The keto diet has quickly become mainstream among the health community, mainly for its tendency to produce quick weight loss results. What does this mean for other important areas of your wellness, like your heart health?

What is the keto diet?

The keto diet has been used medically to help treat seizures in children since the beginning of the 20th century. However, it wasn’t until the 1970s that Dr. Atkins first widely popularized the very low-carb, high-fat diet for health benefits like weight loss.1

Short for “ketogenic”, the keto diet refers to a diet that makes your body release molecules called ketones into your blood and enter a metabolic state known as ketosis. Ketones are produced from fat when glucose from carbohydrates is not available as a source of energy. Most cells in your body prefer glucose as their primary fuel, and the keto diet is a shift from this.

The keto diet typically means eating 20-50 grams of carbs per day on a typical 2,000 calorie diet, with a moderate amount of protein and the majority of calories coming from fat.

This often looks like 55-60% fat, 30-35% protein, and 5-10% carbohydrates. This is very different from what the typical American diet looks like, which is around 55% carbohydrates, or around 250-300 grams of carbs per day.1

The keto diet is typically rich in animal-derived foods such as meat, fish, eggs, and full-fat dairy, as well as nuts, seeds, and non-starchy vegetables. It usually excludes foods like starchy vegetables, fruit, bread and baked foods, pasta and grains, beans and legumes, added sugar, processed snacks, and diet foods.

Is the keto diet good for your heart?

The simple answer to this question is that research is inconclusive, and more long term studies are needed. Evidence is mixed when it comes to how the keto diet impacts heart health, which appears to depend on a number of factors. For instance, what specific foods you eat, how long you’re on the keto diet, and other factors that may be unique to an individual.

Some animal and human studies have indicated that keto diets can induce non-alcoholic fatty liver disease and insulin resistance. The keto diet may increase HDL “good” cholesterol for some people, but while some have experienced a reduction in LDL “bad” cholesterol and triglycerides, others have seen an increase in these blood fats. Studies on blood pressure have shown mixed results.1,2

Overall, most research has found minimal impact on heart health when the keto diet is followed for less than 1-2 years. After that, research is limited, making it difficult to make conclusions.

What we do know is that choosing more whole, high-fiber, minimally processed foods is always a good idea when it comes to protecting your heart.

How to follow a heart healthy keto diet

The keto diet is rich in fats, making it important to base your diet on the right ones. Incorporate healthy fats like avocados, nuts and seeds, olives, and coconut. Choose eggs and lean meats like fish and chicken breast, over processed meat products like bacon, sausage, and hot dogs.

When it comes to carbs, it’s worth recognizing that one of the biggest problems with carbs is that most people in Western cultures are eating an abundance of unhealthy ones, like processed snack foods and refined products. Replacing these with complex carbs like whole grains, fruits and vegetables, and legumes are known to have protective effects on the heart, and may be better for you than minimizing your carb intake altogether.

There is more evidence of potential short term benefits (e.g., when used for 1-2 years) of the keto diet on heart health and other conditions. More research is needed to understand what the long term impacts of eating a very low-carb, high-fat diet may be on your heart.1

Yours in Health-
Ana Reisdorf, MS, RD
IVL’s Community Registered Dietitian

References

  1. Masood W, Uppaluri KR. Ketogenic Diet. [Updated 2019 Mar 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499830/
  2. Kosinski C, Jornayvaz FR. Effects of Ketogenic Diets on Cardiovascular Risk Factors: Evidence from Animal and Human Studies. Nutrients. 2017;9(5):517.