Lowering carbohydrates and eating foods like grass-fed beef, bacon, and butter are great ways to lose weight quickly. But if your cholesterol health is essential to you, adopting a more Mediterranean approach to living a low-carb lifestyle may be the best choice.
Many foods found in abundance on a keto diet indeed contain saturated fat. Still, low-carb foods like mackerel and sardines are high in omega-3 fats, and they can help curb carbs and manage triglycerides—a way to support healthy cholesterol levels.
Those interested in managing or improving their cholesterol health need not give up the many benefits of ketosis. The tips we share can help you craft your low-carb meal plan with heart health in mind.
What is Cholesterol
Several people are concerned about determining the cholesterol level in foods, how these foods impact triglycerides and the potential consequences.
Before we get to those points, let's talk about cholesterol and its function when working correctly. A waxy substance, cholesterol, is present in virtually every cell of the body and is involved with all the body's normal functions.
Cholesterol is involved in many vital processes in the body, including:
- Cell integrity: Cholesterol is required to maintain the structure and fluidity of every cell membrane in the body.
- Hormone synthesis: Cholesterol plays a crucial role in the synthesis of steroids such as estrogen, testosterone, cortisol, and vitamin D3, as well as other related hormones.
- Creation of bile acids: Your liver produces bicarbonate acids, which are essential for absorbing fats and fat-soluble vitamins A, D, E, and K.
- Myelin formation: Myelin, which surrounds and protects nerve cells, contains plenty of cholesterol.
Like inflammation, cholesterol is crucial to health and well-being when in balance but can wreak utter havoc when dysregulated.
Most of the cholesterol in the body is endogenous and produced by the liver. However, animal products such as beef, bacon, and heavy cream provide a significant amount of saturated fat that could impact your overall triglyceride levels, as well.
However, more recent information appears to fly in the face of conventional wisdom's assertion of causation between including egg yolks in your meals and an increased risk of heart disease––instead noting that judicious inclusion of such foods aids in satiation and helps regulate cholesterol levels.
Cholesterol does not circulate in the bloodstream on its own. Instead, it must be packaged within lipoproteins to move through the bloodstream since it is hydrophobic (water-repellent).
Lipoproteins safely courier cholesterol and other compounds containing lipoprotein particles and proteins called apolipoproteins and triglycerides through the body.
Although once demonized, like another ingredient we now rely on primarily for fuel along with ketones, cholesterol in and of itself is not 'good' or 'bad' and is of one type, with the synonymous LDL and HDL designations referring to how much of those respective lipoproteins are present in the bloodstream.
Despite being maligned as bad cholesterol, LDL plays a vital role in immune response, among other functions. A lower HDL cholesterol level is associated with a higher risk of heart disease, so HDL cholesterol is said to be beneficial. Once kept in context, logic suggests that cholesterol is useful and needed to a degree––just like inflammation.
So, tossing out all foods containing cholesterol seems like a moot and unrealistic point.
What are “normal” cholesterol levels?
The recommended cholesterol levels vary slightly among countries and health agencies. According to the US National Institutes of Health website, people at low risk for heart disease should have the following cholesterol and triglyceride values:
- Total cholesterol: < 200 mg/dL (5.2 mmol/L)
- LDL cholesterol: < 100 mg/dL (2.6 mmol/L)
- HDL cholesterol: > 40 mg/dL (1.0 mmol/L) for men, > 50 mg/dL (1.3 mmol/L) for women
- Triglycerides: < 150 mg/dL (1.7 mmol/L)
LDL levels >160 mg/dL (4.1 mmol/L) are considered high, and levels 190 mg/dL (4.9 mmol/L) and above are deemed very high.
Keto and Cholesterol
Eating nutrient-rich foods like eggs for added choline or grass-fed beef, for a boost of vitamins A and E, vitamins B12 and B6, and selenium, do provide cholesterol, but the quality of your food matters in how your body processes those ingredients.
Plus, the most nutrient-dense foods help you feel fuller for longer with fewer calories.
Some best practices to follow to cut your cholesterol while lowering carbs and sugars may include the following, in addition to limiting specific fats and controlling calories. Consider this as you formulate your approach to keto, since your food selections need to be tailored to your unique health goals.
Eat Foods Rich in Omega-3s: Increasing fats on a keto diet is likely not a surprising concept, however, which fats you select make all the difference in how you look and feel. Consider stocking up on the following fare to load up on heart healthy fat options shown to support ideal triglyceride levels.
- Atlantic Mackerel
- Lake Trout
- Tuna (light, packed in water)
- Seeds (e.g., flaxseed, chia seeds, and hemp seeds. etc.)
- Nuts (e.g., pecans, walnuts, pili nuts, almonds, et al.)
- Shrimp is high in cholesterol but has not shown a negative impact on heart health. On the contrary, shrimp may lower your triglyceride and “bad” cholesterol levels. So opt for the seared or broiled variety and pass on the deep-fried selections.
Other Keto-Friendly Foods to Support Healthy Triglycerides
- Dark Leafy Greens
- Nut butters
As is the case when considering other keto-friendly food options, not all selections are advisable––even if their macros meet the mark. If cholesterol is a concern, it may be wise to avoid the following foods:
- Shellfish: Oysters, mussels, crabs, lobsters, and clams are high in cholesterol, especially for their modest portion size. For example, King crab legs, lobster, and oysters contain 71 mg of cholesterol per serving, 61 mg per serving, and 58 mg per serving, respectively.
- The high cost of caviar may keep some away from this delicacy, but if you consider adding it to your rotation, note that 100g of caviar contains 588 mg of cholesterol, which is 196 percent of the recommended daily allowance of cholesterol!
- Duck contains large amounts of protein, iron, and vitamin B, and is an oily meat with a distinctive taste. Sadly, it also contains a large amount of cholesterol. Duck is thought to contain more than 100 mg of cholesterol per serving!
- Ice Cream is a fantastic treat at the end––or middle––of the day, but the heavy cream used in most varieties is rich in cholesterol. Consider mixing in options like So Delicious and other dairy-free options to diversify your dessert selections to curb cholesterol intake.
Bacon is probably the reason you decided to try the keto diet; it’s likely the first time in your adult life that you’ve been encouraged to eat America’s favorite breakfast side to lose weight.
However, just one piece of bacon contains about 9 mg of cholesterol and 5 mg of fat. Because of the typical serving size, cholesterol-conscious individuals should avoid or limit bacon.
- Butter is ubiquitous on a keto diet; we use it in everything from our morning coffee to our baked goods and other confections. Unfortunately, it also contains a significant amount of cholesterol, with just one tablespoon of butter containing 30g of cholesterol. That translates to 10 percent of the recommended daily allowance for cholesterol for a minimal amount. Instead, opt for olive oil, which is high in monounsaturated fats and can have a cholesterol lowering effect.
Processed Meat: Sausage, bacon, and hot dogs are processed meat products high in cholesterol. In addition, processed meats––specifically those containing carcinogenic compounds like nitrites and nitrates––contain ingredients linked to an increased risk of heart disease and certain types of cancer.
Consider steaming, baking, or broiling most of your meals rather than frying them.
Fried Foods: The keto diet permits fried foods and string cheese snacks, but deep-fried meats, cheese sticks, and other common charcuterie foods are high in cholesterol and should be limited.
Although low in carbs, some meat and dairy products are packed with calories and contain trans fats. These fats can adversely impact health in many other ways; so select your food brands carefully.
Heavy Cream: Morning coffee and many other beverages are enhanced by the creamy and silky addition of heavy cream. However, pouring this fatty fare on heavily can quickly rack up the cholesterol macros for the day, placing you at your desired daily limit before noon.
Consider capping your intake and logging your food consumption consistently if you notice weight-loss stalls or are actively looking to curb cholesterol consumption. You can also try swapping cream for unsweetened almond milk.
- Cream cheese makes for a decadent spread on your breakfast bagel or as the binder in keto pizza crusts, but just 1 oz of cream cheese contains a whopping 27 mg of cholesterol.
- Does keto or low-carb eating affect your cholesterol?
Keto or low-carb eating can increase cholesterol levels during weight loss. After the first few months of losing a great deal of weight, it is common to experience a fall in cholesterol levels, but one may experience a rise in cholesterol after the weight has stabilized with cholesterol levels typically returning to normal following weight loss.
As a result, it may make sense to assess cholesterol levels after someone's weight has been stable for a few months following dramatic weight loss.
Increasingly, a more nuanced approach that distinguishes excellent sources of nutrients from cheaper varieties and emphasizes quality, or a lack thereof, is taking hold as the cause of chronic inflammation and degenerative diseases.
In addition, the argument for the impact of insulin sensitivity on organ health seems more plausible and a matter of priority than worrying about the cholesterol provided by animal fats and proteins.
Nutrition, genes, and other factors influence cholesterol synthesis and absorption. So it's not surprising that a minority of low-carb dieters experience significant changes in blood LDL cholesterol levels, perhaps because the exact mechanism of cholesterol synthesis in the body varies from one person to another.
Lifestyle Tips to Improve Triglycerides
Maintaining healthy cholesterol levels is about more than genetics and diet. There are some lifestyle factors within your control that can prevent or contribute to triglyceride health. Consider the following as you cultivate your heart-healthy approach to the low-carb, high-fat diet:
- Exercise: Regular exercise has long been linked with improved heart health and maintaining an ideal weight. Both factors will prove helpful as you customize your diet to provide loads of mono and polyunsaturated fats that are filling and an asset to coronary wellness.
- Limit Alcohol: Reducing alcohol consumption is a wise idea for so many reasons. Drinking regularly adds extra calories to your diet and diminishes your inhibitions making binging and poor food choices much more likely.
- Get Rest: A lack of sleep often leads to poor food choices, eating more than usual, and slipping on sipping enough water throughout the day. Ensure ample sleep each night to guarantee that you’re recharged to tackle the day.
- Manage Stress: The consistent release of cortisol due to chronic stress can disrupt hormonal function and encourage the body to store fat. Consider creating a relaxation and mindfulness routine to help you unwind to keep hormones in check.
Improving and maintaining heart health is a priority for many, especially since in the United States, heart disease is the leading cause of death for men, women, and people of most races and ethnicities. Heart disease kills one American every 36 seconds. Every year, nearly 659,000 Americans die of heart disease––accounting for one in every four deaths.
However, maintaining healthy cholesterol levels doesn’t mean you can’t enjoy the benefits of a low-carb, high-fat ketogenic diet. Lean toward a Meditteranean take on low-carb living, eating mostly low-glycemic produce, fish and other omega-3-rich animal fat and protein sources while saving red meat for special occasions.
Metabolic ketosis, where we train our bodies to run on fat and ketones primarily for fuel offers improved triglyceride heath, improved insulin sensitivity, and better hormone regulation, as well as improving the proper functioning of all the body’s system, including the heart.
Plus losing weight and maintaining a healthy resting weight, limiting fast-acting carbs and sugars, and adopting a healthier lifestyle focused on eating the highest quality food possible, while staying active and as stress-free as possible all come together to set you up for the best outcomes while following a ketogenic diet.
Rather than fretting over including yolks in your diet or the occasional 80/20 angus beef burger you add to your menu, focus on filling the majority of your plate with foods lower in cholesterol or those filled with healthy monounsaturated and polyunsaturated fats to mitigate triglyceride levels while aiding feelings of fullness and satiety––while keeping heart health and the habits that support it top of mind.
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- Norwitz, N. G., Feldman, D., Soto-Mota, A., Kalayjian, T., & Ludwig, D. S. (2021). Elevated LDL cholesterol with a carbohydrate-restricted diet: Evidence for a “Lean mass hyper-responder” phenotype. Current Developments in Nutrition, 6(1). https://doi.org/10.1093/cdn/nzab144
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