How to follow a Ketogenic diet and manage blood cholesterol. Many people who follow the ketogenic diet experience elevated cholesterol levels. The additional fat may cause your cholesterol levels to rise, so being diligent is essential. Let’s dive into the topic and take a look at what it is all about.
A ketogenic diet is a low-carb, high-fat dietary regimen that has become popular among health-conscious people in recent years. Proponents of this diet claim that it can result in weight loss. Simply by forcing the body to burn off fat. A new study shows that ketogenic diets may have an added benefit. In that, they seem to decrease weight and cholesterol levels.
Ketogenic diet and cholesterol
I’m sure one of the first questions you asked yourself when you started reading about the ketogenic diet. Is it possible, in order to burn fat, I should eat more fat?
👉 Let’s start with the most common question: Why starting the ketogenic diet put cholesterol up for many people?
This statement, far from being of concern in the right context, is a sign of good adaptability to the new situation presented by the environment: the absence of carbohydrates.
I mean, your body is responding as it should, and that’s always good news. Below we explain in detail why this elevation occurs, when it is positive and not, and what to do in each situation.
What is the relationship between a ketogenic diet and cholesterol?
A ketogenic diet or diet, also known as a keto diet, is a therapeutic tool. It was raised with the aim of your body using fat as the primary energy substrate and not glucose.
After following the protocol of entry into ketosis, your body achieves this goal and needs to resort to body fat stores to meet the energy demands of all cells in the body.
👉 This is a natural process.
Using the fat stored as an energy substrate and therefore producing ketones is a natural body state. The body usually feels comfortable, because on average, we have 135 thousand kilocalories stored as a reserve in adipose tissue.

👉 The idea is to start using these reservations.
Therefore, having access to this almost unlimited energy storage gives us an unmistakable signal that we have excess energy for all our daily functions.
The only complication is that if our context has always been sedentary and used to eating five times a day when we need to use our reserve fat, the body must go through an adaptation process.
This adaptation process is necessary because our body requires transporting energy to each of our cells through the bloodstream.
The point is that for this, there is a problem, fat is hydrophobic. Meaning it does not circulate well in the blood.
Of course, our body already knows how to solve this problem.
Can you imagine that our ancestors, after a day without finding food, could not use their fat reserves?
Our body is an amazing machine. For this problem, it found a brilliant solution. The production of proteins that circulate well in the blood and incorporate fat and transport it.
These are known as lipoproteins. The lipo prefix comes from lipids meaning fat, but they are commonly known as cholesterol in the everyday world.
👉 If you incorporate the ketogenic diet and start using fat as an energy substrate, this will require greater transport from your fat tissue to the cells. For this, you will produce more lipoproteins, and your blood cholesterol will rise.
I can already imagine the faces of many readers and their thoughts:
- What a horror! Cholesterol!
Seriously, if I diet ketogenic, is my cholesterol going to go up?
Yes, that’s right, your cholesterol will go up. And before you start trashing your avocados, nuts, and olive oil to buy you a snack, I want you to know some essential things about the relationship between a ketogenic diet and cholesterol.
After reading our ketogenic diet article, you may have a lot of experience in this diet. However, you don’t know much about cholesterol beyond the outdated information provided to you by the media and sellers of light products.
Let’s learn more about cholesterol

Humans have between 100 and 140 grams of total body cholesterol, distributed among 3 main storages:
- Cholesterol in lipoproteins in the blood (these we just met) is about 7%.
- Approximately 10 grams of cholesterol is present in bile.
- Most of the total body cholesterol is distributed among all cells and tissues in cell membranes. They make up 30-50% of the membrane lipids.
That is, cholesterol is essential.
The membrane of the cells is its border with the outside. So cholesterol fulfills the double function of protection and communication with the external environment.
A crucial role of cholesterol in cell membranes is to stabilize the fluidity of eukaryotes, with changes in fatty acid saturation and temperatures, as fluidity is critical to maintaining membrane function.
This role is so vital that all cells in our body can manufacture cholesterol themselves to regulate the fluidity of their cell membrane.
The fact that all nucleated cells can synthesize cholesterol and strict control of the cellular levels of this cholesterol underscore the importance of the cholesterol molecule for cellular function.
In addition to its role in regulating cell membranes, cholesterol has other vital functions, such as the synthesis of:
- neurotransmitters
- hormones
- Bile Acids
- vitamin d
In short, cholesterol is an indispensable substance for life, which provides the raw material for the manufacture of multiple bodily substances, and allows to maintain the integrity of cellular barriers.
👉 So why do they say cholesterol is bad?
This is due to 2 reasons:
- The finding that high concentrations of total cholesterol and LDL (a type of lipoprotein) are associated with atherosclerotic cardiovascular disease (AS-CVD).
- Identification of atheroma plates. The embedding of LDL particles in the wall of the blood vessel is surrounded by a type of immune cell, macrophages, and that they are known as foam cells when consuming this cholesterol.
- If the buildup is excessive, a fat vein is produced, making it difficult for blood to circulate and break off by covering a blood vessel and causing a heart attack.
But to understand these findings, there are 3 essential nuances:
- There are significant differences in LDL cholesterol response and its association with the disease.
- When evaluating interventions that have reduced the amount of blood cholesterol, they, despite lowering LDL cholesterol, do not impact mortality or are associated with cardiovascular disease.
- These observations do not contemplate what leads the LDL particle to embed in the blood vessel. This is really where the problem is starts.
When does cholesterol circulation become a problem?
We have seen that to understand the relationship between ketogenic diet and cholesterol, you must realize that our body will produce more lipoproteins to transport energy.
But cholesterol has circulated before because it is decisive for our health. We depend on this circulation to use the energy that we had stored in adipose tissue, whether or not we are in ketosis.
Under normal conditions, the acquisition of fat from adipose tissue, circulation through the bloodstream, and the use of that fat by cells is a natural process. This process does not generate any problems.
The problem occurs in these three circumstances:
The type of LDL particles we produce are too small
As they are smaller, they are easier to embed in the wall of the vessels.
This usually occurs when we consume low fat and many carbohydrates,i.e., the opposite of the ketogenic diet.
If you think about it, it makes a lot of sense. Suppose the functions of lipoproteins are essentially to transport fat for use as energy, and we use glucose as the primary substrate. In that case, we allocate less energy to manufacture large fat transporter trucks since, with small transports, we have enough.
The point is that smaller lipoproteins sneak more easily into the walls of blood vessels. High-fat diets, primarily saturated, have been shown to increase large and floating LDL particles in most individuals.
There is growing evidence that it is small LDL particles and not the large ones that generate atheroma plaques.
In short, the fat-rich ketogenic diet makes it easier for you to express a subtype of LDL lipoproteins with little atherogenic risk.
Cholesterol oxidation
There is growing evidence to suggest that oxidized cholesterol influences atherosclerosis, as it is involved in several critical steps of this process:
- Dysfunction of endothelial cells (the wall of blood vessels).
- Adhesion of circulating blood cells.
- Formation of foamy cells (macrophages that eat that cholesterol)…
Besides, oxidized cholesterol is at least 1 or 2 orders of magnitude more reactive than non-oxidized cholesterol, as it exerts pro-inflammatory, pro-apoptotic, and pro-fibrogenic effects.
Therefore, more and more authors comment that a pathological level of cholesterol oxidation in the vasculature may be the molecular link lost between hypercholesterolemia (which does not have to generate pathology) and the formation of atherosclerotic lesions.
👉 What do these complex terms have to do with ketogenic diet and cholesterol?

Because ketogenic diet and cholesterol form a very positive relationship for your body. The key with cholesterol oxidation is that once mobilized from adipose tissue to be used quickly, longer circulating, more likely to rust.
In this factor, we must stop a little since the ketogenic diet is characterized by a low intake of carbohydrates, and…
Non-intake of carbohydrates drastically decreases the release of a hormone, insulin, which regulates the absorption of these carbohydrates into tissues such as muscle or liver.
In adipose tissue, insulin slows down the release of fat. The presence of carbohydrates allows us to continue saving our fat reserves. So we use the sugars we have just ingested as an energy substrate.
👉 That is when there is insulin glucose is used, and no fat is used.
The moment insulin drops, fatty tissue releases cholesterol, as it knows that the body will need its reserves to get energy.
If we remember that all the cells in our body can manufacture by themselves the cholesterol they need…
Where, under normal conditions, is all this energy being released headed?
👉 Muscles will primarily use it.
Although all cells in the body will acquire some of the energy distributed from adipose tissue, the great consumer will be the active muscle.
The point is that the best way to supplement the ketogenic diet and cholesterol is to incorporate physical activity.
In this way, we stimulate absorption by the muscle rather than circulate for a long time. The likelihood that it will oxidize is much higher.
Therefore, the incorporation of the ketogenic diet will require, in many cases, physical activity to generate good circulation and absorption of fats.
Other factors that are also associated with cholesterol
oxidation include inflammation, toxic habits (smoking, for example), and poor blood glucose regulation.
Glycation of cholesterol
Ldl glycation (Low-Density Lipoprotein) occurs mainly due to excessive contact of lipoprotein with sugar.
Hence people with diabetes have higher concentrations of glycated LDL.
It appears that glycosylated LDL has a greater entry into blood vessels and attracts macrophages to ingest it, facilitating the formation of atheroma plaques.
Therefore, it is the combination of sugar and cholesterol that causes the perfect storm of atheroma plaques.
What happens next to the ketogenic diet and cholesterol?
As a rule, as fat by cells becomes more efficient, it is absorbed faster by all cells. This happens even though we mobilize more fat and initially lower cholesterol.
We will see this situation, especially if there is a good amount of omega 3 acids in your diet. Therefore, blood values tend to normalize and even be below the norm.
Even if this is normal, let me remind you that’s not always the case.
As long as you follow a food-based keto diet and not in processed foods, and you’re in a non-inflammatory state, energy circulation back and forth is not a problem.
Conclusions of the relationship between ketogenic diet and cholesterol
- Cholesterol is an indispensable substance for human health.
- During the ketogenic diet, cholesterol increases because the increased use of fat reserves in adipose tissue is required.
- Cholesterol alone is not a risk marker, but small, oxidized, and caramelized transport particles must also be present.
- To prevent the oxidation of increased circulating cholesterol during the ketogenic diet, the key is the simultaneous incorporation of physical activity.
- For other risk factors associated with cholesterol pathogenicities such as inflammation, LDL particle size, or poor blood glucose regulation, the ketogenic diet functions as a protective factor in itself.
Alex is a passionate fitness enthusiast dedicated to helping people lead healthier, more active lifestyles. He encourages small – sustainable changes over drastic transformations and works with people to create customized wellness plans. His mission is to help others benefit from the most effective methods available, sharing tips, strategies, and health & fitness tools on Gearuptofit.com to inspire people to live their best lives.