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In recent years, the clinical outlook on the safety and therapeutic use of ketosis has undergone a paradigm shift. For decades, most doctors believed that elevated ketone levels should be avoided due to their association with diabetic ketoacidosis (DKA), a life-threatening condition experienced by people with type-1 and late-stage type-2 diabetes who can no longer produce insulin. Recently, however, the medical community has begun to recognize that moderately elevated ketones are not only safe but beneficial for a wide variety of conditions.

In this post, we’ll dive into the research on nutritional ketosis and its benefits for chronic disease management.

Nutritional Ketosis and Type 2 Diabetes

Type-2 diabetes is a condition where the body is unable to effectively use glucose for energy. Because type-2 diabetics are resistant to the effects of insulin, glucose cannot enter the body’s cells and instead builds up in the bloodstream. At this point, the body loses its ability to maintain blood sugar levels within a safe range. Chronically high blood sugar is associated with cardiovascular disease, nerve damage, blindness and an increased likelihood of infection. 

Although most people consider type-2 diabetes to be a permanent condition, studies have shown that diabetes can be effectively managed, and even reversed, using a low carb diet and nutritional ketosis. When combined with a remote care program, a low-carb diet was shown to lower blood sugar levels and dramatically reduce the need for insulin and other diabetes medications. On top of that, participants on a low carb diet lost an average of 30 pounds!

What’s behind these improvements? Eating fewer carbohydrates helps the body rediscover how to use glucose. In other words, eating a low carb diet restores insulin sensitivity in people with type-2 diabetes. The result is that the body is better able to regulate its blood sugar levels and maintain a healthy metabolic state.

What about low fat diets? Systematic literature reviews have shown that low-carb diets are more effective than low-fat diets for lowering blood sugar in people with type-2 diabetes. In fact, in 2019 the American Diabetes Association (ADA) concluded that a low-carb (but not a low fat) diet improves A1c, a standard measure of blood sugar levels. The cumulative effect of these studies was a change in the ADA standards of care to include low carb and ketogenic diets as beneficial, evidence-based therapies for metabolic disease.

Taken together, these studies provide strong evidence for a beneficial link between nutritional ketosis and type 2 diabetes. By adhering to a ketogenic diet, individuals with metabolic diseases like diabetes are likely to experience improvements not only in symptoms but also in biomarkers associated with disease risk.

Nutritional Ketosis and Cardiovascular Disease

One misconception about the benefits of nutritional ketosis is related to the impact of increased fat consumption on heart health. Many physicians, including cardiologists, have expressed concern that a high fat diet puts people at greater risk of developing cardiovascular disease. This belief has been handed down from the low fat, high carbohydrate dietary guidelines that were developed in the 1970s and 80s to control or prevent cardiovascular disease.

However, evidence from many randomized controlled trials demonstrates just the opposite — that the ketogenic diet is beneficial for cardiovascular disease. These trials consistently show that low-carbohydrate, high-fat diets lead to beneficial changes in a wide range of cardiovascular risk markers. These include HDL cholesterol,  LDL cholesterol and triglycerides. In addition, studies have found improvements in blood pressure and markers of cardiovascular inflammation.

These improvements are all associated with a decreased risk of heart attack or coronary heart disease. In this way, nutritional ketosis can be quite beneficial for heart health.

Tracking Ketones as a Clinical Intervention

While you should always consult your doctor when considering treatment options for type 2 diabetes and cardiovascular disease, these studies show that nutritional ketosis is a promising clinical intervention to improve risk factors and symptoms. However, in order to experience these health benefits, individuals must ensure that they are entering and maintaining the state of ketosis. This can only be done through continuous ketone monitoring.

Frequently monitoring ketone levels is important because different individuals react differently to certain foods and exercise. The only way to gain a comprehensive understanding of your metabolism is through continuous ketone monitoring. BIOSENSE™, a breath ketone meter developed by Readout Health, and its associated smartphone app provide a convenient, highly accurate, and data-driven tool to help at-risk individuals understand their metabolism and make informed decisions about their health.

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