Very Concerning Article Claiming Keto Diet Causing Afib in Rats and Humans

science
#27

Thanks for posting this @Saphire.

I wonder if Tom @tdseest still looks in on the forums? He is a lived expert on heart arrhythmias and the ketogenic diet.

I need to find a reference for you as to why rats are not a good animal for ketogenic diet studies. I think it was well explained on either the STEM talk podcast, or the Peak Nutrition podcast. So, the rat studies needs to be ‘triangulated’ with other data sources, such as mechanistic studies where beta-hydroxy-butyrate is tested on human heart cell cultures, and other animal models for human disease, possibly a primate study would be more clear. It may be worth gathering other experimental types to fill out the picture?

It’s interesting that you relate the concern to viral disease. Can I say SarsCov2? There definitely are ACE2 cell receptors concentrated in heart muscle tissue. Those cells can then be very badly impacted from COVID-19. So correlating the two concerns is a worthy discussion.

I hope Tom is around to comment.

Oh, I had a bout of AF on Wednesday night just passed. 2am.I treated it at home with therapeutic steps that I have worked out that work for me. I flipped i back to normal rhythm within an hour this time. I do have a beta-blocker on hand if I need it, but that is rarely. My n=1 observation is that I developed atrial fibrillation in 2017, 3 years after starting ketogenic eating. The first episode related to going off the plan. After a bit of research and self-experimentation I solved the problem for my own situation, including reverse remodelling my heart and resolving left atrial enlargement. All that on a ketogenic diet. But since I have been doing some carnivore challenges the AF episodes do reoccur. For me zero carb carnivore is not as ketogenic as the standard ketogenic diet.

#28

Thank you,

I wish that were true but it has been this way since about 4 months into Keto back in 2017. Except When I am binging (sadly happens to often) I am nowhere near Zone levels. In a binge I am at SAD levels of carbs. However I think when I am trying to stay keto It is more that since I do not love fatty meats, I tend to eat nuts, some lower carb fruits like berries and more almond flour than I should. All block ketosis since I am not active. I am ok with that. I know when I am in ketosis because I get a certain taste and feel the tiniest bit nauseous. It is subtle but I know it is there.

Actually this concern way predates Covid. I posted a long time ago, in 2017 or 2018 that shortly after starting fasting and then Keto I started getting a lot of colds. They were mostly an annoyance. I could not figure out why and then someone posted an article, possibly @richard that fasting made you more vulnerable to viruses and less vulnerable to bacteria (since I got a bacterial infection in the middle of a fast in 2017 or 2018 I am not sure that is true for me).

The viruses seemed to stop in July 2018, not sure if it was because I started taking Lypisomal Vitamin C or because I did not fast as often. Did not have another illness until after Thanksgiving 2019 where I both cheated alot and was around a lot of people. It was a whopper, it was so bad I later thought it was an early version of Covid but since I had no antibodies, it was not. Bottom line, I am willing to risk an ordinary cold by fasting but not Covid which is why I have limited myself to 36 hour fasts or less as it is usually on Day 3 that I start to get sick (not that it always happened).

As for rats, I might have dismissed it the same way cholesterol in rabbits is dismissed but the link to the earlier study on patients with subsequent Afib had higher levels of circulating BHB made me very nervous

(Edith) #29

I will have my keto and/or carnivore four year anniversary this June. In all that time, I’ve only been sick once, and that was about a month after I was in a car accident. I think the stress of the car accident lowered my resistance. I do not fast except for some intermittent fasting every once in a while. Maybe your body finds fasting stressful.

(Bob M) #30

Not a big deal. After 7+ years low carb/keto, my breath ketones are between 20-30 normally (ketonix, first edition), whereas they could get into the 80s years ago.

@CFLBob The ONLY time my breath ketones go up (save fasting multiple days) is when I eat a lot of fat.

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For comparison (when I was testing “resistant starch”):

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(Bob M) #31

Sorry, did not read this until now. This is completely incorrect. As someone with heart failure, ketones are the preferred fuel for the failing heart:

Lots of studies here, but here’s one:

When blood sugar remains at 100 or higher
(Michael - When reality fails to meet expectations, the problem is not reality.) #32

That has been my understanding as well. However, from the article cited I find this ‘takeaway’ curious:

Takeaways
…
These results suggest that ketogenic diets do not enhance cardiac ketone body metabolism, but rather stimulates fatty acid oxidation, which may be responsible for the improved cardiac remodeling and performance.

From the original paper, which is the source of the above ‘takeaway’ I presume:

Abstract

… Diets with higher fat content, but enough carbohydrate to limit ketosis, also improved heart failure, while direct ketone body provisioning provided only minor improvements in cardiac remodeling in CS-MPC2−/− mice…

Unfortunately, the paper is behind a subscription/pay wall so only the abstract is viewable. Maybe I’m missing something, but it seems like they downplay the role of ketones and say that metabolism of straight fatty acids causes the improvement.

When blood sugar remains at 100 or higher
(Bob M) #33

Yeah, I can’t get it, so I’m not totally sure what that means. They did inject mice (if you look way at the bottom of the page, they have “extended data”, where they describe the injections) with BHB. Or here:

https://www.nature.com/articles/s42255-020-00296-1/figures/12

But it doesn’t say under what conditions.

When I was originally looking into this, I got a bunch of studies. Here’s another:

Now, I THINK this should transfer to “normal” hearts, but it’s hard to say that it does.

When blood sugar remains at 100 or higher
#34

i realized i posted in the wrong place. :smiley:

(Scott) #35

This nobody eats all the fat on a steak. I also select cuts based on the amount of fat they have, the more the better.

(Vic) #36

I eat it first, its the best part. Yummm

(Bob M) #37

Here’s a good article that just came out about ketones and the heart:

https://www.jacc.org/doi/10.1016/j.jacc.2020.12.065

My least favorite part:

The KD has become extremely popular, both within and outside of the medical arena. KD consists of a very low-carbohydrate and high-fat diet that forces the body into endogenous ketosis (25). Although sustained KD can raise blood βOHB to 2 to 4 mmol/l (10), long-term compliance is low, often due to gastrointestinal (GI) distress.

(Michael - When reality fails to meet expectations, the problem is not reality.) #38

:thinking::thinking::thinking::thinking:

Thanks for the link, Bob! Basically, the criticism seems to be: “Wow, ketones are really beneficial to heart health and wellbeing. Too bad you have to give up ice cream, pizza and [add your fav carb here] because no ones gonna do that. Oh! by the by, we can just add exogenous ketones to SAD and we’re all good.”

I find it hilarious when folks who don’t eat keto express their disbelief that anyone can eat keto ‘long term’. Which means a day longer than their experiment lasted.

(Gregory - You can teach an old dog new tricks.) #39

More like lack of donuts distress … :grin:

(You've tried everything else; why not try bacon?) #40

Yeah, I guess four years is very short-term.

Surprisingly, given that glazed doughnuts were my carb of choice, I don’t really miss them. What I miss is bread. Go figure!

#41

My body does find it stressful but strangely I do not! Most days I have nothing but coffee before 5, often because I forget. I have no explanation but there are times when I have to start eating due to a family event or business dinner and I almost regret ending the fast on Day 3-5 (other times I am thrilled). Will be getting my shots soon and going back to the gym and fasting are at the top of my list.

#42

Best bread other than the real thing and pretty easy to make https://www.dietdoctor.com/recipes/the-keto-bread

(Edith) #43

No one realizes that humans lived without these things for most of our existence. They are the truly abnormal foods.

#44

Not even that. It is possible to make low carb donuts for a treat, if one is really donut-distressed.

I’m one who loves this WOE because of how wonderful the food is. Everything tastes better with butter!

#45

Thank you for sharing. It made me research about it, because I’ve been feeling weak and wondering if it’s depression, or something heart related.

(Sara Smiles001) #46

There is however a lot of science coming out about the link between keto diet and long term gut health. I did Atkins through out my entire 20s. Went off for a year and was diagnosed with celiac disease. Obviously I had the gene or I couldn’t have gotten adult onset celiac. However, they know adult onset is set off by an extreme change in gut bacteria. I am currently back on keto and super nervous about some of the effects I’m seeing… severe dehydration, extremely dark urine. Maybe because I have digestive issues keto is too hard on my body now? I’m sticking with it to see if things get better but I’ve always wondered if the extreme dieting caused the initial upset in my gut bacteria. I’m sure I’ll never know. :woman_shrugging:t3: