Is the Keto Diet Heart Healthy? 7 Reasons Why This Cardiologist Agrees

lchf, ketogenic diet, nutrition, health, weight loss

Is the Keto Diet Heart Healthy? 7 Reasons Why This Cardiologist Agrees


I am a board certified, card-carrying cardiologist, and I want my clients to eat more fat, more meat, more cheese, more eggs, more avocado, more, more, more.


For decades medical establishments have convinced us to eat low fat, higher carb diets. How has that worked for our health? Here’s a hint, we have record numbers of obesity, diabetes and dementia. Yet, as a cardiologist, that’s the party line I am supposed to support.


But I can’t. It’s just wrong, and I can’t support that line of thinking, not for a second.


Instead, I am a Low Carb Cardiologist. Here are the top Seven reasons why



              1-  Reducing Insulin is Essential to Health and Weight Loss.


Insulin is a hormone naturally secreted by the pancreas to help regulate blood sugar levels. Everything we eat (except possibly for 100% fat meals) causes insulin to rise. That is normal physiology. The problem occurs when our bodies become resistant to the effects of insulin, thus requiring our pancreas to make more and more and more insulin.


The problem? Insulin promotes fat storage, increase inflammation and oxidation, and can even help fuel the growth of cancer cells. Therefore, the healthiest approach is one which reduced the level of insulin to the lowest possible levels. As it happens, a Low-carb High-fat or ketogenic lifestyle (LCHF/Keto lifestyle) dramatically improves your body’s sensitivity to insulin, reduces the amount of insulin secreted, and it allows your body to naturally use your fat stores for what they are designed for: Break them down into energy! Once we see that we need to fight chronic elevations of insulin, it becomes obvious why a low-fat diet is harmful, and why a low carb diet is the true path to health.


2-    Eating Fat Improves Your Cholesterol!


Wait, what? Eating fat can improve my cholesterol? Sounds crazy, right? That goes against everything we have heard from the medical establishment. Notice I said “cholesterol.” I didn’t say the "bad" low density lipoprotein (LDL), I didn’t say the "good" high density lipoprotein (HDL), or any one specific type of cholesterol. We have over emphasized the solitary variable of LDL for too long. Total cholesterol to HDL ratio, Triglyceride to HDL ratio, lipoprotein size and density, insulin sensitivity, and other metabolic measures are more powerful predictors of cardiovascular health than just LDL.


Once again, we see that all these markers improve with a Low Carb High Fat (LCHF) lifestyle. The medical establishment needs to realize that we are more complicated than one lab value. The key is to look at the whole picture, and this picture dramatically improves with a LCHF lifestyle.


3-    Higher HDL is Associated with a Lower Risk of Heart Disease.


HDL is your friend, but drugs are not. Observational evidence has consistently shown that higher HDL is associated with a lower risk of cardiovascular disease. However, our healthcare establishment does not prioritize HDL for one simple reason- Drugs that raise HDL don’t make you healthier. Trial after trial has failed to show any benefit from drugs that significantly increase HDL. 


Instead, it’s the HDL-raising lifestyle that provides the benefit, not artificially increasing it with drugs. What’s the best lifestyle to naturally raise HDL? You guessed it. LCHF/Keto lifestyle. Add in some resistance training and you have your friendly HDL climbing the way it was meant to…Naturally.


4-    LCHF Leaves You Feeling Great, Leading to Healthier Decisions


What kind of health decisions do you make when you are fatigued, achy, and find it difficult to concentrate? That’s a rhetorical question, I already know the answer. When things look glum and we don’t feel well, it's far too easy to sit on the couch or reach for the chips and cookies. Compare those decisions to those you make when you are well rested, energetic, and seeing the world more clearly. For most people, the better you feel, the better decisions you make.


Guess what? The majority of people who change to a LCHF lifestyle feel better! It may take a few days or weeks, but in general, they feel more in control of their health, more energetic, and they are able to make better health decisions. I admit this is difficult to prove in a scientific trial. That is why we all should become our own n=1 scientific trial. How do you feel and how are your health decisions after going to a LCHF lifestyle? What matters most is what works for you, not what works for hundreds of people who are kinda-sorta like you.


      5-    Keto helps you with fasting.


Eating better helps you not eat. People who eat a high carb diet eat a lot, don’t they? They are always grazing and snacking. Our bodies go through the roller coaster of blood sugar and insulin spikes, making it a challenge to go 24, 18, or even 6 hours without eating. This creates a constant, unwavering supply of insulin in our blood stream.


Why is this harmful? For one, it promotes fat storage and keeps us from using our fat as fuel. Secondly, chronically elevated insulin can predispose to heart disease, strokes, cancer, dementia and other devastating health conditions. When people change to Keto, however, they realize they do not need to eat nearly as much or as frequently. Avoiding the carbs and increasing the fats keeps us full longer, and our bodies quickly adapt to longer periods without eating. The result? We can use our fat stores for what they were designed- a source of fuel! It also allows our body to maintain lower insulin levels, and also allows our cells to take care of their health chores, referred to as…..


6-    LCHF Promotes Health Through Increased Autophagy.


Autopha-What? In medicine we like using fancy words to make us look smart. Autophagy is a big word to describe cellular housekeeping. When we have low enough intake of carbs and protein, or when we do intermittent fasts, our bodies can take care of their “to do” lists.  That list includes breaking down weak or damaged cells, recycling the good parts and discarding the rest, and slowing down the processes that can lead to abnormal cell growth (i.e. excess proteins in Alzheimer’s disease, abnormal cancer cells etc.).


Admittedly, long term outcome studies evaluating fasting or LCHF and cancer or dementia risk have not been done. But, on the flip side, drug trials to prevent the same are showing no benefit despite hundreds of millions of dollars invested. If you asked me (which you sort of did since you are reading my article), I’d vote for autophagy as a preventative strategy any day. It makes good physiologic sense, and it is so easy to achieve.


7-    With Keto You Will Enjoy Eating Again!


That’s right. A way of eating that helps you lose weight, helps you feel better, improves your health and is actually enjoyable! No fake processed soy products, no cardboard tasting rice cakes. True, it also means no more candy, processed snack foods, doughnuts and danishes. But once you swear them off for a few weeks, and you are eating all the eggs, avocados, nuts, fish, steak, cheese etc. that you want, you won’t miss those old crutches any more. Let the enjoyment begin!

I could go on, but since it seems people like “7 Reason” articles, I will leave it at that. 


Now you know the secret: Look at the whole picture. Look for a lifestyle, (not a diet) that helps you feel better, increases your enjoyment, and still benefits your overall health.


Is LCHF/Keto the right lifestyle for you? It just may be. It is for me, The Low Carb Cardiologist, and it is for most of my patients and clients. Want to learn more about how LCHF lifestyle impacts your health? Visit us at


Thanks for reading


Bret Scher, MD FACC

Founder, Boundless Health


ADDENDUM!! Since I have published this article, there has been a windfall of media buzz around low carb diets increasing our risk of heart disease or diabetes. Let's look at where that information came from.

1- A study force feeding mice excessive amounts of industrial omega 6 oils. You can guess what I have to say about that. The article was incredibly helpful, and I immediately stopped force feeding my pet mice industrial seed oils. Thanks goodness for that article. As for how it applies to humans eating real food that contain fat, there is zero correlation. 

2- Epidemiological study suggesting those who ate low carb (40% calories from carbs, which by the way is NOT low carb) as measured by two food journals over 25 years had a higher risk of dying. Oh and by the way, at baseline they were heavier, more sedentary, smoked more, and ate fewer veggies. Yet somehow they concluded it must be the low carb diet that "caused" the harm. Once again, it may not be bad science, but it sure was awful interpretation of the science. 

In light of those two studies and the hoopla surrounding them, has anything happened to change my mind about a LCHF/keto diet being beneficial for our overall health and our heart health?

Absolutely not.

We still need to individualize our care and our lifestyle for who we are and how our bodies respond. That is always the case regardless of our nutrition, our medications, our exercise etc. As long as we do that, then this cardiologist still believes that LCHF IS HEART HEALTHY!

23 thoughts on “Is the Keto Diet Heart Healthy? 7 Reasons Why This Cardiologist Agrees”

  1. Really enjoying your shows, Doctor. Especially the ones with Dave Feldman, Dr. Shawn Baker and Dr. Jason Fung.  I wish my doc was as open minded as you guys. 

    1. Thanks K. There is defintely a changing tide with docs starting to be more open, I just wish it was moving faster! Thanks for your comments, and let me know if I can help in any way.

  2. I've been living the keto lifestyle ever since Dr. Scher told my sister to go on keto (she didn't, I did).  I've lost 35 pounds (and my husband has lost 50 pounds).  I feel great, have tons of energy and am back exercising regularily.  Best shape of my life at 50!  And I plan to keep eating like this forever.  I bake keto treats and desserts and try new recipes to keep things interesting.  Doesn't feel like a diet at all.  

      1. I am finding all the health benefits of Keto but I was trying to address this today on Facebook.  

        i believe keto is right even though my LDL is high and my HDL low early on my keto journey. Labs again in Oct. going to ask for NMR test.


        1. Good idea about the NMR. I think it pays to learn more about our lipids when we are trying to figure out exactly what effect our nutrition has on them. Our reactions can be incredibly individualized. 

    1. Hi Jane. Thank you for your comment. Red meat “causing” colon cancer is a common concern, but in reality, the evidence is very flimsy. Looking at hazard ratios, smoking and cancer has an impressive association with the hazard ratio being above 3. The hazard ratio for red meat consumption and colon cancer is 1.18. That is tiny and very sensitive to confounding variables. In addition, in making their recommendation, the WHO did not consider various interventional trials that showed no relationship between red meat and colon cancer. As is frequently the case, the data is not as clear as some agencies promote. It is my belief (and studies support) that red meat consumption as part of a low carb, low sugar, healthy diet is perfectly healthy for  most people. Of course we are all different, and therefore need to adjust our diet to our own personal circustances.  I hope that helps clarify. Thanks!

  3. This is great, but my Lipid panel showed bad things and my internal medicine primary care physician wanted me to get on statins, I refused, my friend who is a cardiologist looked at my numbers and said my LDL of 206 sucks and I should be on a statin. I'm still refusing.  The lipid test was in July, Tri's 131, Total Cholesterol 280, HDL 48, Chol/HDL ratio 5.8%, LDL-Calculated 206.  Since that test I have lost 15lbs, increased my exercise drastically, started a LCHF Keto diet (average carb per day is 20g or less, max of 30 except for the one day ever week to 2 weeks I have a few beers, sorry.) and implemented in fasting including "one meal a day" 24 hour fasts and longer fasts up to 36 to 48 hours.  My next lipid panel is October 30th.  By then I plan on keeping with this program, losing another 10lbs and probably completing a 5 day fast at the end of September and one 5 day in October.  I am 5'8" and my weight was at 181, it is currently 166 with a goal of 155.  My waist (belly button) to height ratio is 5.4 as of last week.  With ALL that said, I still see my doctor and cardiologist pushing for a statin drug.  I plan on staying with this way of life, I feel better, I have more energy, my excercise endurance is steady and strong, my inflamation is gone, my IBS is all but gone (got to watch refeeding after fast!), I"m not hungry as much.  I don't "have" to eat.  Help keep me off statins!

    1. Hi David. Thank you for sharing your story. This is the most common dilemma I help people with–Whether to continue a low carb lifestyle in the face of contrary advice from doctors. As you can imagine, this is an incredibly complex topic that I could not begin to address over the internet. But if you are inetersetd, I can provide scond opinion health coaching consults to help you make sense of all the conflicting advice. You can lear more here:

      All the Best! Bret

  4. So what about the studies that have proven eating  animal products raises serum cholesterol to the point that asthlerosis is triggered?  Are you saying these people should do this diet when it could trigger hesrt disesse stroke cancer and Alzheimer's ? just to lose a bit of weight ? Why have you not posted the long term ill effects ? Why are you misleading people?

    1. Hi Danny. Thank you for your comment. Although I am sorry that you feel I am misleading people. Please see the posts below that will hopefully help you understand my position better. I feel we have been mislead and misinformed when it comes to the health risks of low carb high fat nutrition. Studies that  have shown a link to heart disease and strokes (even as weak as the link may be) have been high carb and high fat diets. Low carb high fat is completely different without evidence to show danger. Hopefully these articles will help clarify.

      1. LDL should be under 70 according to Loren Cordian, i fear a generation of people are setting themselves up for an early death.

        1. Thank you for your comment. I am afraid comments like “LDL should be under 70” are far too simplistic and dont consider all the important factord that go in to assessing our cardiovascular risk. Evidence shows those over 65 live longer with higher choletserol and most people admitted for heart attacks have LDL between 70 and 130. It appears there are many other factors to consider raher than making an LDL targer the most important factor.

  5. Dr Scher, I have been listening to your podcast daily for several weeks. Though with some guests you do get "into the weeds" with technical jargon that flies over the heads of many listeners like me, I am convinced by the balanced viewpoints you offer from your many brilliant and highly experienced guests.  I am an afib patient and my cardiologist highly favors Dr Michael Greger's plant based approach to the exact same nutritional and health challenges.  Greger's science based podcasts sound every bit as convincing as yours, and several other Low Carb diciples, always citing double blind randomized trial studies.   Are both camps correct?  Are refined sugars, processed foods and vegetable oils, the enemies that both groups despise, the only true enemy?  Please help with my internal conflict. 

    1. Hi Jim. I understand your internal conflict. I think you are right, the main true enemies are refined sugars, processed foods and industrial seed oils. Eliminating those will “fix” the majority of what ails us. Beyond that, there may still be work to be done, and this is where individualization is very important. If you are obese or insulin resistant, than LCHF has the best data to support it. If you want to lower your BP, there is some data that a vegan diet is successful, as there is for LCHF. You also have to consider on which diet will you feel better, be happier, and not have to worry about what to eat all the time. That is very indivdualized. Although that may not set your internal conflict to rest, I hope it does help!

  6. My n=1 keto experiment at age 70 is in its 7th month. My 6' 2" frame lost 45 lbs (243-198) and 6" around my waist. My triglycerides dropped from 191 to 50. HDL went from 44 to 55. Blood Pressure dropped 20 points to 120's. Energy is much better, so I have been walking 3 -8 miles most days. In early September, I participated in a 15-mile veteran suicide awareness march, finishing well ahead of most participants. I'm  sleeping much better with no bathroom trips, and waking refreshed and ready to go early  each day. I have a ways to go to reach my weight and fitness goals, but sm convinced my new permanent lifestyle is the right way to enjoy my golden years.

  7. Hi! Your article is very interesting. But do you have any evidence/scientific research to support all 7 listed reasons above? I just want to understand it better before trying Keto diet. Thanks in advance.

    1. Hi Sam. Thanks for your question. When I get a chance later this week, I will update the post with references. For now, here are a few that you should find helpful. There are many more but I will try to not overwhelm you and include the most relevant!

      3 on insulin resistance and hyperlinsuliemia

      An overbiew of the lipid, glucose and insulin benefits

      A list of 23 studies comparing LC vs LF diets for wright loss and lipid changes

      Virta Health’s 1 year cardiovascular risk paper


      I hope that helps!


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Bret Scher, MD FACC

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