Dr. Eric Berg, a prominent figure in the low-carbohydrate and ketogenic diet communities, frames high cholesterol not as a simple dietary fat problem, but as a symptom of deeper metabolic imbalance. He suggests that the body’s cholesterol regulation systems are often overwhelmed by conditions like insulin resistance and inflammation, primarily driven by a diet high in refined carbohydrates and sugar. Since the body produces most of its cholesterol for hormone creation, bile production, and cell maintenance, external dietary cholesterol has a lesser impact than often believed. His approach focuses on fixing the underlying metabolic dysfunction, which he argues is the most direct path to normalizing lipid panels. This methodology centers on nutritional strategies designed to improve insulin sensitivity and support the organs responsible for fat processing.
The Foundational Dietary Approach: Keto and Fasting
The cornerstone of Dr. Berg’s methodology is the combination of a low-carbohydrate, high-healthy-fat ketogenic diet, often referred to as “Healthy Keto,” with intermittent fasting protocols. This nutritional strategy is designed to stabilize blood sugar levels and aggressively reduce elevated insulin, which he identifies as the root cause of metabolic syndrome and related cholesterol issues. By drastically lowering carbohydrate intake, the body is forced to switch its primary fuel source from glucose to fat, a state known as ketosis.
This metabolic shift is intended to improve the profile of lipoproteins in the bloodstream. Specifically, the reduction in sugar and refined carbohydrates is believed to significantly lower triglycerides and reduce the prevalence of small, dense low-density lipoprotein (LDL) particles, which are considered more damaging to the arteries. Furthermore, a nutrient-focused ketogenic diet, emphasizing healthy fats like olive oil and avocado oil, aims to support long-term heart health and balanced cholesterol levels. The goal is to move beyond simply reducing total LDL cholesterol and instead focus on the quality and size of the lipoproteins.
Intermittent fasting (IF) complements the ketogenic diet by restricting the window in which food is consumed, alternating between eating periods and fasting periods. Protocols often start with a 16/8 schedule and may progress to two meals a day without snacking. This pattern of restricted eating is not primarily focused on calorie reduction but on allowing the body extended periods without insulin spikes.
Fasting helps to improve lipid metabolism and enhances insulin sensitivity, both of which are important for maintaining healthy cholesterol levels. Prolonged periods encourage the body to utilize stored fat for energy, which is associated with a decrease in triglyceride levels and an increase in high-density lipoprotein (HDL) cholesterol. By keeping insulin levels low, the body is better able to manage fat storage and mobilization, thereby modulating the overall cholesterol profile.
Supporting the Liver and Bile Production
A distinctive component of Dr. Berg’s approach is the heavy emphasis on supporting the function of the liver and the flow of bile, which he views as central to cholesterol regulation. The liver is the primary site of cholesterol production and creates bile, a digestive fluid essential for processing fats and eliminating excess cholesterol from the body. Bile acts like a natural detergent, breaking down fats for absorption and carrying cholesterol to the intestines for excretion.
A deficiency in bile is believed to impair the body’s ability to excrete cholesterol, potentially leading to elevated lipid levels. To promote a healthy bile flow, he recommends specific dietary aids that stimulate production and support the liver.
Dietary Aids for Bile Support
- Bitter greens such as dandelion and arugula, which stimulate bile secretion.
- Cruciferous vegetables like kale and Brussels sprouts, which support liver detoxification.
- Fermented vegetables, such as sauerkraut and kimchi, which feed beneficial gut bacteria.
- Choline, found in foods like egg yolks, which transports fats and cholesterol out of the liver.
These microbes play an important role in creating secondary bile salts and recycling bile, which is necessary for the continuous process of cholesterol elimination. This focus on organ support ensures the body’s natural cholesterol management system is operating efficiently.
Targeted Supplements and Key Ratios
Beyond the foundational diet and liver support, Dr. Berg frequently suggests specific supplements to further aid in cholesterol management. Niacin, or Vitamin B3, is often highlighted for its potential to influence cholesterol production within the liver itself, thereby contributing to overall balance. The recommended mechanism suggests Niacin can directly lower low-density lipoprotein (LDL) cholesterol and triglycerides.
Other supportive supplements may include purified bile salts, which can be taken to directly assist the body in breaking down fats and improving the excretion of excess cholesterol, particularly in individuals with compromised gallbladder function. Fiber from vegetables is also presented as a powerful tool because it binds with cholesterol in the gut and increases the production of bile, facilitating the removal of excess cholesterol through the bowels.
To monitor progress, Dr. Berg advises looking beyond the simple total cholesterol or total LDL number and focusing on specific markers and ratios that offer a more comprehensive picture of cardiovascular risk. He emphasizes the importance of the Triglycerides to HDL ratio; a lower ratio is generally seen as a better indicator of metabolic health and lower risk. Furthermore, he suggests assessing inflammatory markers like C-reactive protein (CRP) and considering advanced lipid profiles that look at the size of the LDL particles, rather than just the total count. This nuanced interpretation of blood work is intended to help individuals determine if their cholesterol levels truly reflect a state of metabolic dysfunction or are simply a temporary fluctuation from a high-fat diet.