Cardiovascular disease

Cardiovascular disease develops primarily from metabolic dysfunction, inflammation, and damage to blood vessels—not from cholesterol alone. High carbohydrate intake and repeated insulin spikes drive insulin resistance, which elevates blood glucose, increases oxidative stress, and chronically inflames the arterial wall. This inflammation causes LDL particles to become trapped and oxidized beneath the endothelium, forming plaque. LDL itself is not inherently dangerous; what matters is the LDL-to-triglyceride ratio and particle size. High triglycerides create small, dense, oxidizable LDL particles that easily penetrate vessel walls. Low triglycerides (seen in ketosis) produce large, buoyant LDL that does not enter or inflame arteries. A heart attack or stroke occurs when unstable plaque ruptures or blood flow becomes critically restricted.

• Carbohydrates → Insulin spikes: drive fat storage, raise triglycerides, and promote small dense LDL formation.
• Insulin resistance: accelerates endothelial damage, inflammation, and plaque growth.
• Chronic inflammation: oxidizes LDL, stiffens arteries, and destabilizes plaques.
• High triglycerides: strongly correlate with arterial disease; low triglycerides predict healthy arteries.

Ketosis (from fasting, ketogenic diet, or carnivore diet) directly reverses the metabolic drivers of cardiovascular disease:

• Lowers insulin and restores insulin sensitivity.
• Drastically lowers triglycerides, improving LDL particle size and removing the dangerous small-dense LDL phenotype.
• Reduces systemic inflammation (IL-6, TNF-α), stabilizing arterial plaques.
• Improves HDL and lowers VLDL, reducing lipid deposition in arteries.
• Activates autophagy, which repairs endothelial damage and reduces plaque vulnerability.

The core problem is not LDL itself, but a high-carbohydrate, high-insulin, high-triglyceride metabolic state that drives inflammation and plaque oxidation. Ketosis creates the opposite metabolic environment—low triglycerides, low inflammation, stable LDL particles, and improved vascular integrity—making it protective against heart attack and stroke.