I have to do a little rant today. I can't help it.

A new paper came out recently "investigating" reports of a connection between ketogenic diets and cardiac fibrosis, an inflammatory, pathogenic thickening of the heart tissue. Cardiac fibrosis is bad. It means reduced heart function and an increased risk of death down the line. Bad, bad news. Previously, they'd "proven" that keto diets based on long chain fatty acids like the kinds found in dairy and meat caused cardiac fibrosis. Supposedly. This time, they wanted to know if changing the fats to medium chain triglycerides (like the ones found in coconut oil) helped the matter or reduced the fibrotic effect.

It didn't help. The rodents on the MCT keto diet still went fibrotic and still lost heart function. According to the authors, their results from the new study "support the growing concern about keto diets and fibrosis." I'm paraquoting here, by the way.

Case closed? Keto bad for heart function?

No. The source of the fat changed, but you know what didn't change? The protein content of the diet.

The protein percentage of the diet was maybe 5%. That is exceedingly low. Extremely low. So low that you're grazing the point where organ function begins to be compromised. And the human evidence seems to bear this out:

In human heart failure patients, those eating the least protein had the highest mortality. An earlier study in a similar population found the same effect. More protein, less heart failure.

An actual controlled trial found that eating a high protein diet actually reduced cardio-metabolic risk factors in human heart failure patients.

And another actual case study in real humans found that a Modified Atkins diet, which is ketogenic but higher in protein, directly improved heart muscle function.

So here's where we are:

Rodents eating a 5% protein and over 90% fat diet suffer from poor heart function.
Humans eating a high-fat diet with upwards of 30% of calories from protein have improved heart muscle function.

Which one applies to you?

About the only thing we can glean from this study is that you shouldn't eat a 5% protein diet, whether keto or not. Isn't this kind of thing annoying, folks? What about modern nutritional science really bugs you? Let me know in this week's New and Noteworthy.

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