What the Science Really Says About Ketogenic Diets and Heart Health
Dr. Bret Scher (6 minutes)
Published by: Metabolic Mind - 21 February, 2026.
One claim that always resurfaces? That ketogenic diets are bad for your heart. But when you take a closer look at the science, that assumption simply doesn’t hold up.
In this video, Dr. Bret Scher breaks down the real evidence behind ketogenic diets and cardiovascular risk, addressing:
How many “keto” studies don’t actually study true ketogenic diets
The truth about LDL cholesterol on keto (it doesn’t go up for everyone!)
Why triglycerides, HDL, insulin, and inflammation may matter more than LDL
How keto compares to DASH for blood pressure and metabolic health
Why saturated fat from real food behaves differently in the body
The critical difference between ultra-processed high-fat/high-carb diets and low-carb, whole-food ketogenic diets
Using the most up-to-date clinical evidence, Dr. Scher explains why ketosis can be a heart-supportive strategy, especially for those with type 2 diabetes, hypertension, insulin resistance, or poor metabolic health.
Most heart attacks occur while PRE-DIABETIC HbA1c below 6.5%
Dr Ken Sikaris (4 minutes)
Published by: Doctors to Trust - 12 Sept 2023
Randomized, control trials in low carb for type 2 diabetes creates
lower triglycerides; HDL rises; and HbA1c is lower.
This is much better than the high carb; low fat diet, once recommended.
Red color in blood is hemoglobin - sugar sticks to red blood cells
[that is HbA1c]
-hemoglobin stays in blood for about 3 months so HbA1c is measure of
glucose for past 3 months.
If you go on low carb eating, HbA1c won't change for awhile...
"My own HbA1c was 5.4; fell to 5.2 after 3 months but, after 1 year, it is now 4.8"
As your HbA1c rises, so does coronary heart disease risk.
-Above 6.5%: diabetes is diagnosed and there is increased risk of eye
and & kidney disease.
Heart risk did not start when you hit 6.5%, but started way back at 5.5...
-most people who have heart attacks are not diabetic, they are prediabetic, and the heart attack got them before diabetes was diagnosed.
HEART ATTACK PREDICTOR?
Dr Ken Sikaris (7 minutes)
Published by: Doctors to Trust - 9 Feb 2025
If triglycerides are over 1.5, you will have sdLDL…
-To be confident that you are free of sdLDL, are your triglyceride should be less than 1.
That is likely if on ultra low carb eating [less than 50g / day]
What's the best lipid marker ratio to predict sdLDL? -TC/HDL
-better than TG or HDL
TC/HDL is also the best predictor of cardiovascular disease
-Other tests, non-HDL, apoB, or apolipoprotein A-1 are no better than TC/HDL
There is a high correlation between TC and LDL [.83 & .88]…
-in the ratio TC/HDL, don't use HDL, use 1/HDL -1/HDL correlates with TG [.89]
