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Will The Keto Diet Negatively Affect My Cholesterol?


As you begin to research what a high-fat ketogenic diet looks like, your brain is probably reeling with stories of high cholesterol, heart attacks, clogged arteries and near-death experiences…

Well I’m here to confirm to you that this is a common misconception which all stems from one very flawed study, the “Diet-Heart Hypothesis” published in the 1950’s by Ancel Keys, who found a very weak correlation between heart disease and fat.

From his observational work he deduced that hypercholesterolemia [elevated cholesterol] is the result of a diet high in fat. At the time, several studies showed that when eating a standard diet and increasing intake of fat, total cholesterol levels went up; however there was no link found and published that related this to heart disease.

For more than 50 years, we’ve been taught that putting any form of fat (especially saturated fat) into our mouths will cause our cholesterol to rise. This dogma is so ingrained into our minds and cultures that I bet you’re feeling just a tad emotional at the thought of eating more butter, bacon, or using tallow (pure animal fat) to cook with.

Much research has been carried out since then, as well as countless examples in patients of doctors advocating a ketogenic diet, which show when you consume a low-carb, moderate-protein, high-fat diet, HDL cholesterol (the good kind) goes up, triglycerides come way down and LDL cholesterol particles shift from the dangerous small, dense kind to the much more benign large, fluffy kind. Keto win!

Dr. William Davis, cardiologist and author of Wheat Belly Blog, talks at length about the effects that eating lots of “healthy whole grains” has on our cholesterol; showing an astounding excess of the damaging LDL “bad” cholesterol in these people. In comparison to those people who eliminate “healthy whole grains” and sugars from their diet, increasing their fat intake and enjoying the healthy metabolic state of nutritional ketosis have shown a dramatic reduction, even entire elimination, of the dense and damaging LDL cholesterol particles.


First, make friends with cholesterol, it’s not your enemy. In fact, without it, we would die. The part it plays is necessary for many essential bodily functions;

  • It’s required to make sex hormone such as oestrogen, progesterone, testosterone and DHEA.
  • It transfers nutrients to the brain to protect from dementia.
  • It repairs damaged cells and maintains the integrity of the cell to extend cell life.
  • It maintains the integrity of the intestinal tract.
  • It helps with serotonin receptor firing, which is essential for feeling happy.
  • It assists with vitamin D uptake, which is essential for healthy bones, nerves, muscle tone, insulin production, fertility and a strong immune system.

Cholesterol also plays an important role in combating systemic inflammation – without satisfactory levels, inflammation is left to do its things with very little working against it. When left to run wild, excess inflammation in the body makes it more susceptible to disease. Common conditions where inflammation is often at the root cause are;

  • Overall body pain
  • Asthma
  • Gall bladder disease
  • Allergies
  • Psoriasis
  • Heart disease
  • Diabetes
  • Migraines
  • Dental issues and many more


When we eat more cholesterol, we produce less in our body, and vice versa. Which means eating more dietary cholesterol has little effect on its levels in the body. Cholesterol comes from two sources: about 25% of the cholesterol in our bodies comes from the food we eat and about 75% is synthesised by our body, which tightly regulates the amount of cholesterol in the blood by controlling internal production.

You’ve most likely come across LDL (low-density lipoprotein) and HDL (high-density lipoprotein) but what part do they play in cholesterol levels?

These little floating balls of brilliance are essential triglyceride and cholesterol ester transporters, through the bloodstream. Some move fat from the gut to the fat cells, some move fat from the fat cells to the liver, brain and muscles, and some love the fat back to the fat cells again if it wasn’t used elsewhere in the body.

HDL is associated with better cardiovascular health while the health implications of LDL depend on the size of the particles. Higher amounts of large fluffy LDL particles are associated with normal cholesterol and triglyceride levels. Higher amounts of small, dense LDL particles are associated with low HDL, elevated triglycerides and a tendency to develop high blood sugar and type 2 diabetes.

We used to believe, the higher the concentration of cholesterol being carried by an LDL particle, the higher the risk of heart disease. However, studies now show us that it’s the overall number of LDL particles that really matter.

For the vast majority of people, a ketogenic diet reduces the number of small, dense LDL particles and increases HDL, and for some people, the total cholesterol level will go up (like in Ancel Keys study I mentioned earlier) – however, this isn’t as big of a deal than we’ve been lead to believe. As long as small, dense LDL stays low, the total cholesterol count is less important. In fact, the ratio between your triglyceride count and HDL count can be a stronger indicator of heart health than your total cholesterol number.

What we want to pay attention to instead of our total cholesterol is our blood sugar and triglyceride levels; which increase directly by increasing levels of insulin, and foods that raise insulin are carbohydrates, starches and sugar. HDL count and hs-CRP (high-sensitivity C-reactive protein), which measures the amount of inflammation in the body. If inflammation increases on a ketogenic diet, it’s usually because of nuts, seeds, a food sensitivity (dairy is a common trigger) or products that contain artificial sweeteners, flavours and/or colours.

If you’re curious about how many of the fluffy LDL and how many of the small, dense LDL you have, your count of HDL and other cholesterol stats, an NMR lipid profile test is the blood test you’re looking for.

Sophie Laura

Hi! I'm Sophie (Easy Keto Lifestyle). I'm a Certified Nutrition Coach and I help women who struggle with their weight to radically transform their health and body, by living a simple yet delicious ketogenic lifestyle.

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