Is the Keto Diet Heart Healthy? 7 Reasons Why This Cardiologist Agrees

Is the Keto Diet Heart Healthy? 7 Reasons Why This Cardiologist Agrees

 

I am a board certified, card-carrying cardiologist, and I want my clients to eat more fat, more meat, more cheese, more eggs, more avocado, more, more, more.

 

For decades medical establishments have convinced us to eat low fat, higher carb diets. How has that worked for our health? Here’s a hint, we have record numbers of obesity, diabetes and dementia. Yet, as a cardiologist, that’s the party line I am supposed to support.

 

But I can’t. It’s just wrong, and I can’t support that line of thinking, not for a second.

 

Instead, I am a Low Carb Cardiologist. Here are the top Seven reasons why

 

 

              1-  Reducing Insulin is Essential to Health and Weight Loss.

 

Insulin is a hormone naturally secreted by the pancreas to help regulate blood sugar levels. Everything we eat (except possibly for 100% fat meals) causes insulin to rise. That is normal physiology. The problem occurs when our bodies become resistant to the effects of insulin, thus requiring our pancreas to make more and more and more insulin.

 

The problem? Insulin promotes fat storage, increase inflammation and oxidation, and can even help fuel the growth of cancer cells. Therefore, the healthiest approach is one which reduced the level of insulin to the lowest possible levels. As it happens, a Low-carb High-fat or ketogenic lifestyle (LCHF/Keto lifestyle) dramatically improves your body’s sensitivity to insulin, reduces the amount of insulin secreted, and it allows your body to naturally use your fat stores for what they are designed for: Break them down into energy! Once we see that we need to fight chronic elevations of insulin, it becomes obvious why a low-fat diet is harmful, and why a low carb diet is the true path to health.

 

2-    Eating Fat Improves Your Cholesterol!

 

Wait, what? Eating fat can improve my cholesterol? Sounds crazy, right? That goes against everything we have heard from the medical establishment. Notice I said “cholesterol.” I didn’t say the "bad" low density lipoprotein (LDL), I didn’t say the "good" high density lipoprotein (HDL), or any one specific type of cholesterol. We have over emphasized the solitary variable of LDL for too long. Total cholesterol to HDL ratio, Triglyceride to HDL ratio, lipoprotein size and density, insulin sensitivity, and other metabolic measures are more powerful predictors of cardiovascular health than just LDL.

 

Once again, we see that all these markers improve with a Low Carb High Fat (LCHF) lifestyle. The medical establishment needs to realize that we are more complicated than one lab value. The key is to look at the whole picture, and this picture dramatically improves with a LCHF lifestyle.

 

3-    Higher HDL is Associated with a Lower Risk of Heart Disease.

 

HDL is your friend, but drugs are not. Observational evidence has consistently shown that higher HDL is associated with a lower risk of cardiovascular disease. However, our healthcare establishment does not prioritize HDL for one simple reason- Drugs that raise HDL don’t make you healthier. Trial after trial has failed to show any benefit from drugs that significantly increase HDL. 

 

Instead, it’s the HDL-raising lifestyle that provides the benefit, not artificially increasing it with drugs. What’s the best lifestyle to naturally raise HDL? You guessed it. LCHF/Keto lifestyle. Add in some resistance training and you have your friendly HDL climbing the way it was meant to…Naturally.

 

4-    LCHF Leaves You Feeling Great, Leading to Healthier Decisions

 

What kind of health decisions do you make when you are fatigued, achy, and find it difficult to concentrate? That’s a rhetorical question, I already know the answer. When things look glum and we don’t feel well, it's far too easy to sit on the couch or reach for the chips and cookies. Compare those decisions to those you make when you are well rested, energetic, and seeing the world more clearly. For most people, the better you feel, the better decisions you make.

 

Guess what? The majority of people who change to a LCHF lifestyle feel better! It may take a few days or weeks, but in general, they feel more in control of their health, more energetic, and they are able to make better health decisions. I admit this is difficult to prove in a scientific trial. That is why we all should become our own n=1 scientific trial. How do you feel and how are your health decisions after going to a LCHF lifestyle? What matters most is what works for you, not what works for hundreds of people who are kinda-sorta like you.

 

      5-    Keto helps you with fasting.

 

Eating better helps you not eat. People who eat a high carb diet eat a lot, don’t they? They are always grazing and snacking. Our bodies go through the roller coaster of blood sugar and insulin spikes, making it a challenge to go 24, 18, or even 6 hours without eating. This creates a constant, unwavering supply of insulin in our blood stream.

 

Why is this harmful? For one, it promotes fat storage and keeps us from using our fat as fuel. Secondly, chronically elevated insulin can predispose to heart disease, strokes, cancer, dementia and other devastating health conditions. When people change to Keto, however, they realize they do not need to eat nearly as much or as frequently. Avoiding the carbs and increasing the fats keeps us full longer, and our bodies quickly adapt to longer periods without eating. The result? We can use our fat stores for what they were designed- a source of fuel! It also allows our body to maintain lower insulin levels, and also allows our cells to take care of their health chores, referred to as…..

 

6-    LCHF Promotes Health Through Increased Autophagy.

 

Autopha-What? In medicine we like using fancy words to make us look smart. Autophagy is a big word to describe cellular housekeeping. When we have low enough intake of carbs and protein, or when we do intermittent fasts, our bodies can take care of their “to do” lists.  That list includes breaking down weak or damaged cells, recycling the good parts and discarding the rest, and slowing down the processes that can lead to abnormal cell growth (i.e. excess proteins in Alzheimer’s disease, abnormal cancer cells etc.).

 

Admittedly, long term outcome studies evaluating fasting or LCHF and cancer or dementia risk have not been done. But, on the flip side, drug trials to prevent the same are showing no benefit despite hundreds of millions of dollars invested. If you asked me (which you sort of did since you are reading my article), I’d vote for autophagy as a preventative strategy any day. It makes good physiologic sense, and it is so easy to achieve.

 

7-    With Keto You Will Enjoy Eating Again!

 

That’s right. A way of eating that helps you lose weight, helps you feel better, improves your health and is actually enjoyable! No fake processed soy products, no cardboard tasting rice cakes. True, it also means no more candy, processed snack foods, doughnuts and danishes. But once you swear them off for a few weeks, and you are eating all the eggs, avocados, nuts, fish, steak, cheese etc. that you want, you won’t miss those old crutches any more. Let the enjoyment begin!

I could go on, but since it seems people like “7 Reason” articles, I will leave it at that. 

 

Now you know the secret: Look at the whole picture. Look for a lifestyle, (not a diet) that helps you feel better, increases your enjoyment, and still benefits your overall health.

 

Is LCHF/Keto the right lifestyle for you? It just may be. It is for me, The Low Carb Cardiologist, and it is for most of my patients and clients. Want to learn more about how LCHF lifestyle impacts your health? Visit us at www.LowCarbCardiologist.com

 

Thanks for reading

 

Bret Scher, MD FACC

Founder, Boundless Health

www.LowCarbCardiologist.com

 

 

The Number One Secret to Living Forever!

OK, maybe not forever, but pretty darn long. Here is the secret to the fountain of youth.

 

Metformin.

 

Maybe.

 

Metformin is a common medication used to treat diabetes and has also been shown to decrease the cellular aging process in mice and other animals. Now it has been approved for human studies to see if it increases our longevity as well. If not, then we will just have a bunch of young mice running around as we continue to age away.

 

The longevity community is full of excitement that this may be the one drug that pans out and makes a real difference. Not just for the high-profile Silicon Valley CEOs who want to live forever, but for masses of people. The hope is that it will drastically delay the onset of cancer, cardiovascular disease and neurodegenerative diseases. We have been down this road before  with resveratrol, so many are tempering their enthusiasm.

 

But this time may be different! Or so we hope.

 

How Metformin Works

 

Metformin helps us lower our glucose production, keep our insulin levels low, and helps our cells respond better to insulin.

 

It works by activating an enzyme called AMP Kinase, which decreases glucose production in the liver. The key point is that it lowers glucose levels without increasing insulin.

 

Insulin is a fat storage and potentially pro-inflammatory hormone. It is also associated with an increase in insulin-like growth factor-1 (IGF1), which has been implicated in cancer promotion over the long term. Safely minimizing insulin, therefore, should have direct health and longevity benefits. 

 

Metformin has other actions that directly improve muscle cell sensitivity to insulin. This means our bodies require less insulin to provide us with energy, thus ultimately reducing insulin resistance.  In addition, metformin can potentially alter the oxygenation of cells, providing the right balance of oxygen to stave off cellular aging.

 

 

Why would this help us live longer?

 

Lower blood glucose and insulin levels mean lower risk for diabetes, cardiovascular disease, and probably neurodegenerative diseases like Parkinson’s and Alzheimer’s. That certainly seems like a reasonable goal.

 

In addition, lower insulin and lower insulin growth factor 1 (IGF1) could mean less risk of developing cancer. In fact, studies have shown that those who take metformin have a lower incidence of most cancers. This does not prove that metformin itself reduces cancers, but it certainly makes for an interesting hypothesis that deserves further investigation.

 

And of course, anything that can slow down cellular aging could be of great benefit for longevity.

 

We have plenty of data to suggest metformin might be a fountain of youth.  Now, we eagerly await the results of the randomized, prospective, placebo controlled trial. The pinnacle of scientific evidence.

 

In the meantime, what can we do to help us extend our lives?

 

What Else Has Shown Promise for Longevity?

 

For starters, don’t smoke. No brainer there.

 

Also, wear your seat belt.

 

Don’t text and drive.

 

Don’t drink and drive.

 

It may sound like glib advice, but if you want the biggest return on your longevity investment, start there.

 

Caloric restriction

 

As the saying goes, caloric restriction may not make you live longer, but it certainly makes your life feel much longer

 

Calorie restriction has different definitions, but in general it means cutting your caloric intake by 30-50% or down to about 1500 kcal per day while avoiding malnourishment. If you have tried this, it can be a challenge to do and remain a social being in modern day society.

 

If living longer means being hungry and grumpy all the time and not being able to socialize, then no thanks. I will pass. As will most of the Silicon Valley elite.

 

But what can we learn from why long term caloric restriction works?

 

It turns out, caloric restriction improves insulin sensitivity, sound familiar? It also reduces our metabolic rate and reduces oxidative stress.

 

Calorie restriction also reduces the activity of a compound called mTorc1. The long name for this compound is mammalian target of rapamycin complex 1. The drug rapamycin has been around for decades as an antifungal and anti-cancer drug, but has now become the new kid on the longevity block. Some believe that the right dosing of rapamycin and/or inhibition of mtorc1 could reduce cellular aging and delay age related diseases.

 

Interestingly, AMP Kinase (the same mechanism stimulated by metformin) also inhibits mTorc1. When mechanisms combine, that gets scientists really excited. And when scientists get really excited, watch out.

 

So, in the end, we want to reduce glucose levels while also keeping insulin and IGF1 levels low. We want to reduce oxidative stress. And we probably want to reduce mTorc1.

 

Metformin can do this. Calorie restriction can do this. Rapamycin might be able to do this.

 

We Don’t Need Drugs

 

But guess what?  We Don’t Need Drugs to do all that!

 

If you are sleeping 4 hours per night, you are stressed out, you eat low quality- high carb fast food, and you sit on your arse all day, do you think metformin will help you live longer? Sorry Charlie.

 

If we have any interest in living longer and living better, we all have to start with the basic and critical elements called lifestyle.

 

Consistent, restorative sleep improves your cortisol levels, thus improving your glucose and insulin levels.

 

Managing your stress likewise reduces your cortisol and adrenaline spikes, again maintaining lower average glucose and insulin levels.

 

High intensity exercise and resistance training increases our mitochondrial activity, which increases glucose utilization, thus decreasing serum glucose and insulin levels.

 

Then there is nutrition.

 

This is a big one, and potentially the topic that is more variable from person to person. The key is to eat the minimum number of calories needed for nourishment, while still allowing you to enjoy your life and thrive. Specifically, we need to choose food that will keep our average blood glucose and insulin levels as low as possible.

 

A few tricks to achieve that:

  1. Avoid/limit added sugars. Hopefully this is obvious to everyone at this point.
  2. Avoid/limit processed simple carbohydrates (white flour, packaged snack foods etc.).
  3. Make low starch veggies (like green leafy veggies, cauliflower, zucchini etc.) the focus of the majority of your meals.
  4. Liberally add healthy fats (nuts, avocado, olives and olive oil).
  5. Don’t overdo it on the proteins. We only need 0.36- 0.5 grams of protein per pound of ideal body weight each day. So, if you weigh 180lbs., you only need 65-90gm of protein per day. If you are overweight and weigh 250lbs (but your ideal body weight is around 180 pounds), you still only need a maximum of 90gm of protein per day. So, don’t worry too much about getting enough protein. Instead, make sure you are not eating too much.

 

Once you have implemented all those lifestyle factors, then and only then should you even start to think about the effects of metformin, rapamycin, or other fountain of youth drugs. The future may be promising for a quick fix to slow the aging process. But one thing will hold true for ever:

 

The best way to live better and live longer is to make your life worth living.

 

Live with a purpose.

 

Take care of yourself emotionally and physically.

 

Take care of others.

 

And don’t forget to take care of the earth as well. Our health may just depend on it.

 

 

Thanks for reading.

 

Bret Scher, MD FACC

Cardiologist, author, founder of Boundless Health

www.DrBretScher.com 

3 Simple Breathing Techniques You Can Practice Anywhere

It doesn’t always take a vacation to a private island or a lavish spa day to get some relaxation time in. There are simple, quick techniques you can learn and incorporate into your everyday schedule to help ease that nagging tension and anxiety you might feel, and they take only take 5 minutes or less! Any time you might feel overwhelmed by an upcoming deadline at work or stressed out just coping with everyday tasks, you can try out any of these three breathing techniques. Find a quiet space wherever you are (even at work!) and try one of these out to help you feel more relaxed and ready to tackle the rest of your day. 

Belly Breathing 

Also known as diaphragmatic breathing, this technique requires you to focus on expanding your stomach, rather than your chest, as you take in each deep breath. 

1. Preferably lying on your back, place one hand over your stomach and another over your chest. 

2. Breathe in slowly through your nose and through your stomach so that you feel your stomach rise against your hand as your abdomen fills with air. 

3. Exhale completely and as you exhale through your nose, feel your stomach deflate to its neutral position. 

4. Repeat this process for 5-10 minutes, focusing on the sensation of your stomach rising and falling with each breath. 

The 4-7-8 Method

This exercise helps you breathe more deeply while putting your mind into a meditative state as you focus on counting the seconds during each breath in and out. 

1. Sit in a comfortable position and start by slowly inhaling through your nose on a count of 4 seconds.

2. After the fourth second, hold your breath for a count of 7 seconds*

3. After 7 seconds, exhale your breath for a count of 8 seconds. Repeat this exercise 3-4 times. 

*If 7 seconds feels too long, lower the count to a number of seconds that feels more comfortable for you. 

Progressive Relaxation

Your entire body will take a role in this breathing exercise as you coordinate each breath with the tensing and relaxing of your toes and feet all the way up to your shoulders and head. 

1. Lying or sitting, start by tensing the muscles in your feet as you breathe in through your nose. Hold the breath for a moment as you experience what the tension feels like in your feet and toes. 

2. As you relax your feet, release your breath and exhale through your nose. Take another moment to appreciate the feeling of your feet no longer tensing and contracting. 

3. Continue the process throughout your whole body, including your legs, abdomen, arms, hands, shoulders, jaw and eyes. 

4. Finish the exercise by tensing the entire body as you take a final deep breath in, and as you release your breath make sure to focus on the sensation of each muscle returning to a relaxed state. 

Taking the time to breathe deeply not only helps remind your brain to calm down but it can help remind you to be mindful and present in the moment.  Just by taking 5 to 10 minutes out of your day to try any of these breathing techniques you’ll notice a difference in how you cope with your stress, negative thoughts and the tension you’re holding in your body. Give it a try and let us know which one works best for you! 

Our Best Medicine- Pills Not Required

“Walking is man’s best medicine”- Hippocrates (Greek physician 460 BC-377BC). That is one of my favorite all-time quotes. I can’t say it enough or hear it enough. Hippocrates didn’t have scientific studies, he didn’t have fitness trackers, yet it was inherently obvious to him that physical activity and simply moving our bodies provided unparalleled physical and psychological benefits.

 

Combine that with more modern observations from Dan Buettner’s book The Blue Zones, and it becomes clear that regular physical activity is an essential key to our health and longevity. Mr. Buettner evaluated the most common personal habits in societies where they routinely live into their 90s and 100s. He found that they didn’t hit the gym every day, they didn’t train for marathons. They simply moved their bodies consistently. They worked in the garden, they walked to do their errands, they walked for social purposes.  They moved their bodies.

 

Don’t get me wrong. I am a big proponent of regular exercise, including high intensity interval training and resistance training (more on this in another post), but it is becoming clear that the basis for health is moving our bodies.  But why is this a challenge?

 

Technological Advances = Health Disintegration

 

Our society does not encourage regular physical activity. Most of us work desk jobs sitting in front of computers for hours at a time. We live as part of urban sprawl with longer commutes. And what minimal leisure time we have is spent on computers, tablets and video games. The days of centralized communities encouraging regular physical activity are largely gone.

 

This isn’t necessarily all bad. The technological advancements in the past few decades are unprecedented. It just hasn’t been good for our health. The priority has shifted. Now it’s time to shift it back!

 

It is time to re-examine all our unconscious habits. Why do we automatically go to the elevator or escalator? Why do we instinctively look for the closest parking spot? Why do we automatically sit on the couch instead of going outside for a walk?

 

Don’t just read these questions and keep going. Stop. Think. Answer the questions in your mind and resolve to re-examine those reasons and change them! Look at your daily habits and find places to purposely add more physical activity.

 

As I frequently say, you don’t have to try to be perfect. Just try to be better. If you can change one unconscious habit today that helps you move your body more, then you have a major success. If you can change another one tomorrow…even better!

 

Activity Trackers

 

My advice: Get an activity tracker and use it!

“But wait! Didn’t I just read a story about activity trackers being useless? Doesn’t that mean being active isn’t helpful?” I’m glad you asked.

 

There was a study in JAMA that asked a specific question: When it comes to weight loss, is a simple pedometer better than a program with regular encounters and encouragement from research staff? The answer, not surprisingly, was no (read a more detailed analysis of this study here).

 

Regular human interaction and encouragement is one of the most important factors when it comes to successful lifestyle changes. In this study, those in the activity tracker group didn’t have that interaction. It’s no surprise that they didn’t fare as well.

 

It is important to realize that activity trackers are one part of an overall health program. They are not an end-all tool for weight loss. And remember, weight loss is not the best marker for health. Healthy habits themselves should be the goal, the weight loss will follow.

 

So, don’t throw out your Fitbit, Jawbone or Apple watch just yet. When used correctly, activity monitors are a powerful tool to get you moving.

 

You may feel like you did a good job being active today. But then you glance down at your wrist and see a measly 4000 steps for the day. Now you know it is time to get moving. You can’t talk your way out of that one!

 

Or you may notice you hit your 10,000 steps and you are feeling good about yourself. You log in to the computer and see your good friend is already at 12,000 steps today. Time to put down your remote control and get another 2,001 steps in just to show him that you can!

 

That’s the power of activity monitors. Objective motivation day after day. Get one. Use it. Listen to the motivation.

 

Exercise Lowers Risk of Death

 

Ok. So, it’s well established that being consistently physically active is important for our health. But what about exercise? Aside from being physically active, how much exercise should we try to get?

 

It turns out, we don’t need that much to save our life.

 

A 2015 study in JAMA followed 661,000 Middle Aged adults over 14 years. They found the highest risk of death in those who did not exercise at all. Even a “little amount” of exercise (less than the official guidelines but more than no exercise) reduced the risk of death by 20%. The benefit continued to increase linearly with increasing exercise duration until it plateaued at 450 min per week.  The following table summarizes the results.

 

Amount of exercise per week

Cardiovascular/Mortality result

Sedentary

Highest mortality and cardiovascular risk

Less than 150min

Reduced death by 20% over sedentary

150 min

Reduced death by 31%

450 min

Reduced death by 39%

More than 450 min

No additional benefit, but no increased harm either

 

In addition, the Copenhagen City Heart Study  showed that “light” running, even just 20-minutes once per week, resulted in reduced risk of death. The maximal benefit was in those who jogged at a slow or average pace between 1-2.5 hours per week.

 

So, although the official recommendation is 150 minutes of moderate exercise per week, even minimal amounts of exercise provides some benefit. And it wasn’t an obscure benefit that you may or may not care about. It was reducing the risk of dying! That’s something we can all get on board with.

 

Move Your Body

If your goal is to reduce your risk of death, move your body.

 

If your goal is to improve your health, move your body.

 

If your goal is to feel better, move your body.

 

Be active, and add in at least small amounts of exercise.

 

The science supports. Hippocrates supports it. Now it is your job to get out there and do it.

 

(Read more about Resistance training and high intensity interval training Here)

 

Thanks for reading.

 

Bret Scher, MD FACC

Cardiologist, author, founder of Boundless Health

www.DrBretScher.com

 

 

Action Item:

 

Tomorrow, wake up and set your intention to seek out ways to move your body. Spend the entire day parking further away, taking the stairs, walking or biking to do your errands, go for a walk with your kids, and anything else you can find. Make it the focus for your day. You will be amazed at how many ways to can improve your activity level. Then, if you can do it once, you can incorporate it into your life and make it a new healthy habit. But you have to start with the first step. Wake up tomorrow and set that intention!

 

 

Bret Scher, MD FACC

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