Why is my LDL high on keto?
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Most often it’s the saturated fat. A keto day built on butter, cream, cheese, bacon and fatty beef can carry more than twice the saturated fat line, and in some people LDL rises a lot. You can keep the carbs low and change the fat: olive oil, avocado, nuts and fish in place of most of the butter, cream and fatty meat.
Keto is a low-carb diet, and low carb doesn’t require butter. When most of the fat comes from butter, cream, cheese and fatty meat, a lot of it is saturated, and saturated fat turns down the liver’s LDL receptors, the drain that clears LDL from your blood.
What we’d do: if keto works for you, keep it, and rebuild the fat side. Cook in olive oil, put avocado and nuts where the cheese and cream were, eat fish for some of the meat, and retest in two to three months to see what it did.
Same fat, same calories, half the saturated fat
Two keto days from the USDA tables, both around 1,130 calories from these foods and both close to 100 g of fat:
| Foods | Saturated fat | |
|---|---|---|
| The butter day | 2 tbsp butter, 2 tbsp heavy cream, 2 oz cheddar, 3 slices bacon, 6 oz 73% lean ground beef | 50.5 g |
| The olive oil day | 2 tbsp olive oil, 1 tbsp heavy cream, 1 oz cheddar, 3 slices bacon, 6 oz salmon, 2 oz avocado, 1 oz almonds | 23.0 g |
The saturated fat falls by more than half, to about the 22 g line for 2,000 calories.
The study that said LDL didn’t matter
A 2025 study of 100 people on keto whose LDL had gone to 190 mg/dL or more claimed that over a year, their existing plaque predicted new plaque and their LDL and ApoB didn’t. In May 2026, the journal retracted it at the request of the authors and the editors, after concerns about its methods, saying the errors were “too great to be corrected with a corrigendum.” The study’s own starting group does show one thing, that a diet can push some people’s LDL that high.
What to do with your number
How far a fat swap should bring your LDL down, and when a number is a doctor’s question, is cholesterol.guide’s department. If your LDL is very high, talk to your doctor, and if you take a statin, keep taking it. bodyfat.guide covers the weight side of low carb. The scorer below splits your usual keto day into its four fats and finds the swap.
6 sources
- Gebhardt and Thomas, Nutritive Value of Foods, Home and Garden Bulletin 72, Table 9, USDA Agricultural Research Service, 2002ars.usda.gov
- USDA SR Legacy, Fish, salmon, Atlantic, farmed, cooked (FDC 175168), via NutritionValue.orgnutritionvalue.org
- Soto-Mota et al., Longitudinal data from the KETO-CTA study: plaque predicts plaque, ApoB does not, JACC: Advances, 2025 (retracted)europepmc.org
- Retraction notice: Longitudinal data from the KETO-CTA study: plaque predicts plaque, ApoB does not, JACC: Advances, May 2026europepmc.org
- Dietschy, Dietary fatty acids and the regulation of plasma low density lipoprotein cholesterol concentrations, Journal of Nutrition, 1998europepmc.org
- US Department of Agriculture and US Department of Health and Human Services, Dietary Guidelines for Americans, 2025 to 2030, p. 3, January 2026cdn.realfood.gov
