However it doesn't work for everyone! A keto diet can actually worsen cholesterol "numbers" for certain types of FH.
Keto does tend to raise LDL levels (LDL is often referred to as the "bad" cholesterol), especially in the first few months, but it usually evens out over time. Here’s the thing: LDL isn’t all the same. It comes in two main types of particles—small and dense (Pattern B) and large and fluffy (Pattern A).
The small, dense ones (Pattern B) are the ones you want to avoid because they’re more likely to sneak into artery walls, get stuck, and contribute to plaque buildup. They’re also more prone to oxidizing, which triggers inflammation—a major factor in heart disease.
The large, fluffy ones (Pattern A), on the other hand, are much less problematic. They’re too big to easily get into artery walls, and they’re less likely to oxidize. So, even if total LDL goes up on keto, it’s often because your body is shifting from the bad small, dense particles to the larger, fluffier ones. That’s actually a good thing!
At the end of the day, it’s not just about the LDL number. The size and type of LDL particles, as well as other markers like inflammation and triglycerides, matter much more when it comes to heart health.
