Diets · Metabolic & Cardiometabolic
carnivore diet increases LDL cholesterol and ApoB
In plain terms: Does a carnivore diet substantially raise LDL cholesterol and ApoB?
Leans support Diets 💰 Industry COI noted🔬 Includes disconfirming
Part of: 🥗 carnivore diet
RefutedContestedStrong support
consensus score 0.59
Probably, though no study has measured it directly: diets high in saturated fat and very low in carbs tend to raise LDL cholesterol, though not in every trial, and a meat-only diet is an extreme version of that pattern.
🧭 Read this score with how it was built in mindWe re-read the papers behind these claims and corrected how each one is counted
Down from strong because the page had no carnivore-diet trial on it at all: the evidence is saturated-fat and ketogenic-diet studies, one row said the opposite of its paper, and no row measures ApoB. The direction is very likely right; the evidence on this specific diet is indirect.
📅 Last reviewed: 2026-07-15 ⓘ
Evidence ladder
How far up the ladder this claim has climbed. A high consensus on a low rung means "consistent so far," not "proven in people."
Top evidence so far: All trials, pooled (Meta-analysis)
MechanismIn-vitroAnimalObservationalRCTMeta-analysis
How the studies fall
11 support 1 contradict 2 tested null 3 mixed · 17 sources, 12 independent groups
What the evidence shows
Leans support, but on indirect evidence: no trial has fed people a carnivore (animal-only) diet and measured LDL or ApoB. What carries it is the saturated-fat and ketogenic-diet literature — Cochrane evidence that cutting saturated fat lowers serum cholesterol, and a 53-RCT meta-analysis in which ketogenic diets raised LDL-C by 8.
The evidence (20)
| Source | Grade | Stance | Quality | Finding |
|---|---|---|---|---|
| Kris-Etherton PM, Krauss RM 2020 · Am J Clin Nutr | meta-analysis | supports | high | Evidence synthesis affirmed that dietary saturated fat raises LDL cholesterol in controlled feeding studies, the mechanism by which carnivore diets elevate LDL/ApoB. |
| Aronica L, Landry MJ, Rigdon J, Gardner CD 2023 · Front Nutr | observational | supports | low | INDIRECT (ketogenic-like diet, not carnivore; LDL-C only, no ApoB): post-hoc DIETFITS subgroups selected by achieved 3-month intake, KLD n=18 vs ULF n=21 of 609. 'LDL-C decreased by ~3% for ULF, whereas it increased by ~12% for KLD with a significant between-group difference [KLD: 14.9 mg/dL (3.4, 26.4); ULF: -2.9 mg/dL (-13.8, 8.0); p = 0.03].' At 12 months LDL-C was similar, but only 'when substantial dietary recidivism was reported by both the KLD and ULF groups', so the on-diet comparison supports the direction. Authors: post hoc, 'only a small number of subjects met the criteria for inclusion'. |
| Lennerz BS, Mey JT, Henn OH, Ludwig DS 2021 · Curr Dev Nutr | observational | supports | low | Carnivore survey reported self-measured LDL values that were often elevated yet framed favourably by respondents; self-report of labs without standardization is weak and biased evidence. |
| Feng S, Liu R, Thompson C, Colwell B, Chung S, Barry A, Wang H 2025 · Am J Clin Nutr | meta-analysis | supports | moderate | Meta-analysis of carbohydrate-restricted diet RCTs found heterogeneous lipid effects with LDL often rising, especially with animal-fat substitution, supporting the directional claim with caveats. |
| Patikorn C, Saidoung P, Pham T, Phisalprapa P, Lee YY, Varady KA, Veettil SK, Chaiyakunapruk N 2023 · BMC Medicine | meta-analysis | supports | high | Umbrella review of 17 meta-analyses of KD RCTs ('Meta-analyses of RCTs of KD were included.'); 'KD was associated with a clinically meaningful increase in LDL-C.' Ketogenic diets, not carnivore; units are syntheses. Review — zero weight. |
| Graybeal AJ, Kreutzer A, Moss K, Shah M 2024 · BMC Sports Sci Med Rehabil | RCT | tested-null | low | INDIRECT (ketogenic diet, not carnivore; n=6 athletes, 2-week randomized crossover): fasting LDL-C was not significantly different - 'LDL-C (mg/dL) 79.5 (52.3, 106.7) 84.0 (48.7, 119.3) 102.8 (61.6, 144.1)' for habitual, high-carb and keto diets, and the authors report 'significantly higher TC following the KD without differences in HDL-C or LDL-C between diet conditions'. Underpowered trend toward higher LDL-C, so tested-null. Postprandial LDL-C iAUC was LOWER after the keto test meal (p < 0.001), an acute meal response rather than circulating LDL on the diet; ApoB not measured. The earlier extract ('raised fasting and postprandial LDL') misstated the paper. |
| Iatan I, Huang K, Vikulova D, Ranjan S, Brunham LR 2024 · JACC Advances | observational | supports | moderate | UK Biobank cohort: 305 low-carbohydrate high-fat (LCHF) diet participants matched 1:4 to 1220 standard-diet controls; LDL-C and ApoB were significantly increased in the LCHF group vs standard diet (p<0.001), with 11.1% vs 6.2% showing sever |
| Zhao J, Wei C, Gong F, Pang Z, Zhao H 2026 · (MA) | meta-analysis | supports | moderate | Meta-analysis of 53 RCTs found ketogenic (high-fat, animal-food-heavy) diets significantly raised LDL-C (+8.2 mg/dL) and total cholesterol versus control diets. |
| Tindall AM, Kris-Etherton PM, Petersen KS 2020 · J Nutr | observational | supports | high | DUPLICATE-POPULATION and INDIRECT (SFA reduction within a mixed diet, not a carnivore diet): exploratory reanalysis of 'Serum samples from a previously conducted study ( 11 ) ( NCT01235832 )' - ref 11 is Tindall 2019 JAHA (s31039663), which already votes on this claim with the same 34 participants. SFA cut from 12% (run-in) to 7% on all three randomised diets; 'All 3 diets significantly reduced IDL-C, LDL-C, LDL 2 , LDL 1+2 , LDL real , non-HDL-C, and TC from baseline' (LDL-C -13.7 +/- 3.0 mg/dL walnut diet, -6.8 +/- 3.0 ORAD). Direction consistent with high SFA raising LDL (supports, not a null); graded observational because SFA was identical across randomised arms. Zero weight: subsumed by s31039663. |
| Budoff MJ et al 2026 · medRxiv | observational | supports | moderate | Prospective cohort of 100 lean-mass hyper-responders (LMHR/near-LMHR, mean BMI 22.5) on ketogenic/carbohydrate-restricted diets; mean LDL-C 242 mg/dL and mean ApoB 180 mg/dL at baseline/follow-up, markedly elevated versus general population |
| Chang C, Liu Y, Rohani P, Khodadadi N, Prabahar K, Sohouli MH 2026 · Endocr Pract | meta-analysis | supports | moderate | Meta-regression of RCTs confirmed ketogenic diets raise LDL-C and total cholesterol in adults, consistent with animal-fat-driven lipid elevation. |
| Tindall AM, Petersen KS, Skulas-Ray AC, Richter CK, Proctor DN, Kris-Etherton PM 2019 · J Am Heart Assoc | observational | supports | moderate | INDIRECT (SFA reduction within a moderate-fat mixed diet, not a carnivore diet). Crossover controlled-feeding trial, 45 randomized / 36 completed: after a 'standard Western diet run‐in (12% saturated FAs [SFA]...)' all three randomised diets were 7% SFA, and 'the WD (−13.4±2.9 mg/dL; P <0.0001), the WFMD (−11.1±2.3 mg/dL; P <0.0001), and the ORAD (−9.2±2.3 mg/dL, P <0.0001) all significantly improved LDL‐C from baseline, with no differences between study diets ( P =0.5).' Direction consistent with high SFA raising LDL (supports, not a null). Graded observational because SFA was identical across randomised arms - the SFA contrast is the non-randomised change from run-in; moderate quality as an uncontrolled pre-post contrast (authors note regression to the mean for the screening-to-baseline LDL drop). Parent of s31909809 (duplicate-population). Walnut Commission funded. |
| Athinarayanan SJ, Hallberg SJ, McKenzie AL, Lechner K, King S, McCarter JP, Volek JS, Phinney SD, Krauss RM 2020 · Cardiovasc Diabetol | observational | mixed | moderate | INDIRECT (very-low-carb ketogenic diet in T2D, not a carnivore diet). Open-label NON-RANDOMIZED 2-year trial, completers 194 CCI vs 68 usual care, ~50% on statins: 'mean LDL-C and HDL-C increased' in CCI, but 'At 2 years, CCI resulted in a 23% decrease of small LDL IIIb and a 29% increase of large LDL I with no change in total LDL particle concentration or ApoB' and 'Non-HDL, ApoB, ApoB: ApoA1 ratio, and CIMT were unchanged'. Mixed on the claim's object: LDL-C rose, ApoB did not. Virta-funded, founder/employee authors; authors cite 'lack of randomization and lack of tight control over the food consumed'. |
| d10-12775-qs-2025-43-61260 2025 · Quality in Sport | observational | supports | low | Narrative literature review of the Lean Mass Hyper-Responder phenotype in individuals on carbohydrate-restrictive diets (ketogenic or carnivore); characterizes the phenotype as LDL-C >200 mg/dL, HDL-C >80 mg/dL, and triglycerides <70 mg/dL. |
| Sun Y, Shang M, Zhang Y, Hu J, Wang H 2025 · Sci Rep | meta-analysis | contradicts | moderate | INDIRECT (ketogenic / low-carb diets, not carnivore; LDL-C only, no ApoB). Network MA of 21 RCTs (1,663 participants): 'Although other interventions showed trends toward reducing TC, LDL-C, and CRP (Table S10 and Table S13-14), these changes were not statistically significant compared to CD'; authors rank 'KD and LCD for LDL-C lowering'. Table S13: KD vs control LDL-C MD -15.34 mg/dL [-53.3, 23.7]; LCD -14.37 [-35.9, 4.33]. A non-significant estimate pointing AWAY from a rise - clean null against the claim's direction, not evidence of raised LDL. |
| V. Holm S, Baarman E, Anturaniemi J, Hemida M, Salin S, Vuori KA, Moore R, Hielm-Björkman A 2025 · Vet J | animal | mixed | low | Canine diet trial found a raw meat-based (low-carb, high-animal) diet lowered total cholesterol and LDL versus kibble, a contrasting non-human result flagged for species/design limits. |
| Tian W, Cao S, Guan Y, Zhang Z, Liu Q, Ju J, Xi R, Bai R 2024 · Front Nutr | meta-analysis | tested-null | moderate | Meta-analysis of RCTs in overweight/obese T2DM found low-carb diets improved several markers, with lipid effects less uniformly adverse in this population. |
| Anagnostou A, Larumbe-Zabala E, Fiore J, Roberts J, Naclerio F 2026 · European journal of nutrition | meta-analysis | mixed | moderate | Meta-analysis of 18 RCTs (n=905 healthy adults) comparing energy-matched low-carbohydrate vs high-carbohydrate diets; LDL-C fell less (i.e., was comparatively higher) under low-carb than high-carb diets (g=-0.225 favoring HC), while HDL-C a |
| Hengist A, Davies RG, Walhin JP, Buniam J, Merrell LH, Rogers L, Bradshaw L, Moreno-Cabañas A, Rogers PJ, Brunstrom JM, Hodson L, van Loon LJC, Barton W, O'Donovan C, Crispie F, O'Sullivan O, Cotter PD, Proctor K, Betts JA, Koumanov F, Thompson D, Gonzalez JT 2024 · Cell Rep Med | RCT | supports | moderate | INDIRECT (ketogenic diet, carbohydrate <8% energy, not carnivore): open-label 3-arm parallel RCT, 53 healthy adults (LOWCHO n=18). 'In contrast, compared with MODSUG, there was an increase in total cholesterol with carbohydrate restriction at week 4 ( p = 0.02; Figure 4 B), which was not completely reflected by LDL-C concentrations ( p = 0.10; Figure 4 D), but was concurrent with an increase in apoB concentrations ( p = 0.006; Figure 4 E).' 'By week 12, there was no evidence of meaningful differences in total cholesterol, HDL cholesterol, LDL-C, or apoB concentrations with carbohydrate restriction vs . MODSUG (all p > 0.16).' |
| Hooper L, Martin N, Jimoh OF, Kirk C, Foster E, Abdelhamid AS 2020 · Cochrane Database Syst Rev | meta-analysis | supports | high | Cochrane review established that reducing saturated (largely animal) fat lowers serum cholesterol, implying that a saturated-fat-heavy carnivore diet raises LDL. |
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