Keto, Carnivore and High Cholesterol

Why I don’t personally recommend these approaches for people with raised cholesterol

If you’ve been told your cholesterol is high and you’re exploring different dietary approaches, it’s very likely you’ve come across keto or carnivore diets.

They’re often framed as a solution to modern health problems. Cut the carbs. Eat more fat. Simplify everything. And for some people, that message is understandably appealing.

But when it comes specifically to high cholesterol, these are not diets I personally recommend. I want to explain why, calmly and clearly, without fear-mongering or diet bashing.

Because this isn’t about being “anti” anything. It’s about long-term heart health.

A quick overview of keto and carnivore

Keto and carnivore diets dramatically reduce carbohydrate intake and replace it largely with fat. Often a significant amount of that fat is saturated fat.

Foods like butter, cream, cheese, coconut oil, bacon and fatty cuts of red meat tend to feature heavily. Plant foods, wholegrains, beans and fruit are reduced or removed altogether.

This shift is important, because dietary pattern matters more than individual foods.

Saturated fat and LDL cholesterol

One of the main reasons I’m cautious about keto and carnivore diets for people with high cholesterol is saturated fat intake.

High intakes of saturated fat reduce how efficiently the liver clears LDL cholesterol from the bloodstream. When LDL is cleared less effectively, blood levels rise.

This isn’t theoretical. It’s one of the most consistent findings in nutrition science.

While small amounts of saturated fat can absolutely fit into a balanced diet, these approaches often push intake far beyond levels we know support healthy cholesterol management.

For someone already struggling with raised LDL, that’s not a direction I’m comfortable encouraging.

“But my HDL is high and my triglycerides are low”

This comes up a lot, so it’s worth addressing gently.

Yes, keto and carnivore diets often lead to lower triglycerides and higher HDL cholesterol. Those changes are generally positive.

However, they don’t cancel out a raised LDL.

LDL cholesterol remains a key causal driver of atherosclerosis over time. This is well established in decades of research and reflected in guidance from organisations like the British Heart Foundation and Heart UK.

Heart health isn’t about winning on one marker and ignoring another. It’s about the overall risk picture.

Fibre is a big missing piece

Another major reason I don’t recommend keto or carnivore for high cholesterol is fibre.

Fibre, particularly soluble fibre, plays a crucial role in cholesterol regulation. It helps bind bile acids in the gut, which encourages the body to pull more cholesterol out of the bloodstream.

Carnivore diets contain essentially no fibre. Many keto diets provide far less than recommended.

When fibre intake drops, we lose one of our most effective, evidence-based tools for lowering LDL naturally.

This is one of the reasons I see cholesterol rise in people who otherwise feel they’re “doing everything right”.

The issue isn’t carbs vs fat

This is where things often become unnecessarily polarised.

I’m not anti-lower-carb eating. And I’m certainly not pro-ultra-processed carbohydrates.

The issue is that keto and carnivore diets often oversimplify a very complex system into “carbs bad, fat good”.

In reality, heart-protective diets tend to include:

• A balance of macronutrients

• Plenty of fibre-rich plant foods

• A focus on unsaturated fats over saturated fats

• Protein from a variety of sources, not just red meat

These patterns are consistently associated with better cholesterol profiles and lower cardiovascular risk over time.

Why personal preference matters, but physiology matters more

I completely understand why people are drawn to these diets. They can feel structured, clear and easy to follow.

But when I’m advising someone with high cholesterol, my priority is not dietary identity or short-term results. It’s reducing long-term cardiovascular risk in a way that’s sustainable and realistic.

That means choosing an approach that supports cholesterol metabolism, not one that regularly pushes LDL in the wrong direction.

My bottom line

If you have high cholesterol, keto and carnivore diets are not approaches I personally recommend.

Not because they’re trendy. Not because they’re controversial. But because they often work against the very mechanisms we rely on to lower LDL and protect heart health.

This doesn’t mean you need to eat perfectly. It doesn’t mean cutting out foods you enjoy forever. And it definitely doesn’t mean swinging to the opposite extreme.

It means choosing a balanced, evidence-based approach that your heart will thank you for in the long run.

If you’re feeling stuck between conflicting advice and want help finding a way of eating that genuinely supports your cholesterol and fits into real life, that’s exactly the space I work in.

No extremes. No judgement. Just clear, supportive guidance built for the long term.

If you'd like to book a free, no-obligation call to discuss which of my plans would be the best fit for you, you can do that here. Or simply head to this page of my website.