Is it possible to be on keto and not have high cholesterol?

(Sonia) #1

This might be a bad place to post since I know cholesterol means nothing BUT studies have been wrong before so I have that 1% doubt what if drs are right and high ldl is not good for you??

So here are my results. I’ve been on keto for 2.5 years. Last year ldl was 171 and this year 214. Dr asked me to make some changes to diet. Any suggestions? I’m thinking 2 days I’ll be veg keto. Cut down on the coffee and processed foods. This might be a blessing in disguise since I’ve been wanting to do clean keto for a while.

Any advice? Thoughts?

(Bacon by any other name would taste just as great.) #2

I’m not sure what your problem is, given that your ratio of triglycerides to HDL is 1.26. Clearly, your risk of cardiovascular disease is minimal. A lipid panel using NMR would show a healthy Pattern A, and a CAC scan is likely to show a risk of 0.

As far as your LDL reading is concerned, I would say that since several large, government-funded studies have shown a negative correlation between LDL and cardiovascular risk, whatever the cause of cardiovascular disease may be, it cannot be LDL. While a positive correlation between A and B does not constitute proof that A causes B, a negative correlation is definitely proof that A is not the cause of B.

(Todd Allen) #3

Cutting out processed foods is probably a good idea but I would not expect it to lower cholesterol. There are plenty of people in the LMHR (lean mass hyper responders) who aren’t eating processed foods with LDL double and even triple yours. Among the LMHRs the factors associated with elevated LDL are having low body fat %, having higher muscle mass and diets rich in animal fat.

Interventional trials are considered the best evidence of causality and the biggest, longest and best controlled interventional trial I’m aware of which lowered LDL through diet by swapping in plant sourced PUFAs for animal sourced SAFAs, the Minnesota Coronary Experiment, increased morbidity and mortality.

Recovery of unpublished data could shift the evidence base
Only a handful of randomized controlled trials have ever causally tested the traditional diet-heart hypothesis. The results for two of these trials were not fully reported. Our recovery and 2013 publication of previously unpublished data from the Sydney Diet Heart Study (SDHS, 1966-73) belatedly showed that replacement of saturated fat with vegetable oil rich in linoleic acid significantly increased the risks of death from coronary heart disease and all causes, despite lowering serum cholesterol. 14 Our recovery of unpublished documents and raw data from another diet-heart trial, the Minnesota Coronary Experiment, provided us with an opportunity to further evaluate this issue.


100% Incorrect, that’s just keto dogma. It’s true blind lab ranges and prescribing statins just because you hit 200 is rediculous, but “means nothing?” No, sorry.

Answer however is yes, most don’t have high cholesterol. Some people claim they’re LMHR’s, some people put a stick of butter on everything they eat and chug bacon grease while looking for new an inventive reasons to fat-ify everything that goes into their mouth hole. In my opinion, those are typically the ones with those issues from what I’ve seen here and other places.

Do you track your macros? Do you know how much fat you’re even eating? Do you intentnially put fat everywhere?

That won’t do anything, you need to look at your diet as a whole. How would you summarize how you eat?

This was my last Cholesterol test while still eating strict keto, just had my yearly checkup literally yesterday and since I got lucky and I have a DO, she only does NMR’s now so that’ll be interesting to see how everything has changed. Hopefully I got the HDL up a bit.

(Sonia) #5

I eat a lot of eggs. 3-4 eggs for breakfast/lunch a day. 2/3 coffee a day with splash of heavy cream. I cook in olive oil. Butter I use very limited. Bacon I eat once a month. I do eat sausage about twice a week. Lamb once a week. Chicken rest of the time. I was going to try to cut out sausage and salami (I eat salami and cheese roll ups about 3 times a week as snack).

I also have started eating recently keto snacks once or twice a day, which I’m going to try to stop.

I don’t track anymore. I have been maintaining now for about a year.

(Michael - When reality fails to meet expectations, the problem is not reality.) #6

If you want to lower your LDL eat more carbs - like @lfod14 tells us he does. Dave Feldman says the same thing here:

LDL is a transport molecule that delivers fatty acids to the cells that use it. When you’re using fatty acids and ketones for your primary fuel source, you’re naturally going to have more LDL transporting the fat to where it’s needed. Is it a problem? If you can change it significantly in a couple of days with the Feldman Protocol, I seriously doubt it.

(Jane) #7

BS. It’s genetics. My husband and I have basically the same diet. Neither of us chugs butter or bacon grease. Similar exercise/activity level.

His cholesterol is in the 170’s, mine in the 240’s. He envies my low blood pressure. My CAC was 0. His was 110.

But he can eat twice the carbs as me and not gain weight.


I never claimed genetics didn’t play a role, But 170’s and 240’s are both fine and normal IMO and really not what I’m talking about. I’m talking about the people that go keto and go from normal ranges into the 300’s+ and stay there.

From what I’ve seen most of the time these people can’t tell you what they’re eating, they just see a number and start playing with things with zero clue whether they’re actually doing it themselves or not. Then if they learn of a LMHR then automatically that becomes their issue and that what the problem is without any type of troubleshooting to actually confirm it.


I’d start again then, if you start playing with your diet, especially after not tracking for a while and you do change stuff you’re really not going to know why. Trying to remember a coupe less salami and cheese rollups won’t really be a telling store. Then you can see a real breakdown and graph the trends to see exactly what made the impact, which clearly makes planning the future of your diet much easier.

(Vic) #10

@Imcoolsoni My lipids are practically copy of yours.

I’m proud of it.
Shure, the totals are up. I don’t care. Ratio is good.

(Bob M) #11

I actually think you have great numbers.

And I don’t believe “saturated fat” leads to high cholesterol.

There may be a certain genetic component, some percentage of the population where this MIGHT be true. But I don’t think the evidence is there to suggest it’s a bad thing.

In fact, there’s a theory that high LDL is good.

I would LOVE to have your results. Many epi studies suggest that low TC/LDL is bad. That’s what I have. (Though with all epi studies, it’s hard to know what to do with this information.)

I can eat a very high saturated fat diet, with little to no effect on my TC/LDL.

What makes my LDL go up? Fasting multiple days. That’s about it.

I think what might be happening in these population studies is that oils and chemicals from plants contain substances that cause LDL to go down. So, when you eat more “saturated fat” (really, a word that means “meat”), you’re not seeing TC/LDL go up, you’re eating less plant matter, which means these are not driving TC/LDL down.

That’s my theory.

(Jane) #12

Fortunately we have a PCP who also thinks our cholesterol numbers are fine.


Twice I have been on diets in which I was eating several eggs daily. The first time was a low carb diet (but not keto) and I stopped immediately after that very first, high cholesterol reading. My cholesterol troubles ended and I was back into the normal ranges after that and were actually low previously. My next high reading was about 6 months into keto. Again I was eating several eggs a day and so I stopped that since it worked last time. I still eat several eggs on the weekends and I feel free to add them to meals when they are called for. I don’t avoid them but they are not the source of my protein on most days. Again, my cholesterol is now in the normal range. I was once told, on here, that I was wrong and eggs don’t do that to a body. However, if it doesn’t cost anything to give it a try, why not? I have ended up intermittent fasting and just skipping to lunch.

(Bob M) #14

@P_Bash Supposedly, a very few people do react to eggs that way. It’s very small percentage of people, though.

But before I believe that’s happening to you, I’d need to see better data. I’d need you to count calories for at least 1 week and not eat eggs, keeping basically the same meals. Get a test at the end of that. Then I’d like for you to eat 6+ eggs a day, same calories, meals exactly the same otherwise. (You’d obviously have to eat less of something to make up the cals for the eggs.) Get a test. Compare.

Ensure you keep exercise, fasting, and anything else the same, as much as you can.

Without that, there are too many variables.

Here’s an example:


Took the test on 10/31/16, and got way higher trigs and fasting insulin (not shown) than I anticipated. Went on vacation to San Francisco, came back and got another test on 11/14/16, about two weeks later. Note the dramatic differences, and for reasons I don’t understand.

I theorize that the high values for this were due to a lot of fasting just recently before this…but then I also got a very high fasting insulin. Which goes against my theory, as insulin goes down when fasting. Though I wonder if there’s a “rebound” effect with insulin? In other words, you fast a lot and get insulin low, but then eat, and that causes high insulin (temporarily)?

Until we have home insulin meters, I’ll never know.

(Bacon by any other name would taste just as great.) #15

Which is why Keys had his name removed from the study, and why Franz failed to publish it for seventeen years and finally published it in an obscure journal. The re-analysis of the data tapes found in Franz’s basement by his son after his death was startling.

(Bacon by any other name would taste just as great.) #16

I’m not clear about the basis for this assertion. The studies I’ve looked at all suggest that LDL cannot possibly be the cause of cardiovascular disease. The negative correlations discovered in a number of large, well-funded studies are enough to show this, by themselves, and there is plenty of other evidence to suggest that, whatever the cause of cardiovascular disease may be, it ain’t cholesterol in any form.

(Bacon by any other name would taste just as great.) #17

Yes. The correlation of low LDL with increased cardiovascular risk and with all-cause mortality is suggestive, but it is not proof that low LDL is the cause of the problem. What the negative correlation of LDL with cardiovascular risk does prove, however, is that LDL cannot be the cause of cardiovascular disease. Because of the possible presence of confounders, no correlation can be considered to proof be of causality, but a negative correlation is proof of a lack of causality.


Actually, you can have negative confounding. For example, a medication (or food) that both lowers LDL and increases risk of CVD could overwhelm a true positive effect of LDL on CVD, making it appear that lower LDL puts you at greater risk. (Not saying I think this is happening — just that it is possible).

(Bacon by any other name would taste just as great.) #19

That’s what I was getting at. Thanks for the clarification.

(Bob M) #20

True, but there is a lot of evidence about higher LDL being better from an immune system standpoint. The theory then becomes that lower LDL = worse immune system = worse outcomes.

I have a theory about that, though. I’m thinking that at least one effect of low carb has to do with the bacteria in your mouth, which is the first defense against colds/flu/even covid. My theory is that low carb beneficially alters the bacteria so that you get fewer colds/respiratory infections, regardless of your LDL.

Alas, people with higher LDL also seem have less cancer, so that’s where my theory fails.

But LDL is at least partially genetic, as I can’t get my LDL up no matter what I do (except fast for multiple days…but there’s only so long I can do that).

Dave Feldman would question this, saying that if you’re lean and exercising a lot, his belief is you’d have higher TC and LDL under his energy model. While I know there are LMHRs out there, I’m not convinced that every person who is on a low carb diet and gets lean and exercises will be an LMHR.

Also, this implies that as one gets leaner, TC and LDL should go up. Well, my TC and LDL are about the same, though HDL has gone up and trigs down (in general), though I’ve lost quite a bit of weight. And over 7 years, they are basically the same: