Study finds low carb diet linked to AF

This study is interesting, I have always read that the Medertranian diet was the best, beans, veggies, fruits, grains.


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Liz



Edited 1 time(s). Last edit at 03/06/2019 05:45PM by Elizabeth.

Certainly, as I've posted before, getting the body to adapt to ketosis can cause electrolyte shifts which can lead to afib or other rhythm issues. In my case, I was aware of this risk, took it and had one afib episode during the adaptation period and none in the 9.5 years since.. The issue I have with this study is that the diet was based on food frequency questionnaires, which are a very unreliable marker of true food consumption over time. One could generate a hypothesis from them, but would need to be tested with a randomized control trial. Second, their cut for the lowest 1/3 of the data was 44.8% of calories in the diet from carbs (at the top of that range). From a mechanistic perspective, that is very far from where you'd get the electrolyte shift going into keto (which might be around 5% from carbs initially). .

For the record, I developed afib eating a 70% carb diet with plenty of grains, beans and veggies. Said diet also caused me to develop insulin resistance despite being very active (the chronic fitness that led to afib).

George:

Most people don't do all that you did perfecting your diet. Probably the main thing was the lack of electrolytes in the diet, most didn't allow for that, I guess if you don't know what you are doing don't do it.

Liz

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Elizabeth
George:

Most people don't do all that you did perfecting your diet.

Mark your calendars! I agree with Liz again.

George, you've got to admit that your methods are on the extreme side and most people won't be able to replicate them.

Agreed Carey: if there's a scale of 0 to a 100 with 0 being can't be bothered to make any effort at all and 100 being total unswerving cast iron intellectual and physical determination and adherence to a thoroughly researched protocol, then George sits at around 150!!



Edited 1 time(s). Last edit at 03/07/2019 04:40PM by mwcf.

I don't like diets. They are often hard to follow, sometimes overly sophisticated or costly or induce a lot of unpleasant things.
I've tried some different diets in three years, just to reduce my ectopics and my number of afib episodes. When one diet seems to have positive effects, it doesn't last long. Afib is back just like before.
Most of the times, diets have bad side effects and questionable benefits.
My father, who left at 90, used to say : everything, reasonably.

The genetic factors relating to the APOE4 allele that have motivated GeorgeN and other well-informed individuals to follow the Ketogenic program is worth noting for the obvious reasons. It's a side-benefit for George if it also helps keep him Afib free.

While we can cope with and manage AF relatively well with the various treatment options available, the long-term preventive measures for management of dementia or even normal, age-related cognitive decline are important considerations for quality of life. Thus, the remarkable results of the Ketogenic lifestyle are worth consideration as is the gene risk assessment testing.

I commend you, George, for your discipline and perseverance to optimize a highly-active, long, healthy life and sharing your successes with us here.

Best to you,
Jackie

Diets only work if they are a lifestyle change and not temporary. Find something that is good and works (including exercise) and don't change. I have been on the same "diet" for several decades (it's nothing special) and my weight and fitness levels change very little. Maybe 4 lbs. added during the Thanksgiving - Christmas holidays, but that comes off for the rest of the year. Moderation in eating is the secret.

I never considered that afib had anything to do with my diet other than dehydration, that was until I found this site and added the "magic three" post ablation.

Adding Natto (food) to my diet has made a big change to my afib burden.
I also watch what bread I eat. I prefer wholemeal and if I can get it, low carb. which is 40 to 50 % less carbs.

George helped me understand the important of Sodium as well. Many low carb diets have you drinking a lot of water, which depletes MG, K and Sodium. It was the sodium that was getting me to have skipped beats.

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Ghost
George helped me understand the important of Sodium as well. Many low carb diets have you drinking a lot of water, which depletes MG, K and Sodium. It was the sodium that was getting me to have skipped beats.

Low carb diets, especially when going through the keto or fat adaptation stage can cause electrolyte disturbances. This is because of the natriuresis of fasting. In other words, fasting or very low carb diets, <30g carbs/day, can cause very sharp drops in insulin. High levels of insulin signal the kidney to retain sodium, so when insulin drops, it signals the kidney to excrete sodium. In addition, in the beginning of a keto phase, the body depletes the glycogen in the liver and in muscles. Each gram glycogen is associated with 3-4 grams of water. So there will be water urinated out, carrying electrolytes with it. This adaptation phase is (as I noted in my post above) a risk period for someone with afib tendencies. Most guides to keto adaptation will suggest adding in sodium, potassium & magnesium during this time. I think if someone with afib wants to keto adapt, they need to be aware of this and prepare for it. I would also suggest slowly lowering carbs rather than an abrupt drop (which is what I did, because it was all I knew 9.5 years ago).

As I mentioned, I think the study doesn't tell us anything. The food frequency questionnaire data are fairly useless as the main input. Also the cut point around 45% calories from carbs (which would be 900 calories from carbs/day on a 2000 calorie diet) is nowhere near the point where there are electrolyte disturbances (maybe by as much as 10x).

I happened to have been at a medical conference since Thursday. I asked two docs who have prescribed low carb diets in their practice about whether they saw this associate in their clinics. One doc was from the UK and has been prescribing low carb for 7 years. He said he did not see the association, but recommends electrolyte repletion for everyone he prescribes it to. Another doc from the US has been prescribing it for 15 years. He looked at me and said, no, I treat afib with it!. This makes sense, as many presenting with afib have metabolic illness and there are data I've seen suggesting that fixing the metabolic illness can help the afib.

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GeorgeN

Low carb diets, especially when going through the keto or fat adaptation stage can cause electrolyte disturbances. This is because of the natriuresis of fasting. In other words, fasting or very low carb diets, <30g carbs/day, can cause very sharp drops in insulin. High levels of insulin signal the kidney to retain sodium, so when insulin drops, it signals the kidney to excrete sodium. In addition, in the beginning of a keto phase, the body depletes the glycogen in the liver and in muscles. Each gram glycogen is associated with 3-4 grams of water. So there will be water urinated out, carrying electrolytes with it. This adaptation phase is (as I noted in my post above) a risk period for someone with afib tendencies. Most guides to keto adaptation will suggest adding in sodium, potassium & magnesium during this time. I think if someone with afib wants to keto adapt, they need to be aware of this and prepare for it. I would also suggest slowly lowering carbs rather than an abrupt drop (which is what I did, because it was all I knew 9.5 years ago).

As I mentioned, I think the study doesn't tell us anything. The food frequency questionnaire data are fairly useless as the main input. Also the cut point around 45% calories from carbs (which would be 900 calories from carbs/day on a 2000 calorie diet) is nowhere near the point where there are electrolyte disturbances (maybe by as much as 10x).

I happened to have been at a medical conference since Thursday. I asked two docs who have prescribed low carb diets in their practice about whether they saw this associate in their clinics. One doc was from the UK and has been prescribing low carb for 7 years. He said he did not see the association, but recommends electrolyte repletion for everyone he prescribes it to. Another doc from the US has been prescribing it for 15 years. He looked at me and said, no, I treat afib with it!. This makes sense, as many presenting with afib have metabolic illness and there are data I've seen suggesting that fixing the metabolic illness can help the afib.

The study authors do not cite electrolyte imbalance as a potential reason for the increased risk of Afib with low carb diet. Rather they cite potentially increased inflammation due to fewer vegetables, fruits and grains, and increased oxidative stress due to more protein and fat consumption. The electrolyte issue arises with further dramatic cuts in carbs associated with ketogenic type diets.

The study cut point of less than 44.8 percent of carb calories for the group representing low carb is much higher than the ketogenic diet (although only the cutpoint and not the distribution of carb calories is specified). However, the fact that there was between a 16 and 18 percent increase in the likelihood of developing Afib for this level of lower carbs amongst 14000 people spanning 2 decades is nothing to be dismissed. If anything, one might hypothesize the effect would be greater for draconian carb reduction like with keto.

As far as food frequency questionnaires , they are not useless. At this level, they involve extensive sampling and validation methods to ensure accuracy, including elimination of outliers and imputation of missing values. In particular, recent methods of validating these studies based on recording images of food has generally supported their validity as they relate to outcomes. Even though an observational study, if conducted properly I would take this kind of analysis over asking the opinion of a couple doctors who have practiced prescribing low carb for many years, and who evidently have a stake in the outcome.

The study has not appeared in the peer-reviewed literature yet. Let's wait and see. Lacking better data, it supports the Mediterranean-type diet high in fruits, vegetables, grains and beans, for Afib. There is nothing like this for keto and Afib.

George - It's been my impression from listening to the various experts and reading your posts that the key issue is actually getting into ketosis and remaining there... not just tinkering with restricting and lowering carbs on a variable basis.

There are numerous studies showing many benefits of the ketogenic diet and the 'anti-aging' benefits would seem to encompass the cardiovascular benefits which we (afibbers) could extrapolate to also assisting in stabilizing heart rhythm function.

As you know, there are also numerous studies showing significant benefit and improvement in those with neurological disorders or dysfunctions... and it makes sense to make a plausible connection to beneficial effects for afibbers as well


Antiaging

Epigenetic mechanisms underlying lifespan and age-related effects of dietary restriction and the ketogenic diet.
Mol Cell Endocrinol. 2016 Nov 21. Epub 2016 Nov 21 PMID: 27884781[www.ncbi.nlm.nih.gov]

Abstract:

Aging constitutes the central risk factor for major diseases including many forms of cancer, neurodegeneration, and cardiovascular diseases.

The aging process is characterized by both global and tissue-specific changes in gene expression across taxonomically diverse species. While aging has historically been thought to entail cell-autonomous, even stochastic changes, recent evidence suggests that modulation of this process can be hierarchal, wherein manipulations of nutrient-sensing neurons (e.g., in the hypothalamus) produce peripheral effects that may modulate the aging process itself.

The most robust intervention extending lifespan, plausibly impinging on the aging process, involves different modalities of dietary restriction (DR). Lifespan extension by DR is associated with broad protection against diseases (natural and engineered). Here we review potential epigenetic processes that may link lifespan to age-related diseases, particularly in the context of DR and (other) ketogenic diets, focusing on brain and hypothalamic mechanisms.


Jackie

The Hunzas live a robust life past 100 years, they don't eat a keto diet, they do a little fasting and don't overeat, they eat a lot of veggies, yogurt, grains, nuts and a little meat.

[undergroundhealthreporter.com]

Liz

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Elizabeth
The Hunzas live a robust life past 100 years, they don't eat a keto diet, they do a little fasting and don't overeat, they eat a lot of veggies, yogurt, grains, nuts and a little meat.

[undergroundhealthreporter.com]

Liz

It doesn't appear that the Hunza keep records, so pretty hard to document their actual life expectancy. It does appear that their health span and life span are very close, which is my objective.

Most of populations with long health spans do appear to have very healthy metabolisms (glucose and insulin control). Then don't eat much if any processed food, they spend much of their day outside in the sun doing physical work, their circadian rhythms match that of the sun.

George

I don't have anywhere near the level of knowledge you do on this stuff, George. But what I've learned about my body is that my heart will work much harder when I add sweets and sugars to my diet, or heavy carbs. It increases my pulse and I can feel my heart pounding in my chest (it's not pounding as much as I'm making out because I'm so tuned to it now - but it is a significant change). 20 minutes after eating a few cookies this takes place. It's amazing.

If I eat a low carb dinner with some fish or chicken a few hours before bedtime and my heart beats normally (60 bpm or so) and I sleep like a baby. I don't know if cutting all carbs out is the solution but removing all sugars certainly is.

I started Keto in early 2018. I experienced the adaptation symptoms and really had to stay on top of hydration and electrolytes. As a reward, I easily lost about 45 pounds over 8 months. The first 20-30 actually dropped very quickly ... in a couple of months. I started yoga at the same time but weight loss was clearly related to eating keto-ish. I felt great in keto.

As far as I know, I've been NSR since my ablation in March 2015 but always cognizant things could turn for the worse. I never noticed any arrhythmic states while in ketosis but I had an appreciation that the ketosis impact on electrolytes could be a risk factor ... so I tried to be proactive with hydration and supplementation/food choices.

I've been less strict about eating keto since last November due to a move/remodel and other life stuff. I probably haven't been in ketosis much since but have been able to maintain the weight loss for the most part. I've gained about 10 back recently but was probably too skinny at peak weight loss anyways.