Keto, Cholesterol, and the Confusing Heart Study That Everyone’s Talking About

You might’ve seen headlines saying keto doesn’t raise heart disease risk—even if your cholesterol spikes. Sounds reassuring, right?

Here’s where it gets confusing—and why we need to dig deeper.
🧪 A recent study (Soto-Mota et al. 2025) followed 100 people on a long-term keto diet who developed very high “bad” cholesterol (LDL). These folks were called Lean Mass Hyper-Responders. The researchers said their high cholesterol didn’t cause more plaque in their arteries—the stuff that can lead to heart attacks.
Sounds great for keto lovers... but there’s a twist.

***The most important number—how much plaque actually built up—was left out of the published study. When the lead author shared it later on social media, it showed a 43% increase in artery plaque. That’s more than 3x the normal rate.***

Even more confusing? The study didn’t include people with normal cholesterol to compare against. So saying "cholesterol didn’t matter" is like testing if smoking causes lung damage—but only studying smokers.

The truth?
Plaque build-up = heart risk
High LDL (“bad” cholesterol) and ApoB are still very much linked to that
Keto diets have not been shown to be safe in regards to cardiovascular health - and here we're seeing high risk

⚠️ Bottom line: If you’re doing keto (and I don't recommend it) and your cholesterol is high, don’t brush it off. Talk to your doctor. There’s real evidence that this could increase your heart disease risk—even if you’re otherwise healthy.

Let’s stick to facts, not fads.

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