Warnings About The Keto Diet If Youre At Risk For Heart Disease
If youre at risk for heart disease , one overarching factor to consider is that the keto diet is restrictive, and its tough to stick to a restrictive diet, says Steinbaum. People go on keto and in the short term lose a lot of weight, but its not sustainable. So when they go off it, they gain the weight back and maybe even more, she says.
Yo-yo dieting can put stress on the heart. One large study in the October 2018 issue of the journal Circulation found that people who have the greatest variability in measures like fasting blood glucose, cholesterol, blood pressure, and body weight are 2.3 times more likely to die from any cause and more than 40 percent more likely to suffer a heart attack or stroke compared with those who stay more stable. Staying stable in these measurements is healthier than constantly going up and down. Ultimately what youre doing is setting yourself up for developing metabolic syndrome, says Steinbaum.
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One concern is the effect a keto diet has on cholesterol levels. As an article in the Harvard Health Blog explains, data shows that cholesterol may spike when you first start a keto diet but then decrease after a few months of ketosis. The author points out something critical: There isnt long-term research showing what happens to cholesterol levels. And that uncertainty matters especially when were talking about your heart health.
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What Are The Different Types Of Ketogenic Diets
There are several variations of the keto diet that you can try. Before you try any of these ketogenic diets, make sure to consult a healthcare professional first.
- Standard Ketogenic Diet This type of ketogenic diet involves a very low-carb, moderate-protein, and high-fat diet. Typically, it contains 75% fat, 20% protein, and only 5% of carbs.
- Targeted Ketogenic Diet This diet is almost the same as the targeted ketogenic diet with the exception of eating carbs around your workout times. This means that youre just going to consume food with carbohydrates on the days you exercise.
- High-Protein Ketogenic Diet This type of ketogenic diet includes more protein than the standard keto diet. The ratio is often 60% fat, 35% protein, and 5% carbs.
- Cyclical Ketogenic Diet This diet involves rotating between a strict high-fat, low-carb ketogenic meal plan and higher carb intake.
Among these types of ketogenic diets, the standard ketogenic diet is the most researched and most recommended.
How Does Keto Help With Heart Health
Going through ketosis is a healthy, safe way of losing weight and reducing health issues that can come with it. Losing even a modest amount of weight can help reduce cardiovascular risk from obesity, high blood pressure, and the oxidative stress that leads to inflammation. It can even result in lower LDL cholesterol and higher amounts of good HDL cholesterol. A keto diet can also lower elevated blood sugar linked to artery-damaging inflammation.
Frequently Asked Questions About Keto and Heart Health
Not all keto diets are exactly the same. Some have to be adjusted to account for family history in things like cholesterol and high blood pressure. The best diet is one that helps the individual achieve positive results, and keto dieters can maintain steady weight loss while improving important biomarkers like higher levels of HDL cholesterol.
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Why Are Ketones Made
Ketones, therefore, can also be your friend. Ketones can act as a standby form of supplemental energy in times of starvation. Not only are ketones good for energy, but they are also helpful in preventing heart damage from inflammation. When blood vessels become inflamed, they lose their smooth character and become prone to clot formation, and eventually, heart attacks or strokes might occur. Ketones help maintain the linings of our blood vessels and protect them from losing their smoothness.
How Can I Safely Cut Carbs If I Want To Practice This Kind Of Diet
It is best to let your doctor know youre considering a keto diet. They can refer you to a dietitian who will give you specific guidance on how to do it appropriately. Its always best to start slow. Decrease your carbohydrates a little at a time and check in with yourself for any physical side effects.
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What Foods Are High In Carbs
Complex carbohydrates include foods such as beans, peas, legumes, whole grains and vegetables. They also provide important vitamins and minerals.
Simple carbohydrates include some fruit, milk and milk products, but most Americans get the majority of the simple sugar in their diets from foods and drinks with added sugars like soft drinks, candy and desserts.
Keto Vs The Mediterranean Diet For Heart Disease
Although it isnt explicitly stated, the consensus seems to be in favor of the Mediterranean diet as being the best option for people at high risk for heart disease. Even the American Heart Associations dietary recommendations are almost identical to the Mediterranean diet.
The research also backs up the effectiveness of this approach. For example, a recent meta-analysis on the effect of the Mediterranean diet on the prevention of cardiovascular disease incidence and mortality found a few remarkable associations:
These associations were put to the test in a large clinical trial as well. In this study, high-risk subjects who followed a Mediterranean diet supplemented with extra-virgin olive oil or nuts experienced a slightly reduced incidence of major cardiovascular events compared to a control reduced-fat diet.
Unfortunately, we dont have sufficient data to directly compare the impact that Mediterranean diets and keto diets have on heart disease. Similar studies on heart disease incidence and mortality prevention have not been conducted on keto diets, and very few studies use both diets as an intervention.
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Are There Any Good Reasons To Cut Carbs
Cutting back on those simple carbs is very beneficial. Foods that contain simple carbs tend to be empty calories that dont contain much nutrition. If our bodies get an abundance of simple carbohydrates and we cant burn off those calories, they end up being stored as fat which leads to weight gain. Thats why soft drinks really contribute to weight gain.
Is Keto Good For Heart Health
As with most nutritional quandaries, this quandary doesnt lend itself to a yes or no answer. The answer depends on many factors.
It depends what types of fat you eat on keto. It depends on your weight and metabolism going in. And it depends how keto affects your LDL particles.
Check your blood work regularly. If your CVD risk factors are improving, its a fairly safe bet that keto is helping your heart.
An even safer bet? The olive oil from your dinner salad isnt clogging your arteries.
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Effects On Heart Health
As discussed, the keto diet can have positive short-term effects on weight loss, blood sugar control, triglyceride levels, and HDL levels. However, there are concerns of negative effects on heart health with the ketogenic diet.
Many studies have shown the association of keto diets with increased LDL , but this finding is not consistent in all studies. Keto diets that are high in saturated and trans fats seem to be responsible for the increased LDL levels.
Another study showed higher incidence of atrial fibrillation in people on carbohydrate-restricted diets.
The keto diet has also been associated with increased mortality. This effect was especially true when animal-based fats were substituted for carbohydrates. Substituting plant-based fats for carbohydrates, on the other hand, improved mortality.
To minimize this risk of heart disease while on a ketogenic diet, it is prudent to minimize processed foods high in saturated and trans fats, and instead choose plant-based foods with higher unsaturated fat content.
Choosing The Diet Thats Right For You For The Long Term
Diets like keto and paleo are exciting because they produce quick results. But the long-term studies show that the weight loss from these low carb diets is on par with many other diets, so it makes sense to choose the diet you can stick with for the long haul. Take a good look at your lifestyle and realistically assess how often you can cook and which foods you like. Be honest with yourself about the changes you are willing to make to your lifestyle long-term to be successful in your weight loss and health goals, and then start looking for the plan that meets your needs.
My Fat Flush family of plans and my Radical Metabolism plan all have flexibility built into them, so you can tailor them to your individual needs and stick with them for the long haul. They were created with heart health in mind and have been updated as new research comes to light. Ive set you up for even more success with online support in my Facebook groups Fat Flush Nation and Radical Metabolism Revolution with my staff of nutritionists at the ready to help you with the transition to your healthier lifestyle. I also offer my private Inner Circle group for people who need more private, individualized help meeting their goals.
I hope youll become another Fat Flush or Radical Metabolism success story, and I look forward to seeing you in one of my Facebook groups soon!
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Does Keto Work For Weight Loss
Dr. Hollywood says that she did notice weight loss while following the diet, but once she started to reincorporate carbs, she gained the weight back.
Id encourage those following a keto diet to consult his or her primary care doctor or nutritionist for a transition plan to sustain this weight loss and welcome back proteins and carbs, she recommends.
However, Dr. Hollywood warns that it is important to be mindful of these extreme diet programs, like an aggressive carb-conscious keto. The all or nothing phenomenon Ive found is not that practical and not that sustainableand individuals can develop unhealthy relationships with food, she says.
Dramatic Weight Fluctuations Increase Risk Of Death From Coronary Event
If youve been trying to lose weight for any length of time, you may recognize the term yo-yo dieting. What that refers to is following a diet to lose weight for a limited length of time, then stopping that diet and letting at least some of the weight return. With most keto proponents recommending no more than 6 months of following this highly restrictive diet, by definition it falls under the category of a diet with a high risk of rebound weight gain, and this is not good news for your heart.
Recent studies show that losing and regaining just 10 pounds is enough to increase your risk of sudden cardiac death 3.5 times, even if you are a normal weight. And it also puts you at a 66 percent increased risk of dying from heart disease. According to a study published in the New England Journal of Medicine, if you already have heart disease, an 8.5 pound weight fluctuation from yo-yo dieting makes you 64 percent more likely to have a coronary event, increases your risk of a cardiovascular event by 85 percent, makes death 124 percent more likely, increases the risk of heart attack by 117 percent, and your risk of stroke increases by 136 percent.
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What Are Ketones And Are They Good For You
Ketones, or ketone bodies, are chemicals made in your liver from the breakdown of fats, and they serve as this alternative fuel for your body when glucose is in short supply.
Theyve recently been put under the microscope by scientists looking at their possible protective effect on patients with heart disease.
Historically, theres been a negative stigma around ketones because of their link to high sugar levels in diabetics, says Dr Cher-Rin Chong from The University of Adelaide, a co-author of the new study.
But research is now showing theyre not quite the bad boys we once thought.
- Key information:What you need to know about the keto diet
It’s Advertised As A Weight
In the world of weight-loss diets, low-carbohydrate, high-protein eating plans often grab attention. The Paleo, South Beach, and Atkins diets all fit into that category. They are sometimes referred to as ketogenic or “keto” diets.
But a true ketogenic diet is different. Unlike other low-carb diets, which focus on protein, a keto plan centers on fat, which supplies as much as 90% of daily calories. And it’s not the type of diet to try as an experiment.
“The keto diet is primarily used to help reduce the frequency of epileptic seizures in children. While it also has been tried for weight loss, only short-term results have been studied, and the results have been mixed. We don’t know if it works in the long term, nor whether it’s safe,” warns registered dietitian Kathy McManus, director of the Department of Nutrition at Harvard-affiliated Brigham and Women’s Hospital.
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Ketogenic Diets Regulate Serum Lipids
Apart from the cardiometabolic effects mentioned above, the impact of KD on serum CVD biomarkers has also been investigated. Research on 20 normal-weight, normolipidemic men indicated that a 6-week KD notably decreased fasting serum triglyceride, postprandial lipemia, and fasting serum insulin concentrations, tended to increase HDL cholesterol, while not affecting fasting serum total and LDL cholesterol and oxidized LDL . These results revealed that short-term KD would not deteriorate CVD risk profile and, indeed, appeared to ameliorate lipid disorders that are characteristics of atherogenic dyslipidemia. Another research also indicated that changes in the ratio of protein to carbohydrate toward higher protein proportion could provide beneficial effects on serum lipids apart from lowering body weight .
However, Özdemir et al. pointed out that prescribing patients with at least 12 months KD could significantly elevate serum total and LDL cholesterol and triglyceride at a median of 12.6 months while not affecting HDL level. Moreover, another research found that a 6-month KD could notably increase median triglyceride, total cholesterol, LDL, and HDL. They suggested that classic KD was indeed efficient in treating refractory seizures in children but might give rise to hypercholesterolemia and hypertriglyceridemia.
As such, disputable voices concerning the impact of KDs on serum lipids remain to be settled by future work in this field.
The Effects Of Kd On Hepatic Inflammation In Rodents
As a key factor that triggers or exacerbates CVD risk, liver inflammation is a potential safety concern related to KD. In support of this, a study observed that mice fed with KD sustained unimpaired insulin-induced hepatic Akt phosphorylation and whole-body insulin responsiveness but ultimately developed hepatic endoplasmic reticulum stress, steatosis, cellular injury, and macrophage accumulation .
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Does Cutting Carbs Increase My Risk Of Heart Disease
Unfortunately, the keto diet is often very high in saturated fat because of the large amounts of meat and animal products in the diet.
Large amounts of fat just arent good for weight maintenance, weight loss or heart health. Our bodies main source of energy is carbohydrates. Our bodies prefer to run on carbohydrates, so if we have too few carbohydrates over a long period of time, our energy levels and cognitive function could suffer.
What Kind Of Relationship Should You Have With Food
An individuals goal should instead be embracing a lifestyle change instead of a diet, which is more sustainable over a long period of time, expresses Dr. Dougherty. A well-balanced diet, which is high in vegetables and lean meats and low in processed foods, in addition to portion control and daily physical activity has more evidence for success, she adds.
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Keto Diets And Ketones Improved Blood Flow
Heart attacks and strokes also happen when the blood vessel openings constrict. The diameter of the coronary arteries become too narrow, limiting blood flow to the muscle of the heart. Ketones can help dilate blood vessels. Animals in the lab were fed ketone supplements and the scientists found that the ketones made the vessels larger and more blood flowed through the brain, kidneys and heart of these animals, improving blood flow by as much as 75%.
Keto Flu And Other Side Effects
Ketogenic diets can have side effects, especially initially. Some people will feel very sluggish for the first week or so, often referred to as the keto flu. This can manifest as poor energy and mental function, increased hunger, sleep issues, nausea, digestive discomfort and occasionally, decreased exercise performance.
These side effects can usually be mitigated by gradually lowering your carbohydrate consumption over a few weeks. Increasing water consumption, replenishment of electrolytes and a multivitamin can help as well. Although rare, rapid decrease of carbohydrates can cause severe ketosis with marked fatigue and nausea, as well as impaired mental function.
If you are planning to drastically change your diet, be sure to consult your physician first, especially if you have any underlying health conditions or nutritional concerns.
For people who cannot supplement adequate intake of vegetables, grains and fruit, there is a risk of nutritional deficiencies on the keto diet. People with liver conditions may not metabolize excess fat well and those with kidney insufficiency should not be on a high protein diet. In both of those cases, a ketogenic diet can exacerbate these underlying conditions. Lesser concerns are a risk of constipation, mood swings and clouded thinking from inadequate carbohydrates.
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