Hello, and welcome back. Today we're tackling a question, that generates a huge amount of confusion and debate online, and even in doctors' offices: Can you, or should you, use the keto diet for high blood pressure?
On one hand, you’ll hear stories of people, dramatically improving their hypertension with a ketogenic diet. On the other, you'll see warnings from cardiologists that this high-fat diet, could be dangerous for your heart.
So, what is the truth? In this video, we are going to cut through the confusion. We'll look at the scientific arguments on both sides, the real-world evidence, and the critical risks you need to understand to answer the question: is the keto diet a viable option for managing high blood pressure?
The Argument for the Keto Diet.
Let's start with the argument for how a high-fat diet could possibly lower blood pressure. The theory centers on a hormone you know well: insulin. Conventional thinking often blames high sodium intake as the primary cause of hypertension. But a compelling body of research suggests that for many people, the root issue is actually insulin resistance, also known as hyperinsulinemia.
Here’s how it works: One of insulin's many jobs is to tell the kidneys to hold on to sodium. When you eat a diet high in processed carbohydrates and sugars, your insulin levels can become chronically elevated. This signals your kidneys to retain excess sodium, which in turn increases blood volume and pressure. Chronically high insulin can also cause blood vessels to constrict and lose their flexibility.
The ketogenic diet, by dramatically restricting carbohydrates to under 50 grams per day, is highly effective at lowering insulin levels. By addressing the high insulin, the diet may allow the kidneys to excrete sodium properly, potentially leading to a decrease in blood pressure.
What the Pro-Keto Evidence Shows.
This theory is supported by some short-term evidence. The primary way the keto diet may help with high blood pressure is by promoting weight loss. Obesity is a major risk factor for hypertension, and keto can be an effective tool for weight loss, which almost always improves blood pressure.
Several studies have shown that, in the short term, a keto diet can lead to improvements in blood pressure. For example, a study on the Atkins diet, which is similar to keto, showed that participants' systolic blood pressure fell twice as much as on other popular diets. Another study comparing a low-carb diet to a low-fat diet plus the weight-loss drug Orlistat found that, blood pressure fell in the keto group but actually rose in the low-fat group.
Finally, a survey of over 2,000 people on a carnivore diet—an even more extreme version of keto—found that 93% of participants with hypertension reported that, their condition was resolved or improved.
The Argument AGAINST the Keto Diet.
Now, we must look at the significant arguments against using keto for heart health. The primary concern for most cardiologists is the diet's effect on LDL cholesterol. While keto often lowers triglycerides and raises "good" HDL cholesterol, multiple reviews have found that it also raises "bad" LDL cholesterol in about 30 percent of people. In some individuals, this increase can be dramatic.
Furthermore, recent research from a large, cross-sectional analysis of the NHANES database, from 2007-2018 found a concerning link. After adjusting for many confounding variables, the study concluded that, diets with a higher ketogenic ratio were significantly associated with an elevated risk of hypertension. This association was particularly pronounced in middle-aged and elderly populations, and was strongly correlated with an increase in diastolic blood pressure.
The Salt & Electrolyte Question on Keto.
This brings us to a key question: does salt cause high blood pressure on a keto diet? The answer is more complex than you might think.
The ketogenic diet has a natural diuretic effect, meaning it makes your body flush out water and, along with it, essential electrolytes like sodium. This leads to a paradox. If you consume a "dirty" keto diet high in salty, processed meats without enough potassium from vegetables to balance it, your blood pressure can certainly go up.
However, consuming too little sodium can also be a problem. When sodium levels drop too low, your body releases a hormone called aldosterone to retain sodium, and aldosterone itself can raise blood pressure. This is why proper electrolyte management, including adequate sodium, potassium, and magnesium, is critical for anyone on a ketogenic diet.
Other Critical Risks: Drug Interactions & Sustainability.
Beyond cholesterol and electrolytes, there are other serious risks to consider.
First, potential drug interactions. Many cardiovascular patients are on blood thinners like warfarin. A keto diet often involves a high intake of leafy green vegetables, which are rich in Vitamin K. This can interfere with warfarin and make it less effective. Furthermore, SGLT-2 inhibitors—a class of drugs used for both diabetes and heart failure—are generally considered incompatible with a ketogenic diet, due to the risk of a serious condition called euglycemic ketoacidosis.
Second is sustainability. The keto diet is extremely restrictive. This makes it very difficult to stick with long-term, which can lead to a "yo-yo" effect of losing and regaining weight. This weight cycling puts significant stress on the heart, and is associated with a higher risk of heart attack and stroke.
The Expert Consensus on Low-Carb vs. Other Diets.
So, with all this conflicting data, what do major health organizations conclude?
The European Society of Cardiology notes that, while very low carbohydrate diets can produce short-term effects, these benefits tend to diminish over time. An in-depth 2024 review in Current Problems in Cardiology stated that, the ketogenic diet does not fulfill the criteria of a healthy diet, and its long-term efficacy is not significant.
When it comes to a proven, sustainable, and safe diet for long-term heart health, experts and major reviews repeatedly point to the Mediterranean diet. This approach, rich in vegetables, fruits, whole grains, and healthy fats from fish and olive oil, has strong and consistent evidence supporting its cardiovascular benefits.
So, let's bring it all together. Does the keto diet lower blood pressure? It can, in the short term, primarily as an indirect result of weight loss and reduced inflammation. However, it comes with significant, well-documented risks, including elevated LDL cholesterol, nutrient deficiencies, and dangerous drug interactions. Recent large-scale data even suggests an association with an increased risk of hypertension.
The short-term benefits often fade over time, and the restrictive nature makes it difficult to sustain.
For these reasons, the keto diet is not a simple fix, and should not be experimented with lightly, especially if you have high blood pressure or other heart conditions. Any attempt at this diet must be done only under the close supervision of a keto-knowledgeable doctor or registered dietitian, who can monitor your health and labs carefully.
If you appreciate this balanced, evidence-based approach that helps you make informed decisions about your health, please take a moment to click that subscribe button below for more useful health information.
Thank you for watching. Stay informed, and I'll see you in the next video.
No comments:
Post a Comment