If you have been trying to manage your cholesterol, you have probably gotten some confusing advice. Low-carb is bad for cholesterol. High-carb is bad for blood sugar. It can feel like there is no good answer.
Here is the thing: low-carb eating does not raise cholesterol on its own. Your body does not produce excess cholesterol simply because you are eating fewer carbs. The real question is what you are eating instead.
It Comes Down to What Is on Your Plate
Foods like egg yolks are high in cholesterol, but they actually have a minimal impact on your blood cholesterol levels. Eating eggs in moderation is generally fine.
What does have a much greater influence on LDL, that is the “bad” cholesterol, is saturated fat. Saturated fat is found in fatty meats, full-fat dairy, and many processed foods. If your low-carb diet leans heavily on those, that is likely what is pushing your numbers up.
A Word About Keto
The ketogenic diet — the very strict, very low-carb version — has been found to cause hyperlipidemia. That means excess fats building up in the blood and the liver, rather than being safely processed by the body. That is worth knowing if you have been considering it.
For most people, a moderate-carb approach is not a bad middle ground. And researchers point out that what matters even more than counting carbs is getting enough fiber. Most Americans fall well short of what they need.
Fiber slows how quickly carbs are absorbed, which helps keep blood sugar steady. It also supports digestion and offsets some of the effects of carb-heavy eating in general.
Your Genes Play a Role, Too
Researchers led by Dr. Alexa Barad recently studied 20,940 genotyped postmenopausal women. They found that the link between saturated fat and elevated LDL was much stronger in women who carried certain genes associated with higher LDL risk.
In that high-risk group, people with both the relevant genes and a high saturated fat intake had a 45 percent increased risk for atherosclerotic cardiovascular disease compared to those with low genetic risk and low saturated fat intake. In the lower-risk genetic group, saturated fat had a much weaker association with LDL levels.
It is worth noting that this study has not yet completed peer review, so it should not be used to shape medical decisions, but it does suggest that one-size-fits-all dietary advice has its limits.
The Bottom Line
If your cholesterol numbers are high, the first place to look is not how many carbs you are eating. Look at your saturated fat intake: fatty meats, full-fat dairy, and processed foods. That is where the evidence points most clearly.
And if you are somewhere in the middle on carbs rather than at one extreme or the other, that is a perfectly reasonable place to be. Talk with your doctor about what approach fits your specific numbers and health history.
