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  • Writer's pictureDr. Brian Lum

Is Keto Healthy? Heart Health, Cholesterol, and Dietary Fat

Updated: Feb 2, 2022

Considering that heart disease is the number one killer in the United States and the world, it is surprising that it is rarely listed as a priority by patients.

Even those who are diagnosed with a heart condition usually compartmentalize it from their overall health - as if taking a pill is the only thing to do.

The functional medicine approach to heart health is about finding ways to support the overall health of the individual and removing any biochemical impediments to optimal function.

Often, these changes lead to increased longevity and getting off medication.

Despite a person's best efforts to stay informed, it is easy to be led astray by the latest health trends and nutritional marketing. Now, keto and paleo are king - and ample amounts of fat at every meal is encouraged - but is it always healthy?

an artists rendering of human anatomy. text overlay says heart health, cholesterol and dietary fat

The High Fat Diet Trend

There is a trend in nutritional medicine to push high amounts of fat on everyone, regardless of medical condition, genetics, or how they feel.

Much like the popular trends of a few decades ago that proclaimed 'all fat is bad,' ‘low fat is great,’ and ‘fat-free = weight loss’ - be wary of the health claims of those who are making lots of money selling you products related to diet.

The highest healthy level of fat intake will vary based on the individual - amending your diet with too much fat, even ‘healthy’ fat, can cause health problems.

a healthy chicken salad with pomegranate on the side

Other elements of high fat diets (like the elimination of processed foods and the emphasis on eating foods in their most natural form) will have a wide range of benefits in your body.

Healthy fats are fantastic and vital for good health - good quality olive oil (make sure not to use for high heat cooking), coconut oil, grass-fed butter, and nuts all provide essential building blocks for your body to utilize.

Rather than focusing on consuming a particular ‘superfood’ fat - focus on removing the ‘bad’ fats from your diet - poor quality red meat, trans fats, vegetable oils, and fried foods.

Ensure that you eat a sufficient amount of dietary fat - and, yes - carbohydrates to keep healthy. Too few carbohydrates can result in anxiety, depression, mood swings, blood sugar problems and a whole host of other problems.

Fried foods should be a relatively rare indulgence. When you fry foods at home, use organic coconut oil.

With a few exceptions, fried foods from fast food locations and restaurants should be avoided entirely as they use the lowest quality (cheapest) oil.

Excessive Fat & Liver Function

A high amount of fat eaten all of the time burdens the liver whose job it is to detoxify the body. Many people who consume too much dietary fat will start feeling ill, sluggish and start putting on excess weight.

The response to a high-fat diet like the Paleo diet or a ketogenic diet is highly variable and it based on someone's genetics, medical status, and the health of an individual's liver.

a man with an inflamed liver

If your liver is healthy and resilient, then you will be able to adopt a very high-fat diet for a while.

Many people feel great initially with one of these diets, but after about six weeks start having symptoms of fatigue, sluggishness, anxiety, sleeplessness, and a rebounding of previous symptoms.

Like any lifestyle change it is vital to listen to your body, if your body fails to thrive under a particular diet then it may need to be altered.

Excessive Fat & Heart Health

Too much fat is the primary cause of a liver problem, and an untreated liver problem is the most common cause of high blood pressure.

When you eat more dietary fat than your body can handle (‘good’ or ‘bad’ fat), your liver has trouble keeping up with its daily job of detoxifying.

The heart and liver have a very intimate relationship - when one is compromised it is especially hard for the other to function well. Too much fat from animal protein, oils, or other sources can, over time, impair the liver’s capacity to filter your blood.

An impaired liver can cause slightly ’thicker’ and ‘dirtier’ blood which can eventually lead to high blood pressure and a host of other cardiovascular and metabolic problems.

One of the best ways to treat high blood pressure - hypertension - is to change your diet to give your liver a break and a chance to heal.

A Burdened Liver & Small Dense LDL Cholesterol

Dietary fat overload causes the liver to produce increased numbers of small dense LDL cholesterol particles.

Small dense LDL cholesterol is particularly dangerous for your heart and arteries because it damages the inside of blood vessels, triggering plaque to form.

Small dense LDL is one of the markers that I test for when doing a heart panel and that I pay particular attention to.

'Total cholesterol' is a cholesterol marker that is tested when a heart problem is suspected or can be part of annual 'checkup' testing.

'Total cholesterol' is of limited value without the context of how much small LDL (‘bad’) cholesterol and how much protective HDL (‘good’) cholesterol you have.

A typical cholesterol panel often misses true cardiovascular disease risk for many people.

Read More about the Functional Medicine Approach to Heart Health

Extreme, Unsustainable Diets Are Not Healthy

I caution the permanent removal of large groups of food from your diet without medical necessity. Fruits, vegetables, legumes, nuts, seeds, and grains provide a wide range of benefits throughout the body which is too extensive to detail here.

The removal of all grains, for instance, would also remove a significant amount of soluble fiber which helps the liver detoxify the body - it also lowers the ‘bad’ kind of LDL cholesterol. So if all grains are removed, then your soluble fiber intake needs to be amended.

two women walking in a park
The longest lived cultures do not just have healthy diets, they have full and active social lives

A Mediterranean diet is one of the most widely studied diets and it has decades of research supporting its power to increase longevity [1] and reduce chronic illness.

Variations of this diet is shared by those who are in 'blue zones' and enjoy long life and a very low chronic illness rate.

While out of fashion, if you are at a loss on how to proceed with your diet, mix in some of the components of a Mediterranean diet (like lots of fruits, vegetables, dietary fiber and lean meats).

Read more about Nutrition

A Healthy Lifestyle is Sustainable

There is a pervasive idea that a healthy diet and lifestyle should be hard. That you should be exercising until exhaustion and your meals should be bland, and you should be hungry all the time.

I believe a healthy lifestyle should be just the opposite - the healthiest diet for you is one that is sustainable, takes into account your medical condition and your nutritional needs and does not leave you starving or miserable.

The best approach for heart health is the one that incorporates a range of interventions to address your health needs and goals.

Instead of adopting an extreme diet on either end of the spectrum and relying solely on that to achieve optimal health, it would be beneficial to evaluate your lifestyle as a whole, take strides to reduce stress, get more sleep and focus on fiber-rich, plant-based foods.

If you would like to speak to me to ask questions about functional medicine, heart health or how I can help you, please schedule a Free 15 Minute Consultation or call or text my office at 913-728-5291.

My clinic offers functional medicine appointments as well as manual chiropractic treatments. I do online consultations for those out-of-state or outside of the United States.


If you think that you may have a medical emergency, call your doctor or 911 immediately.  No action or inaction should be taken based solely on the contents of this information. Nor should you ever delay seeking medical advice or treatment due to the information contained on this Website.

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