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Old November 17th, 2005, 03:38 AM posted to alt.support.diet,alt.support.diet.low-carb,sci.med.nutrition
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Default Ketogenic Diet Raises Brain Energy (Press Release)

I keep hearing warnings from doctors that ketones are bad
for the heart, but I can't find any evidence for this. This
widespread belief in medicine seems to come from studies of
diabetics who have elevated ketone levels due to the same
metabolic defects which pose a risk to their hearts. Since
this old wives tale is making the circuit again, I thought I'd
post the information I could find on the subject.

FYI, diets like Atkins or South Beach are moderately
ketogenic.

Finally, I tacked on a comparison of high carb diets to low
carb diets and what they did to cholesterol. As usual, the
write assumes lowering cholesterol is a per se good thing.
I wonder if the cholesterol-lowering effects of the high carb
diet might partly explain why people with higher cholesterol
levels live longer - they're eating more fats, have a higher
levels of ketones in their blood and this makes their brains
and other organs healthier by, among other things, protecting
mtDNA. Anybody bothered to ever check mtDNA stability vs.
cholesterol and ketone levels? (It would be useful if the
authors broke high carb diets down according to glycemic
index.)

http://www.nytimes.com/aponline/nati...t-Matchup.html

High Carbs Plus Protein Could Help Heart

By THE ASSOCIATED PRESS
Published: November 15, 2005

Filed at 9:38 p.m. ET

CHICAGO (AP) -- Deciding what to have for a healthy
breakfast just got a little easier. While a healthy high-carb
diet has been shown to be good for you, replacing a few of
the carbohydrates with a little protein like scrambled egg
substitute or beneficial fats like olive oil margarine could be
even better, helping further reduce heart disease risks, a
study found.

At dinner, this might mean instead of pasta, trying black
bean tacos and multigrain pilaf with olive oil, the researchers
said.

They had volunteers try three variations of the same diet, all
of them low in saturated fats and including plenty of fruits and
vegetables.

All three improved blood pressure and cholesterol readings
after just six weeks, and adopting any of them would be
beneficial, said lead researcher Dr. Lawrence Appel of Johns
Hopkins School of Medicine.

''Most people aren't following anything close to any of these,''
he said, adding that the bottom line is: ''You can eat healthy
in three different ways, and two of them are a bit better than
the other.''

Appel presented the results Tuesday at an American Heart
Association conference in Dallas. The study also appears in
Wednesday's Journal of the American Medical Association.

All participants tried each of the diets, eating meals prepared
in a research kitchen and taking a few weeks' break before
starting the next diet.

The volunteers' average blood pressure started out borderline
high -- 131 over 77. Systolic pressure -- the top number in
blood pressure readings -- fell by an average of about 8 points
while they were on the carb diet, 9.5 points on the protein diet
and 9.3 points on the healthy fats diet.

Levels of LDL cholesterol, the bad kind, measured 129 on
average at the start; 100 is considered optimal. LDL levels fell
an average of almost 12 points on the carb diet, about 14 points
on the protein diet, and about 13 points on the healthy fats diet.

Those reductions likely would translate into less heart disease if
the diets were widely adopted, the researchers said.

They estimated that for every 100 people with mild high blood
pressure, there would be one less heart attack over 10 years
for those on the protein or healthy fats diet, compared with the
more carb-friendly diet.

Appel said the high-protein diet also seemed to produce feelings
of fullness and reduced appetite.

''These symptoms raise the intriguing possibility that if individuals
were to follow these diets long-term, there may be some weight
loss on the protein diet,'' he told conference participants.

Dr. Timothy Gardner, a Delaware cardiologist, said at the
meeting that the study was ''a tricky, difficult type of study to
conduct, controlling all the factors, with very interesting results.''

A JAMA editorial about Appel's research, which was funded by
the National Institutes of Health, questioned whether people in
the real world would stick to the diets since they'd have to buy
and prepare their own meals.

''Longer trials examining actual cardiovascular event outcomes
will be needed to convince a skeptical public of the benefit of
yet another unique and difficult-to-achieve dietary regimen,''
said editorial author Dr. Myron Weinberger of Indiana
University.

Rachel Johnson, a University of Vermont nutrition professor,
said the results refine ''what we already know. It's not a huge
about-face.''

------

On the Net:

JAMA: http://jama.ama-assn.org

American Heart Association: http://www.americanheart.org

Epilepsia. 2003 Apr;44(4):618-20. Related Articles, Links

Selenium deficiency associated with cardiomyopathy: a complication
of the ketogenic diet.

Bergqvist AG, Chee CM, Lutchka L, Rychik J, Stallings VA.

Division of Neurology, The Children's Hospital of Philadelphia,
Department of Pediatrics, University of Pennsylvania School of
Medicine, Philadelphia, Pennsylvania, USA.

PURPOSE: The ketogenic diet (KD) is an efficacious treatment
for intractable epilepsy, associated with infrequent side effects.
The KD is known to be deficient in most vitamins and minerals
and may be deficient in trace minerals. We report biochemical
selenium deficiency in nine patients on the KD, including one
who developed cardiomyopathy.
METHODS: A whole-blood selenium level was obtained on the
symptomatic patient after noting the patient's poor appearance
on physical examination. Children already treated and children
beginning the KD were then evaluated prospectively for selenium
status by measuring whole-blood or serum selenium as part of
routine laboratory evaluation every 3 months.
RESULTS: The index case had no detectable whole-blood
selenium. Cardiac physical examination and ECG were normal,
but the echocardiogram revealed cardiomyopathy. Thirty-nine
additional children had the selenium status evaluated. Eight had
selenium levels below the normal range (six initially, and two
developed low selenium levels on serial testing). They were
referred for cardiology evaluations, which were normal. Selenium
supplementation improved levels in all children. Low levels were
seen in some children after only a few months of treatment.
CONCLUSIONS: The nutrient adequacy of the currently used KD
has not been fully evaluated. The nutrient content of KD with usual
supplements may not meet Recommended Dietary Allowances
(RDA) for selenium and may not provide other trace minerals in
adequate amounts. At our center, selenium deficiency was found
in 20% of the patients evaluated. Screening for selenium
deficiency is suggested if the patient KD regimen does not meet
or =75% of the RDA or if the child is symptomatic. Nutrient

supplementation should provide adequate trace elements for
children treated with the KD. The KD requires close monitoring of
the overall nutritional status.

Publication Types:

* Case Reports

PMID: 12681013 [PubMed - indexed for MEDLINE

J Child Neurol. 2004 Jul;19(7):555-7. Related Articles, Links

Lack of long-term histopathologic changes in brain and skeletal
muscle of mice treated with a ketogenic diet.

Rho JM, Sarnat HB, Sullivan PG, Robbins CA, Kim DW.

Barrow Neurological Institute, Phoenix, Arizona 85013, USA.

Although there is increasing awareness of adverse effects
associated with use of the high-fat ketogenic diet, very little
is known regarding its long-term clinical consequences,
especially in relation to cardiovascular health. Recent reports
have highlighted rare but significant cardiac problems in patients
treated with the ketogenic diet. Given the inherent limitations in
conducting detailed pathologic assessments in patients, we asked
whether histologic changes might develop in the brain and
skeletal muscle of mice fed a high-fat diet for 2 to 3 months. We
found no evidence of gross morphologic or histochemical
alterations in muscle or brain after administration of the
ketogenic diet. Further, there was no abnormal lipid storage or
mitochondrial enzymatic staining. Our data suggest that patients
chronically treated with a ketogenic diet are not likely to develop a
lipid myopathy or neuronal inclusions.

PMID: 15526964 [PubMed - indexed for MEDLINE]

CNS Drug Rev. 2005 Summer;11(2):113-40.
Related Articles, Links

KTX 0101: a potential metabolic approach to cytoprotection in
major surgery and neurological disorders.

Smith SL, Heal DJ, Martin KF.

RenaSci Consultancy Ltd, BioCity, Nottingham, NG1 1GF, UK.

KTX 0101 is the sodium salt of the physiological ketone,
D-beta-hydroxybutyrate (betaOHB). This neuroprotectant, which
has recently successfully completed clinical Phase IA evaluation,
is being developed as an intravenous infusion fluid to prevent the
cognitive deficits caused by ischemic foci in the brain during
cardiopulmonary bypass (CPB) surgery. KTX 0101 maintains
cellular viability under conditions of physiological stress by acting
as a "superfuel" for efficient ATP production in the brain and
peripheral tissues. Unlike glucose, this ketone does not require
phosphorylation before entering the TCA cycle, thereby sparing
vital ATP stores. Although no reliable models of CPB-induced
ischemia exist, KTX 0101 is powerfully cytoprotectant under the
more severe ischemic conditions of global and focal cerebral
ischemia, cardiac ischemia and lung hemorrhage. Neuroprotection
has been demonstrated by reductions in infarct volume, edema,
markers of apoptosis and functional impairment. One significant
difference between KTX 0101 and other potential neuroprotectants
in development is that betaOHB is a component of human metabolic
physiology which exploits the body's own neuroprotective
mechanisms. KTX 0101 also protects hippocampal organotypic
cultures against early and delayed cell death in an in vitro model
of status epilepticus, indicating that acute KTX 0101 intervention in
this condition could help prevent the development of epileptiform
foci, a key mechanism in the etiology of intractable epilepsy. In
models of chronic neurodegenerative disorders, KTX 0101 protects
neurons against damage caused by dopaminergic neurotoxins and
by the fragment of beta-amyloid, Abeta(1-42), implying possible
therapeutic applications for ketogenic strategies in treating
Parkinson's and Alzheimer's diseases. Major obstacles to the use
of KTX 0101 for long term therapy in chronic disorders, e.g.,
Parkinson's and Alzheimer's diseases, are the sodium loading
problem and the need to administer it in relatively large amounts
because of its rapid mitochondrial metabolism. These issues are
being addressed by designing and synthesizing orally bioavailable
multimers of betaOHB with improved pharmacokinetics.

PMID: 16007235 [PubMed - in process]

Curr Atheroscler Rep. 2005 Nov;7(6):428-34. Related Articles, Links

Benefits and hazards of dietary carbohydrate.

Connor WE, Duell PB, Connor SL.

Division of Endocrinology, Diabetes and Clinical Nutrition, Oregon
Health & Science University, 3181 SW Sam Jackson Park Road,
L465, Portland, OR 97239, USA.

Since the dawn of civilization, carbohydrate has comprised the
largest source of energy in the diet for most populations. The
source of the carbohydrate has been from plants in the form of
complex carbohydrate high in fiber. Only in affluent cultures has
sugar contributed so much of the total energy. When carbohydrate
is consumed as a major component of a plant-based diet, a
high-carbohydrate, low-fat diet is associated with low plasma levels
of total and low-density lipoprotein cholesterol, less coronary heart
disease, less diabetes, and less obesity. Very low-carbohydrate
(ketogenic) diets may provide short-term solutions but do not lead
to a long-term solution for most people.

PMID: 16256000 [PubMed - in process]