Does your diet really reverse vascular disease?  I mean, will the diet you’re following ACTUALLY reverse the plaque burden that has occurred over the years of eating the SAD diet (Standard American Diet)?

It appears that the ketogenic diet does.  At least that’s what research is showing, and that’s what I am seeing clinically.  Let me give you an example.  Reversal of vascular disease is what I saw last week in this patient case study in my office.

Meet “Mrs. Plaque” (name has been changed to protect her identity).  She is a very pleasant 78 year old female who has been seeing me as a patient for the last 10 years.  We identified worsening cholesterol and hyperinsulinemia in this patient a few years ago, and last year, she finally decided to go on a ketogenic diet after we noted slight worsening blood sugar (HbA1c increased to 6.1%), worsening cholesterol and a recent TIA (transient ischemic attack or “mini stroke”).  We identified a 44% blockage in her left internal carotid artery and a 21% blockage in the right internal carotid artery putting her at risk for further cerebral ischemic events like a stroke and/or other vascular events like a possible heart attack down the road. She refused STATIN therapy as she had previous myalgia and side effects with their use in the past.

Past Medical History:  Hyperlipidemia, Impaired Fasting Glucose (Pre-Diabetes),.Asthma, GERD, Irritable Bowel, Generalized Anxiety, Idiopathic Peripheral Neuropathy, Surgical Menopause (Hysterectomy) with Secondary Atrophic Vaginitis, Recent TIA, Cataracts, Appendectomy

Medications: Plavix 75mg one daily, Premarin Cream 0.635mg every other day, Xanax 0.5mg at bedtime for anxiety, Lyrica 50mg one nightly for neuropathy, Vitamin D 2000 IU daily , TUMS 750mg twice a day.

Her carotid ultrasound and carotid medial intimal thickness (CIMT) study completed April 1, 2015 is present below.  You can see that her intimal thickness is only slightly higher than the average female her age, however, she has notable internal carotid artery blockage in both the right and the left sides.

The “mini stroke” and the report above, convinced her that she needed to tighten up her diet.  The patient’s husband was also a diabetic and the patient had been “partially” restricting sugar in her diet up to this point in time, however, she had not fully jumped on the ketogenic band wagon.    At this point she decided to change her diet.

She was placed on a ketogenic diet, restricting her carbohydrates to no more than 20 grams per day and increasing total fat to >50-60% of her total calories.  Nothing else changed including her medications.  She followed this program for the next year and this is the blood work that she had while following this program:

	4/2/2015	8/4/2015	11/6/2015	5/12/2016
HbA1c (%)		6.1	5.8	5.2
Tot Chol (mg/dL)	224	156	230	233
HDL (mg/dL)	76	76	87	96
LDL-C (mg/dL)	134	65	128	123
Small Dense LDL-P (nmol/L)	481	150	222	217
Triglycerides (mg/dL)	72	76	74	68
Fasting  Insulin (uIU/mL)		12
Glucose (mg/dL)	91	95	92	85

Because she was already partially restricting her sugar intake, her triglycerides and small dense LDL particle number was not bad, however, her average blood sugars were still significantly elevated. Weight decreased from 127 lbs to 119 lbs in August. She admits to slightly increased protein intake over the holidays and her weight increased back up to 125 lbs as of her last visit.

These labs also demonstrate that Total Cholesterol and LDL-C don’t appear to correlate with regression of plaque.

The image below is the patient’s repeat CIMT and carotid ultrasound 13 months later through the same lab.  What is dramatic is that she has had over 10% regression in the plaque in both internal carotid arteries and a return of her carotid intimal thickness to the average female in her age bracket.

This case study is consistent with the findings of Dr.Shai and his group when they did a two year comparative dietary intervention study of Low Fat – Group 1, Mediterranean Diet – Group 2, and a Ketogenic Diet – Group 3 on vessel wall volume and CIMT.

Carotid IMT changed by −1.1% from 0.816 mm at baseline to 0.808 mm after 2 years (P=0.18), with no significant difference between diet groups (P=0.91). There was a trend toward significant correlation between the 2-year changes in carotid IMT and VWV (r=0.173, P=0.056).

So, does your diet reverse vascular disease?  Evidence is pointing to the fact that the ketogenic diet does.  I return to the statement Hippocrates made over 2000 years ago, “Let food be thy medicine, and let medicine be thy food.”

Oh, and pass the bacon.