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Tag: LCHF

Meat and Homocysteine- Irrelevant or Dangerous?

Do we have to avoid meat if we have high homocysteine levels? Not really.

 

What our body does with homocysteine is more important than our food intake. I thought this was easier to explain in video form, so you can see my 4 minute explanation here:

The bottom line is we need to know our methylation status, make sure we have adequate levels of folate, B12 and B6, and make sure we have adequate choline (found in egg yolks).  If all those are perfect, and we still have elevated homocysteine, then we may want to experiment with a diet low in methionine to see if it makes a difference.

 

As always, however, we have to evaluate our overall health picture and not get too hung up on one blood marker. The more important questions to ask are how does homocysteine affect my overall health, and how will altering my supplements or diet change the big picture?

 

Hopefully this helps! Let me know if you have any comments or questions.

 

Thanks for reading (and watching!)

Bret Scher MD FACC

LCHF and “Healthy” Whole Grains: Do we Need Them?

Here it is again. The term “healthy” connected as a descriptor.

We see it all the time. Healthy Whole Grains. It reminds me of the common use of “fruits and vegetables,” as if they are one in the same.

Are whole grains, by definition, “healthy?”

For a full, in depth description, see the Whole Grains Guide on Diet Doctor, where I was the medical editor and reviewer.

For the quick answer, let’s leave it as a “maybe.”

If you choose to eat refined grains, white flour, processed snack foods, in essence the Standard American Diet, then switching to whole grains will almost certainly improve your health. And that is where the majority evidence in favor of whole grains stops. Compared to refined grains, they are great.

Who should eat whole grains?

If you are insulin sensitive, live in a society where you are physically active for most the day, eat fewer calories than most industrialized nations, and maintain a healthy body weight, then whole grains can be a healthy part of your diet. Observation of the Blue Zone countries demonstrate that whole grains can be part of a healthy lifestyle in that setting.

We cannot, however, extrapolate those findings above to apply to all Americans, Europeans, Asians etc. and say whole grains are by definition “healthy.”

Who should not eat whole grains?

If you are metabolically unhealthy with diabetes, metabolic syndrome or insulin resistance (estimated to be 88% of all Americans), then whole grains are anything but “healthy.” Borrow a continuous glucose monitor for a day and see how your blood glucose responds to whole grains. If you aren’t perfectly metabolically healthy, it isn’t pretty.

Instead, if you eat a whole-foods, low carb diet without grains and sugars, then whole grains have no necessary role and no association with health.

Enjoy the more detailed guide from DietDoctor.

Thanks for reading,

Bret Scher, MD FACC

Low Carb Denver 2019

They just keep getting better. These low carb conferences keep raising the bar, and they keep exceeding my expectations.

Low Carb Denver was no exception.

 

Robb Wolf on Low Carb Myths

 

The conference started out with Robb Wolf dispelling the unfounded myths that low carb is dangerous or associated with dying earlier. The quality of science that gets promoted in the media is nauseating, and Robb did a wonderful job highlighting that. (Plus, we had a fantastic podcast interview later that day, so stay tuned for that!)

 

Georgia Ede on the EAT Lancet Report

Next up was Georgia Ede, who destroyed the EAT Lancet report. By saying “destroyed,” I don’t mean she was malicious or attacking. Rather, Georgia was her usual incredibly analytical and science-based self. She showed how the report was based on faulty science, and how the recommendations weren’t even supported by the faulty data they used. It is mind boggling how this amounts to a well-funded PR campaign masquerading as science, and Georgia was masterful at demonstrating this fact.  Bonus- Georgia sat down for another action packed podcast interview. (You will love this one!)

 

Low Carb Practical Implications

From there, we got into practical implications such as how low carb might be an adjunctive treatment in cancer, how it can be safe in pregnancy, and Jason Fung showing how PCOS is essentially a disease of hyperinsulinemia. What’s the best treatment for hyperinsulinemia? Let’s say it together… LCHF! (and I had an amazing podcast interview with Jason as well!)

Then the controversy started.

 

LCHF Controversy

Kudos to the organizers for stirring things up with presentations followed by a civil debate between Dr. Dariush Mozafarrian and Gary Taubes.  It’s important to recognize intelligent opinions and scientific interpretation don’t always agree. This was a nicely highlighted in this section.

There are plenty of times when opinions and “data” against low carb are based on weak or nonexistent science. The discussion with Gary and Dariush showed the nuances of interpreting science, something I aim to continually help with!

 

Zoe Harcombe on Fiber

Fast forward to day two when Zoe Harcombe brought down the house with a riveting talk on how we don’t need fiber. None. Not at all. Zilch. If we eat tons of refined carbs, then fiber is helpful. If we don’t, then don’t worry about fiber! This was a great talk with perfectly placed “potty humor” as Zoe called it.

 

My Talk

Next came my favorite part of the conference. But then again I am biased. It was a 1-2-3 cholesterol punch with Dr. Paul Mason, myself, and Dr. Nadir Ali all discussing different aspects of cholesterol. The take home is that things are different with LCHF. The physiology changes and the existing cholesterol evidence does not reflect the specific subset who follow a healthy low carb diet. That much we know.

Yet, there is much we don’t know. These back-to-back-to-back talks helped highlight this.  That’s why I advise everyone following a LCHF lifestyle to see a practitioner experienced with LCHF. It doesn’t mean ignore cholesterol, but it does mean seeing it in a different light.

As if the first two days weren’t enough, day three kicked off with Dr. Eric Westman, followed by Dave Feldman sharing his amazing N=1 clinical data from the past year. Beware of coffee and high triglycerides!

 

The Diet Doctor on Long-Term LCHF Diets

Then came The Diet Doctor himself, Dr. Andreas Eenfeldt showing us how low carb diets do work in the long term. We just have to stick with them. This was a nice compliment to the earlier talk from Dr. David and Jen Unwin showing us how hope is a powerful force to maintain compliance and behavioral change.

 

LCHF and Sexual Health

And then we had a new topic for the LCHF meeting, sexual health. Perfectly delivered by stand-up comedian and low carb physician Dr. Priyanka Wali, her talk showed us how the number of problems LCHF helps continue to add up. That is why most of the time we are better off thinking of LCHF as an overall healthy lifestyle rather than a “treatment” for a specific disease.

LCHF Community

Despite all these amazing talks, however, the real star was the community. The interactions I had and witnessed between everyone, healthcare providers or not, showed the level of engagement, intelligence, and hope this community represents.

My personal highlight may have been having dinner with an ER doc, family practice doc, forage agronomist and ceramics teacher.  All of us with eclectic backgrounds, and all of us wanting to improve the health of the world (people and the environment).

It was a week’s worth of interactions packed into three days. And it leaves me hopeful for the future of science, the future of nutrition, and the future of health.

Thanks for reading!

Bret Scher, MD FACC

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

Megan Ramos

Humans have practiced fasting for centuries as part of religious rituals, but the medical community has shunned it as risky and dangerous. Megan Ramos, along with her co-founder Dr. Jason Fung, have embarked on a mission to change all that. At IDMProgram.com, Megan and Jason counsel patients how to use fasting safely to help with weight loss, diabetes, management, and overall health promotion. They recently published a case series showing how they can help people get off their insulin in as few as five days! But fasting can be a double edged sword with significant potential risks of hypoglycemia, loss of lean muscle mass, and feeling awful. Megan helps us understand how to overcome those concerns so that we can benefit from fasting in a safe and sustainable manner.

New Major Study: A Calorie Is Not A Calorie

Despite what the sugary beverage and processed snack food companies want us to believe, all calories are not created equal.

A new study from Harvard shows that individuals following a low-carbohydrate (20% of total calories) diet burn between 209 and 278 more calories per day than those on a high-carbohydrate (60% of total calories) diet. So the type of calories we eat really does matter.

The New York Times: How a low-carb diet might help you maintain a healthy weight

This isn’t the first study to investigate this topic, but it is likely the best.

The current study was a meticulously controlled, randomized trial, lasting 20 weeks. Even more impressive, the study group provided all the food for participants, over 100,000 meals and snacks costing $12 million for the entire study! This eliminated an important variable in nutrition studies — did the subjects actually comply with the diet — and shows the power of philanthropy and partnerships in supporting high-quality science.

After a run-in period where all subjects lost the same amount of weight, participants were randomized to one of three diets: 20% carbs, 40% carb, or 60% carbs, with the protein remaining fixed at 20%. Importantly, calories were adjusted to stabilize weight and halt further weight loss, thus making it much more likely that any observed difference in calorie expenditure was not from weight loss, but rather from the types of food consumed.

After five months, those on the low-carb diet increased their resting energy expenditure by over 200 calories per day, whereas the high-carb group initially decreased their resting energy expenditure, exposing a clear difference between the groups. In addition, those who had the highest baseline insulin levels saw an even more impressive 308-calorie increase on the low-carb diet, suggesting a subset that may benefit even more from carbohydrate restriction.

Why is this important? It shows why the conventional wisdom to eat less, move more and count your calories is not the best path to weight loss. Numerous studies show better weight loss with low-carb diets compared to low-fat diets, and now studies like this one help us understand why.

Our bodies are not simple calorimeters keeping track of how much we eat and how much we burn. Instead, we have intricate hormonal responses to the types of food we eat. It’s time to accept this and get rid of the outdated calories in-calories, calories-out model, thus allowing for more effective and sustainable long-term weight loss.

Originally Posted on the Diet Doctor Blog 

Todd White

Alcohol and low carb simply don’t mix, right? Not so fast. As Todd White, founder of Dry Farm Wines explains, it depends on the product. If a zero sugar, low carb, no additive product sounds too good to be true, then you have to listen to this podcast.

But Todd isn’t only a wine expert, he is also a self-described biohacker. Through the years Todd has become an expert on maintaining a keto lifestyle, prioritizing exercise and maintaining a regular meditative practice despite his rigorous international travel schedule. He lives his life with integrity and healthy principles, and promotes these concepts as a main focus of his business culture. I was amazed to hear they start each work day with an hour-long group meditation. That is a company culture I can support!

Todd's knowledge base goes well beyond alcohol, and he provides essential pearls we can all learn from.

Dr. Michael Arata & Stephanie Kennedy

Dr. Michael Arata, founder and lead physician at Arata Medical, is the most unique radiologist I have ever met. He specializes in limb-salvage interventional procedures, and as such, is the last resort to prevent a patient from having an amputation. Luckily, he realized that he could potentially have an even bigger impact by taking a functional medicine approach to prevention, rather than last minute heroics. That’s when he teamed up with his star health coach Stephanie Kennedy to teach people how to use plant-based ketogenic diets and a wholistic approach to their health to prevent the chronic disease that plague our society. Their upcoming book, Keto with Plants, is an accumulation of their experience and their attempt to help thousands of patients with their message. I love their patient care philosophy, and it was quickly evident that they are experts in helping their clients practically implement lifestyle changes that will help them today and for the long haul. You are sure to learn some valuable tips in this interview!

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Bret Scher, MD FACC

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