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.

    If you want to learn more about lipids and cholesterol, I recommend checking out my new dedicated cholesterol course: The Truth About Lipids.

  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 Autophagy.

    If you’re interested in Fasting and want to make sure you’re doing it correctly, download my free Full Guide to Fasting.

  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. To learn more about Low Carb and Keto, download this free E-Book:



Thanks for reading,
Bret Scher, MD FACC
Founder, Boundless Health



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!

If you liked this post, you’ll love my free E-Book on Low Carb/Keto Starter tips to help you get started on your LCHF path!

Thanks for reading.

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

      1. Dr. Bret, is this eating style safe for people with congestive heart failure. I like the idea of losing weight and also the less water retention on Keto. Can u explain how this could benefit me? My EF is 20 percent newly diagnosed. In heart failure groups I have heard people do this and there EF went up.

        1. Hi Nicholas,

          Thank you for your question. This is an interesting topic that deserves a detailed analysis and explanation. We don’t feel the blog is an appropriate forum for this. If you would like a more individualized approach and answer, please feel free to sign up for a one-on-one consultation.

    1. Thanks for sharing this diet. I have being struggling for years now, I being reading some about the keto diet. I am getting excited about starting the diet.
      Thanks again

  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. So as a Cardiologist , how much Saturated fat is acceptable for good heart health for ppl with T2 diabetes which often leads to or currenly has Atherosclerosis?

      1. Hello Paul,

        That’s a great question! This is an interesting topic that deserves a detailed analysis and explanation, especially as it is specific to each individual’s health. We don’t feel the blog is an appropriate forum for this. If you would like a more individualized approach and answer, please feel free to sign up for a one-on-one consultation with Dr. Scher.

      2. I have peripheral artery disease and coronary artery disease. This diet brought all my numbers down to normal including c-reactive protein which is inflammation. I only did healthy fats because every time I eat saturated fats, I would get mild angina pain. No pain with healthy fats. My cardiologist is thrilled. My insulin and blood pressure is normal now. On no meds. So I believe saturated fats should not be included or eaten in moderation.l. I eat seafood, salmon, chicken on occasion. Grass fed beef once a month small portion.

  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. Thanks Doc Scher for a great piece of info about Keto Diet .
      But I am concerned about the potential effects of eating a lot of meat on gut microbiome?

  3. But I thought eating a lot of meat was bad as far as colon cancer goes. Seems like people are just forgetting that.


    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!

  4. 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

      1. I have CHF, EF of 15%..Anyway that was 5 years ago. Turned it around no at 45%. Not to much overweight, 5’10 174 lbs, workout weight training 3x a week. I had high cholesterol my entire life. Anyway against my doctors advice I had my blood done, keto hard core for a month, blood drawn. My cholesterol dropped to normal, my a1C dropped so low to be a non-issue, Some Inflammation test dropped from 7 to 2. Oh and I lost 15 lbs. DR couldn’t believe it. I’m a believer!

    2. I had high LDL for several years. Refused to take statin because I was thin, non smoker, very little alcohol.  Out of nowhere, I had a major heart attack.  100% blockage.  Flatlined 3 times.  Now have 4 stents.  (‘Was called “Miracle lady”) in hospital. I was very active. Did not tire easy. Now, with statin, my cholesterol is good. Although I do feel aches sometimes, the numbers don’t lie. In my case, my dad had heart attack also.  Hereditary.  Something with liver. BUT, again, the numbers don’t lie, and I went from 200+ to -100 for ldl.  I’d consider taking the statin if I were you. I was 54 when I had my heart attack, and have some damaged heart muscle.  I wish I would have listened to my doctor.  

  5. 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.

          1. I agree. I had a patient 2 days ago, acute MI, 56 y/o. He eats: oatmeal, banana, PBJ, admittedly lots of cabs. A little overweight in the middle. But his LDL was NORMAL. Triglycerides were high. I didn’t see HGBA1C, but I float to 27 acute care units including cardiac. The trend with cardiac I see is DIABETES. Metabolic syndrome. I’ve been eating keto 8 months now. I’m normal weight. 41 y/o woman. My LDL has increased to 130 (borderline), but my triglycerides are down from 55 to 37. HDL up from 62 to 70. Chol/HDL ratio from 2.5 to 3.0. I’m still convinced this is right for my health. And deeply concerned we are tragically mismanaging our patients diets: advise/feed high carb, low fat diet.

  6. 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!

  7. 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.

  8. 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!


  9. Hi. Ten + years ago , I had chf and found out I have type 2 diabetes. One month ago, I had a mild heart attack and had 6 stents put in. I have been managing my diabetes well enough to come off the metformin but in the past couple of weeks, my blood sugars are up (13) . I also have diabetic foot ulcers that are keeping me off my feet as much as possible, which makes it frustrating as far as getting any excercise. This has been going on for around 10 years. I am afraid I have become a couch potato.  The hospital has a new clinic that is looking at other ways to close up my ulcers. I want my energy back and want to eat the right things. Do you think the keto diet would be beneficial and not harmful for me? I am kind of afraid to ask my doctor because he is pretty set in his ways. I am 59 and female. Thanks for any help you can give me.

    1. Hi CIndy. I am sorry to hear all that you have been through. Unfortunately, I cannot comment on your specific case without a thorugh consult. If you consider doing a keto diet, I would strongly suggest you find a doctor to follow you very closely for continued safety. If your doctor is not able or willing to do that LowCarbUSA.Org and both have listings of “keto friendly” docs you can see if one is convenient for you to go see. I hope that helps.

  10. Dr. Scher, what are your thoughts on oatmeal. Do you recommend eating oatmeal even though it is a carb, since it can help to keep arteries healthy?

    1. Hi Liz. If someone is trying to stay low carb, and certianly if they want to be in ketosis, then oatmeal is a definite no. If someone has insulin resistance, metabolic syndrome, or diabetes, then even “healthy” carbs like oatmeal can still trigger insulin and glucose spikes. But if someone in more metabolically flexiable and not as concerned with strict low carb, then oatmeal is a reasonable carb choice. Just skip the brown sugar, and be ready to be hungry an hour after eating:)

  11. Help… 2018 was a extremely difficult year for me and my husband and family. Our jobs are both very high stress despite trying to deal with that, we both fail as we work 100% with broken people…now we are broken. He’s 61; I’m 60.

    He end if March I was diagnosed with DCIS-ER breast cancer; technically Stage 0, levels 1-2… a lumpectomy of two areas Later, the drs did not get as clear of margins as they want so they want more. No.

    i chgd to a neutarian diet mostly and lost 20 pounds but our lifestyle makes that difficult to stick to especially since my husband does not like most veggies …

    In August he was on mile 70 of a 300 mike bike ride for our mission organization and had a widow maker heart attack with 99% closure of left ventricle then 3 weeks Later, diagnosed with 99.9% closure of right ventricle! Also diagnosed with borderline diabetes, they put him on metfirmin too. Seven stents and 11 meds Later, he is still weak and tired but forcing himself to move. 

    We are both over weight, scared and discouraged trying to swim through this season in our lives and discern which diet changes would benefit both of us without killing one or the other! We are grateful we can still fall into each other’s arms at night!

    All to say, would keto kill this type of cancer/cellular charge or compound it? Would this be beneficial for a serious heart patient?

    PS we have never smoked, drank alcohol, or lived a questionable lifestyle. He drank a lot of diet sodas; I gave up soda and sweetened drinks years ago. His father died at 62 of massive heart attack. No one in my family on either side has ever had breast cancer…

    its a quandary. Can you help give guidance?

    1. Hi Thea. I am so terribly sorry to hear about all that you and your husband have been through. I wish you strength and peace during this difficult and confusing time I am happy to give general advice and education, but unfortunately I cannot comment on specific individual cases unless I am working with that individual as my patient. I hope you can find a doctor to work with you and entertain all the possible options including keto to find the right one for you. Best of luck.

    2. i feel ur pain guys, i too had no issues health wise until at 60 i had a 100% blocked artery. had a stent put in lad artery. after 3 months i got on a ant-depressent drug for my anxiety. wish i left the hospital with one! everyone should get something to help with their fear & anxiety if they need it. next i started walking, at first like 5-7 minutes at a walk- then 15min & then before long i was walking an hour. it makes a ton of difference in how u feel & for ur heart. (after about 3months i stopped taking the anxiety meds) didnt need it anymore. mostly due to my walking. i take the meds my doctor suggests & watch my diet- no meat little dairy & my issue was cheese (which i ate tons of) hardly any fried food. its been over 3 yrs now & i work and am pretty fit & feel good most all of the time. it is a long road to get to where u feel good but u can do it with work! keep trying & realize most people die & u were given another day to get better so keep trying & goodluck to u both.

    1. Hi John. Thanks for your comment. Sorry, but I cannot give specific advice over the internet. Definitely ask your doctor if it is safe for you.

  12. Hi Dr Scher.

    Thank you for a wonderfully written, informative piece on keto. I am just over two weeks in and have to say that today I have felt the best I think I have ever felt. I suffer from Hashimoto’s thyroiditis and all that the condition entails. I have found keto easy, sustainable and the concept/ physiological mechanism (from my lay understanding) so obviously sensical.

    At this stage I am 100% happy to commit to this lifestyle… no keto baking… just clean fats, proteins and carbs from leafy greens.

    I can’t, however, commit to letting go of my evening red wine (s), which do not seem to effect ketone production. Do you have any comment on red wine and keto please… aside the obvious in moderation, and that the liver will prioritise processing of alcohol over fats for a while post consumption…

    Also… will my new found fabulous energy remain???? (How long is a piece of string!!! )

    Very much enjoyed your article… thank you.

    1. Hi Justine. Great news! Congrats on making the change and feeling great. As for wine, please see my podcast with Todd White from Dry Farms Wine. I am a huge fan of their no sugar, low carb, no additive natural wines. They are far and away the best option for wine on a keto diet in my opinion. I hope that helps!

  13. One further very quick query… my fasting blood glucose is consistently around 3.3 – 3.7… any comments?

  14. Dr. Scher,
    Thank you for providing a cardiologist’s perspective and one that involves current research and studies instead of the tired advice of decades ago. After reading several books by Dr. Stephen Phinney and Dr. Jeff Volek and a few testimonies, I began my ketogenic nutrition adventure in 2014. after a couple years of success losing 50 lbs and feeling the best I’ve ever felt with great improvements on already good health biomarkers like blood pressure and cholesterol. I have had several hurdles (and excuses) that made the keto lifestyle less than easy. After a few off and on stints, I can report that I am 100% back on keto and have been going strong for the last month with no plans to stop again as my diet choices before were causing help concerns and weight gain. I’ve noticed that on many blogs and sites that the essence and science behind keto usually go by the wayside and the guidelines that Dr. Phinney and Dr. Volek have outlined in their extensive research are usually ignored in other studies and attempts to replicate their results. For instance, following the appropriate ratios of fat to protein to carbs may be followed but only for several days to a week (the Keto flu) and these results are reported as the conclusion to show how nutritional ketosis makes you feel sick. Or the longer studies include too many carbs or too much protein (leads to gluconeogenesis) and the subjects don’t enter into ketosis and feel poorly with poor results. I’m just a lay person but a literate one, but how can I explain the health benefits to detractors and why do you think there is so much bad or misleading information about nutritional ketosis and its positive effects on metabolism and other biological and physiological processes?

    1. Great points Jason. I think the best research of late comes from Virta Health. They study a real low carb, keto diet over years. You are absolutely correct that many studies call 40% carbs a “low crab diet.” Although this is true in relative sense compared to the standard American Diet, it is a far cry from the healthier low carb diets we want to discuss. Keep pointing people to the work of Drs. Volek and Phinney and the whole crew at Virta and they will have a hard time arguing the science!

  15. Hey Doc! I have high cholesterol as well. My friend and roommate has a BA in Biology and we have had constant fights over Keto, even though I will be doing a modified version of it (no red meat and no butter). I just restarted this diet because I just got my blood work back and my cholesterol and tryglycerides are terrible. Do you have any other articles or anything that I can show my friend to try to set aside his fears about this lifestyle change? I’m honestly tired of fighting with him about it, especially since everything I will be eating is exactly what my Doctor told me to eat, but he is still worried and I understand his fears.

    Thank you!

    1. Hi Treyson. Unfortunately, we don’t have long term data to show everything is fine with altered blood work on a keto diet. There is plenty of reason to believe it is fine, but the data isn’t there. I have found that if people are skeptical, they may continue to be so without hard data. The keys are if you are feeling better, losing weight, lowering your BP, improving your metabolic health, thinking better etc… then cholesterol may not be the most important marker. It is very individualized. I am concerned, however that your Tgs are not good. That may require more digging. I suggest you work with a doc or health coach who is familiar with low carb and keto who can help you.

  16. Thank you for posting this article Dr. Scher. I am a registered nurse. I started a LCHF lifestyle a month ago. I have lost almost 12 pounds. I have been taken off blood pressure medication. My resting heart rate is 62 and my blood pressure runs on the low side of normal now. I have history of PCOS and was borderline diabetic. My glucose is staying around 96-99 now. My cholesterol has dropped from 225 to 160! I feel better so I plan to make this my new way of life.

  17. Thank you for your posts. On 03/25/2019 diagnosed with type 2 :diabetes Ac1 7, Fbs 139, Wt 237 by my nephrologist (i have 1 kidney living donor Gfr 61). Was told if i could drop 5-10% of weight i could drop meds (metformin for glucose ) and hypertension (lisinopeil 10mg) which he prescribed on 03/27/2019 , also take lipitor 20mg. Started Keto eating 3/26, on 4/4/19 my pulse after exercise bounded between 96 – 42 drove myself to ER , spent night with heart monitor and next day stress treadmill test with nuclear imaging .Got clean bill of health for heart . Heart beat diagnosed as bigeminy prescribed Metoprolol 25mg. I am 68yo M 5’11’ at present 229 .
    Is this common ?
    My cardiologist gave thumbs up to keto ,suggested i add more carbs if i feel lightheaded and be sure to hydrate. Keto diet lowers my cravings for carbs thus less calories taken in . Average 20-30 grams carbs daily .
    Any suggestions . As of this post meds seem to be improving rhythm post workout (1 hour walk daily) .

    1. Thanks for your comment. Unfortunately I cannot give advice over the internet, but I am certainly glad to hear things are improving. If you want to dig deeper into your lifestyle and its impact on your health, you can always sign up for a health coaching consult through my website. Keep up the great work! Bret

  18. Hi Bret

    I’ve lost 10 kg’s in my first keto-diet month – and best of all, it does not feel like a diet. Eating lots more veggies and healthier meat, preparing meals through proper planning. I’ve no longer feel hungry, but best of all, I no longer have those hunger surges. My cholesterol has dropped to 4.0 – lowest in years, blood-pressure has reduced to 120 / 80, also the best it has been in many many years, even my doctor is impressed. I sleep so much better, no longer having to get up in the middle of the night for a bath-room break, of to look for a snack.

    Keep up the great work – really wish more people could join in. Many of my friends cannot believe this!

  19. I got on the keto diet two weeks ago for the purpose of trying to reduce the frequency of my seizures (focal and generalized). I have been on different AEDs over the years and my hope is that this diet will succeed in making it so that I can eventually wean off of them totally. Seizure meds suck. I have already noticed much improved mental clarity. That alone has been a very interesting change. I found this post because I got worried about the health of my heart in the long term. Besides the epilepsy, I’m pretty healthy and active. The last thing i want is to trade seizures for heart attacks or strokes. Haha, that would suck.

  20. Hi Dr. Bret!
    Is is very safe to go on keto diet for people with high bad cholesterol, especially that the diet focuses on eating high fat like pork fats and other meat fats? I have high cholesterol and uric acid and i am on my 3rd day of keto diet. I feel weak and dizzy not being able to eat carbs. But what i really would like to know to be reassured if keto diet is okay with me considering i have high bad cholesterol and uric acid? Thank you in advance for your reply.

    1. Hi Cecil,

      That’s a great question. Unfortunately, we can’t give medical advice over the blog, but we can recommend a medical consult so that we can dig in, in-depth and see why you’ve been experiencing dizziness. Click here to learn more.

  21. I stumbled onto this site, and SO glad I did! I had a minor heart attack 3 yrs ago. I lost 30lbs duringbtge year that led to it. I’ve kept 20lbs off, but then plateaued. I started me to last week, and have been feeling great! I just purchased Dr. Axe’s book, but still searching and researching. Thank You for this!!

    1. Thanks for your comment. Just please remember to continue to check up regularly with your doctor to make sure your metrics are all improving as expected.

  22. I just suffered a heart attack. The diet they want me on Iis full of carbs. Example one of the things I can eat while out is breadsticks from Olive Garden and waffle fries from Chick-fil-A. I am so confused and scared. I don’t know what to do. I did very dirty Keto but I am thinking clean Keto is the best. If I am wrong I am dead. Thanks for the article.

    1. Hi Patricia. I am very glad that you recognize there is nothing healthy about breadsticks and waffle fries! Yuck. I hope you can find a doc who is willing to work with you and find the best approach for you as an individual.

  23. I was on keto for 2 months lost 25 lbs but l had a heart attack which l am thinking from the other eating habits of carbs carbs..l am 59 and l was told l need to do the low fat cardic diet…l have already gained 3 lbs since being home from the hospital. I dont want to keep on that diet….but l sure dont want another episode so is there a lchf diet for cardiac paitents that l could follow instead?

    1. Hi Bernadine. I am sorry to hear about your heart attack. I hope you are having a speedy recovery. While I can’t comment on your case exactly, I can say that I have numerous patients with prior heart attacks whom I follow on a low carb diet. The key is doing it safely and making sure all the important risk markers improve. If they don’t, then it is time to mix it up with a new experiment. I hope you can find a doc who is willing to work with you and find the right approach for you as an individual.

  24. I’m 5’8”, 140 lbs, and without any health problems except my father had coronary artery thrombosis event @ age 59: after much med/surgical intervention, he survived until age 97. I’ve been in ketosis for 2 yrs to ward off the diseases of civilization, but I am a lean mass hyper-responder. I don’t see much about LCHF for “normal” population. What’s the current thinking about lchf for the skinny guy normotensive nondiabetic population like me?

    1. Great question David! This is definitely an area where we need more data. There simply isn’t much out there. In theory it seems like it should promote optimal health by keeping blood glucose and insulin levels low, keeping you lean and active, and helping ward off diabetes, cancer, dementia etc. Now we just need the data to prove it!

  25. My husband and I have been doing Keto since Jan 8. We have both lost weight but also I’m off BP meds and his A1c has gone from 5.9 to 5.4. The problem is his TC and LDL have both gone up. TC was 424 and LDL was 350. HLD went up and triglycerides came down. His LDL has been slightly elevated for a couple of years and his Dr wanted him on statins, which he did take for a short time. Now with these numbers he is wanting him to take them again. We are going to schedule a CAC scan, but even the cardiologist said if the scan score is high he should take a statin. My question is, is TC and LDL as bad as they are made out to be? Is there anything we can do to lower the numbers? Even thou I’ve done a good bit of research, Dr Phinney, Dave Feldman, Ivor Cummins and others, it’s scary! Thanks Debbie

    1. Hi Debbie. Those are loaded questions that don’t have an easy general answer. That is why I have been so busy lately with individual consults! People want answers that they can’t easily get. I would be happy to help with an individual consult, but short of that there is no easy answer.

  26. Hi, have just read your article and wanted to give my input. I started keto at the end of last year, felt great, then fell off the wagon (for some reason I couldn’t cope with the extra energy). I started keto again last month and am really enjoying the energy, exercising more, but still have the restless feeling due to the extra energy. I did have one day where I had too many carbs and felt very ill so I will stick with the keto. I did a lot of research before starting it, and I tend to go with what my body says it needs, usually salads, so keto works with me. Since I’ve been back on it I’ve not had dizzy spells or palpitations which is is great.

  27. I’m 52 with heart disease. My grandfather died at 48 and my father had his first heart attack at 52 (quadruple bypass at 56). I had my first heart attack at 46 and in the last 6 years I’ve had 4 heart surgeries (stents) and 2 heart attacks! Additionally, I’m statin intolerant and cant afford the only non-statin cholesterol inhibitor, Repatha. Cardiologists say its “not what I’m putting into my body, its what my body is putting out!” – I’m a dead man walkin’ at this point and I am considering a keto diet to hopefully extend my life a little. Any thoughts or suggestions?

    1. Hi Curtis,

      That sounds like quite a tough journey you’re on. We’re sorry to hear, but we are here to help. We don’t believe in “dead men walking” – anyone’s health can be improved. Unfortunately, we can’t give medical advice over the blog, but we highly recommend a medical consult with Dr. Scher, so we can truly get to the bottom of what’s going on and help you achieve your best health ever.

  28. I would really like to know how you feel about coconut oil? I hear it’s bad, I hear it’s good. I have elevated cholesterol, so for me, I like the bottom line so I do not raise it any more that it already is. p.s. I love the keto diet, but all the bad press also scares me. Your article is refreshing!

  29. High carb – what foods? Could be processed and not “ Whole Food Plant Based Diet- makes a BIG difference ‍♀️ unprocessed, organic and locally grown is the best. I Why don’t Keto people acknowledge that 98% of meat/ animal fat is produced in CAFOS where animals never see the light of day until en route to a slaughterhouse …all killed while still babies. High speed slaughter lines are causing many animals to be stunned improperly and dismembered while still alive. The rural poor that live near these houses of horror are suffering from increased rates of cancer and asthma. Animal AG uses 2/3rds of all arable land and is responsible for species extinction and environmental devastation. 90% of the Amazon is burning because of Animal AG- causing a decrease in oxygen and warming the planet. Why do people who promote a heavy animal food based diet sumply ignore the impact of their food choices? I’m honestly curious?

  30. It’s easy to find information about keto for weight loss and diabetes, but not much related to heart disease. What effect do keto and intermittent fasting have on reversing heart disease, removing plague from arteries, etc?

    1. Hi Charles,

      Thank you for your question. This is an interesting topic that deserves a detailed analysis and explanation. We don’t feel the blog is an appropriate forum for this. If you would like a more individualized approach and answer, please feel free to sign up for a one-on-one consultation with Dr. Bret Scher.

  31. Dr. Scher. Can you share blood test, patients and yours, who have been on the LCHF lifestyle for a while?

    Thank you.
    Disabled Combat Veteran

    1. Hi Ron,

      Thank you for your question. We value our patient’s privacy and cannot share any tests or information.

  32. Dr. Bret, I love this article and was really helpful in my research into keto and shared to my family who are skeptic about high fat and cholesterol. Btw, why do you have an apple on your logo when its not low-carb? maybe replace it with an avocado? 🙂

  33. Hi

    The point is can you back the lchf diet with real evidence. They are not asking for names and addresses but for the Drs heart patients had he really monitored them and had seen a significant improvement in outshines in the lchf patients Vs others? You cardiologists are key in showing the success or not of this approach. Why hide it. If it’s not working then please let us know that too

    1. Hi Rav,
      From Dr. Scher: “As of yet, we do not have long term interventional trial results comparing LCHF to other diets. We eagerly await such trial data. In the meantime, we need to rely on studies showing improved biomarkers, improved diabetes care, improved weight loss and other surrogate measures.”

  34. My cholesterol is nearly 300 and my triglycerides are over 500. I am 46, both my parents have high numbers, and I have for nearly 15 years. Will Keto bring these down to a healthy range? Will it reverse arteriosclerosis, like the Ornish diet claims to?

    1. Hi JM,

      Thanks for your comment! Unfortunately, Dr. Scher is unable to give medical advice on his blog. If you would like a more detailed evaluation and answer to your questions, you could always consider an individualized consult.

  35. Hi I think this approach to diet is going to help me. I need to lose around 15kg. I was wondering, can you lose weight with just moderately low carb or do you have to be in keto? And does one cheat like eating a pain au chocolat (flaky pastry with chocolate) ruin your progress or is it harmless if it’s only occasional?

    1. Hi Liv,
      Thanks for writing! We think so, too. These diets affect everyone differently, however, and unfortunately, Dr. Scher is unable to give medical advice on his blog. If you would like a more detailed evaluation and answer to your questions, you could always consider an individualized consult.
      We hope this helps!

  36. Dr David Harper in his book The Bio Diet has a cautionary alert for LCHF and Cardiomyopathy. Can you comment on whether you would have reservations regarding Cardiomyopathy and LCHF?

    1. From Dr. Bret Scher:

      Thank you for your question, Tina! There is some promising research about myocardial tissues using ketones for energy, but it is preliminary at this point. At this point, I think the use of a LCHF diet in the setting of a cardiomyopathy is a potential option but needs to be individualized.

  37. I’d love to see some research that could help explain my recent improvement since going LCHF… or more specifically, Keto. I have had 3 open heart surgeries… the last one as a result of severe endocarditis which left me with ongoing, debilitating out of whack heart beats which I was told were harmless…. but they were so bad I couldn’t sleep. I went on the keto diet and within a week they were all but gone. Now, as long as I stay in ketosis, I have a nearly 100% normal heart rhythm. Not one Dr or Cardiologist expresses any interest in this whatsoever… I’m not sure why though as they all know my complex cardiac history and to have such a profound improvement should spark at least a little intrigue!

    1. Hi Vanessa,

      Dr. Scher asked me to relay his response to you:

      “I agree, physicians should be fascinated by your case and I wish it inspired them to learn more about the role of low-carb nutrition on various aspects of health. We could all benefit from a great deal more intrigue and research in this area. Thanks for sharing your experience!” – Dr. Bret Scher

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