Keto Diet Beats DASH Diet For Hypertension

Aug 24, 2023

Keto Diet Beats DASH Diet For Hypertension

A new study demonstrated a ketogenic diet lowers blood pressure better than the commonly recommended DASH diet. But the reaction to this study likely highlights the stigma and bias against keto diets, and it’s unlikely clinical practice will change despite the clear benefit to therapeutic nutritional ketosis.

Studies like this should help us understand the clear indications for nutritional ketosis for hypertension and type 2 diabetes. We also believe therapeutic ketosis has a role in treating serious mental illness.

Study referenced in this video:
Comparing Very Low-Carbohydrate vs DASH Diets for Overweight or Obese Adults With Hypertension and Prediabetes or Type 2 Diabetes: A Randomized Trial
https://www.annfammed.org/content/21/…

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Content

0 -> a new four month long randomized

2.58 -> controlled trial demonstrates that a

4.62 -> very low carb diet lowers blood pressure

6.899 -> better than the traditionally

8.639 -> recommended DASH diet I'm Dr Brett Sher

11.34 -> and welcome to metabolic mind and you

13.38 -> may think well wait a second metabolic

15 -> mind talks about metabolic health and

16.92 -> mental health and ketogenic therapies

19.56 -> and metabolic therapies as treatments

21.6 -> for mental illness so why are we talking

22.859 -> about a blood pressure study that's a

24.779 -> good question but stick with me here

26.1 -> we're talking about a blood pressure

27.72 -> study because it really highlights sort

30.48 -> of this this bias or this stigma against

33.78 -> a ketogenic diet or as we like to think

36.84 -> about it as therapeutic nutritional

38.52 -> ketosis so when we're talking about

40.64 -> using therapeutic nutritional ketosis as

43.8 -> a medical intervention to treat mental

45.84 -> illness or to treat neurocognitive

47.879 -> decline or to treat a metabolic

50.16 -> condition like type 2 diabetes there's

52.079 -> this hurdle we need to overcome within

54.12 -> the medical community that sort of you

56.16 -> could say biased against a keto diet

58.32 -> because we see reports on the U.S news

60.36 -> and World Report how it's the worst diet

62.16 -> for health we would probably hear how

64.019 -> it's a terrible diet for high blood

65.76 -> pressure too but yet this DASH diet is

68.7 -> commonly recommended and thought to be

70.38 -> sort of the quote unquote best or the

72.119 -> go-to diet for high blood pressure but

74.88 -> now we have a randomized control trial

76.86 -> showing the exact opposite that a very

79.26 -> low carbohydrate diet or a ketogenic

81.24 -> diet

82.04 -> outperforms the traditional DASH diet

84.42 -> for lowering blood pressure and improves

86.82 -> other things as well like reduction in

88.74 -> medication use and reduction in blood

90.6 -> sugar and hemoglobin A1c which I'll get

92.4 -> into so it's important to bring this up

94.38 -> though to see to sort of highlight this

96.96 -> bias because I'm really curious to see

98.7 -> what the reaction is will a very low

101.04 -> carb diet now become the go-to

102.78 -> recommended diet for lowering blood

104.52 -> pressure I highly highly doubt it

106.92 -> because of this bias and these hurdles

109.02 -> that we have have to overcome within the

110.939 -> medical community so let's talk about

112.56 -> the study real quickly without getting

114.54 -> into too much of the details but hit the

116.28 -> highlights and then show how this really

118.619 -> impacts how we think about a low carb

121.2 -> diet versus other diets within the whole

123.72 -> you know nutritional milieu of how we

126.24 -> recommend people eat so the study was

128.64 -> done by Dr Laura saslow and and some of

131.039 -> her colleagues at Michigan it was

132.78 -> published in the annals of family

133.98 -> medicine and it's called comparing very

136.14 -> low carbohydrate versus Dash diets for

138.3 -> overweight or obese adults with

139.62 -> hypertension and pre-diabetes or type 2

141.48 -> diabetes or randomized trial so right

143.52 -> away we learn a lot from the title it's

145.44 -> a long title but we learn a lot from it

147.14 -> you had to be overweight or obese to be

150.54 -> enrolled and you had to have

152.16 -> hypertension

153.84 -> um and pre-diabetes or type 2 diabetes

156.06 -> okay so abnormal blood sugar abnormal

158.64 -> blood pressure and having overweight or

161.22 -> obesity and it was randomized which is

163.56 -> really important right it was an

165.239 -> observational it was randomized and it

167.22 -> was four months long when we look back

168.72 -> to the original Dash trial in in 1997

171.72 -> when the dash Tower got all its

173.16 -> recognition it was like a three-week

174.78 -> trial but here we have a four month

177.239 -> trial so there's also another Arm about

180.72 -> higher intensity versus sort of lower

182.519 -> intensity

183.84 -> um support but we'll talk about that a

185.76 -> little bit later that's a little bit

186.72 -> less important but here are the

187.98 -> highlights right let's jump to the

189.18 -> highlights after four months of a very

191.64 -> low carb diet 25 to or 20 to 35 grams of

195.48 -> carbohydrates net carbohydrates versus

198.18 -> the DASH diet focuses on limiting sodium

200.94 -> to 2300 milligrams per day and fat

203.459 -> intake 20 to 30 percent of calories per

206.04 -> day with recommending to eat a variety

208.26 -> of fruits and vegetables lean meats and

210.42 -> fish whole grains and low-fat Dairy so

213.18 -> what they find after three months the

215.58 -> people in the very low carbohydrate

217.2 -> group reduce their systolic blood

219.42 -> pressure by 10 millimeters of mercury

221.159 -> and in the dash group five millimeters

223.5 -> of mercury so sure the DASH diet helped

225.48 -> people lower their blood pressure but

227.34 -> the very low carbohydrate group lowered

229.44 -> it by twice as much okay and remember

232.379 -> these patients all had or these subjects

234.36 -> all had pre-diabetes or type 2 diabetes

236.459 -> so um from a blood sugar perspective the

239.4 -> very low carbohydrate group also lower

241.5 -> their hemoglobin A1c by more than twice

243.84 -> as much by 0.35 percentage points versus

246.06 -> point one four percentage points and

248.58 -> they lost more weight again almost twice

250.14 -> as much 19 pounds versus 10 pounds but

252.06 -> here's the other point not only did the

254.22 -> very low carbohydrate group lower blood

255.72 -> pressure more but they also reduced

257.519 -> their blood pressure medicines more 31

259.979 -> were able to reduce versus only 13 in

263.28 -> the dash group and the same thing for

265.38 -> the hemoglobin A1c not only did the very

267.479 -> low carbohydrate group lower the A1C

269.52 -> more but they also lowered their

271.259 -> medications more 40 percent of very low

273.479 -> carbohydrate versus none in the dash

275.88 -> group so this makes it even like more

278.34 -> impressive right if they would have

279.419 -> stayed on the same amount of medication

280.74 -> they probably would have lowered their

281.88 -> blood sugar and their blood pressure

282.84 -> even more but because they were lowering

285.12 -> their blood pressure and their blood

286.139 -> sugar so much they kind of had to come

287.82 -> off their medications and they did a

289.259 -> better job of doing that less

290.82 -> medications less side effects less money

292.979 -> right and and better outcomes with lower

295.86 -> blood pressure and lower blood sugar so

298.139 -> really impressive results now the second

300.54 -> part of the study there was sort of like

301.979 -> a you could say a higher intensity

303.84 -> intervention both again in the dash and

306.24 -> the very low carb group for the very low

307.979 -> carb group didn't make much of a

309.18 -> difference but for the dash group did

310.56 -> make a little bit of a difference which

312.24 -> just shows I don't know my

313.74 -> interpretation is that diet needs more

315.84 -> support whereas the very low

316.979 -> carbohydrate does diet doesn't need more

318.84 -> support but for me that was sort of a

320.16 -> secondary analysis the main keys were

321.9 -> better blood pressure lowering with

324.06 -> fewer medications better blood sugar

326.1 -> lowering with fewer medications So based

330.24 -> on this study the a very low

332.639 -> carbohydrate diet should absolutely

334.8 -> replace the dash diet as the number one

337.139 -> recommended diet for blood pressure

339.3 -> control because this was a randomized

340.8 -> control trial over four months showing

342.78 -> impressive results is that going to

344.16 -> happen I don't think so and that's what

346.56 -> sort of plays into this this bias this

349.38 -> stigma that we encounter when we're

351.72 -> trying to open the discussion about

354.3 -> using therapeutic nutritional ketosis as

356.88 -> a therapy for Mental Illness but studies

358.979 -> like this need to help Open the Eyes of

362.16 -> Physicians to say wait a second it's not

364.38 -> going to raise your blood pressure it's

366.12 -> not going to harm you it's actually

367.68 -> likely going to help you more so than

370.199 -> the traditional diet that we're

371.46 -> recommending so does this mean everybody

373.32 -> should be on a very low carb diet

375 -> ketogenic diet no no it's not for

377.1 -> everybody right whenever you talk about

378.419 -> diet you have to think about the diet

380.039 -> that's going to work for each individual

381.539 -> but should everybody be on a dash diet a

384 -> low sodium low fat diet absolutely not

386.46 -> as well right and even probably more

388.44 -> emphatically no because it's it's

390.24 -> inferior to the very low carbohydrate

392.699 -> ketogenic diet for outcome measures of

395.039 -> blood pressure and blood sugar so I

397.979 -> Dr saslow and our colleagues for doing a

400.319 -> study like this for going against the

402.36 -> conventional wisdom for for starting a

406.08 -> protocol that that many people would say

408.12 -> why are you even doing that we know the

409.56 -> dash diets the diet for high blood

411 -> pressure right but no we don't know and

413.16 -> that's why we have to test these things

414.6 -> so hopefully this will like I say help

417.06 -> open open people's eyes that we do need

419.639 -> to be more inclusive of a very low

421.259 -> carbohydrate diet for many interventions

424.08 -> whether it's blood pressure blood sugar

425.52 -> or as a therapeutic intervention to

427.74 -> treat mental illness neurocognitive

429.78 -> decline type 2 diabetes and other

431.639 -> medical conditions all right so thanks

433.319 -> for being with us here at metabolic mind

435.18 -> I'm Dr Brett Sher and I look forward to

436.919 -> seeing you again thanks a lot have a

438.479 -> great day

Source: https://www.youtube.com/watch?v=6DrhH3V_wTE