Low Carb Health and Fixing Our Broken Healthcare Experience Webinar

We had an incredible turnout for our Webinar, aimed to help you transform your health in 2019. As a result, we decided to create a blog post that includes the full webinar recording, as well as an overview of the learnings for those that were unable to attend.

Webinar Recording

Webinar Overview

Cardiovascular Disease Is the #1 Killer for Men and Women

  • 1/3 of all Americans die from Cardiovascular disease
  • Around 92 million Americans are living with CVD
  • Every 34 seconds someone suffers a heart attack
  • Annual health expenditure and lost productivity from CVD ~$330 billion

It’s been estimated that 50-80% of these are preventable! Unfortunately, our healthcare system and associated lifestyle guidelines have failed to prevent disease. We could say at best they have failed to prevent heart disease, obesity and diabetes. At worst they have been implicit in its prevalence. While this graph doesn’t show causation, it certainly shows the association of instituting national nutritional guidelines and the rise in diabetes.

Drugs Don’t Fix the Problem

  • 60% of Americans take at least 1 prescription drug
  • 15% take more than 5 drugs
  • Despite this, our overall health and life expectancy continue to decline

HEALTH IS NOT THE ABSENCE OF DISEASE!

In this webinar, we will discuss how to be your own best advocate, why low carb, high fat nutrition should be an option for everyone, and how lifestyle really is the best medicine.

3 Interventions to Improve your Healthcare Experience and Be Your Best Advocate

  1. Make sure your doc is working with accurate information! Lipids and blood pressure are two prime examples of when doctors make decisions based on limited and faulty information.
  2. Get your questions answered by writing them down ahead of time so you don’t forget anything and tell your doctor at the beginning of the appointment that you have some questions you’d like to ask at the end.
  3. Make sure you understand the purpose and benefit of each and every medication. Not some vague answer like “It will improve your cholesterol,” or “It will lower your blood pressure.” Rather, “what impact will it have on my longevity and quality of life?” Will I live longer? Will I feel better? What are the chances the drug will actually benefit me? These are the questions we need answered.

Why Low Carb, High Fat Nutrition Should be an Option for Everyone!

LCHF vs Low Fat Diets

LCHF Benefits

  • Decreased hunger, increased energy, mental clarity
  • Treats metabolic syndrome/insulin resistance
  • Better weight loss
  • Improves overall cardiovascular risk for most people

LCHF may not be the best for everyone, but it certainly should be an option for everyone. If you want tips that do work for everyone, follow these bonus tips for weight loss and overall health!

  • Don’t drink your calories – even “natural” drinks are full of unnecessary calories. Think about it this way, you would drink a glass of orange juice, but would you really sit down eat the 5 or so oranges it takes to make it? If not, why drink that same amount?
  • Get rid of “Food Delivery Systems” – Think about the big sandwiches or burritos we see everywhere in our culture. What is the food? The stuff in the middle! The meat, the cheese, the veggies. What is the unnecessary food delivery system? The bread, the tortilla, the outer layer that has a fraction of the nutrients and a multitude of the carbs!

Lifestyle Really is the Best Medicine!

Science says lifestyle, not drugs, reverse disease:

  • NEJM study reported findings on patients at highest genetic risk for heart attack, over 90% more likely to suffer heart attack. Those with healthy lifestyles had a 50% reduced risk with no drugs and no surgeries!
  • JACC study found 85% of all heart attacks could be prevented with greater attention to lifestyle.
  • A 2018 British Journal of Sports Medicine study found that increasing walking pace to “brisk” for those over 50 reduced all-cause mortality and cardiovascular mortality by 20-24%.

Why is it so hard?

We have all been told that in order to be healthy, we need to eat less, move more, and reduce fat in our diets. But if that is the case, why is it that only 12% of Americans are metabolically healthy, and only 3% of Americans follow a healthy lifestyle?

Because the simple Eat Less, Move More, Reduce Fat approach DOESN’T WORK!!!

I want to assure you that it’s not your fault, you’ve been given the wrong information.

“I was always told I simply didn’t have enough willpower to stick to a diet. I couldn’t understand why I was always hungry and craving foods. I figured it was all genetics. But working with Dr. Scher showed me there is a better lifestyle that I can stick with and still feel great and enjoy my life! Thanks Dr. Scher!”

  • E

Keys to Making Lifestyle Change Stick

  • Beware of one-size-fits-all nutrition and lifestyle claims
  • Individually tailored and flexible nutrition is the key.
  • When you eat is just as important as what you eat
  • Move your body more
  • Get Serious about your sleep
  • Don’t be afraid to test and adjust

A Word of Caution

Don’t try to Change Everything at one time.

Choose YOUR most important first step (nutrition, stress, fitness, etc.) and work on that until a new habit is created!

And remember, you don’t have to do it alone! Working with an expert who can help you on your health journey will increase your likelihood for long term success.

As you can see, this was a quick tour to highlight the main points in the webinar. To get the full benefit, I recommend watching the full recording to get all of the context and be able to see the Q&A session at the end.

If you want to get the full experience, here is that recording again:

If you’d like to see the date and content of our next webinar, or be notified when our next webinar will be, please visit our Webinar Page.

I hope you enjoyed this recording, and that we will see you at the next live webinar!

 

Thanks for reading,

Bret Scher MD FACC

The Great Misunderstood High-Density Lipoprotein

What do I mean by “misunderstood?” Look no further than the common misnomer of “good” or “bad” cholesterol.

Good and Bad Cholesterol

While it may be true that High-Density Lipoprotein (HDL) has potentially beneficial functions (reverse cholesterol transport), we have to remember there is no such thing as good and bad cholesterol. The cholesterol carried by HDL is the same as that carried by LDL. The only thing that makes it good or bad is if it ends up synthesizing our hormones or bile acids (good), or if it ends up in our vessel walls (bad).

If it’s true there is no such thing as good and bad cholesterol, why do we care about our HDL levels?

First, let’s start with the basics.

HDL is the smallest and most densely packed lipoprotein and has one or more ApoA protein on its surface. HDL can help lipids move around in circulation by accepting triglycerides or cholesterol from other particles, thus helping a VLDL turn into an LDL, or helping an LDL contain less cholesterol (turning a small dense LDL into a less densely packed LDL).

Like LDL, HDL transports cholesterol to the liver for recycling or excretion, or to the hormone producing cells like in the adrenals. Unlike LDL, HDL does not have the potential to get retained in the vascular wall and does not, therefore, contribute to plaque formation. In fact, functioning HDL can remove cholesterol from the vessel wall, thus putting it back into circulation and possibly removing it from the body.

Back to the question at hand.

 

Why should we care about HDL levels?

Early epidemiological trials showed that lower HDL levels were associated with a higher risk of cardiovascular disease and even death.  With such a strong association, the medical profession promoted elevated HDL levels as protective and low levels as something we need to avoid.

Since these were observational epidemiological studies, they do not prove that the low HDL caused the problems, only that HDL was associated with it. For instance, HDL is also known to be low in diabetes, metabolic syndrome and insulin resistance. It may, therefore, simply be a marker of underlying metabolic dysfunction that contributes to increased risk.  Yet, HDL’s function in reverse cholesterol transport, and its ability to remove cholesterol from vessel walls suggests a more direct impact on cardiovascular health.

It is also important to note that the Framingham data suggested that increased cardiovascular risk with elevated total cholesterol and LDL-C was lost in the presence of high HDL. In fact, very low levels of LDL combined with very low HDL levels had a much higher risk than markedly elevated LDL levels when combined with elevated HDL.

Thus, HDL proves to be a useful marker to help predict cardiovascular risk. For instance, one large meta-analysis showed that total cholesterol/HDL ratio was a much stronger predictor of cardiac mortality than total cholesterol alone.

In addition, the PURE study, an observational trial in over 135,000 subjects, showed that when considering lipid changes brought about by nutritional changes, ApoB/ApoA1 (essentially LDL-P/HDL-P ratio) is the best predictor of clinical outcomes.

Thus, HDL level is important in assessing cardiovascular risk.

 

Drugs Muddy the Picture

While HDL may be a good predictor of risk, raising it with drugs does not seem to confer added benefit.

For instance, cholesterol ester transferase protein inhibitors (CETP inhibitors) significantly reduced LDL by 20-30% and increased HDL 100-fold, yet showed either no clinical benefit or even worse, an increased risk of death.

This was a shock to many in the lipid world as the notion of “good” and “bad” cholesterol would clearly predict lowering LDL and raising HDL would confer dramatic health benefits. So much so, that multiple pharmaceutical companies invested hundreds of millions of dollars developing these drugs only to abandon them when the trials showed no benefit.

Part of the issue is that not all HDL lipoproteins function the same. There are subsets of people with genetically determined markedly elevated HDL levels who have an increased risk of CVD. They may have plenty of cholesterol circulating in HDL particles, but the HDL particles are dysfunctional and therefore  do not effectively remove cholesterol from vessel walls or LDL and do not effectively transport it to the liver. Conversely, there are those with a specific genetic mutation called ApoA1 Milano who have very low HDL-C and lower cardiovascular risk.

Simply measuring the HDL cholesterol content, therefore, may not accurately reflect its function. While we do not have easily available tests to measure HDL function, we can potentially use HDL particle assessment as well as the company it keeps (i.e. low triglycerides, larger less dense LDL particles) to better assess the potential benefits of HDL. Thus, if there is any concern about potentially dysfunctional HDL, I usually recommend advanced lipid testing to see the specific subtypes of HDL.

What can we conclude from all the HDL confusion?

Raising HDL with drugs does not reduce cardiovascular events, yet having a naturally low HDL is associated with increased risk.

The best answer, therefore, is to live a lifestyle that helps you have a “not low” HDL level. This means first and foremost avoiding the medical conditions associated with low HDL (i.e. insulin resistance, diabetes, and metabolic syndrome).

Textbooks predictably state the interventions to naturally raise HDL include exercise and moderate alcohol intake. Unfortunately, these have minimal effects. In fact, they pale in comparison to a low carb high fat lifestyle. In my 20+ years in the medical field, I have never seen an intervention as effective as LCHF in raising HDL, and the studies agree.

This brings us back to our question once again.

Why are HDL levels important?

HDL levels are important because it is a reflection of our underlying metabolic health and our lifestyle. A properly constructed LCHF lifestyle lowers triglycerides, raises HDL, and reduces the small dense LDL, among other benefits. Such a lifestyle likely reduces overall cardiovascular risk and will likely be shown to improve longevity and health span. While HDL may not be the main reason for this, we can’t ignore its role simply because it is more nuanced than “good” and “bad” cholesterol.

My advice, therefore, is to see the whole picture. Embrace the nuance. And make sure you get a thorough and proper evaluation of your cardiovascular risk.

If you are hungry for more, I created my Truth About Lipids program, a program focused on Cholesterol, to help break through the confusion and provide you with everything you need to thoroughly understand cholesterol and its impact on your health.

Learn more: Truth About Lipids Program

 

If you still have questions, you may want to consider a one-on-one health coaching consultation so you can get the individual attention you deserve  with a thorough assessment of your lifestyle and its impact on you as an individual.

Please comment below if you have any questions or comments that may help further the discussion.

Thanks for reading.

Bret Scher MD FACC

Dr. Robert Lustig

The debate wages. Is a calorie just a calorie? Or is there something specifically dangerous about fructose and carbohydrate calories? To anyone who has experienced the benefits of a low carb lifestyle, the practical answer is obvious. But answering that question on a global scale and making meaningful changes to improve the health of millions of people is much more complex. That’s where Dr. Robert Lustig comes in. As a pediatric endocrinologist who is now armed with a law degree, Dr. Lustig has made it his mission to fight our health crisis on the legal and policy front. It won’t be easy, but after this interview, I for one am glad he the one leading the charge.

Ruminant, Diet & Human Health

Peter Ballerstedt has the background and personality to help us bridge the knowledge gap between how we feed and raise our animals, and how we feed and raise ourselves! His fascinating story begins with understanding animal nutrition and food systems, but quickly transitioned to human nutrition as well after a personal health discovery. Since then, he has become a leading voice to promote a rational and science based approach to ruminant agriculture and how ruminants can save our human health crisis.

Low Carb USA Recap

This past weekend, I had the pleasure of attending the Low Carb USA Conference in West Palm Beach.

I was blown away by the amazing community of providers and participants. Everyone I came across was very engaged and hungry for knowledge. There was also a special day devoted to the Spanish speaking audience. I was impressed by their growth from previous conferences.

Low Carb Spanish-Speaking Leader Ignacio Cuaranta

One leader in the Spanish speaking community is Ignacio Cuaranta, who is also a leader promoting low carb for the prevention and treatment of mental disorders. A big take home from his keynote was that that problems with our brains are not that different from the problems with our body. Metabolic derangements affect both, and low carb nutrition appears to be very beneficial for both.  I was lucky enough to record a podcast with him, so look for that in the near future! I don’t want to give away all the spoilers but suffice it to say, he is seeing outstanding success with Low Carb and Intermittent Fasting in his practice.

 

Dr. Robert Cywes on Carbohydrate Addiction

The headliner of the meeting was Dr. Robert Cywes. He is a weight loss bariatric surgeon, and the most unique surgeon I have ever met. He doesn’t want to operate. He would rather cure people of their underlying carbohydrate addiction and help them heal themselves. He has a refreshing perspective focusing on the emotional and psychological aspects of weight gain and recognizes that food choices alone won’t help if these aspects aren’t also addressed.  I also recorded a podcast with him so stay tuned for that!

 

Dr. Will Cole Spoke About Vegetarian Keto

Dr. Will Cole presented his case for Keto-tarians, essentially vegetarian ketosis. One of the predominate theories is that when we are in ketosis, our bodies require much less protein that we otherwise would. That way we can focus more on the non-animal fats and worry less about getting our 20+% of calories from protein. It is an interesting theory that he has had success with and highlights that a ketogenic diet can take many forms and mean different things to different people.

 

Dr. Ryan Lowery on Ketosis Being Protein Sparing

Florida’s own Dr. Ryan Lowery from ASPI echoed Dr. Cole’s theory that something about being in ketosis appears to be protein sparing, thus we don’t have to eat as much for muscle growth or maintenance. He also shared his research in rats that suggests lifelong ketosis promotes longevity. And guess what? That’s right, I filmed a podcast with him as well! This one was packed with information and I know you will love it as much as I did.

 

The food was fantastic!

Did I mention the food? WOW, the food was incredible! Some of the best conference keto buffets I have seen. The leg of lamb with onions on Friday night along with the spinach salad, avocado, and fat-soaked veggies were just what this doctor ordered (pun intended!)

I was in Keto heaven.

 

Learning from the conference overall

As usual the team from Low Carb USA did an incredible job and the event went off without a hitch. It inspired me to take away lessons on how they put together a successful conference for hundreds of people and adapt it to our upcoming intimate and personalized Low Carb Beach Retreat in April.

At this retreat, we will combine the benefits of didactic teaching with small group discussions and development of individualized low carb programs.  Due to its small size spots are limited so reserve your spot today!

Dr. David Ludwig

In the messy world of nutritional science, some researchers rise above the others in their attempt to produce high quality and useful data. Dr. Ludwig exemplifies that role. As a practicing pediatric endocrinologist, he has seen first hand the rise in obesity, type 2 diabetes, fatty liver and other previously rare complications in adolescents. As a result, he has made it his mission to help us better understand the role of calories, the importance of quality of calories, and the importance of the quality of the science we read. Is a calorie just a calorie? Why are so many scientific studies not helpful in answering this question, and what can we do about that? Dr. Ludwig answers these questions and more.

Amber O’Hearn

Many have referred to a ketogenic diet as “extreme,” “restrictive” and “potentially dangerous.” Now, those same concerns have focused on an all-meat carnivore diet. Although it is new in popularity, people have been practicing a carnivore diet for decades, and possibly centuries. Does that mean it is safe and without concern? Not necessarily. There is much we still don’t know about eating only meat, and Amber admits that. With her balanced and intellectual approach, she helps us understand the complexity of defining if this diet is “safe,” and helps us understand who might benefit most.

Is a Low Carb High Fat Diet Heart Healthy?

We hear the words Heart Healthy a lot, especially when it comes to our nutrition.

 

By now, you’re likely used to seeing cereals with the “heart healthy” moniker. Is it really heart healthy? We all too frequently refer to foods as “heart healthy”, or we say that our doctor gave our hearts a “healthy” checkup.  

 

It all sounds nice. But what does it mean? How do we define heart health?

 

How does LDL Cholesterol affect Heart Health?

 

Unfortunately, most of our current definitions center around LDL cholesterol concentration.  While LDL cholesterol plays a role in heart health, it by no means defines heart health in totality.

 

In fact, in many cases it is the least important factor.

 

Our healthcare system has simplified things too much, so as a result we focus on one bad guy, one demon to fight. In reality heart disease is caused, and made more likely to occur, by a constellation of contributing issues.

 

Elevated blood sugar, elevated insulin levels, inflammation, high blood pressure, poor nutrition, and yes, lipids all contribute to heart health.  It does us all an injustice to over simplify it to one single cause.

 

What food is heart healthy?

 

Our superficial definition of cardiac risk is how industrial seed oils containing polyunsaturated fatty acids (PUFAs) became known as “heart healthy.”

 

Studies show that they can lower LDL. But they can also increase inflammation and have no clinical benefit and even increase risk of dying. According to our simplified definitions, that doesn’t stop them from being defined as “heart healthy.”

 

 That’s right! Something that increases our risk of dying is still termed “heart healthy.”  How’s that for a backwards medical system?!

 

Same for blood sugar. If you have a diagnosis of Type 2 Diabetes (DM2) that is a risk for cardiovascular disease. If you don’t have the diagnosis, you are fine. That ignores the disease of insulin resistance that can predate diabetes for decades and increases the risk of heart disease and possibly even cancer and dementia.

 

Cereal can also be called “heart healthy” as they may minimally lower LDL. But is that a good thing if they contain grains that also worsen your insulin resistance and metabolic syndrome? I say definitely not.

 

Time has come to stop this basic, simplified evaluation and start looking at the whole picture.

 

How Low Carb High Fat Diets Improve Heart Health

 

Low carb high fat diets have been vilified as they can increase LDL. But the fact of the matter is that it does so only in a minority of people. The truth is that they can improve everything else!

 

These diets reduce blood pressure, reduce inflammation, improve HDL and triglycerides, and reverse diabetes and metabolic syndrome! Shouldn’t that be the definition of “heart healthy” we seek? Instead of focusing on one isolated marker, shouldn’t we define heart health by looking at the whole patient?

 

Only by opening our eyes and seeing the whole picture of heart healthy lifestyles can we truly make an impact on our cardiovascular risk and achieve the health we deserve.

 

Join me in demanding more. Demand better.

 

Thanks for reading,

Bret Scher, MD FACC

Is LCHF Keto the right diet for you in the new year?

With New Year’s resolutions looming, many people are thinking about reinvigorating their health. In fact, 45% of people want to lose weight or get in shape as their New Year’s resolution.

The LCHF Keto diet has been quickly gaining momentum, and it is piquing a great deal of curiosity.

So, is this particular diet right for you? It may just be.

 

What are your diet goals?

Before selecting a diet, it’s important for you to define why you want to diet in the first place. Are your goals weight loss, general health, or a combination?

If you want to lose weight, reduce your hunger, enjoy your meals, and improve your metabolic health, then LCHF may be right for you.

 

Do you want to lose weight?

The primary reason most people go on a diet is to lose weight. As far as weight loss, low carb has you covered. Out of 60 studies comparing low carb to low fat diets, low carb had better weight loss in 30 and they were equal in 30. Low carb was inferior in exactly zero of these studies. That’s an impressive record, and definitely something to consider if weight loss is your primary goal.

But there is so much more to life and health than weight loss.

 

Do you want to reduce your hunger?

One main struggle in health and weight loss is how hungry we are and how much we need to think about food during the day. Studies show that following a LCHF diet reduces our hunger in the long-term. That means less worry about constant snacks, and less concern with needing to eat every few hours. In fact, LCHF works so well at curbing appetite that more people can practice time-restricted eating by compressing eating into a 6-8 hour window, which has indicated potential beneficial effects for longevity.

 

Do you want to improve your focus?

Food, especially the wrong food, can make us feel lethargic and unfocused. Many people report thinking more clearly and having better mental performance when on a low carb diet. The brain loves ketones, whereas carbs can cloud your thinking. Why not switch to low carb and see if your brain fog lifts?

 

Do you want to improve metabolic health?

A recent study showed that only 12% of Americans are metabolically healthy. Low carb diets are one of the fastest and best ways to improve metabolic health. Studies show it puts type 2 diabetes in remission, improves insulin resistance, reduces visceral fat, and improves overall metabolic health.

 

Do you want to decrease your cardiovascular risk?

Fat phobia is gone. Limiting carbs to real food veggies and eating plenty of healthy fats improves our cardiovascular risk profile. It reduces BP, reduces TG, increases HDL and improves the size and density of LDL, which all add up to a net improvement in cardiovascular health.

 

The main reason you should consider LCHF/Keto in the new year

You will love it!

No counting calories, no feeling hungry, no wild glucose swings and post meal crashes, no afternoon slump. With all of this research backing this diet, it’s definitely worth a try.

 

One last consideration

A note of caution, most people will do great. But not everyone reacts to this diet the same way, so you may want to consult a doctor experienced in low carb nutrition.

If you don’t already have a doctor to consult with or want to speak with one who specializes in Keto, I’m a professional who has extensive experience with LCHF diets and how they affect your health. If you’re just getting started, I recommend downloading my free LCHF/Keto starter tips e-book to get you on the right track:

 

 

 

If we can be of any additional service, please let us know!

Thanks for reading,

Bret Scher, MD FACC

Dr. Sarah Hallberg

For decades the medical world has seen type 2 diabetes as a chronic condition that we can only hope to manage with medications to delay inevitable complications. Dr. Hallberg and her colleagues at Virta Health have completely changed that paradigm by showing us that we can reverse type 2 diabetes and we can allow patients to safely stop most if not all of their medications. How have they done this? With a ketogenic diet combined with high touch and high tech. Could this approach work for the millions of people suffering with type 2 diabetes? Dr. Hallberg certainly thinks so, and in this interview explains why.

Bret Scher, MD FACC

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