One of the individuals' most common reservations about starting a ketogenic diet is that it may result in dangerously high cholesterol. Or, more particularly, that eating a higher-fat diet raises serum cholesterol, increasing your chance of getting heart disease. This article separates reality from myth, showing why this fear is frequently misguided and how eating a higher-fat diet may lower your bad cholesterol and risk several forms of heart disease.

What is Cholesterol, and What Role Does it Play in the Body?

Cholesterol comprises a few different types of fatty compounds produced by the body and present in various foods. It is necessary for healthy homeostasis (the regular functioning of the human body and its cellular structures) since the body uses it for different natural processes, including forming cell walls, synthesizing vitamin D, and producing various hormones. Without cholesterol, the body would be incapable of adequate cellular growth and intercellular communication.

But, as anybody with a lipid panel test can tell you, not all cholesterol is created equal.

How to Interpret Lipid Panel Test Results

The body produces and uses a variety of distinct forms of cholesterol. The ones you hear about the most are those covered in a standard lipid (cholesterol) profile, which we shall go through below.

The following are the major components of a lipid panel lab test:

• Triglycerides
• High-density lipoprotein (HDL)
• Low-density lipoprotein (LDL)
• Total Cholesterol (this includes both LDL and HDL cholesterol)

Triglycerides

Though triglycerides are directly regulated by carbohydrate intake and have no relationship with dietary fat consumption, they are also commonly connected with higher body fat percentages, particularly in those who carry most of their fat in the abdomen. High levels of triglycerides have been linked to the development and worsening of coronary artery disease in studies that look at prognostic data (the long-term risk of bad outcomes). A ketogenic diet usually has a good effect on lowering triglycerides since it drastically reduces carbohydrate consumption. Triglyceride levels should be kept around 150, preferably under 90.

HDL

HDL (high-density lipoprotein), sometimes known as "good" cholesterol, has been linked to a lower risk of coronary atherosclerosis (heart disease) and hence has been linked to a lower risk of heart attack and stroke. The optimal HDL range is usually about 60, although anything above 40 is acceptable. (1)

LDL

LDL (low-density lipoprotein) is the lipid component responsible for heart disease, strokes, and other disorders associated with atherosclerosis throughout the body. A normal LDL is less than 130, whereas the optimum is less than 100. If you have previously been diagnosed with cardiovascular disease or diabetes, your cardiologist would most likely want you to keep your number below 70. However, not all LDL is made equal. We'll get there in a second. (2)

Total Cholesterol

Because total cholesterol comprises HDL and LDL, evaluating whether you are at risk for cardiovascular disease or if your "bad" cholesterol is too high is rather unhelpful. However, most healthcare organizations recommend keeping acceptable cholesterol levels below 200. (That was lowered from 300 in 1996 when lipid-lowering drugs like statins came to the market). Unfortunately, by reducing that value, cardiovascular outcomes have improved.

The critical components of a typical lipid panel are listed above. However, this is only part of the picture. Most lipid panels exclude VLDL (very low-density lipoprotein) and do not distinguish between the two basic sizes of LDL particles. (large and small particles). What is the significance of this? Because particle size is essential.

Size Matters with LDL Particles

Identifying the size of LDL particles allows for a more accurate risk assessment for atherosclerosis. (a disease in which plaque builds up inside your arteries). This is because big particle LDL has not been linked to the development of coronary artery disease, but tiny particle LDL has a significant link.

Why isn't the size of LDL particles measured and discussed? The most reasonable argument is expense; evaluating several forms of LDL may be costly. The common wisdom holds that reducing overall LDL will reduce small-particle concentrations, reducing your risk of coronary disease. Patients with well-controlled lipid panels on statin medication and serum-LDL concentrations less than 70, on the other hand, continue to develop and aggravate pre-existing coronary artery disease.

To begin, it is crucial to understand that the body generates 80 percent of the cholesterol in the average human body and is not changed by food consumption, including dietary fat. The remaining 20% may be altered by dietary fat and other macronutrients such as carbs. We establish the distinction of a "normal human body" since it may not apply to those with congenital hypercholesterolemia. (a disorder that causes LDL levels to be very high).

People with this diagnosis have fewer cholesterol receptors and, as a result, more free-floating cholesterol in their circulation. Because there are fewer receptors, the body believes it receives less cholesterol than it requires, producing more cholesterol. (even if your levels are typical). This becomes troublesome since most people with hypercholesterolemia do not burn off this cholesterol, owing to their systems' reliance on eating carbs rather than dietary fat for energy. Dietary choices will have a more significant effect on serum cholesterol in these people. On the other hand, an individual with normally functioning cholesterol receptors would not have their blood cholesterol level altered by increased dietary fat consumption, especially if that individual follows a lower-carbohydrate diet focused on utilizing lipids for energy.

Hyperlipidemia (an excessively high concentration of fats or lipids in the blood) can also be caused by other causes such as steroids, exogenous hormones, other drugs, impaired thyroid function, and renal disease. And fructose is a leading cause of fatty liver disease and excessive triglycerides.

Keto vs. Low Fat

Some studies have been conducted to evaluate the ketogenic diet as a low-fat diet for weight reduction and diabetes management. Triglycerides were consistently reduced in the ketogenic group but not in the low-fat group in these investigations. In addition, there was a more significant improvement in HDL (good cholesterol) compared to the low-fat group. When particle size was considered, the ketogenic group nearly always showed a more substantial reduction in small particle LDL linked to an increased risk of heart disease or stroke. (3)

Facts vs. Fiction

To conclude, selecting the section of the lipid panel we focus on is critical. The emphasis should be on triglycerides and HDL, and studies demonstrate that a low-carb ketogenic diet improves cholesterol by reducing triglycerides and boosting HDL. Lower small particle LDL (associated with heart disease) and more excellent considerable particle LDL cholesterol often offset slightly increased LDL cholesterol. (not associated with heart disease).

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