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Plus, because keto hasn't been studied long term, researchers don't know if the diet may also result in nutrient deficiencies regardless of whether you have diabetes. This means that if you have risk factors for heart disease — such as elevated cholesterol levels, high blood pressure , or a strong family history of the disease — you should use caution when following this diet. The diet's heavy reliance on fat, especially saturated fat, can elevate cholesterol levels, further increasing your chances of developing heart disease in the future.