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9. Keto to Reverse Heart Failure

Updated: Jun 9, 2023

Most people knows keto can reverse obesity and keto reverses diabetes. But very few people know keto reverses heart failure (HF). Professor Eric Westman gave a talk at Ketofest 2022 on their clinical experience of using keto to reverse HF. Here is the summary of his talk.

There are three big categories when we talk about the heart. The first one is the heart muscle itself, or the "pump", including the atria and ventricles. HF means the heart muscles cannot pump the blood as well as it should be. However, when we talk about heart attack, that is related to the second category, which is the coronary arteries that carry the blood flow to the heart muscles. Atherosclerosis and artery blockage can reduce or completely cut off the blood flow to the heart muscles, and cause heart attacks. The third category is about coordination of contraction, which is controlled by the conduction system. If it does not work well, there will be arrhythmias and skipped heartbeat happening.

When discussing about heart failure, there is one very important parameter that needs to be remembered, which is the ejection fraction (EF) - percentage of the blood pumped out per contraction. Normal EF is about 55%, meaning a little more than half of the blood is pumped out of the heart and the rest of the blood remains inside the heart. If EF is below 35%, the risk to develop heart failure is very high.

Now comes to several examples of reversing HF with keto diet. The first one is a 43-year old female. Her BMI was 55 and EF was only 20% when she was hospitalized for acute congestive HF. She tried low calorie diet first, dropped her weight from 310lb to 260lb. EF improved from 20% to 30%. Then she hit plateau, so decided to try keto diet. She lost more weight since. Although still having very high BMI(=33.5), her EF improved to 50%.

The second example is a 62-year old male, who had a HF in 2012 with EF of 25%. With keto diet, his BMI improved from 44.4 to 35.7, and EF from 25% to 42%. The third example is a 76-year old female, who had history of non-ischemic cardiomyopathy, complete heart block and pacemaker placement. Her BMI was 32.9 and EF was 35% in 2016 when starting keto diet. In 2022, her BMI reduced slightly from 32.9 to 31.9. But her EF improved from 35% to greater than 55%.

In all three cases, all patients are obese before and after keto. Weight loss cannot explain why their EF improve so much. Maybe we can find some clue from the following study, "comprehensive quantification of fuel use by the failing and nonfailing human heart". It says “the heart primarily consumed fatty acids and, unexpectedly, little glucose”. So the heart likes keto.


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