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Is Fat Healthy for Me?
Benefits & Course Corrections
During a Year of Ketosis
Jim McCarter, MD, PhD
Adjunct Professor of G...
Why Did You Change Your Diet?
Weren’t You Healthy Before?
McCarter Family, Chicago, 2012
@JPMcCarter
Carbs Result in a Glucose & Insulin Roller Coaster
(Post-breakfast munchies, Post-lunch food coma)
Dr. Jeff Volek, The Man...
“The high-carb diet I put you on 20 years ago gave you
diabetes, high blood pressure, and heart disease. Oops.”
Daily
• Work, Sleep, Mood
• Exercise, Steps & Stairs
• Weight
• Heart rate & blood pressure
• Food log & photos
• Blood gl...
What is Nutritional Ketosis and Why is it Desirable?
Benefits of nutritional ketosis include
- Reduced oxidative stress & ...
Benefits & Challenges I’ve Experienced with Ketosis
Benefits
1. Achieved desired weight & body
composition
2. No longer hu...
From A Standard American Diet to Nutritional Ketosis
carbohydrate
protein
fat
U.S. Average Diet (2006 1) My Ketogenic Diet...
What I Eat in Nutritional Ketosis
(Challenges –
Too Much
Protein)
Tracking Ketosis With Daily Blood BOHB
mmol/L Beta-hydroxybutyrate
Points – days, Line – 7 day moving average
AM fasting 2...
Ketosis is Disrupted by Carbohydrates at
Restaurants and During Travel
fasting experiment
Juniper
Chestnuts Hodak’s
Almond...
days – blue points
20 day moving average – black line
Caloric
Restriction
LCHF
Reduced
Hunger
Ketosis
maintenance
LCHF
mai...
Athletic Stamina for Sustained High Intensity
by Tapping Fat as Fuel
Running & Swimming – Able to sustain near
sprint pace...
- Hip Pain During Long Runs Resolved
- Shoulder Pain During Swims Resolved
- Verified with C-Reactive Protein Test (3/10/1...
Blood Pressure is Down Substantially
Twice Daily Scanadu Scout Blood Pressures Averaging 113/71
BP at Physical Down from H...
Triglyceride is Down
HDL “Good” Cholesterol is Up
Ketosis
(<20g carb)
LCHF
(<50g carb)
Mg/dL
January 2010 April 2013 July ...
<90
22.1
NMR Lipoprofile
Results
Higher LDL But Favorable “Pattern A”
Benign Large Buoyant Particles
Large Buoyant LDL (Pa...
Other Challenges –
Cramps, Slow Warm-ups, & Cold Sensitivity
Cures for Electrolyte (Na, K, Mg) Imbalance
- Bouillon cubes ...
Water is Cold. Salt Keeps Me Warm.
Optimal Sodium for Cardiovascular Health May Be 4-6 Grams Daily
O’Donnell et al. “Urinary
Sodium and Potassium
Excretion, ...
Conclusions. Yes, Fat is Healthy for Me.
- Benefits of ketosis are substantial but with room for improvement
- Getting eno...
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Is Fat Healthy for Me? Benefits & Course Corrections During a Year of Ketosis, Quantified Self 2015

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Burning fats instead of carbohydrates for energy can have advantages for weight loss, disease treatment, and athletic performance. I'm tracking ketones (markers of fat metabolism) and other health metrics, and seeing both benefits and challenges

Publié dans : Santé & Médecine
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Is Fat Healthy for Me? Benefits & Course Corrections During a Year of Ketosis, Quantified Self 2015

  1. 1. Is Fat Healthy for Me? Benefits & Course Corrections During a Year of Ketosis Jim McCarter, MD, PhD Adjunct Professor of Genetics, Washington University in St. Louis Entrepreneur in Residence, BioGenerator Quantified Self 2015 June 18, 2015, San Francisco @JPMcCarter
  2. 2. Why Did You Change Your Diet? Weren’t You Healthy Before? McCarter Family, Chicago, 2012 @JPMcCarter
  3. 3. Carbs Result in a Glucose & Insulin Roller Coaster (Post-breakfast munchies, Post-lunch food coma) Dr. Jeff Volek, The Many Facets of Keto-Adaptation
  4. 4. “The high-carb diet I put you on 20 years ago gave you diabetes, high blood pressure, and heart disease. Oops.”
  5. 5. Daily • Work, Sleep, Mood • Exercise, Steps & Stairs • Weight • Heart rate & blood pressure • Food log & photos • Blood glucose • Blood ketones (BOHB) What Have I Tracked While Reducing Carbs? Periodically • Exhaled ketones • Body fat & bone density (DEXA) • Blood Pressure (via cuff) • Blood Chemistry Panels • NMR Lipoprofile • Gut Microbiome
  6. 6. What is Nutritional Ketosis and Why is it Desirable? Benefits of nutritional ketosis include - Reduced oxidative stress & inflammation - Decreased blood pressure - Decreased triglycerides & increased HDL - Decreased hunger & easier weight loss - Increased endurance – by accessing 80,000 calories of fat instead of 2,000 calories of glycogen - Ketone bodies are natural products of fatty acid metabolism - Nutritional ketosis is the production of ketone bodies from stored or dietary fat - Ketone bodies increase when fasting or when dietary carbohydrates are limited - During fasting, ketones provide 60% of brain energy needs
  7. 7. Benefits & Challenges I’ve Experienced with Ketosis Benefits 1. Achieved desired weight & body composition 2. No longer hungry or tired after meals 3. Athletic stamina supports sustained high intensity 4. No longer have symptoms of inflammation 5. No longer get cold & flu symptoms 6. Blood pressure is down 7. Resting heart rate is down 8. Triglyceride is down 9. HDL cholesterol is up 10.LDL cholesterol subclass is favorable pattern A Challenges 1. Cholesterol is higher (likely benign) 2. Muscle cramps 3. Longer warm-up time for workouts 4. Sensitivity to cold temperature increased
  8. 8. From A Standard American Diet to Nutritional Ketosis carbohydrate protein fat U.S. Average Diet (2006 1) My Ketogenic Diet (estimated) 48.7% 15.7% 33.7% USDA Advised US Average Carbs 45-65 48.7 Protein 10-35 15.7 Fat 20-35 33.7 1 Austin et al. Am J Clin Nutr 2011. 93:836. Caloric Intake By Macronutrient LCHF Ketogenic Carbs 7-14 3 Protein 13-21 13-21 Fat 69-76 80 3% 17% 80% US Averages follow USDA guidelines LCHF = Low Carb High Fat
  9. 9. What I Eat in Nutritional Ketosis (Challenges – Too Much Protein)
  10. 10. Tracking Ketosis With Daily Blood BOHB mmol/L Beta-hydroxybutyrate Points – days, Line – 7 day moving average AM fasting 2.0±0.9 PM post-meal 0.9±0.6 <0.1 carb-rich diet >0.5 ketosis cut-off
  11. 11. Ketosis is Disrupted by Carbohydrates at Restaurants and During Travel fasting experiment Juniper Chestnuts Hodak’s Almond Butter Picnic One Market Thanksgiving Moving Business Trip
  12. 12. days – blue points 20 day moving average – black line Caloric Restriction LCHF Reduced Hunger Ketosis maintenance LCHF maintenance pounds Benefits – Achieved Desired Weight & Body Composition Date Nov 2001 Feb 2015 Weight (lbs) 191 166 % Fat ~21- 24 12 DEXA Fat (lbs) ~40- 46 19.9 BMI 23.9 20.7 Waist (inches) ~34 31
  13. 13. Athletic Stamina for Sustained High Intensity by Tapping Fat as Fuel Running & Swimming – Able to sustain near sprint pace for long distances From Dr. Jeff Volek, The Many Facets of Keto-Adaptation
  14. 14. - Hip Pain During Long Runs Resolved - Shoulder Pain During Swims Resolved - Verified with C-Reactive Protein Test (3/10/15) Reduction in Inflammation Indicated by Resolved Joint Pain & Verified by Low CRP Low Risk <1.0 Mg/L HS CRP Average Risk 1-3 High Risk >3.0 0.4 10th percentile1 Active Infection >10.0 1 Rifai and Ridker. 2003. Population Distributions of C-Reactive Protein in Apparently Health Men and Women in the U.S.: Implication for Clinical Interpretation. Clinical Chemistry, 49:666-669.
  15. 15. Blood Pressure is Down Substantially Twice Daily Scanadu Scout Blood Pressures Averaging 113/71 BP at Physical Down from High of 136/90 in 2009 to 112/71 in 2014-15
  16. 16. Triglyceride is Down HDL “Good” Cholesterol is Up Ketosis (<20g carb) LCHF (<50g carb) Mg/dL January 2010 April 2013 July 2014 March 2015 Prior Diet (estimated 300-400g carb) HDL TG 46 78 99 85 139 75 41 94 “HDL >60 is considered protective of heart disease” “TG <150 is desirable”
  17. 17. <90 22.1 NMR Lipoprofile Results Higher LDL But Favorable “Pattern A” Benign Large Buoyant Particles Large Buoyant LDL (Pattern A) Is Associated with Lower Cardiovascular Disease Risk
  18. 18. Other Challenges – Cramps, Slow Warm-ups, & Cold Sensitivity Cures for Electrolyte (Na, K, Mg) Imbalance - Bouillon cubes for sodium replacement - Slow release magnesium - Muscle Cramps - especially calf muscles overnight - Longer warm-up time for workouts – first 15-20 min of a run - Sensitivity to cold temperatures – especially hands in winter All Are Symptoms of Electrolyte Imbalance Kidney Function - High Carb Diet = Sodium Retention - Low Carb Diet = Sodium Excretion
  19. 19. Water is Cold. Salt Keeps Me Warm.
  20. 20. Optimal Sodium for Cardiovascular Health May Be 4-6 Grams Daily O’Donnell et al. “Urinary Sodium and Potassium Excretion, Mortality, and Cardiovascular Events,” NEJM, 371:610, 2014. Study of Over 100,000 People in 17 Countries Found Lowest Risk at Estimated Sodium Intake of 4-6 grams
  21. 21. Conclusions. Yes, Fat is Healthy for Me. - Benefits of ketosis are substantial but with room for improvement - Getting enough fat and salt is a challenge - Blood ketones levels provide daily feedback @JPMcCarter

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