Objections to the Keto Diet – Part 11 – Heart Disease Gets Worse

This issue raised by a dietitian is interesting:

While trying to control blood sugar levels in diabetics through ketogenic diet, one can exacerbate the symptoms of cardiovascular disorders, or may increase the risk of developing it in case of absence.

There are literally hundreds of studies on the keto diet and heart disease that universally show improvements in cardiovascular markers. Yet somehow this dietitian states that keto makes heart disease (CHD) worse?

Where’s the evidence? This argument seems to have come from the vegan site (Low Carb Diets Found to Feed Heart Disease). This site is a vegetarian site run by Dr. Michael Greger (Wikipedia article):

Michael Herschel Greger (born 1972)[2] is an American physician, author, and professional speaker on public health issues, particularly the benefits of a whole foods, plant-based diet and the harms of eating animal products. He is a vegan and the creator of NutritionFacts.org.

Here’s the study that Dr. Greger refers to on his site:

There has only been one study ever done measuring actual blood flow to the heart muscles of people eating low-carb diets. Dr. Richard Fleming, an accomplished nuclear cardiologist, enrolled 26 people into a comprehensive study of the effects of diet on cardiac function using the latest in nuclear imaging technology–so-called SPECT scans, enabling him to actually directly measure the blood flow within the coronary arteries.

He then put them all on a healthy vegetarian diet, and a year later the scans were repeated. By that time, however, ten of the patients had jumped ship onto the low carb bandwagon. At first I bet he was disappointed, but surely soon realized he had an unparalleled research opportunity dropped into his lap. Here he had extensive imaging of ten people before and after following a low carb diet and 16 following a high carb diet.

Continuing with the article:

Those sticking to the vegetarian diet showed a reversal of their heart disease as expected. Their partially clogged arteries literally got cleaned out. They had 20% less atherosclerotic plaque in their arteries at the end of the year than at the beginning. What happened to those who abandoned the treatment diet, and switched over to the low-carb diet? Their condition significantly worsened. 40% to 50% more artery clogging at the end of the year.

This study is also cited by the Physicians Committee for Responsible Medicine (PCRM) another radical vegan group. It is worth noting that this is a single study with a sole author.

Let’s look at the actual study (Angiology. 2000 Oct;51(10):817-26. The effect of high-protein diets on coronary blood flow. Fleming RM)  and see what it says.

It is really important to understand what this study wasn’t. This study wasn’t intended to be a comparison of High Protein vs High carb diets. The people on the diet were instructed to eat 10 calories per pound of body weight with 15% of their calories from protein, 70% from carbohydrates, and 15% from fat. If this is the alternate to low carb then this is a death sentence for diabetics.

Everyone in the study was only instructed on the High carb diet. There was no instruction given on how to do a “High Protein” diet. The ten people who adopted the High Protein plan did so at some time during the following year.

The High Protein diet doesn’t resemble any Low Carb diet I have seen since the people on the diet only lost an average of 1% of body weight. And their cardio markers as well as heart health got worse. I believe that. They were not on effective diet. There are no macro values given for the High Protein dieters.

This study has so many methodological holes in it that it has no real value. But let’s look at the real story behind the “study”:


Here’s where it gets really interesting. The author of the study, Dr. Richard M Fleming, was the head of the “Fleming Heart and Health Institute”. Sounds like something credible right? Turn out Fleming isn’t what he appears (Former Omaha doctor faces possible sanctions for fraud. Lincoln Journal Star Apr 1, 2010).

Author and former Nebraska physician Richard M. Fleming faces possible sanctions to his medical license following convictions for health care fraud and mail fraud. Fleming, formerly of the Fleming Heart and Health Institute in Omaha, lives in Reno, Nev.

A cardiologist who has appeared on national news programs, Fleming also garnered state scrutiny in 2004 following leaks from a medical examiner’s report into the death of Dr. Robert Atkins, founder of the famed Atkins’ Diet. The New York City medical examiner’s office filed a complaint against Fleming after a group with which he was affiliated said Atkins, comatose following a head injury from a fall on the ice, was obese at the time of his death. The examiner’s office then said it erroneously sent Fleming the report.

Fleming is the author of “Stop Inflammation Now!” “The Diet Myth, Keeping Your Heart Forever Young” and “How to Bypass Your Bypass.”

According to complaints filed by Nebraska and Iowa, Fleming was sentenced to five years of probation and six months of electronically monitored home confinement, and he was ordered to pay $107,244 in restitution after pleading guilty in August to one count each of health care fraud and mail fraud.

Fleming admitted that in 2002 he billed Medicare, Medicaid and Blue Cross Blue Shield of Nebraska for falsely represented medical tests.

In 2004, Fleming admitted, he submitted false data after being paid to perform a clinical study on the health benefits of a soy chip food product.

A state licensure hearing regarding his convictions was March 24, said a spokeswoman with the Nebraska Department of Health and Human Services. An order against Fleming’s inactive medical license, if issued, could take as long as six weeks to be announced.

A similar licensure hearing is set in April before the board of medicine in Iowa, where Fleming’s license was active until Feb. 1.

OK. I think I will wait until someone who doesn’t have convictions for fraud produces a study on this subject.

And yet this guy is quotes by the vegans? Wow. More on their authority:

Hardly an independent researcher (The Corruption of Evidence Based Medicine – Killing for Profit).

Actual Studies On the Subject

Here’s a few studies that show cardiovascular risk factors improve:

Author: Doug

I'm an Engineer who is also a science geek. I was pre-diabetic in 1996 and became a diabetic in 2003. I decided to figure out how to hack my diabetes and in 2016 found the ketogetic diet which reversed my diabetes.

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