Heart Healthy Keto

Many people have turned to the ketogenic diet, or “keto,” for weight loss and other health benefits. But a new study warns that this popular diet may promote heart disease risk factors, including a rise in “bad” cholesterol levels.

The keto diet can boost blood sugar and triglycerides, and lead to a spike in LDL cholesterol, experts say. The diet also may interfere with some heart patients’ medications.

1. Limit Saturated Fat

Many people who follow a keto diet worry that the high fat content will lead to heart disease. The truth is that the type of fats in your diet matters more than whether or not you eat them, and reducing certain types of fats can improve your heart health.

The key is to limit saturated fat, which is found primarily in animal products, such as milk, eggs, and meats. In contrast, unsaturated fats, which include monounsaturated and polyunsaturated oils, are generally considered healthy. These fats have fewer hydrogen atoms attached to their carbon chains, and they remain liquid or semi-liquid at room temperature.

A ketogenic diet typically provides 55% to 60% of a person’s calories from fat, and some sources of these fats are particularly heart-healthy. You can find these in olive oil, avocado oil, seeds, and nuts. In addition, ghee, tallow, and coconut oil are excellent cooking fats because they have high heat resistance (as indicated by their smoke point).

However, it’s important to avoid processed vegetable oils that contain linoleic acid, which is an omega-6 polyunsaturated fat that’s been linked to increased inflammation, obesity, and cardiovascular disease. Instead, choose high-quality, organic vegetable oils that have a low smoking point.

It’s also important to avoid trans fats, which are found in commercially-prepared foods and may be listed on the ingredient list as partially hydrogenated oils or shortening. These have been linked to increased cholesterol levels and can significantly increase heart disease risk.

When it comes to limiting saturated fat, the evidence is not clear-cut, and for most people, it’s better to limit processed foods that contain these fats. However, the ketogenic diet is generally safe for most people when it’s followed in moderation and if the right types of fats are consumed. The fatty acids in the ketogenic diet are unique and provide a variety of benefits, including improved cholesterol levels and triglyceride levels. And the ketone bodies produced during ketosis can help to reduce inflammation in the body. These effects are likely in part due to the way that these fatty acids and ketone bodies interact with the gut microbiome.

2. Get Enough Fiber

Fiber is a carb, but it’s one that does your body a lot of good. It helps prevent constipation, lowers blood sugar, reduces triglycerides and makes you feel fuller. It also boosts gut health and has a role in lowering your risk of heart disease, diabetes and obesity.

The problem is, the keto diet is so low in carbohydrates, it can be hard to get enough of this essential nutrient. That’s because the goal of keto is to reach a state of ketosis, which requires cutting out almost all carbohydrates so your body generates energy using fat instead of carb-created glucose.

If you’re following the keto diet to lose weight, boost your gut health or improve your heart health, it’s important to find a balance between the protein and healthy fats you’re eating, and the carbohydrates and other nutrients you need from fruits, vegetables and whole grains.

A good place to start is with your vegetables, which are an excellent source of soluble and insoluble fiber. Non-starchy veggies like broccoli, cauliflower, carrots and zucchini are a great choice. They’re rich in nutrients and contain fewer carbohydrates than most other vegetables. You can also add leafy greens, such as kale and spinach, to your diet for a heart-healthy dose of fiber.

Fruits are another excellent source of fiber and offer a variety of vitamins and minerals, including vitamin C, potassium and folate. A cup of berries offers 3 grams of fiber and can help you meet your daily vitamin C requirement. Some berries may be better for you than others, so be sure to read nutrition labels and choose the ones with the lowest sugar content.

Nuts and seeds can also be a good source of fiber, but remember to keep your serving size in check. One ounce of pistachios, for example, provides almost 3 grams of fiber, as well as healthy fats and plant-based proteins. You can also try avocados, which provide both a healthy dose of fiber and omega-3 fatty acids. Lastly, don’t forget to include some carbs from healthy sources, such as coffee and tea.

3. Keep Your Cholesterol in Check

While the keto diet does have many heart-healthy benefits, it can also raise cholesterol levels, especially in those who are already at risk of cardiovascular disease. However, it’s important to understand that the way a person’s cholesterol level responds to keto is highly individual and dependent on a variety of factors.

First, the cholesterol-raising effect of a low carb diet is related to the types of fats you’re eating. The saturated fats found in red meat, processed foods and fast food can lead to elevated LDL (bad) cholesterol levels, which promote atherosclerosis and heart disease. In contrast, monounsaturated and polyunsaturated fats, which are typically consumed on a keto diet, can help lower cholesterol levels by reducing triglycerides and improving HDL (good) cholesterol. Examples of these healthy fats can be found in avocados, olive oil, nuts and nut butters, eggs and some fish.

Another factor that influences cholesterol is the liver’s ability to process it. This can be affected by a number of things, including genetics and the type and amount of medication a person takes. It can also be impacted by diet and lifestyle, such as weight loss, avoiding alcoholic beverages, incorporating more fiber and whole grains into the diet, exercising regularly, and taking bile salts or choline supplements to support liver function.

While total cholesterol levels may increase for some people on a keto diet, it’s important to remember that other markers of heart health improve as well. For example, a study published in Nutrition & Metabolism found that a 24-week Ketogenic diet led to significant weight loss, reduced blood sugar and triglycerides and increased HDL cholesterol in 83 obese individuals. All of these changes are positive for heart health.

Those who are on medications that control blood pressure, blood sugar or cholesterol should talk to their doctor before going on a keto diet. This is to make sure they don’t experience any side effects from the diet or have any other underlying conditions that could be negatively impacted.

It’s also a good idea to check in with your doctor periodically during your keto journey. They can assess your progress and help you determine if any adjustments need to be made.

4. Eat More Healthy Fats

The keto diet is all about fat, with up to 75 percent of calories coming from healthy fats and about five percent from carbohydrates. The goal is to prompt the body into a state known as “ketosis,” where it will burn fat for energy instead of sugar. It’s a popular weight loss diet, but it also has some heart-healthy benefits.

It’s important to note that the heart-healthy benefits of the keto diet are tied to the type of fats a person consumes, not the amount. Generally speaking, the more unsaturated fats a person eats, the better their cholesterol profile will be. Saturated fats, on the other hand, tend to raise LDL cholesterol, which is linked with heart disease and stroke.

A person following the keto diet can choose from a variety of healthy, heart-healthy sources for fat, including nut butters (like almond and walnut), avocados, seeds, tofu, olive oil, and low-saturated dairy products. It is possible to overdo the fat on a keto diet, however. “You can quickly eat an excessive amount of unhealthy fat on the keto diet if you’re not careful,” says nutritionist Kendra Whitmire, RD.

Many people who follow the keto diet rely on meat products to reach their fat and protein goals, which can have downsides for cardiovascular health. For one, meats are often cooked at high temperatures, which can produce carcinogens. Plus, red meat can be high in saturated fat and cholesterol.

Despite these concerns, the keto diet has shown some benefits for heart patients, like reducing blood sugar and triglycerides, says Michigan Medicine dietician Susan Ryskamp. However, she suggests that anyone with heart failure talk to their doctor before making any major changes to their diet.

That’s because some people may find that the keto diet increases their cholesterol levels, which can be harmful for those with heart disease. It’s also a good idea to periodically check your biomarkers—like cholesterol, blood pressure and blood glucose—under the guidance of a medical professional. That way you can keep your heart in tip-top shape.