto diet as many carb-rich foods are also fiber-rich. Soluble fiber in particular has been linked with helping to decrease LDL cholesterol. Foods like kidney beans, oatmeal, Brussels sprouts, and apples are high in soluble fiber and can fit well with your keto eating plan.
- Consider sterol- or stanol-fortified foods. For example, there are juices fortified with sterols and stanols. These are plant-based compounds that seem to be able to inhibit absorption of LDL cholesterol while having little to no effect on HDL cholesterol or triglycerides. According to the Mayo Clinic, ‘adding 2 grams of sterol to your diet every day can lower your LDL cholesterol by 5 to 15 percent’ - science is so cool.
- Consider weight loss. The simple truth is, higher weight can be linked to adverse health effects. Speak with a dietitian or your doctor to see if weight loss could help improve your LDL levels. If it turns out weight loss may help improve your LDL, give it a shot! You could work with a dietitian to find a meal plan that’s right for your goals, or try incorporating some enjoyable physical activity to your schedule more often.
Test your LDL and cholesterol levels from home
If you’re trying a new diet, what better way to see its impact than to do an at-home lab test? Skip the lines at the lab center, and forget about waiting for your doctor to call you to discuss your results. Take action on your diet based on personal lab results.
A cholesterol and lipids test can give you insight as to what your LDL is doing while on keto, and other tests can tell you if you’re deficient in other nutrients, while you’re at it.
Discover your LDL is creeping up after a couple of months of testing? Try to get more of your fats from unsaturated fats, or incorporate some plant stanols in your diet to see how these changes impact your LDL. Find a lifestyle plan that works for YOU and helps keep your LDL right where you want it.
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