The Charlie Foundation’s response to the article in Big Think.
‘No one should be doing the ketogenic diet,’ says top U.S. cardiologist
Big Think – September 5, 2018
by STEPHEN JOHNSON
Response written by Beth Zupec-Kania RDN, CD
Dr. Kim Williams is quoted in this article that attacks ketogenic diet therapy. He based his opinion on a 2013 review of 17 studies which found low-carbohydrate diets to be associated with an increased chance of death, with particular increased risks to cardiovascular health. What he failed to understand is that this article is a review of low-carbohydrate, high-protein diets, not ketogenic diets, which are low-carbohydrate, high-fat, moderate protein.The difference is monumental. The article doesn’t even address ketosis or ketones. Dr. Williams has twisted the results of this study because he doesn’t know the difference. What he should have referenced are the articles that show an improvement in cardiovascular disease on ketogenic diets in the following studies.
Effects of low-carbohydrate and low-fat diets: a randomized trial.
A low-carbohydrate, ketogenic diet versus a low-fat diet to treat obesity and hyperlipidemia: a randomized, controlled trial.
My 88 year old mother’s cardiologist prescribed a statin because her LDL is elevated. Her cholesterol, HDL, and triglyceride levels are all in the normal range. It outraged me to learn that he didn’t explain the potential adverse effects of this drug and didn’t offer that she could modify her diet. Recent evidence has linked LDL in the elderly with longer life-spans (article). You can bet that I stepped in and refused to let my mother take this drug that has no statistical benefit of improving her lifespan or preventing her from having a heart attack, and would significantly increase her chances of developing diabetes.
Lack of an association or an inverse association between low-densitylipoprotein cholesterol and mortality in the elderly: a systematic review https://bmjopen.bmj.com/content/6/6/e010401
Statin induced diabetes and its clinical implications
For 25 years, the Charlie Foundation has been dedicated to providing education, resources and advocacy for medically supervised ketogenic therapies. A treatment discovered in the 1920s that was nearly abandoned for epilepsy, is now known to help improve and even cure epilepsy and has shown benefit in other conditions such as brain cancer, diabetes, autism and several genetic disorders. Ketogenic therapies have also grown into one of the largest areas of study for improving overall health. The Charlie Foundation remains committed to ensuring everyone who may benefit, especially those with epilepsy, are aware of and able to access dietary therapies.
Ketogenic fad diet could do more harm than good
By WRDW; Nick Viviani | Posted: Tue 10:32 AM, Sep 04, 2018
Responses written by Beth Zupec-Kania RDN, CD
BZK- I’m writing in response to the poorly researched article by Nick Viviani. Clearly he has not looked into the growing body of evidence of the benefits of a medically supervised ketogenic diet for numerous disorders. His statements show a lack of debth in fact checking.
NV- New studies show the keto diet and other extreme high or low carb diets can actually be deadly to those trying to use them long term.
BZK- Which studies are you referring to? None were cited for this article.
NV- “Carbohydrates are the main source of energy that our brain uses. It’s the most efficient source of energy. If we use a protein or fat for fuel, it puts more stress on the body,” said Yurechko.
BZK- New research indicates that ketones produced by the ketoegnic diet are a “more efficient fuel for the brain”. The ketogenic diet can provide neurological protection and disease modifying effects for conditions such as epilepsy, Alzheimers and Parkinson’s diseases. – see attached article.
NV- Doctors say this diet was intended for children dealing with severe cases of Epilepsy, and even in those cases, there are still risks.
BZK- There are multiple studies proving the effectiveness and safety of ketogenic diet therapy under medical supervision for epilepsy including a recent consensus guidleine on use (which cites all of those studies) – see attached. The risks associated with epilepsy drugs and surgery can be significant, even life-threatening, therefore, its one-sided to target ketogenic diet therapy as dangerous.
NV- The diet is not recommended for people with uncontrolled Diabetes. Ketosis is a sign of not using enough insulin.
BZK- Ketosis can improve and even reverse diabetes. Recent studies show that a medically supervised ketogenic diet can be very beneficial for people with difficult to control diabetes – see final 2 articles.
Beth Zupec-Kania RDN, CD
Charlie Foundation www.charliefoundation.org
Dietary Fats and Cardiovascular Disease: A Presidential Advisory From the American Heart Association
Frank M. Sacks , Alice H. Lichtenstein , Jason H.Y. Wu , Lawrence J. Appel , Mark A. Creager , Penny M. Kris-Etherton , Michael Miller , Eric B. Rimm , Lawrence L. Rudel , Jennifer G. Robinson , Neil J. Stone , and Linda V. Van Horn
and On behalf of the American Heart Association
Originally published15 Jun 2017Circulation. 2017;136:e1–e23
Response from The Charlie Foundation – Author: Beth Zupec-Kania RDN, CD
Dietary fat has endured a long history of controversy in its role in health. Saturated fat, found predominately in animal products (butter, cheese, cream, meat fats), and, in coconut oil, have been villainized as “bad” fats. Newer research is turning the tide on this old way of thinking. A 2015 systematic review found no association between saturated fat consumption and risk of heart disease, stroke, diabetes, or death (1). An even more recent review of randomized controlled trials concluded that replacing saturated fats with mostly polyunsaturated fats is unlikely to reduce coronary heart disease. This 2017 review showed that inadequately controlled trials that were included in earlier meta-analyses explain the prior results (2). Despite these recent findings, the American Heart Association continues to tout the old data. It’s important, however, to understand that their reference to fat is in the context of a high-carbohydrate diet. Ketogenic and modified ketogenic diets have a completely different effect on metabolism. Emerging data from several sources reveal that low-carb, high-fat diets are effective in improving metabolic syndrome (3-5). Metabolic syndrome is the name for a group of risk factors that raises your risk for heart disease and other health problems, such as diabetes and stroke. Coconut oil is a safe fat to include in low-carb, high-fat diets. Its shorter chain length makes it easier to digest then long chain animal and vegetable oils. It also contains antibacterial properties which is helpful for the digestive tract. While coconut and palm oils found in processed snack foods are undoubtedly unhealthy, pure coconut oil has been used for decades in epilepsy. The MCT oil diet, originated at The Mayo Clinic consists of 60% MCT oil – a concentrated form of coconut oil. Not only has this oil been helpful in treating epilepsy, it has recently shown to be beneficial for brain health (6.7).
The Charlie Foundation encourages you to have regular cholesterol and lipid testing, including particle size, during ketogenic diet therapy. The particle size is important in understanding cardiovascular risk. Ketogenic diets often increase the large-sized LDL which is thought to be protective against heart disease. We also advise including monounsaturated fats such as extra virgin olive oil and avocado oil daily in the diet. These unique monounsaturated oils contain several vitamins plus the essential omega-3 and 6 fats.
Note- This commentary was written in response to this advisory from the AHA.
1. de Souza RJ et al. (2015). “Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: systematic review and meta-analysis of observational studies”. BMJ. 351 (h3978).
2.Hamley, S. (2017). “The effect of replacing saturated fat with mostly n-6 polyunsaturated fat on coronary heart disease: a meta-analysis of randomised controlled trials”. Nutrition Journal. 16 (1): 30. PMID28526025. doi:10.1186/s12937-017-0254-5.
7. Fernando W.M.A.D et al. (2015) “The role of dietary coconut for the prevention and treatment of Alzheimer’s disease: potential mechanisms of action.“ British Journal of Nutrition. doi:10.1017/S0007114515001452.