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  #1   ^
Old Tue, Mar-07-23, 13:36
doreen T's Avatar
doreen T doreen T is offline
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Default ‘Keto-like’ diet may be associated with a higher risk of heart disease - new study

CNN news - Monday March 6, 2023

link to article
Quote:
‘Keto-like’ diet may be associated with a higher risk of heart disease, according to new research

A low-carb, high-fat “keto-like” diet may be linked to higher levels of “bad” cholesterol and double the risk of cardiovascular events such as blocked arteries, heart attacks and strokes, according to new research.

“Our study found that regular consumption of a self-reported diet low in carbohydrates and high in fat was associated with increased levels of LDL cholesterol – or “bad” cholesterol – and a higher risk of heart disease,” lead study author Dr. Iulia Iatan with the Healthy Heart Program Prevention Clinic, St. Paul’s Hospital and University of British Columbia’s Centre for Heart Lung Innovation in Vancouver, Canada, said in a news release.

“This study provides an important contribution to the scientific literature, and suggests the harms outweigh the benefits,” said Christopher Gardner, a research professor of medicine at the Stanford Prevention Research Center who has conducted clinical trials on the keto diet. Gardner was not involved in the study.

“Elevated LDL cholesterol should not be dismissed as simply a negligible side effect of a VLCD (very-low-carb diet) or ketogenic diet,” Gardner said, pointing to the higher risk of cardiovascular events in individuals with higher ketone levels in the blood, when compared to those on a more standard diet.

In the study, researchers defined a low-carb, high-fat (LCHF) diet as 45% of total daily calories coming from fat and 25% coming from carbohydrates. The study, which has not been peer reviewed, was presented Sunday at the American College of Cardiology’s Annual Scientific Session Together With the World Congress of Cardiology.

“Our study rationale came from the fact that we would see patients in our cardiovascular prevention clinic with severe hypercholesterolemia following this diet,” Iatan said during a presentation at the session.

Hypercholesterolemia, or high cholesterol, increases a person’s risk of heart attack or other adverse cardiovascular events.

“This led us to wonder about the relationship between these low-carb, high-fat diets, lipid levels and cardiovascular disease. And so, despite this, there’s limited data on this relationship,” she said.

The researchers compared the diets of 305 people eating a LCHF diet with about 1,200 people eating a standard diet, using health information from the United Kingdom database UK Biobank, which followed people for at least a decade.

The researchers found that people on the LCHF diet had higher levels of low-density lipoprotein, also known as LDL, cholesterol and apolipoprotein B. Apolipoprotein B is a protein that coats LDL cholesterol proteins and can predict heart disease better than elevated levels of LDL cholesterol can.

The researchers also noticed that the LCHF diet participants’ total fat intake was higher in saturated fat and had double the consumption of animal sources (33%) compared to those in the control group (16%).

“After an average of 11.8 years of follow-up – and after adjustment for other risk factors for heart disease, such as diabetes, high blood pressure, obesity and smoking – people on an LCHF diet had more than two-times higher risk of having several major cardiovascular events, such as blockages in the arteries that needed to be opened with stenting procedures, heart attack, stroke and peripheral arterial disease,” researchers found, according to the news release.

The researchers said in the release that their study “can only show an association between the diet and an increased risk for major cardiac events, not a causal relationship,” because it was an observational study, but their findings are worth further study, “especially when approximately 1 in 5 Americans report being on a low-carb, keto-like or full keto diet.”

Experts say the keto diet isn't sustainable, so why is it so popular?
Iatan said the study’s limitations included measurement errors that occur when dietary assessments are self-reported, the study’s small sample size and that most of the participants were British and didn’t include other ethnic groups.

The study also looked at the longitudinal effect of following the diet, whereas most people who follow a keto-like diet tend to follow it intermittently for shorter periods of time.

Most of the participants – 73% – were women, which Iatan said is “quite interesting to see, but it also supports the literature that’s available that women in general tend to follow more dietary patterns, tend to be more interested in changing their lifestyles.”

When asked if there were any groups that were not harmed by following a LCHF diet, Iatan said how long people are on the diet and whether or not they lose weight “can counterbalance any LDL elevation.”

“What matters to remember is that each patient responds differently. And so, there’s really an inter-individual variability between the response. What we found is that, you know, on average, patients tend to increase their LDL cholesterol levels,” she said.

Dr. David Katz, a lifestyle medicine specialist who was not involved in the study, said that “there are various ways to put together a LCHF diet, and it is very unlikely they all have the same effects on serum lipids or cardiac events.”

However, he added, “That a LCHF diet is associated with adverse effects in this study is reality check for those adopting such diets just because they are in vogue.”

“Those food groups that have to be eliminated to achieve ketosis are major sources of fiber in the diet, as well as many important nutrients, phytochemicals, and antioxidants. This is of concern to many health professionals who consider the VLCD or ketogenic diet to be harmful for long-term health,” Gardner said.

Keto is short for ketosis, a metabolic state that occurs when your liver begins to use stored fat to produce ketones for energy. The liver is programmed to do that when your body loses access to its preferred fuel – carbohydrates – and thinks it’s starving.

The keto diet has been around since the 1920s, when a doctor stumbled on it as a way of controlling seizures in children with epilepsy who didn’t respond to other treatment methods.

Low-carb diets like keto rely heavily on fats to fill you up. At least 70% of the keto diet will be made up of fat; some say it’s more like 90%.

While you can get all that fat from healthy unsaturated fats such as avocados, tofu, nuts, seeds and olive oil, the diet also allows saturated fats like lard, butter and coconut oil, as well as whole-fat milk, cheese and mayonnaise. Eating lots of foods high in saturated fat increases the body’s production of LDL cholesterol, which can build up inside the arteries and restrict blood flow to the heart and brain.

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  #2   ^
Old Tue, Mar-07-23, 16:28
Dodger's Avatar
Dodger Dodger is online now
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25% carbs is not keto-like and just marginally low-carb.
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  #3   ^
Old Tue, Mar-07-23, 18:46
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Bob-a-rama Bob-a-rama is offline
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I've been on keto since it was called Atkins.

Note: I'm just one case, so it's not a scientific study.

A few years ago, I was having some heartbeat irregularity. My doc sent me to a heart specialist who did every test from the blood going to my heart, to the blood going to my toes, to the blood going to my lungs, to treadmill tests.

The results? My entire circulation system was that of an extremely healthy man, 20 years my junior. The doc and the people testing were amazed at how good everything was.

So why the irregularity? Temporary stress.

I was having trouble with my part-time online business. A big company bought the shopping cart company I used, and someone figured out how to "buy" my products for free. The big company didn't import all the safety requirements.

It took the technicians 4 days to figure out what the problem was. The cure was for me to rewrite the cgi code for over 550 products from the old shopping cart way, to the new shopping cart method. That took about a half hour per product.

With the stress I was having Premature Ventricular Contractions, and after the stress was over, it never happened again.

So as far as I'm concerned, eating fewer than 20 carbs per day results in me having a circulatory system so good it actually amazed the heard doctor.

Bob

Note: Whenever you read an article, whether it agrees with what you are like, or disagrees with what you like, it could contain a hidden agenda.

The article that says sugar substitutes are bad for you, might be covertly financed by big sugar.

The article that says grapefruit is good for you might be financed by the Florida Citrus growers.

The articles could be true, or could be false. Take them all with the proverbial grain of salt, and do your own research.

I tend to put more weight on peer-reviewed articles published in respected journals. You can find them at https://pubmed.ncbi.nlm.nih.gov/ but they aren't that easy to find, and sometimes not that easy to understand. It's worth the work though.
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  #4   ^
Old Wed, Mar-08-23, 03:27
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WereBear WereBear is offline
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Quote:
Originally Posted by Bob-a-rama
I've been on keto since it was called Atkins.


Excuse me, I’m sneaking in here to steal that line! Will use it.


Quote:
I tend to put more weight on peer-reviewed articles published in respected journals. You can find them at https://pubmed.ncbi.nlm.nih.gov/ but they aren't that easy to find, and sometimes not that easy to understand. It's worth the work though.


Hand to heart, I wouldn’t be here now if it weren’t for Pub Med. Even if I couldn’t pull much from the tech side, I had folks like Teaser who were dissecting it. Now, there’s DietDoctor and tons of podcasts who explain their take on studies.

I would read an article and get excited. We learn the weasel words. Like anti-oxidants. We all know they are good for us, right?

I’m starting to rethink that. I found an article which soothed people about pesticides because “plants have more pesticides naturally than the stuff we put in there! And plants haven’t killed us yet.”

This started as a “satire or not?” tone puzzle and turned into conformation that there are articles out there on Pub Med explaining that there is no scientific confirmation of their theorized advantage to our health.

Here I was doing autoimmune keto, which led me to lots of nuts and chocolate. I didn’t gain weight, but I would mysteriously go on and off the nuts. Chocolate is turning out to be a pry-it-away from me situation

It was a pattern. Eat seeds, eat salad, and now, eat nuts. But I had searched all known toxin patterns to choose my nuts! Macadamias win every time, BTW, and low oxalate content, so my investment in the bag I keep in the fridge was safe.

But of course they are expensive so I was eating lots of walnuts. Which I shouldn’t have. I didn’t, unless I reminded myself that they are “good for me.” Turns out, they aren’t.

Here’s another conundrum: I bught some organic cocoa, but wound up using dutch cocoa. This is the Special Dark Hershey’s puts out that I can get at the grocery store. It’s less bitter, because the process loses antioxidants. Now, I’m avoiding too much plants and I’ll be low on antioxidants.

But it’s an unsupported theory. And they’ve tried.

But it turns out I can lower my ratio, add the right herbal teas, and cocoa extract (which is not available in a 150 mile radius of me so I’m tracking the brown truck because I’M OUT,) which has no oxalates. And I get decaff coffee back!

I can mocha my way to good health anytime, anywhere.

When I stumbled on carnivore for my autoimmune, and had great success, which faltered, I could not figure out how to get it back on track. Granted, we’ve all been dealing with high stress levels, which is enough all by itself

But I need enough information to put into Pub Med. Once I was thinking about plant phenols and had them called pesticides, I knew the right words to put into the search function. I also know where to go to help me interpret it.

Like if I put in “nitrites” and find an abstract which points out celery has more than cold cuts. That’s easy for me to find support for, or stumble on a meta-study that looks solid.

We don’t have to believe the influencer, the blogger, or the magazine name. We can see just how tenuous the actual evidence is, and most of the time, this information would not get the criminals off, it would send them to jail.
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  #5   ^
Old Wed, Mar-08-23, 03:44
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WereBear WereBear is offline
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Also, “keto-like” means what? It means we get more clicks because the word keto is hot right now. I should change the name of my site to Keto Cats. Which they are, actually.

But that would be misleading. Headline writers don’t care.

25% carbs is nothing like my keto 5%. As Dr. Atkins intended, and named Induction. I always got as far as fruit when climbing the carb ladder, and then, got into trouble. At least I learned that

But keto as most people will learn it, from Instagram and Youtube, is the glam version with lots of spinach, nuts, and chocolate. Likely to soothe any fears about all that meat, which will be be terrible for our health, we are told. In my case, less and less because I’ve been low carbing for two decades.

Except my problems were from the plant foods. Full stop. But if we have a buildup of oxalates and never drop to low oxalate, as our pre-agriculture ancestors did every winter, our body can’t purge this known toxin, and who knows how many others, I’m thinking now.
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  #6   ^
Old Wed, Mar-08-23, 07:06
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cotonpal cotonpal is online now
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Apart from the ill-defined variables (keto like and low carb), unreliable data (self reports) and unrepresentative subjects (small sample size for one) plus a questionable outcome variable (risk factor), this is a great study. And to think, people get paid to carry out these kinds of non-scientific studies.
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  #7   ^
Old Wed, Mar-08-23, 08:39
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GRB5111 GRB5111 is offline
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Really not worth the paper or time it took to write this "study." I'm not going to bother, but I'm sure if I investigated the funding sources for this "study," I'd find evidence of an agenda, conflicts, and bias. I've gotten to the point where I no longer believe in simple Cholesterol and LDL levels as valid heart health markers as pharma wants us to. I'll take Apo B and favor TG/HDL ratio along with hsCRP to reveal the true cardio health of an individual, as the claims of the "study" are things that don't register with me. Then to really top it off, the author at CNN adds in a comment from David Katz who was not involved in the study, but he's a barometer for identifying those diets that are currently in vogue but not effective, especially if they are not plant based or vegan.

My final observation is the constant claim that keto or low carb or paleo or whatever WOE that favors whole foods and limits unhealthy carbs is unsustainable. So, those who have been doing this well over 12 years should be concerned? When will I get to the point I can no longer sustain this WOE??? Maybe when I hit 15 years, a plate of pancakes and maple syrup will appear when I sit down to breakfast and make me realize I just can't go on . . . .
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  #8   ^
Old Wed, Mar-08-23, 09:39
WereBear's Avatar
WereBear WereBear is offline
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Quote:
Originally Posted by GRB5111
the constant claim that keto or low carb or paleo or whatever WOE that favors whole foods and limits unhealthy carbs is unsustainable


...to their profits.

Is the part that was redacted.

I am pleased that, at least in outlets who are seriously tackling our food crisis, the subject of junk food addiction is getting serious discussion.
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  #9   ^
Old Wed, Mar-08-23, 09:52
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Ms Arielle Ms Arielle is offline
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“Our study found that regular consumption of a self-reported diet low in carbohydrates and high in fat was associated with increased levels of LDL cholesterol – or “bad” cholesterol – and a higher risk of heart disease,” lead study author Dr. Iulia Iatan [QUOTE]

Self reported is a crap study. A hint, not cause and effect.

And what kind of fats??? Corn oil, trans fats, rapeseed oil?? Or olive oil, suet and avocado oil??
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  #10   ^
Old Wed, Mar-08-23, 10:02
WereBear's Avatar
WereBear WereBear is offline
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I'm having more and more sympathy for "normies" who don't pay close attention. I know far more than average and I'm still confused.

Some of the ideas of people who are dutifully listening to health authorities:
  • Any food has "some" protein. You'll be fine.
  • Haven't a clue what a seed oil is.
  • Believe very much in those complex carbs.
  • I take a multivitamin. What do you mean, what's in it? Stuff. Stuff so I don't worry about malnutrition.
  • Healthy? I'm like 90% plant-based now.
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  #11   ^
Old Wed, Mar-08-23, 21:29
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Bob-a-rama Bob-a-rama is offline
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Quote:
Originally Posted by WereBear
<...snip...>
Like if I put in “nitrites” and find an abstract which points out celery has more than cold cuts. That’s easy for me to find support for, or stumble on a meta-study that looks solid.<...>

I don't know if this is true or not, because it came from a site that sounded good (don't they all) but I didn't take the time to look through the tons of pubmed articles to see if it is verifiable.

The article stated that the reason the nitrites in celery don't harm you is because the vitamin C in celery renders them harmless. Since I take a multivitamin with my meals, if that's true, any nitrites in the bacon won't hurt me.

I love bacon, but only eat it once a week or less, because the salt makes me hold water.

I eat a small square of chocolate almost every day. Ghirardelli 86% is my choice because it isn't Dutched, and that brand has very low lead and cadmium content. And it tastes good, too.

I have it with a cup of organic black tea.

I don't eat much ultra-processed food as it has too many ingredients that aren't food. I try to eat organic whenever I can. My beef is 100% grass fed and finished. I also eat a lot of dairy. DW is A1 intolerant, so the cheese comes from Europe or Australia, where most of the cows are A2 cows.

I'm not keto-like. but keto, and for me that's fewer than 20 net carbs per day. It's restricing, but I'm down to a normal BMI instead of obese, and I'm healthy. Without good health, you have nothing.

Bob
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  #12   ^
Old Thu, Mar-09-23, 03:03
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WereBear WereBear is offline
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Everyone has to work out how their body works. You are doing great. And why doesn't the vitamin C work for meat?

I'm now quite attuned to "animal food prejudice" by now. The irony is that I seem to be a natural carnivore.

I didn't need plants. My body doesn't want it. Unless it's fruit, where the plant wants me to eat it🤣
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  #13   ^
Old Thu, Mar-09-23, 04:34
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Ms Arielle Ms Arielle is offline
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Bob, we have started making our own bacon and sausages. And generally skip salami and the like, because of the added nitrates. We particularly like the homemade bacon. 🥓
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  #14   ^
Old Thu, Mar-09-23, 05:13
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WereBear WereBear is offline
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For me, having a minor obsession with fine Italian cold cuts, finding out it's fermented meat made all the difference.

Celery is far worse for nitrites if they were really worried. Celery and carrots, which I grazed on back in the low fat days, are loaded with oxalate.

That's the substance with the biggest impact on my health right now. Cold cuts have NONE, with protein, thiamine, fat, and the ability to tempt my appetite no matter how low I am. So I don't care about the nitrites. They haven't proved their case. It's all about how they interpret beyond those ridiculous food memory questionnaires. It's China Study all over again.

It's not even viable epidemiology, much less proper nutrition advice. It's all to scare us away from meat!

Vegetarianism has always been a religious crusade, and now, in classic fundamentalist toxicology, they've doubled down to veganism and cheating. (If they are alive, they are cheating on veganism OR dying in denial.)

Once we have a grip on that ridiculous yet salient fact, much more about how I eat, and how I should, has become clear.

But everyone has to do what works for them. And making our food better, in any way, gives us real time feedback on how that's going.

I have had such dramatic improvement in my serious burnout from diet only once before, when I started carnivore. I get the same sense of relief from my body signals now.

Which is why I'm so excited and hopeful. And you don't need to follow my reasoning. I'm only saying I have some.
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  #15   ^
Old Thu, Mar-09-23, 05:18
WereBear's Avatar
WereBear WereBear is offline
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Quote:
Originally Posted by Bob-a-rama
Ghirardelli 86% is my choice because it isn't Dutched


I was so carb conscious I went for dutched, it's less bitter. No antioxidants, but then... I'm wondering if that's not just another buzzword.

I did find several studies that admitted the whole antioxidant/plant phenols are good for you thing?

I'm deeply skeptical about that. Antioxidants were something I tried to build in... but they didn't make me better. In fact, plants were, once again, MY big problem.

And even I'm not immune to the incessant "health" articles pushing plants. That's where I kept hurting myself under the guise of "needing" plants when it's for pleasure. Now I can make better choices.
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