Keto Clarity: Your Definitive Guide to the Benefits of a Low-Carb, High-Fat Diet
medicine,” she shared. “I just wish it hadn’t taken me twenty-five years to figure this out.”
    The same could be said about Dr. Lowell Gerber, a cardiologist from Freeport, Maine, who went through a similar epiphany about nutrition in his own life that has revolutionized the way he looks at his patients.
    When Dr. Gerber himself began packing on the pounds, he realized, just as Dr. Wolver did, that he was wrong when he pushed a low-fat diet on his patients all those years and then accused them of lying about following it because they were gaining weight and seeing worse cardiac risk factors. Dr. Gerber is now ashamed of the arrogance he displayed in shaming his patients.
    “It was an unnerving realization that my patients were not ignoring my advice,” he admitted. “When I [tried a low-fat diet] myself, the truth was facing me. The low-fat diet just did not work for them, or for me.”
     
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[In Dr. Atkins’ clinic, we] made it clear to our patients that this was not a low-fat diet. Natural fats were an important part of the plan.
    – Jackie Eberstein
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    This sent Dr. Gerber on a personal investigation into what went wrong. He started looking at all the evidence for a low-carb, high-fat, ketogenic diet and began implementing it into his own lifestyle in 2009. After seeing its positive effects on his own weight and health and that of members of his family who became keto-adapted, Dr. Gerber started recommending it to his patients with obesity, pre-diabetes, type 1 and type 2 diabetes, high blood pressure, abnormal cholesterol readings, polycystic ovary syndrome, and metabolic syndrome.
    Even among those who are open-minded or even enthusiastic about ketosis, Dr. Gerber explains, ketones are usually seen only as an alternative fuel source when glucose availability is limited—most do not understand their broader therapeutic role. But the health benefits ketones provide is something that Dr. Gerber has seen many times in his patients.
    “Ketones upregulate the NRf2 pathway, which modulates many genes involved with inflammation and cell function,” he noted. “For example, the genes regulating pro-inflammatory cytokines are downregulated, resulting in less [inflammation], and the gene regulating IL-10, an anti-inflammatory cytokine, is upregulated.”
    What this means is that eating a ketogenic diet lowers inflammation naturally, without the use of prescription medications such as statins. It’s this inflammation that is the true culprit in heart disease, and the fact that ketosis reduces systemic inflammation is further evidence supporting the use of a low-carb, high-fat diet for improving heart health.
     
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    Ketosis reduces systemic inflammation as long as blood glucose is also lowered. Having higher levels of ketones with simultaneously higher levels of blood glucose would be unhealthy. Most of the side effects encountered on a ketogenic diet occur when blood glucose levels remain elevated. Indeed, insulin insensitivity, elevated blood glucose, and dyslipidemia will result from excessive consumption of the ketogenic diet.
    – Dr. Thomas Seyfried
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    Dr. Gerber connected the dots when he began digging deeper into the role of ketosis. “So [a] low-carbohydrate, high-fat, ketogenic diet may have multiple beneficial effects, in addition to its role as an alternative fuel source, preferred by the heart, muscle, and brain,” he concluded.
    In fact, rather than immediately putting his cardiac patients with high cholesterol—including patients with the genetic form of heterozygous familial hypercholesterolemia (which simply means a predisposition for high cholesterol passed on by one parent)—on a statin drug, he instead prescribes a ketogenic diet to “stabilize and perhaps reverse existing plaque” in their arteries. He monitors this through regular checkups on their blood markers and CT scans of the heart. Dr. Gerber is “eliminating the need for statins” in even his most high-risk patients

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