The Food Medic - S9 Ask Dr Hazel: Keto diets and cholesterol

Episode Date: March 10, 2023

Welcome back to Ask Dr Hazel, our mini episodes that drop each week. Our listener question this week is “I am wondering if the keto/ LCHF diet really is for everyone, or if there are some people to whom it may do more damage than good, increasing their cholesterol or even causing non-fatty liver syndrome?"Please note : this podcast should not be taken as medical advice or replace that of your usual medical practitioner. Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit podcastchoices.com/adchoices

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exclusions and terms apply. Instacart, groceries that over-deliver. Hello and welcome back to Ask Dr. Hazel, our mini episodes that drop each week. I'm your host, Dr. Hazel, and I'll be answering all your burning questions. So let's jump into this week's question. I would like to ask a question about the keto or low-carb high-fat diet. I am wondering now if the keto diet is really for everyone or if there are some people to whom it may do more damage than good and increase their cholesterol or even cause non-fatty liver syndrome. I did read that it is normal that the lipogenic profile of the liver can change on the keto diet but I'm wondering if it's safe or even worth it and can you achieve similar fat loss goals on a more balanced diet that includes eating carbohydrates? Thank you. Thank you for your question. I'm going to answer this quite generically and remind you that

the information provided here on the podcast should never be taken as individual medical advice or replace that of your usual healthcare practitioner. So firstly, let's just talk about the ketogenic diet. The keto diet or the ketogenic diet is one form of a low carb diet but it's considered to be a very low carb diet in that it only includes five to ten percent calories from carbs per day so that's about 20 to 50 grams per day the amount that you'd probably find in about two to three slices of bread compared to the 50 percent of calories from carbohydrates currently recommended in the public health recommendations for the general population. It also includes moderate levels of protein with no restriction of fat. This means this diet tends to be really high in foods like

meats, lards, butter, cream, olive oil and other oils, avocado and oily fish. As a result, the keto diet can end up being quite high in saturated fat and cholesterol and low in foods which we know are good for our health, such as legumes, whole grains, fiber-rich starchy vegetables and most fruits. In terms of weight management, the research shows that very low carbohydrate diets can suppress your appetite, but they haven't been shown to be superior to other types of diets for weight loss and they can also be really difficult to maintain in the long term so they're not very sustainable. In terms of their impact on cholesterol levels and cardiovascular

health studies have shown mixed effects on cholesterol levels with some studies showing an increase and now this appears to be related to the saturated fat content in the diet. In case reports where the diet has caused any derangement in cholesterol and liver enzymes, stopping that diet has shown normalization of the blood tests after a couple of weeks. So the thing is, when we naturally reduce one nutrient, i.e. carbs in this case, we increase another. And typically with a ketogenic diet, that means we're increasing a lot of saturated fat and we're reducing a lot of foods and whole grains. But also our risk and our response to these types of diets are very individual. And genetics also plays a role, particularly in certain cholesterol disorders, which run in families like familial hypercholesterolemia.

So personally, I don't think there's enough evidence to suggest that the keto diet is superior for weight loss or cardiometabolic health. And I think the number of downsides outweigh the upsides. Again, if this is a diet that you want to explore for your own health, you need to speak to your own doctor or registered dietitian or nutritionist and make sure that this is the best approach and the safest approach for you. I hope that answers your question.