Nick NorwitzMD PhD, Oxford-Harvard | Metabolic Health Educator | “Stay Curious”

Unexpected Cause of High Cholesterol 🤨 on #Keto 🥑

10 Nov 2024 · 1 min

Watch on YouTube

0:59

The presenter cites a meta‑analysis of 41 human randomized controlled trials showing an inverse relationship between LDL‑cholesterol change and body‑mass index (BMI) when following low‑carbohydrate (keto) diets. Specifically, only individuals with a healthy‑weight BMI (< 25) experience LDL increases, and the lower the BMI, the larger the rise. A clinical example is given: a patient with severe obesity (BMI 42) and LDL ≈ 80 mg/dL maintained that LDL level while losing weight, but once the patient reached a lean, healthy BMI (~25), the LDL spiked dramatically into the 200s. This pattern suggests that weight loss into the healthy BMI range on a low‑carb diet can trigger substantial LDL elevation.

Chapters

In fact, we already know from a set of meta-analyses of 41 human randomized control trials that there is an inverse association between LDL cholesterol change and body mass index on low-carb diets. In fact, if you do the meta-analyses broken up by BMI categories, only healthy weight lean populations with BMIs less than 25 as a population see increases in LDL.. And the leaner the person is, the higher their LDL goes up, all things being equal. For example, I've seen clinical cases where a patient with a BMI of 42, in the severe obesity range, and an LDL around 80 went keto, and their LDL remained around 80 as they lost weight until they got into the lean, healthy range for BMI, and, in this case, around BMI of 25, their LDL shot up. Boom! It went from the 80 to the 200s when they hit that healthy range. Isn't that interesting?