Does Going Low-Carb Cause High Cholesterol?

It’s Q&A Day at 10almonds!

Have a question or a request? We love to hear from you!

In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

No question/request too big or small 😎

❝I’m confused, I saw that Low Carb diet is bad for cholesterol levels, but High Carb is bad for blood glucose, and Low Carb doesn’t give enough energy, and High Carb causes energy crashes, is there no way to win? If I have to choose,t he cholesterol is the most important one because my numbers are too high❞

It sure can seem like a lot of mixed messaging, can’t it!

The short answer is: you could always consider a moderate carb diet 🙂

That sounds flippant, but in seriousness, it’s actually not a bad approach for most people: Carb-Strong or Carb-Wrong: Should You Go Light Or Heavy On Carbs?

And really, what’s (again, for most people) more important to count than carbs is actually fiber, of which most Americans don’t get anywhere near enough (see: Why You’re Probably Not Getting Enough Fiber (And How To Fix It) for more on that), and if they did, it would offset those carbs in various ways—by enjoying carbs with adequate fiber, you still get the energy benefit, but the fiber slows absorption (thus helping to regulate blood sugar levels nicely) and improves digestion (amongst other things).

With regard to low-carb eating and cholesterol specifically, it comes down to how you do it.

Cholesterol does not get elevated because of a low intake of carbs.

Our bodies do many strange things, but synthesizing excess cholesterol due to wanting more carbs is not one of them!

The real issue in this case is less about what’s not on your plate (bountiful carbs), and more about what is on your plate (you tell us).

• If your plate is low in carbs but has high-cholesterol foods such as eggs… That’s usually fine in moderation, actually. Egg yolks are high in cholesterol but have a minimal impact on blood cholesterol levels.
• If your plate is low in carbs but high in saturated fats (as found in fatty meats or dairy, and many processed foods), then this has a much greater influence on LDL (“bad” cholesterol) levels than dietary cholesterol.

We wrote more about that here: What Actually Causes High Cholesterol?

The low-carb ketogenic diet has quite a lot of problems, and one of them is that it has been found to cause hyperlipidemia, meaning excess fats accumulated in the blood and the liver rather than being safely metabolized.

You can read more about that, here: The Hidden Cost Of Keto

And some related approaches just do not particularly work for anything much, for example: What’s The Real Deal With The Paleo Diet?

One thing to bear in mind is that with regard to finding the right macro balance (for example, whether we try to get more energy from carbs or fats or try to balance them equally), there may not be a correct one-size-fits-all answer.

For example, researchers (Dr. Alexa Barad et al.) recently did a big study of 20,940 genotyped postmenopausal women, and after looking at many factors, found:

❝Saturated fat intake was positively associated with LDL-C in the high PGS_LDL group, but the association attenuated in the low PGS_LDL group (P-interaction for LDL-C = 0.01). Spline analysis revealed a non-linear interaction between PGS_LDL and saturated fat, with modifying effects emerging at higher PGS_LDL. Compared to individuals with low PGS_LDL and low saturated fat intake, only those with both high PGS_LDL and high saturated fat intake had increased risk for ASCVD in an adjusted analysis (HR 1.45, 95% CI 1.20-1.75).❞

In other words: the association between saturated fat intake and LDL (“bad” cholesterol), and the risk of subsequent atherosclerotic cardiovascular disease, existed in all but was much worse in those with certain genes associated with increased risk of elevated LDL.

You can read the paper itself, here: Association between saturated fat intake and low-density lipoprotein cholesterol across the genetic spectrum: Results from the Women’s Health Initiative

…with the caveat that this one’s so hot-off-the-press that peer review has not been completed for it yet, which means a) in practice probably nothing that changes the overall conclusion b) you shouldn’t use this to shape clinical policies.

It also doesn’t look at other markers, such as Lp(a), which we wrote about here: What is lipoprotein(a) cholesterol, or Lp(a)? And can you lower yours?

For practical purposes, if you’d like to just directly get started on lowering your cholesterol levels, then we have you covered for that, too:

• What Two Days Of Oats Will Do To Your Lipids
• Statins: His & Hers?
• Lower Cholesterol Naturally
• Take These To Lower Cholesterol! (Statin Alternatives)
• How To Lower Your Cholesterol By 50+ Points Without Drugs

And if you’d rather some more broad-scope dietary understanding when it comes to macro balances and similar issues, then check out: What Macronutrient Balance Is Right For You?

Want to learn more?

For a much deeper understanding, you might like this very good book we reviewed:

The Great Cholesterol Myth, Revised and Expanded – by Dr. Jonny Bowden and Dr. Stephen Sinatra

Enjoy!