I get so annoyed by authors that bury this point. Rodents are NOT tiny humans. Although there are some findings that carry over, there is much that does not.
Thanks! Would love a TLDR from you or another knowledgeable HNer. I couldn’t tell how big a problem this would be for people who are on the keto or IF spectrums.
My guess, noting that I am not a doctor or medically trained, merely have a BSc Biology.
The study has only been done on rats, which are a good model species but not perfect. The next logical step would be investigating pigs perhaps.
The mechanism of heart damage here is probably that the process for maintaining cardiac tissue requires material that is not available on a ketogenic diet, thus unmaintained cardiac tissue is replaced with scar tissue (mostly collagen)
The problem with scar tissue in the heart is that it doesn't contribute to fibrilation/pumping blood.
Article mentions nothing about intermittent fasting.
This is concerning, because whilst not strictly ketogenic, my (and my partners) diet has shifted to significantly less carbs, as part of managed weightloss and if the consequence is cardiac fibrosis, thats a significant concern for her: she has pre-existing conditions including lack of strong heart function.
I think the vilification of all carbs is misguided. Complex carbohydrates and resistant starch should be kept in the diet. Straight sugar is the real killer.
We reduced. we didn't cut out entirely. We still have a high fibre (carb sourced) breakfast every day. Pasta moved to a special treat, potato likewise. Bread is mostly avoided.
It's important to remember that the whole point of the keto diet is to introduce a near-fundamental change in your body's metabolism, including brain function.
It should be regarded the same way you would regard a very potent medication-- one that does not have FDA approval. It's probably the sort of thing you should approach with extreme caution and the advice of a doctor & dietician.
While I agree they should be more clear that the main focus of the study is about rats, reading the study suggests they did link it to human patients with atrial fibrosis. AF patients had higher ß-OHB concentrations than healthy people, which is one of the by products of a ketogenic diet. Not a direct link to KD, but certain a point of interest. I think this study is a decent case for follow up studies at the very least.
There are a lot of good work digging into the mechanism of how it causes cardiac fibrosis in rats. I don't think we should completely dismiss it just because it is in a non-human model. If anything, this study allows us to try to use the same assays on humans to see if we can observe similar results.
It annoying to me the extraordinary divisiveness conversations on ketogenic diets generate at this point. But I get we are still in the middle of the learning curve scientifically, and there is a lot of confusion.
If you follow the threads though, it’s becoming more and more clear though that practicing keto on a more or less ‘permanent’ basis, might not be the best choice for everyone. It goes both ways though, the ‘food pyramid’ they taught us growing up where the whole thing is based on bread & pasta is almost certainly bad too.
The real benefits come from having a flexible metabolism that can ‘switch gears’ and go back and forth between carb burning and fat burning. This switch triggers a cascade of beneficial mechanisms is our bodies, so riding the line and being flexible is the best place to be I think.
In the short term however, there are clear benefits to strict keto. An anecdotal example in my own case after practicing strict keto for about 6 months, I inadvertently cured my lifelong battle with acid reflux.
I had no idea that would happen. I was honestly doing it in a general attempt to be more healthy and cut sugar out of my life. But I had a problem with heartburn literally since I was 13 years old. I used to have to eat rolaids like candy. I had on and off bouts with prescription strength stuff like Prilosec & others.
After 6 months of keto my gut was permanently healed, even after stopping keto. I no longer need any medicine. Short term keto is a real treatment for acid reflux, this is something I think gets overlooked.
I no longer practice keto, but a lot of the concepts I learned still stick with me. I practice intermittent fasting many days but not always. If I feel like eating breakfast I do. If I want some bread or pasta I eat it. But I don’t base my diet on it.
I behave exactly the same way (fasting then keto for 6 month, not practicing keto long term but still lowering my sugar/alcohol intake). I still have occasional acid reflux, though less than before.
I thing that when you start something like IF or keto, you already care enough for most of diet-related issues to tone done, like a placebo effect somehow.
>It annoying to me the extraordinary divisiveness conversations on ketogenic diets generate at this point. But I get we are still in the middle of the learning curve scientifically, and there is a lot of confusion.
One of the big name diet plans blamed Keto for when they lost a huge portion of their revenue. At exactly the same time advertisements everywhere were about 'keto crotch' which is no longer a thing. Clearly were paid for articles to discourage women from going keto.
There's a ton of $ to prevent people from going keto. Why?
Imagine what a grocery store looks like if there were no carbs. A meat department, some drinks? The entire business model collapses. How about fast food? Some fast food joints have been catering to keto folks. The fast food joints that dont and traditionally push nothing but sugar are struggling.
>I no longer practice keto, but a lot of the concepts I learned still stick with me. I practice intermittent fasting many days but not always. If I feel like eating breakfast I do. If I want some bread or pasta I eat it. But I don’t base my diet on it.
How come you quit keto? Were there effects you didnt like or was it just the inconvenience that you basically cant eat anywhere?
Early appologies for the long essay, but I have a strong opinion on this topic if you can't tell :)
> There's a ton of $ to prevent people from going keto. Why?
I've never really seen this, but you're probably on the right track. In the US, the whole basis of our food system is centered around grains, especially corn. There are a lot of vested interests that want us to keep consuming as much of their product as possible.
> How come you quit keto? Were there effects you didnt like or was it just the inconvenience that you basically cant eat anywhere?
No, none of these things really. In my case, the effects were great. Exactly as advertised. Weight loss, high energy level that lasts all day, no hunger cravings, no mental fog et-cetera. I never had any ill-effects. Everyone is different though, I'm sure not everyone has the same results. I think I 'quit', maybe after a solid 6-9 months or so, just because I reached all the goals I had intended to achieve when I started.
They were 1) get myself off of a long time sugar addiction 2) improve my energy level, and reduce the feeling like I needed to take a nap halfway through the day 3) some mild weight loss (I wasn't obese or anything, but carried around a solid 15-20 lbs. I did not need). Healing my life long acid reflux was an unintended but welcome side effect :)
You right, it can be inconvenient to eat out when you are practicing strict keto, but the idea you "can't eat anywhere" is a little aggressive. Back then I was traveling a lot, and I learned to pack myself meal kits to get me through the day. If you encounter a lot of gas stations, practicing keto can be very problematic :) Almost everything in there is corn syrup and empty carbs. My gas station go-tos are things like pistachios or mixed nuts, meat & cheese, hard boiled eggs, pickles, or pork rinds if I want something similar to potato chips. As far as drinks, I stick to coffee of water.
You end up reading a lot of nutrition labels, and learn to identify the few snacks that fit into the model. I honestly don't know what the current recommendations are. When I did it strict, I used to shoot for 50 grams carbs and 25 grams added sugar. I definitely didn't achieve that every day, it is pretty difficult honestly. Some days probably consuming more like 75-100 grams carbs.
Fast food is basically just out the window, forget about it haha. Really though, a lot of places have decent salads, and some places you can get your burger or whatever in a lettuce wrap. As far as sit down restaurants, most places have at least a few offerings that are mostly meat and veggies, so once you get into a 'keto rhythm', your eyes automatically scan the menu and lock onto the dishes that satisfy your requirements.
But honestly, you have to be able to let yourself 'cheat' sometimes. You're not going out to eat to be healthy, it's to be social and have fun. So sometimes you gotta just enjoy yourself. A couple cheat meals a week isn't going to derail the whole diet, and if you are too hard on yourself it can become exhausting.
I say I 'quit' keto, but like I said, I still uphold and benefit from the concepts I learned. I'm just not obsessed with staying in ketosis all the time. I eat bread and pasta sometimes, I mean come on, they are delecious! I don't count carbs anymore, but in genereal I try to get the bulk of my carbs from vegetables.
As things like this article and other science come out, there may actually be downsides to trying to doing keto long term. But if your metabolism has spent it's whole life in carb burning mode, I think there is real value to forcing it to switch gears, and for some it can be a difficult process.
But once you get there, staying in the middle, and trying to maintain a 'flexible' metabolism that switches gears easily is really the best place to be in my opinion. A lot of beneficial side effects are triggered in our bodies when we switch from carb burning to fat burning, and at this point that is my goal. We are still leaning more and more about the mechanisms behind it, but I think this style of diet might be the future.
>I've never really seen this, but you're probably on the right track. In the US, the whole basis of our food system is centered around grains, especially corn. There are a lot of vested interests that want us to keep consuming as much of their product as possible.
I guess even before the keto crotch thing that died quickly. The source of the keto craze was from Australia. Known for the various meat exports, their recommended diet coming from the government literally said dont eat meat because it's cancer. The government was like WTF and investigated. Found that the dieticians of australia were receiving millions of $ from the cereal companies. Clear and obvious conflict of interest. Yet the dieticians said nope they didnt have conflict of interest because this was widely known science.
So the government did a bunch of studies and went further basically testing if they were right. They found the complete opposite was true. That not only were the cereal companies responsible for the mess, they were clearly fabricating science. Thats when they initiated diabetes studies. They selected some smaller towns and targetted people on heavy diabetes meds and put them on high fat keto. They were supposed to go for a year but after like 6 months they practically cured these people's type 2 diabetes. The news of them pushed a huge amount of people follow suit.
The ironic thing, you can still see the manipulation. They will go about mentioning carbs but American Diabetes Association is still reocmmending heavy carb eaying. Australia diabetes doesnt even have it on their website anymore: https://www.diabetesaustralia.com.au/wp-content/uploads/low-...
The reality is that we know the fix, but there's a ton of interest in killing keto.
>But honestly, you have to be able to let yourself 'cheat' sometimes. You're not going out to eat to be healthy, it's to be social and have fun. So sometimes you gotta just enjoy yourself. A couple cheat meals a week isn't going to derail the whole diet, and if you are too hard on yourself it can become exhausting.
For me, I'll do the occasional pizza or some noodle meal. My main thing was that I always more or less wanted to eat this way but I took the advice of experts who pushed ultra carbs as healthy. Then I learnt oh wait apparently the food guide has nothing at all to do with healthy eating.
I have one suggestions which has worked wonders in my family on a recommendations by a doctor. it is to let 1-2 tablespoon of boiled rice ferment in an earthen pot/container overnight or longer and eat it along with the water on an empty stomach. this will allow the growth of good bacteria in gut.
Never heard of that, but I guess it makes sense. I always recommend fermented products to friends and family, such as kimchi, sauerkraut, kombucha, kefir, buttermilk. If you can find ways to work these things into your diet, even a little bit, it's always a good way to promote probiotics and help your gut do it's job properly.
In regards to the acid-reflux or GERD problem, through practicing keto I inadvertently learned that the common wisdom is just plain wrong. Many doctors will tell you the problem is too much acid. This couldn't be more wrong. Either they are behind on the current literature, or they have no incentive to recommend real long term treatments because the ant-acid market is a HUGE cash cow for pharmaceutical companies. This is a case where unfortunately the combination of capitalism and medical treatments have led us astray.
The problem is not too much acid, but too little acid. This sounds very counter-intuitive but I can give you the quick TL;DR. The main idea is that GERD is a result of mal-digested carbohydrates that cause excess gas in your gut. Your esophagus isn't burning because there was too much acid and it overflowed. It's burning because your gut isn't digesting all the bread and pasta you put into it, causing gas, which makes the 'flap' that separates your stomach and esophagus to get forced open and leak acid.
This is why a low carb diet is the perfect treatment. You temporarily reduce your bready carb intake, introduce probiotics, and over time the bacteria re-balances and you can properly digest carbs again. It's not easy though, it does take some months to repair, and a strict low carb diet takes a lot of effort and planning. It's much easier to just pop a pill, but antacids are only treating the immediate symptoms, and in fact making the problem worse long term by reducing acid even more.
To anyone with acid reflux problems, I highly recommend Chris Kresser's website. He has an fantastic series of articles explaining the current science on this topic.
It seems obvious that various animals have different natural diets, that is, different diets that they are evolutionarily adapted to. A horse eats grass, a cat eats meat. I expect that of you performed the same dietary experiments using horses as the experimental animal, you would get very different results than if you used cats as the experimental animal. Cats are obligate carnivores, and are on a ketogenic diet, always.
Is the rat natural diet the same as the human? If so, this might have some relevance to the human diet.
This appears to be another example of the garbage that passes for nutrition science.
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