Diets · Metabolic & Cardiometabolic
Does the keto diet raise bad cholesterol?
The claim, precisely: ketogenic diet increases LDL cholesterol
Yes, often dramatically in lean people, though whether that rise carries normal heart risk is unsettled.
Evidence ladder
How far up the ladder this claim has climbed. A high consensus on a low rung means "consistent so far," not "proven in people."
Top evidence so far: All trials, pooled (Meta-analysis)
How the studies fall
What the evidence shows
Ketogenic diets reliably raise LDL cholesterol and ApoB - dramatically and in essentially everyone in lean cohorts, with the rise inversely proportional to BMI. Whether this LDL elevation carries normal cardiovascular risk is genuinely unproven (measure ApoB, don't assume benign).
The evidence (5)
| Source | Grade | Stance | Quality | Finding |
|---|---|---|---|---|
| Soto-Mota A, et al. 2024 · Am J Clin Nutr | meta-analysis | supports | moderate | MA: LDL rise inversely related to BMI (large in lean, absent in obese) |
| Buren J, et al. 2021 · (RCT) | RCT | supports | high | Controlled-feeding RCT n=17 normal-weight: LDL +~70 mg/dL, rose in EVERY participant |
| Cooper ID, ... Norwitz NG, Soto-Mota A 2023 · Front Endocrinol | observational | supports | low | Lean healthy women on keto showed marked LDL rise predicted by body composition (LMHR/LEM) |
| Zhao (53-RCT MA) 2026 · (MA) | meta-analysis | supports | high | MA 53 RCTs: LDL +8.22, TC +8.06 mg/dL (TG down, HDL up) |
| Joo (normal-weight MA) 2023 · (MA) | meta-analysis | supports | moderate | MA: VLCKD raised LDL & TC significantly in normal-weight adults |
Educational only, not medical advice. Grades and scores reflect published evidence weighted by study design and quality; see the methodology.