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This week, I got a great question from a reader asking about the relationship between vegan or vegetarian ketogenic diets and high triglycerides. More specifically, they wanted to know if a ketogenic diet would be appropriate for someone with high triglycerides. In order to explore this further, let’s take a look at just what triglycerides are, what conventional medicine tells us about lowering triglycerides, and how this information can be considered in terms of low carb or ketogenic diets.
What are Triglycerides?
Essentially, triglycerides are a type of fat found in the body. Triglycerides are synthesized from foods we eat, and stored in our liver and fat cells. While many of the dietary fats we consume (like butter) are in triglyceride form, it’s typically excess carbohydrates that actually lead to increased triglyceride levels. In fact, studies have shown that when the intake of carbohydrates exceeds 55% of total calories, triglycerides rise. In some cases, high triglycerides are actually genetic, and not necessarily indicative of a poor diet. In order to determine the cause of high triglycerides, you’ll have to talk to your doctor!
High triglyceride levels are associated with several conditions, like metabolic syndrome, hypothyroidism, diabetes, kidney disease, obesity and general poor eating habits. High triglyceride levels have been shown to cause heart disease, fatty liver disease and pancreatitis. It’s basically bad news bears.
Does Eating Lots of Fat Raise Triglycerides?
Since triglycerides are a type of fat, it’s not unreasonable to think that high serum levels would be associated with high dietary fat intake. However, there is little evidence to support fat consumption leading to an increase in triglycerides – and even further, studies have demonstrated that high fat diets can help to reduce triglycerides more effectively than low fat diets! As high triglycerides are often a result of over-production in the body, as opposed to dietary intake, it would seem that dietary fat consumption is not the cause.
One type of fat that may actually be associated with higher levels of triglyerides is trans fats. Consuming trans fats has been associated with an increase in triglycerides, and should be avoided if you have high triglycerides. In fact, trans fats are gross in general and should be avoided whether or not you have high triglycerides.
Another type of fat that is often implicated in raising triglyceride levels is saturated fats. Currently, there’s actually a lot of conflicting information on saturated fats and heart disease. While there isn’t overwhelming evidence to support the theory that consuming saturated fats, many health professionals and organizations still cling to this idea. Saturated fats are the ones that are solid at room temperature, like butter, lard and coconut oil (it’s also found in high quantities in meats and other animal products, though not really in fish). As you might imagine, vegans don’t really consume as much saturated fat, so this isn’t really an issue for vegans, who can likely have some coconut oil without panicking about a heart attack.
I won’t tell you what to think either way, but definitely suggest doing some more reading to form your own opinion. This post by Mark Sisson pretty clearly outlines the saturated fat debate. I’d also recommend reading The Big Fat Surprise, Eat Fat, Get Thin and Good Calories, Bad Calories. These three books offer up an interesting perspective on fat intake (though, from a predominantly pro-meat stance).
How Do You Lower Triglycerides?
The overwhelming consensus in the medical community is that to lower triglycerides, you need to lower carbohydrate intake (especially simple sugars and refined carbohydrates). This is recommended by both Cleveland Clinic and the Mayo Clinic, as well as many doctors, and isn’t just wishful thinking on my part. Weight loss is also recommended, in addition to other dietary changes. A quick list is below, though the Cleveland Clinic’s list is more comprehensive.
To be clear, this is not only advice recommended by the ancestral health movement, and other more fringe alternative medicine groups. While I actually do tend to think our knowledge can be enhanced by these alternative ways of looking at diet and nutrition, there is certainly something to be said for the research behind much of our current conventional wisdom. Given this, I find it important to note that the following advice is endorsed and promoted by the conventional medical establishment, as well as by many alternative medicine schools.
To lower triglycerides, one should:
- eliminate sugars (the Cleveland Clinic even recommends reducing and eliminating natural sugars…)
- consume carbohydrates in the form of veggies
- reduce or eliminate grains (certainly eliminate refined grains)
- avoid alcohol (best to eliminate it completely)
- avoid trans fats
- lose weight
- (maybe) watch saturated fat intake
Interestingly, losing weight comes up again and again as the best way to reduce triglycerides. Whether this is related to reducing body fat (where triglycerides are stored), or reducing excess calories (as our bodies synthesize triglycerides from excess calories) has yet to be determined, but this is important to note either way!
So, is vegan or vegetarian Keto appropriate for someone with high triglycerides?
In a nutshell, unless you have an underlying medical condition (talk to your doctor!), a vegan or vegetarian ketogenic diet should not raise triglycerides, and will likely help to lower them. Looking at the factors that contribute to lowering triglycerides (mentioned above), a vegan ketogenic diet will actually contribute positively to each of these.
Weight loss is common on a ketogenic diet, and the nature of keto means that you will automatically be eliminating refined sugars, grains and most carbohydrates (except for those from veggies!). Saturated fats are more difficult to find on a whole foods, vegan diet (though their responsibility in raising triglycerides has yet to be confirmed), and trans fats can easily be avoided, so long as you stay away from fake butters (basically, don’t eat anything that contains “hydrogenated” oils).
Based on the information provided by premier medical facilities in mainstream medicine, as well as doctors in the mainstream and ancestral health community, it would seem that a vegan or vegetarian ketogenic diet could actually be really beneficial for those with elevated triglycerides!
Do you have experience with changes in your triglyceride levels on a ketogenic or low carb diet? I’d love to hear about it in the comments!
Sources:
http://jn.nutrition.org/content/131/10/2772S.long
http://www.webmd.com/cholesterol-management/tc/high-triglycerides-overview
Click to access ucm_425988.pdf
http://www.aicr.org/press/health-features/health-talk/2013/06june2013/triglycerides-fat.html
https://www.ncbi.nlm.nih.gov/pubmed/15173403