The methods proposed by health educator Dr. Eric Berg, who focuses on ketogenic and fasting principles, have gained significant attention for managing cholesterol levels. His approach centers on the idea that high cholesterol is not the root problem but a symptom of underlying metabolic dysfunction, particularly insulin resistance. By shifting the body’s primary fuel source and supporting specific organ health, his methodology aims to optimize the processes that regulate lipids.
The Connection Between Cholesterol and Liver Health
Dr. Berg’s philosophy posits that a stressed liver, often due to insulin resistance, is the primary driver of cholesterol imbalances. The liver produces approximately 75% of the cholesterol in the body, which is a structural substance needed for cell membranes, hormones, and vitamin D synthesis. When the body’s metabolism is impaired, the liver may struggle to process and eliminate this waxy substance effectively.
A crucial component of this process is bile, a digestive fluid made from cholesterol by the liver. Bile salts are responsible for breaking down dietary fats and fat-soluble vitamins, and they also serve as a primary pathway for the body to excrete excess cholesterol. If the liver is fatty or sluggish, bile flow can become compromised, leading to a buildup of cholesterol within the body. This poor bile flow can cause cholesterol to recirculate instead of being properly eliminated.
The accumulation of fat in the liver, known as a fatty liver, is often linked to the overconsumption of refined carbohydrates and sugar. High insulin levels drive fat storage in the liver, stressing its function and impairing its ability to produce and excrete adequate bile. Therefore, addressing the liver and its bile production is considered a prerequisite to achieving a healthy cholesterol balance.
The Foundational Approach of Healthy Keto and Intermittent Fasting
The core of Dr. Berg’s metabolic strategy involves two synergistic practices: the Healthy Ketogenic Diet and Intermittent Fasting (IF). Both methods are employed to target and correct the underlying issue of insulin resistance. A reduction in blood insulin levels is considered the fastest way to alleviate stress on the liver and improve its function.
The Healthy Ketogenic Diet requires a significant reduction in carbohydrate intake, forcing the body to switch from burning glucose for fuel to burning fat, a state called ketosis. The emphasis is placed on consuming high-quality fats, moderate protein, and large quantities of nutrient-dense, low-carb vegetables. This includes consuming several cups of leafy greens and cruciferous vegetables daily, which provide essential vitamins and minerals that support metabolic health.
Intermittent Fasting involves limiting the eating window to specific hours of the day, such as an 18/6 or 16/8 schedule. By extending the fasting period, the body is given time to lower insulin levels and switch into a deeper fat-burning mode. The combination of IF and a very low-carb diet maximizes insulin sensitivity, which in turn allows the liver to recover and regulate cholesterol more effectively.
Targeted Nutritional Support for Bile and Detoxification
Beyond the fundamental dietary shifts, Dr. Berg advocates for specific nutritional support aimed at optimizing liver and gallbladder function to enhance bile flow. The proper emulsification and flow of bile are necessary steps for successfully processing and eliminating cholesterol and fat-soluble toxins.
A primary recommendation is the use of supplemental purified bile salts, often derived from ox bile, which can directly assist in the digestion and absorption of fats. These supplements help improve the breakdown of fat globules, relieving the burden on a sluggish liver and gallbladder. Choline, a nutrient found in eggs and liver, is also recommended to support the synthesis of bile and help prevent fat buildup in the liver cells.
Specific B vitamins, such as B6, and high-potassium foods are emphasized for their role in metabolic processes. Potassium, sourced from large amounts of vegetables, helps restore the electrolyte balance often disrupted by insulin resistance, supporting detoxification pathways. Furthermore, incorporating apple cider vinegar (ACV) may aid in stimulating stomach acid production, which signals the release of bile from the gallbladder into the small intestine, improving fat digestion.
Understanding Cholesterol Test Markers
For individuals following this high-fat, low-carb methodology, a temporary rise in total cholesterol and LDL cholesterol is sometimes observed, which can cause concern. Dr. Berg’s perspective encourages looking beyond the total LDL number and focusing on other, more meaningful markers of metabolic health.
The key distinction lies in the size and density of the LDL particles, which standard lipid panels do not typically measure. Small, dense LDL particles are considered more atherogenic, meaning they are more likely to contribute to plaque formation in the arteries. The larger, buoyant LDL particles, often seen in individuals following a ketogenic diet, are viewed as less harmful.
A more insightful indicator of cardiovascular risk is the Triglyceride-to-HDL ratio, calculated by dividing the triglyceride value by the HDL cholesterol value. A high ratio suggests poor metabolic health and a greater presence of the small, dense LDL particles. Conversely, a low ratio, ideally two or less, indicates a healthier metabolic state, even if the total LDL number is elevated.