Incidence of metabolic syndrome is steadily growing among adults in the US, with no cut and dry intervention in sight.

In a recent study published in the Current Developments in Nutrition journal, researchers examined the impact of a ketogenic diet on markers for metabolic syndrome.[1

While the ketogenic diet is known for its anti-inflammatory benefits, some healthcare professionals raise concern about the amount of cholesterol and saturated fat that the typical keto diet contains.

To specifically assess how a keto diet high in cholesterol would impact metabolic syndrome, the authors controlled for egg consumption, with one group only consuming egg whites and the other group consuming plenty of egg yolks. 

What did they find? Read on to learn more.

What Is Metabolic Syndrome?

Metabolic syndrome is a serious public health concern as it is one of the most common conditions we see today. In fact, statistical analysis shows that around one-third of the adult population in the US has some form of metabolic syndrome.And the prevalence of this condition only seems to be on the rise.[2

So what exactly is this condition that's so prevalent in our society? 

As opposed to being one clear-cut disease state, metabolic syndrome is a term used to describe a group of conditions that together raise your risk of cardiovascular disease, type 2 diabetes (insulin resistance), stroke, and other serious health problems.

While the exact pathway to metabolic syndrome may look different for everyone, at its core, it is a condition that results largely from lifestyle factors like lack of exercise and poor diet. 

As you're probably aware, the food you eat can significantly impact your health. Consuming a high-carbohydrate diet full of processed foods is one of the fastest ways to throw off your metabolic health. This way of eating can cause dysfunction in your entire system, creating issues like dyslipidemia (irregular blood lipids), fatty liver (hepatic overload of fat), insulin sensitivity and irregularities in insulin levels (diabetes mellitus), hypertension, and more.

If you have three or more of the following conditions, you may have metabolic syndrome:[3]

  • High blood pressure
  • Abdominal obesity (a large waistline)
  • High blood sugar levels
  • High blood triglycerides
  • Low HDL cholesterol (High-density lipoprotein)

The good news is that even if you currently have metabolic syndrome, there are tangible steps that you can take to turn this condition around. Diet can significantly impact all of the above metabolic markers; the key is finding the diet that is right for you and your condition.

The Basics Of A Ketogenic Diet

The study's authors chose to focus on a low-carbohydrate ketogenic diet for metabolic syndrome as this way of eating has already been shown in several clinical trials to produce many beneficial health outcomes. 

Just a handful of potential benefits that come with a ketogenic diet include:[4][5][6][7]

  • Weight loss
  • Reduced inflammation 
  • Improved cognitive health (specifically in neurological conditions such as Alzheimer's disease)
  • Improved cholesterol levels 
  • Decreased blood triglycerides 
  • Improved glucose control
  • Reduced body mass index (BMI)
  • Improved mitochondrial health

While many people confuse the ketogenic diet with a standard low-carb diet, the primary difference is the level of carbohydrate restriction. 

While a low-carb diet is somewhat subjective, a ketogenic diet follows specific guidelines for macronutrients that keep dietary carbohydrates low enough for your body to shift into a state known as ketosis. This makes the ketogenic diet a high-protein, high-fat diet, allowing your body to run primarily on energy obtained from fatty acids. While amino acids from protein still play a role, your body likes to preserve those molecules for other uses.

With a standard diet or even a typical low-carb diet, your body still receives enough carbohydrates each day to run primarily on glucose (the fuel generated from carbohydrate consumption). In the absence of glucose, your body switches its metabolic gears to start fueling itself on energy molecules called ketone bodies. 

To accomplish this feat, carbohydrates must be kept low, while foods high in fat and protein become the focus of your diet. 

Many of the benefits listed above that are associated with the ketogenic diet come directly from the production of ketones, which is why fully embracing the ketogenic diet is often much more beneficial than simply going low-carb. 

Study Methods

Now that you've grasped some of the basics of metabolic syndrome and the ketogenic diet let's dive into the specifics of the study. 

The study subjects were all currently diagnosed with metabolic syndrome. 

The study included three phases:

Phase #1: 4-week run-in phase where all participants ate a similar diet without any intervention

Phase #2: A 12-week intervention phase where the participants were divided into three groups:

  1. Ketogenic diet with the inclusion of whole eggs (Yolk KD)
  2. Ketogenic diet without any egg yolks, supplemented with egg whites (White KD)
  3. Balanced diet with controlled energy 

Phase #3: follow up at week 36

The three diets reflected a high-cholesterol intervention (Yolk KD), a low-cholesterol intervention (White KD), and a control group to serve as a comparison. 

Before and during the study, the participants were monitored for specific changes in biomarkers related to metabolic syndrome, including:

  • Body weight 
  • Waist circumference 
  • Triglyceride levels
  • Blood glucose levels
  • Blood pressure
  • HDL cholesterol 

Outcomes Of A Ketogenic Diet For Metabolic Syndrome

Following the 12-week trial, significant changes were seen in both the Yolk-KD and White-KD groups. Regardless of cholesterol consumption, both groups saw significant positive shifts in:

  • Average body weight
  • Waist circumference 
  • Triglycerides
  • Blood pressure

The authors also note that there were no significant differences between the two intervention groups, indicating that the higher amount of cholesterol in the yolk group did not negatively impact weight, waist circumference, triglycerides, or blood pressure. 

Furthermore, HDL cholesterol did not change significantly from baseline, indicating that the high dietary cholesterol intervention did not poorly affect cholesterol balance. 

Fasting blood sugar didn't shift significantly from week 1 to 12.

As for the long-term effects, after 36 weeks, both of the ketogenic intervention groups maintained the beneficial effects of the ketogenic diet on body composition with a sustained reduction in body fat.

Meanwhile, the control group that was not receiving a ketogenic diet saw no significant changes in any of the above markers. 

What Does This Mean For You?

The authors of the study concluded that dietary intervention plays a pivotal role in the outcomes of metabolic syndrome. Specifically, watching your carbohydrate intake with a ketogenic diet (both high and low in cholesterol) can have a positive impact on several metabolic and cardiovascular risk factors, including weight, waist circumference, lipid profile, and blood pressure.

Furthermore, this study showed that dietary cholesterol intake did not have any adverse effects on the associated markers and did not impact glycemic control.

If you've been diagnosed with metabolic syndrome, prediabetes, or any of the associated cardiometabolic conditions, making changes in your diet can have a significant impact. The ketogenic diet is a potential therapeutic intervention for these conditions and many more. 

If you're interested in learning more about the ketogenic diet and how to implement this style of eating, BioCoach would be happy to help you on your journey.


  1. Pinsawas, Bonggochpass, et al. "A Healthy Asian Ketogenic Diet, Regardless of Dietary Cholesterol Intake Improves Metabolic Parameters in Individuals With Metabolic Syndrome." Current Developments in Nutrition 6.Supplement_1 (2022): 856-856.
  2. Hirode, Grishma, and Robert J. Wong. "Trends in the prevalence of metabolic syndrome in the United States, 2011-2016." Jama 323.24 (2020): 2526-2528.
  4. Gomez-Arbelaez, Diego, et al. "Resting metabolic rate of obese patients under very low calorie ketogenic diet." Nutrition & metabolism 15.1 (2018): 1-10.
  5. Kosinski, Christophe, and François R. Jornayvaz. "Effects of ketogenic diets on cardiovascular risk factors: evidence from animal and human studies." Nutrients 9.5 (2017): 517.
  6. Rusek, Marta, et al. "Ketogenic diet in Alzheimer’s disease." International journal of molecular sciences 20.16 (2019): 3892.
  7. Dashti, Hussein M., et al. "Long-term effects of a ketogenic diet in obese patients." Experimental & Clinical Cardiology 9.3 (2004): 200.

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