Keto and Heart Disease: Are Keto and Paleo Bad for your Heart?

keto and heart disease

Is the link between grain free diets like keto and heart disease really true? This is the question many people following the Paleo or keto diets are asking.

There have been some recent alarming reports linking low carb, grain free diets like keto and Paleo diets to heart disease. Naturally followers of these diets are worried and want to know more about any link between the Paleo diet or keto and heart disease.

The cause of the alarm is because researchers found a biomarker which has been linked to a higher risk of heart disease in people who followed a Paleolithic type diet for a year. Naturally people are concerned that the same could apply to other low carb diets like the keto diet.

But before you get worried about this, let us dig deeper about the link between keto and heart disease and whether both the keto and Paleo are bad for your heart’s health.

Paleo and Heart Disease

The Paleo Diet, also known as the Caveman Diet, is a type of diet that relies heavily on healthy grass-fed meat. Followers believe that this diet resembles what our ancestors ate during the Paleolithic era, which consists mainly of fish, meat, vegetables, seeds, nuts, and some fruits. The diet prohibits eating refined sugar, dairy, processed oils, salt, legumes, and any type of grains.

Paleo dieters believe that by eating the same food that our ancestors ate 2.5 million years ago, they will be able to lose weight and reduce their risk of developing certain diseases.

However, the Australian study shows that people who follow the diet may actually increase their risk of developing heart diseases.

According to the study, which was done by a group of researchers from the Edith Cowan University in Australia, those who followed the Paleo diet had twice the amount of the biomarker that’s linked to heart diseases compared to a group who followed a typical diet.

The study examined the effect of the diet on gut bacteria. They compared only 44 people following the Paleo Diet with 47 people who follow a typical Australian diet. They measured the amount of trimethylamine-N-oxide (TMAO) in the participants’ blood.

TMAO is an organic compound that’s produced by bacteria in the gut and a high blood level of TMAO has been linked to an increased risk of heart diseases.

The study’s lead researcher, Dr. Agela Genoni, has stated that,

“Many Paleo diet proponents claim the diet is beneficial to gut health, but this research suggests that when it comes to the production of TMAO in the gut, the Paleo diet could be having an adverse impact in terms of heart health.”

The researchers believe that the reason why the TMAO was elevated in people who follow the Paleo Diet is that they exclude whole grains in their diet. Dr. Genoni further stated that,

“We found the lack of whole grains were associated with TMAO levels, which may provide a link between the reduced risks of cardiovascular disease we see in populations with high intakes of whole grains.”

On the other hand in an article on the Western Price website Christopher Masterjohn, an independent researcher in nutrition states:

Elevated TMAO could reflect dietary trimethylamine or TMAO from seafood, but it could also reflect impaired excretion into the urine, or enhanced conversion of trimethylamine to TMAO in the liver.

He is saying here that there are other reasons for finding elevated levels of TMAO in the blood and so it’s not necessarily the lack of grains on a Paleo type diet.

Keto and Heart Disease

The ketogenic diet is one of the most popular diets today and that’s because it has helped millions of people to lose weight. Not only that, but the keto diet may also help people prevent or reverse type 2 diabetes and other illnesses.

If you’re following a keto diet, most of the food that you eat should come from healthy fats, low carb vegetables and fruit and a moderate amount of grass-fed meat.

Several studies have linked consumption of red meat to the high levels of chemicals that are associated with heart disease.

We know that saturated fat from meat has long been linked to heart disease, one of the leading causes of death around the world, although this has now been refuted. The blame was put onto high carb diets so many health conscious people have now switched to low carb diets.

Contrary to what some people thought, there’s actually no convincing proven link between keto and heart disease. Losing a moderate amount of weight on the keto diet may help to lower cardiovascular risk factors, such as high blood pressure and obesity.

Keto and Cholesterol 

A 2017 study has found that the ketogenic diet can lower the LDL (bad cholesterol) and increase HDL, the good cholesterol, which may prevent heart disease.

In fact, several studies show that a low carb, high fat diet such as the keto diet can lead to an improved cholesterol profile.

There is a lot of controversy about the significance of cholesterol and heart disease because just as many people with low cholesterol levels have heart attacks. It’s obvious that there are many factors besides cholesterol involved.

Although there may be limitations to these studies, it’s clear that the keto diet will not actually have any harmful effects on a person’s cholesterol profile despite what many people thought.

Keto and Triglycerides

If you’re going to follow the a ketogenic diet by eating fewer carbs and more healthy fats, your triglycerides could significantly drop.

Triglycerides are fat molecules circulating in your bloodstream and if you have a higher level of these fat molecules, you’ll be at high risk of developing heart diseases.

Many studies have linked high triglycerides to increased risk for heart disease and death, but once again the topic is highly controversial.

Whole Grains and Fiber Gap

One of the reasons why people link keto and heart disease is because of its similarity to the Paleo diet. As discussed above, a recent study found that following the Paleo diet could lead to a high level of TMAO, which is linked to an increased risk of heart diseases.

The researchers believe that it is the lack of whole grains in the Paleo diet that may be the reason behind this.

Both the Paleo Diet and Ketogenic Diet limits the consumption of carbs and encourages the consumption of healthy fats instead. And although both diets eliminate grains, there are some authorities suggest that some low carb grains can be eaten on the keto diet.

One of the differences in paleo versus keto is that keto focuses mainly on the macronutrient balance while Paleo is mainly about food choices. What this means is that with the keto diet, you can eat any kind of healthy foods that you want for as long as you adhere to the keto macros.

In order to maintain ketosis, 50 grams of carbs or less is allowed for a keto dieter to eat per day.You can have some grains on keto, as long as you don’t go beyond the recommended amount of carbs that you’re allowed to eat. In fact, there are low carb grains that you can include on your diet.


Although many people would associate keto and heart diseases since the diet focuses mainly on eating healthy fats, this is really not the case.

Remember that the development of heart disease is based on different factors, including blood pressure, blood sugar, cholesterol, unhealthy lifestyle, family history, and more. It is not mainly about the type of diet that you follow.

Chris Kessler, a highly respected Functional Medicine practitioner and proponent of ancestral nutrition states:

Frankly, the conclusions of the authors (that eating red meat increases the risk of heart disease via TMAO production) are so incongruous with the data in the study that it’s difficult to imagine how it could have passed peer review.

I’ll leave you with that thought. I’m sure you will do your own research before you jump to any conclusion about keto and heart disease.  As always it’s best to consult a knowledgeable doctor or Functional Medicine practitioner before deciding to follow a particular diet.


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