Keto Clarity: Your Definitive Guide to the Benefits of a Low-Carb, High-Fat Diet (47 page)

GERD and Heartburn

Gastroesophageal reflux disease (GERD), generally experienced as heartburn, is a common disorder that affects 20 to 30 percent of Americans at least once a week. The medical costs associated with treating GERD are estimated to be in excess of $9 billion annually. We hear all the time that when people stop eating carbohydrates, the burning sensation from GERD improves or completely goes away.

Whole grains and sugars, in particular, are the main culprits in GERD, which is why you will find relief so quickly when eating keto. Some people with autoimmune conditions also need to cut out nightshades like tomatoes and peppers. Far too many people are reaching for over-the-counter heartburn relief from products, like Rolaids or Tums, and even prescription medications like Nexium and other such drugs that rake in billions of dollars in revenue annually. Can a simple diet change really help?

You bet it can! A study published in the July 27, 2006, issue of the journal
Digestive Diseases and Sciences
, featuring contributions from Dr. Eric Westman, measured stomach acidity after eight study participants with GERD were placed on a low-carb, high-fat, ketogenic diet. Each of them had a small tube threaded into the nose and down to their stomach for a period of twenty-four hours to measure stomach and esophageal acidity before and after changing the diet. Over just three to six days on the ketogenic diet, all eight individuals showed improvement in the severity of their heartburn and a reduction in the acidity at the lower esophagus—which is usually the cause of heartburn. They found relief simply by making changes to their diet.

Nonalcoholic Fatty Liver Disease (NAFLD)

Nonalcoholic fatty liver disease (NAFLD) is commonly found in individuals with obesity. It can become so severe that it leads to liver failure, and without a liver transplant, liver failure is a fatal condition. When fat in the liver accounts for more than 10 percent of the liver’s weight, insulin can no longer properly control your blood sugar—a condition known as
insulin resistance
—which can lead to some serious damage to your health.

Interestingly, the fat in the liver doesn’t come from dietary fat but rather from carbohydrates. The liver turns dietary carbohydrates into a blood fat called
triglycerides
, and it’s this fat that is stored in the liver. This is why corn, a high-carbohydrate grain that many think is a vegetable, is used to fatten up pigs, and why it’s also used to fatten the livers of ducks and geese for foie gras (which literally means “fatty liver”!).

In a study published in the September 2006 issue of
Digestive Diseases and Sciences,
ten healthy volunteers experienced fat loss in the liver after following a low-carb diet for ten days. But another clinical study (again by Dr. Eric Westman and other researchers) published in the February 2007 issue of the same journal looked at five patients with NAFLD who were all put on a low-carb, high-fat, ketogenic diet for a period of six months. The four people who followed the instructions given by the researchers showed significant weight loss and improvement or even resolved the fatty liver according to their follow-up biopsy. Even the severe scarring (known as
fibrosis
) that can accompany NAFLD improved on a ketogenic diet.

It seems that increasing saturated fat intake and reducing carbohydrate consumption can bring about phenomenal reductions in liver fat. A May 2011 study published in the
American Journal of Clinical Nutrition
placed eighteen study participants with NAFLD on either a very low-carb diet or very low-calorie diet, and the low-carb diet reduced triglycerides in the liver (called
hepatic fat
) because of the fat-burning effect brought on by ketosis. This is very strong support for the positive health effects that happen as a result of being in a ketogenic state.

We’ve shared some pretty compelling information in this chapter about how to distinguish good science from bad, and we have detailed the strong scientific evidence in support of low-carb, high-fat, ketogenic diets. Coming up in the next chapter, we’ll take a look at the health conditions that there’s good evidence may be helped by ketosis; we anticipate that this evidence will become even stronger as research continues in the coming years.

Key Keto Clarity Concepts

• Learning to distinguish between strong and weak research is critical.
  
• All studies are not made the same—most research is observational, not controlled.
  
• Determining if a study applies to you is the first question you must always ask.
  
• Animal studies should only be used to form hypotheses for human studies.
  
• N=1 case studies can be helpful in revealing unusual responses to a given stimuli.
  
• Correlation should never be assumed to equal causation without further research.
  
• Experimental research in a controlled clinical trial provides the most reliable study data.
  
• Adding randomization to a controlled clinical trial makes it the gold standard in human research.
  
• In the end, every person is different, and no study can tell you exactly what will work for you.
  
• Controlling epileptic seizures with the Ketogenic Diet has been around since the early 1900s.
  
• Type 2 diabetes responds well to ketogenic diets because of its insulin-lowering effect.
  
• Most people associate low-carb, high-fat diets with weight loss, and they are quite effective for making that happen.
  
• Studies have shown that heart disease and metabolic syndrome greatly improve on a ketogenic diet.
  
• Women with PCOS see improvement when they start eating a low-carb, high-fat diet.
  
• IBS can be virtually eliminated through the strategic use of a ketogenic diet.
  
• GERD and heartburn are no longer an issue when you remove the carbohydrate-based foods that increase stomach acid.
  
• Nonalcoholic fatty liver disease is caused by the consumption of carbs, not fat.
  

I haven’t encountered a lot of stigma about ketogenic diets. I think scientists are much more open-minded than physicians. It was actually very easy for me to find mentors who were interested in low-carb, high-fat diets.

– Bryan Barksdale

We’ve already seen the wealth of scientific evidence that strongly supports low-carb, high-fat, ketogenic diets. But the evidence doesn’t stop there; there is also very good, though less definitive, scientific research underway on many other common diseases. The effects of ketosis on the conditions covered in this chapter haven’t been examined in long-term studies—all the studies outlined lasted one year or less—but they seem to respond quite well to a ketogenic nutritional therapy and show great promise for future controlled clinical trials, if and when the funding for such research can be obtained.

Alzheimer’s Disease (AD), Parkinson’s Disease, and Dementia

Increased ketone availability has been demonstrated to improve cognitive function in patients with mild Alzheimer’s disease. The science is so compelling that the FDA has actually approved a medical food that increases ketone availability as an Alzheimer’s treatment. In one study, a ketogenic diet provided more improvement in functionality for Parkinson’s patients than pharmaceutical intervention.

– Dr. David Perlmutter

The human brain needs fat and cholesterol for proper functioning, and it can be fueled by either glucose or ketones. After keto-adaptation from consuming a low-carb, high-fat diet, the brain gets most of its energy from ketone bodies. This becomes an important factor when we begin looking at the diseases of the brain such as Alzheimer’s, Parkinson’s, and dementia. We know that being in a state of ketosis lowers chronic inflammation levels, provides a fantastic fuel source for the brain, and significantly reduces the production of insulin—which have all been implicated in the development of these neurological diseases.

Alzheimer’s disease (AD), commonly referred to in research circles now as “type 3 diabetes,” is a progressive dementia leading to memory loss and loss of function due to a lack of insulin sensitivity in the brain, and unfortunately there is no good treatment for it. Just as insulin resistance in the liver leads to the development of type 2 diabetes, so too does insulin resistance in the brain lead to the development of Alzheimer’s disease. When the brain cannot receive the primary fuel source (glucose), signs of mental decline begin.