Long-term ketogenic diet impact on health and cardiovascular outcomes

Metabolic health 0:00 0
“The research overwhelmingly shows that glucose levels are the driving force, at least the primary driving force for cardiovascular disease risk.”

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Metabolic health 0:39 0
“We've been very interested in these ketogenic diets or low carb diets for a long time the reason being is because they have powerful metabolic effects and in metabolic diseases is particularly diabetes they can have a very very powerful effect even sometimes independent of calories.”

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Metabolic health 1:45 0
“So, what we did is we assessed the ketogenic diet's impact over a 10-year period.”

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Metabolic health 6:05 0
“Elevated invariable glucose levels is what is associated with nearly all the consequences related to cardiovascular disease in this both microvascular and macrovascular disease in this particular disease.”

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Metabolic health 6:28 0
“However, in type 1 diabetes, one of the largest ever clinical trials funded by the National Institutes of Health, north of $400 million, looking at over a,000 patients over a 30-year period, demonstrated the causal effect of glucose in this disease.”

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Metabolic health 7:04 0
“Improvements in glycemic control almost completely explained 99% of the cardiovascular benefits derived from the group with more insulin, demonstrating the causal relationship between glycemic control and cardiovascular disease in this particular disease.”

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Nutrition 9:49 0
“So, a ketogenic diet for those who aren't aware, but most your channel will know this is a a diet that's very low in carbohydrates. So, you reduce the carbohydrates dramatically.”

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Disease prevention 12:23 0
“calcium score is an indication of plaque the laying of plaque in the vascular wall that can be detected through one of these advanced CT scans or another type of advanced measurement.”

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Disease prevention 12:54 0
“The way to look at it is to look at the early signs of aththeroscerotic progression when the vascular wall begins to be damaged is actually indicated by changes in vascular hemodynamics.”

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Disease prevention 13:57 0
“So imagine you have a ton of pressure being laid up against this adaptive tissue, and that adaptive tissue experiences high pressure just like when you lift weights. What happens when you lift weights? Your muscles adapt and get stronger. What happens if you place high pressure on a vascular wall? It becomes more resistant and is able to kind of push back against that pressure by getting stiffer.”

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Nutrition 18:29 0
“purposely the ketogenic diet. And that's exactly what happened. We had confirmed the patient was on the American Diabetes Association diet before this, a healthy whole foods American diet American Diabetes Association diet prior to this and then a confirmation switch to a ketogenic diet that was maintained throughout the entire 10-year period and a pre and post assessment.”

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Disease prevention 18:49 0
“And this patient not only had remarkable measures of cardiovascular disease through advanced cardiovascular assessments, they also had a calcium score of zero.”

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Nutrition 20:42 0
“And we saw that the ketogenic diet not only normalized the key biomarkers related to cardiovascular disease progression but in concert in alignment with that they showed remarkable cardiovascular physiology and health sometimes better than people even without the disease of the same age and sex.”

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Nutrition 21:02 0
“Do you think uh you know your own speculation on it or maybe even have data to back it up that much of the positive impact comes from the stabilization of glucose?”

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Nutrition 24:28 0
“diet can have on someone's health and how does that rank um and an and overall risk for what they're trying to improve? And in this case, we were looking at a disease with rapid cardiovascular disease progression and and saw that uh it it had remarkable therapeutic impact both from cardiovascular disease but also things like bone mineral density was not impaired.”

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Nutrition 25:32 0
“So if I mean saturated fat does elevate LDL that's not a um I think people out there still try to like uh debunk that and that's that's just that's that's true like we know it does that right I mean it's it's a what saturated fat I think it docks to an LDL receptor making it so that LDL essentially can't dock in the liver or something right and then it's like so that even acutely can elevate it.”

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Nutrition 26:10 0
“But the it seems as though if you were to be combining saturated fat and high glucose, that could be problematic. And that's almost as though where we're missing missing the point a little bit where it's like the finger maybe is getting pointed a little bit inaccurately when in reality like it still matters.”

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Disease prevention 26:29 0
“And if your sugar is high and you're also at the same time driving up LDL with saturated fat, then that would make sense that it could be problematic. But if your glucose is under control, it's probably not as much of a concern.”

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Disease prevention 29:49 0
“the number one factor in type 1 diabetes is glycemic control and is also the case in diabetes in general that's a extremely high risk factor”

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Mental health 32:02 0
“not only do you not feel right, you can actually Google hypoglycemia and hypoglycemia and see that these are associated with not just physical symptoms but mental health symptoms.”

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Metabolic health 33:40 0
“high glucose levels change metabolic function not only at rest but also during exercise.”

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Nutrition 35:37 0
“patients are doing a diet and and all you have is certain levels of evidence? Do you ignore it or do you make informed decisions based on the weight of the evidence that we have today?”

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Nutrition 36:45 0
“It's about helping patients understand what really matters and then giving them the tools and guidance to help them feel empowered to help them guide them on the journey.”

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Nutrition 37:15 0
“dietitians nutritionalists do not feel prepared to do therapeutic strategies or do not feel supported by their healthcare team to do diets like therapeutic carbohydrate reduction.”

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Most important takeaways of the video

  1. Glucose levels are closely linked to cardiovascular disease risk, emphasizing the importance of controlling glucose levels to manage cardiovascular health effectively.
  2. Ketogenic and low carb diets have significant metabolic effects, particularly in managing diabetes, sometimes independently of caloric intake.
  3. Long-term studies on the ketogenic diet provide valuable data on its impact over time, highlighting its potential benefits for metabolic health.
  4. Proper glycemic control is crucial in preventing complications in type 1 diabetes, as demonstrated by a significant NIH-funded study over 30 years.
  5. The ketogenic diet has shown to normalize key biomarkers related to cardiovascular disease, leading to better cardiovascular health outcomes compared to healthy individuals of the same age and sex.

Overview of Metabolic Health and Nutrition Research

Dr. Andrew Kutnik’s research emphasizes the significant role of glucose levels in cardiovascular disease risk, advocating for its management to prevent heart-related conditions. He highlights the profound metabolic impact of ketogenic and low-carb diets, particularly beneficial in diabetes management, often independent of caloric intake. These diets substantially lower carbohydrate consumption, which is crucial for controlling blood sugar levels and reducing insulin requirements.

Key Studies and Findings

A substantial study over a decade analyzed the effects of ketogenic diets, underscoring their long-term benefits on metabolic health. Further, the research funded by the National Institutes of Health over 30 years establishes a causal connection between glucose control and improved health outcomes in type 1 diabetes. This discovery points towards better glycemic management as a strategy to mitigate cardiovascular risks effectively.

Disease Prevention Insights

Advanced imaging techniques such as CT scans provide insights into cardiovascular health, specifically through calcium scoring that detects plaque buildup in vascular walls. Understanding vascular hemodynamics and changes therein can serve as early indicators of atherosclerosis, suggesting that monitoring and management of these factors are crucial for early disease prevention.

Nutritional Approaches to Health Management

Transitioning to a ketogenic diet from a standard American Diabetes Association-recommended diet has proven beneficial in a long-term study, indicating no coronary artery calcification and improved cardiovascular health. Such diets have not only normalized essential biomarkers for cardiovascular disease but have shown superior health outcomes compared to individuals without the disease, thus reinforcing the diet’s therapeutic potential.

Impact of Diet on LDL Cholesterol and Health Risks

Discussions around the effects of saturated fats on LDL cholesterol levels underline that while LDL levels are elevated by saturated fats, the combination with high blood glucose could exacerbate health risks. Conversely, controlling glucose levels might reduce the detrimental effects of high LDL cholesterol, emphasizing the intertwined effects of dietary components on health.

Challenges in Nutritional Guidance and Support

There is a noted gap in the preparedness and support for nutritionists to implement specific dietary strategies, such as carbohydrate reduction. This points to a need for improved training and support structures to aid healthcare professionals in guiding patients effectively through dietary choices tailored to mitigate particular health risks.