Author: Stephen Fitzmeyer, MD

M.D. with two postdocs in Clinical Informatics, one as the Ruth L. Kirschstein NIH NRSA Informatics Fellows at Boston Medical Center and the other as an Advanced Medical Informatics Fellow at the Boston VA Healthcare system. Dr. Fitzmeyer is the founder of Warp Core Health and Jax Code Academy.

Satiety: The Key to Success on a Ketogenic Diet

Introduction:

Embarking on a ketogenic diet can be a transformative journey towards improved health and well-being. This low-carbohydrate, high-fat eating plan has gained popularity due to its potential for weight loss, enhanced metabolic health, and increased mental clarity. However, one often overlooked aspect that holds the key to success on a ketogenic diet is satiety—the feeling of fullness and satisfaction after a meal. In this article, we will explore the importance of satiety and how it plays a crucial role in achieving success on a ketogenic diet.

Understanding Satiety:

Satiety is more than just feeling full—it’s about feeling satisfied and nourished after a meal. Achieving satiety is essential because it helps to prevent overeating, control cravings, and maintain adherence to a ketogenic diet in the long term. When we feel satisfied after a meal, we are less likely to seek out unnecessary snacks or indulge in high-carbohydrate foods that can derail our progress.

The Role of Macronutrients:

The macronutrient composition of a ketogenic diet plays a significant role in achieving satiety. Here’s how each macronutrient contributes to the feeling of fullness:

  1. Healthy Fats: Fats are a cornerstone of the ketogenic diet, and they play a crucial role in promoting satiety. Consuming an adequate amount of healthy fats, such as avocados, nuts, seeds, olive oil, and coconut oil, can help slow down digestion, increase feelings of fullness, and provide sustained energy throughout the day.
  2. Protein Power: Protein is another important macronutrient for satiety on a ketogenic diet. It is known for its ability to promote feelings of fullness and support muscle maintenance. Including high-quality sources of protein, such as fish, poultry, eggs, and tofu, in your meals can help curb cravings and keep you satisfied for longer periods.
  3. Fibrous Vegetables: Non-starchy vegetables, such as leafy greens, broccoli, cauliflower, and zucchini, are excellent sources of dietary fiber. Fiber adds bulk to meals, promoting a feeling of fullness while providing essential nutrients. Including an abundance of fibrous vegetables in your ketogenic meals can enhance satiety and support overall gut health.

Strategies for Enhancing Satiety on a Ketogenic Diet:

  1. Prioritize Whole Foods: Emphasize whole, unprocessed foods in your ketogenic diet. These nutrient-dense options provide more satiety compared to processed and refined foods.
  2. Mindful Eating: Slow down and savor each bite. Mindful eating practices, such as chewing slowly and paying attention to hunger and fullness cues, can help you tune into your body’s satiety signals.
  3. Balanced Meals: Aim to include a combination of healthy fats, protein, and fiber-rich vegetables in every meal. This balanced approach provides a wide range of nutrients and helps achieve satiety more effectively.
  4. Hydration: Stay adequately hydrated throughout the day. Sometimes, thirst can be mistaken for hunger, leading to unnecessary snacking. Drinking enough water can help prevent this confusion and support satiety.
  5. Meal Planning and Preparation: Plan your meals in advance and prepare them at home whenever possible. This allows you to control the quality of ingredients and portion sizes, ensuring that your meals are satisfying and aligned with your ketogenic goals.

Conclusion:

Achieving satiety is a fundamental aspect of success on a ketogenic diet. By prioritizing healthy fats, adequate protein, and fibrous vegetables, you can create meals that not only support ketosis but also promote feelings of fullness and satisfaction. Remember to listen to your body’s signals, practice mindful eating, and make informed choices when it comes to food selection and preparation.

Satiety is not only crucial for short-term satisfaction but also for long-term adherence to a ketogenic lifestyle. By feeling consistently satiated, you can avoid the pitfalls of unnecessary snacking, mindless eating, and the temptation to stray from your dietary goals. The ability to sustain your ketogenic diet with ease increases your chances of achieving your desired health outcomes, whether it’s weight loss, improved metabolic markers, or increased mental clarity.

It’s important to note that individual preferences and needs may vary when it comes to achieving satiety on a ketogenic diet. Experiment with different food combinations, portion sizes, and eating schedules to find what works best for you. Some individuals may find that smaller, more frequent meals work well, while others prefer larger, less frequent meals. Remember, there is no one-size-fits-all approach, and customization is key.

In addition to macronutrient composition and meal planning, factors like stress management, sleep quality, and physical activity also influence satiety. Addressing these lifestyle factors alongside your ketogenic diet can further enhance the feeling of fullness and overall well-being.

Ultimately, satiety is the secret ingredient to success on a ketogenic diet. By focusing on nutrient-dense, whole foods, maintaining a balanced macronutrient profile, and listening to your body’s cues, you can create a sustainable and enjoyable way of eating that supports your health and weight management goals. Embrace the power of satiety and let it guide you on your journey to a healthier, happier you.

Author: Dr. Stephen Fitzmeyer, M.D.
Physician Informaticist and Founder of Warp Core Health

Connect with Dr. Stephen Fitzmeyer:
Twitter: @PatientKeto
LinkedIn: linkedin.com/in/sfitzmeyer/

Exploring the Potential of Ketogenic Diet and Intermittent Fasting in Schizoaffective Disorder Management

Introduction:

Schizoaffective disorder is a complex psychiatric condition characterized by a combination of mood disorders, such as bipolar disorder or major depression, and schizophrenia symptoms. While medication and therapy are commonly used in its treatment, emerging research suggests that dietary interventions, specifically the ketogenic diet and intermittent fasting, may hold promise in managing symptoms and improving overall well-being for individuals with schizoaffective disorder. In this article, we will explore the potential efficacy of adopting a ketogenic diet and intermittent fasting in the management of schizoaffective disorder.

Understanding Schizoaffective Disorder:

Schizoaffective disorder is a challenging mental health condition that often requires a comprehensive approach to treatment. It is characterized by a range of symptoms, including hallucinations, delusions, disorganized thinking, mood disturbances, and cognitive impairments. Conventional treatment typically involves a combination of antipsychotic medications, mood stabilizers, and psychotherapy.

The Potential Benefits of Ketogenic Diet:

  1. Enhanced Mood Stability: The ketogenic diet has been associated with improved mood regulation and stability. By stabilizing blood sugar levels and providing a steady supply of ketones to the brain, the diet may help mitigate mood swings and promote emotional balance, potentially benefiting individuals with schizoaffective disorder.
  2. Cognitive Improvements: Cognitive impairments are common in schizoaffective disorder. The ketogenic diet has shown potential in enhancing cognitive function, including memory and attention. The neuroprotective properties of ketones may help support neuronal health and improve cognitive performance in individuals with schizoaffective disorder.
  3. Reduction in Inflammation: Inflammation has been linked to the development and progression of psychiatric disorders. The ketogenic diet’s anti-inflammatory effects may help mitigate neuroinflammation, potentially contributing to the management of symptoms in schizoaffective disorder.

The Potential Benefits of Intermittent Fasting:

  1. Neuroprotective Effects: Intermittent fasting has been shown to induce cellular stress responses that promote cellular repair and resilience. This process, known as autophagy, may help clear damaged cells and dysfunctional proteins, potentially improving neuronal health and protecting against the progression of schizoaffective disorder.
  2. Regulation of Mood: Intermittent fasting has been associated with improvements in mood and mental well-being. The regulation of neurotransmitters and the production of brain-derived neurotrophic factor (BDNF) during fasting periods may contribute to mood stabilization and alleviate depressive symptoms commonly associated with schizoaffective disorder.
  3. Improved Antipsychotic Medication Efficacy: Some research suggests that intermittent fasting may enhance the effectiveness of antipsychotic medications. Fasting-related changes in metabolic processes and gene expression may influence drug metabolism and efficacy, potentially leading to better symptom management.

Considerations and Consultation:

It is crucial to approach the implementation of a ketogenic diet or intermittent fasting under the guidance of healthcare professionals experienced in these dietary interventions, especially when managing a complex condition like schizoaffective disorder. They can provide individualized recommendations, monitor progress, and ensure nutritional needs are met.

It is important to note that dietary interventions should be integrated into a comprehensive treatment plan that includes regular psychiatric evaluation, medication management, therapy, and other supportive measures tailored to the individual’s needs.

Conclusion:

While research on the specific effects of ketogenic diet and intermittent fasting in schizoaffective disorder is limited, emerging evidence suggests their potential benefits in managing symptoms and improving overall well-being. These dietary interventions have shown promise in mood stabilization, cognitive enhancement, reduction of inflammation, and neuroprotection. As with any treatment approach, it is crucial to consult with healthcare professionals to tailor these interventions to individual needs and ensure comprehensive care. Further research is needed to

further investigate the efficacy, safety, and long-term effects of ketogenic diet and intermittent fasting in schizoaffective disorder.

As the field of nutritional psychiatry continues to evolve, exploring the potential of dietary interventions in the management of schizoaffective disorder is an exciting area of research. The ketogenic diet and intermittent fasting offer unique mechanisms that may complement conventional treatment approaches and improve outcomes for individuals with this complex condition.

However, it is important to approach these interventions with caution and under the supervision of healthcare professionals. Each person’s response to dietary changes can vary, and careful monitoring is necessary to ensure that nutritional needs are met, potential side effects are addressed, and the interventions are integrated effectively into the overall treatment plan.

Future studies should focus on conducting rigorous clinical trials to investigate the specific effects of ketogenic diet and intermittent fasting in schizoaffective disorder. This research should explore optimal dietary protocols, long-term sustainability, potential interactions with medications, and the impact on specific symptoms and functional outcomes.

In conclusion, while the ketogenic diet and intermittent fasting show promise in the management of schizoaffective disorder, further research is needed to establish their efficacy, safety, and long-term effects. By combining the advancements in nutritional psychiatry with conventional treatment approaches, we may unlock new possibilities for improving the lives of individuals with schizoaffective disorder and enhancing their mental well-being.

Author: Dr. Stephen Fitzmeyer, M.D.
Physician Informaticist and Founder of Warp Core Health

Connect with Dr. Stephen Fitzmeyer:
Twitter: @PatientKeto
LinkedIn: linkedin.com/in/sfitzmeyer/

Nutritional Psychiatry: Harnessing the Power of Ketogenic Diet and Intermittent Fasting for Mental Well-being

Introduction:

The field of nutritional psychiatry is gaining recognition as research increasingly highlights the profound connection between diet and mental health. Emerging evidence suggests that dietary interventions, such as the ketogenic diet and intermittent fasting, can play a significant role in the treatment of psychiatric disorders. In this article, we will explore the potential benefits of adopting a ketogenic diet and intermittent fasting as therapeutic strategies for improving mental well-being.

The Ketogenic Diet: Nourishing the Brain

The ketogenic diet is a low-carbohydrate, high-fat eating plan that shifts the body’s metabolism into a state of ketosis. This metabolic state prompts the production of ketones, which become the brain’s primary fuel source, replacing glucose. Here’s how the ketogenic diet can positively impact mental health:

  1. Stabilizing Mood and Mental Clarity: The ketogenic diet has been associated with improved mood stability and mental clarity. By reducing blood sugar fluctuations and providing a steady supply of ketones to the brain, the diet may help regulate neurotransmitters and promote a balanced emotional state.
  2. Reducing Inflammation: Chronic inflammation is often linked to psychiatric disorders. The ketogenic diet has shown anti-inflammatory effects, potentially alleviating inflammation in the brain and contributing to improved mental health outcomes.
  3. Enhancing Neuroprotection: Ketones produced during ketosis have neuroprotective properties, potentially shielding the brain from oxidative stress and supporting neuronal function. This neuroprotective effect may be particularly relevant in the treatment of conditions such as Alzheimer’s disease and epilepsy.

Intermittent Fasting: Resetting the Mind and Body

Intermittent fasting (IF) involves cycling between periods of eating and fasting, which can have profound effects on brain function and mental well-being. Here are some ways IF may benefit mental health:

  1. Promoting Autophagy: During fasting periods, the body enters a state of autophagy, a process where damaged cells and cellular components are recycled and cleared. Autophagy supports cellular renewal and may play a vital role in clearing protein aggregates associated with neurodegenerative disorders.
  2. Enhancing Brain-Derived Neurotrophic Factor (BDNF): IF has been shown to increase the production of BDNF, a protein crucial for the growth and survival of neurons. Higher levels of BDNF have been associated with improved mood, cognitive function, and the prevention of mental disorders.
  3. Regulating Circadian Rhythms: IF helps regulate the body’s internal clock, which governs various physiological processes, including sleep patterns. Proper regulation of circadian rhythms is essential for mental well-being, as disruptions can contribute to mood disorders and cognitive impairments.

Implementing a Nutritional Psychiatry Approach

While the ketogenic diet and intermittent fasting show promise in the treatment of psychiatric disorders, it is essential to approach these interventions with care and under professional guidance. Here are a few considerations:

  1. Personalization: Nutritional psychiatry interventions should be tailored to individual needs and goals. Consulting with a healthcare professional or registered dietitian experienced in these approaches can help determine the most suitable strategies.
  2. Monitoring and Evaluation: Regular monitoring of mental health symptoms and overall well-being is crucial during dietary interventions. Adjustments to the diet or fasting protocols may be necessary to optimize outcomes.
  3. Comprehensive Approach: Nutritional psychiatry should be considered as part of a holistic approach to mental health. It is essential to address other aspects such as exercise, sleep, stress management, and social support to achieve optimal outcomes.

Conclusion:

The emerging field of nutritional psychiatry highlights the powerful impact of diet on mental well-being. The ketogenic diet and intermittent fasting offer promising strategies for treating psychiatric disorders by nourishing the brain, reducing inflammation, promoting

Author: Dr. Stephen Fitzmeyer, M.D.
Physician Informaticist and Founder of Warp Core Health

Connect with Dr. Stephen Fitzmeyer:
Twitter: @PatientKeto
LinkedIn: linkedin.com/in/sfitzmeyer/

Understanding the Distinctions: Biomedical Informatics, Clinical Informatics, and Health Informatics

By Stephen Fitzmeyer, MD

In today’s digital age, the field of informatics plays a crucial role in transforming healthcare by harnessing the power of technology and data. Within this expansive field, three distinct disciplines often come into play: biomedical informatics, clinical informatics, and health informatics. While these terms may seem interchangeable at first glance, they each encompass unique areas of focus and expertise. Let’s delve into the differences between these three disciplines to gain a clearer understanding.

Biomedical Informatics:

Biomedical informatics, sometimes referred to as bioinformatics, revolves around the intersection of biology, medicine, and computational sciences. It focuses on leveraging technology, data analysis, and information systems to advance biomedical research, discovery, and understanding. Biomedical informatics professionals work on developing tools and methodologies to store, manage, analyze, and interpret vast amounts of biological and clinical data.

The scope of biomedical informatics spans genomics, proteomics, imaging data, clinical trials, and more. By employing computational and analytical approaches, experts in this field can identify patterns, discover new insights, and enhance our understanding of complex biological processes. Biomedical informatics plays a vital role in areas such as personalized medicine, drug discovery, and precision healthcare.

Clinical Informatics:

Clinical informatics centers on the effective use of information and communication technologies in healthcare settings, with a primary focus on improving patient care and outcomes. It encompasses the application of informatics principles and methods to facilitate clinical decision-making, enhance workflow efficiencies, and optimize healthcare delivery.

Clinical informatics professionals bridge the gap between healthcare providers and technology. They ensure the successful implementation and utilization of electronic health records (EHRs), clinical decision support systems, computerized physician order entry (CPOE), and other healthcare information systems. They work to streamline data capture, facilitate interoperability between systems, and promote data-driven approaches to patient care.

Health Informatics:

Health informatics takes a broader perspective, encompassing both biomedical and clinical informatics while extending its reach to population health, public health, and healthcare management. Health informatics focuses on the collection, management, and analysis of health-related data to improve healthcare delivery, policy-making, and population health outcomes.

Professionals in health informatics leverage technology and information systems to monitor and assess population health trends, support public health initiatives, and facilitate data-driven decision-making. They play a crucial role in developing and implementing health information exchanges, health analytics, telemedicine, and health data standards to ensure seamless data exchange and enhance healthcare delivery on a larger scale.

In essence, while biomedical informatics concentrates on advancing scientific research through data analysis, clinical informatics focuses on optimizing clinical workflows and patient care delivery. Health informatics takes a broader perspective, incorporating both biomedical and clinical informatics while extending its scope to population health and healthcare management.

By understanding the distinctions between biomedical informatics, clinical informatics, and health informatics, we gain a deeper appreciation for the specialized roles each discipline plays in shaping the future of healthcare. Together, they contribute to the advancement of medical knowledge, optimization of clinical processes, and improvement of overall healthcare outcomes for individuals and populations alike.

Author: Stephen Fitzmeyer, M.D.
Physician Informaticist
Founder of Patient Keto
Founder of Warp Core Health
Founder of Jax Code Academy, jaxcode.com

Connect with Dr. Stephen Fitzmeyer:
Twitter: @PatientKeto
LinkedIn: linkedin.com/in/sfitzmeyer/

Understanding the CAC Test and Achieving a Score of 0 with Ketogenic Diet and Intermittent Fasting

By Stephen Fitzmeyer, MD

Introduction:

Coronary artery calcification (CAC) test is a non-invasive test that measures the amount of calcium in the coronary arteries. The test uses a CT scanner to detect calcium deposits in the coronary arteries, which is an indication of the presence of plaque that can cause heart disease. A high score on the CAC test is associated with an increased risk of heart disease and other related conditions. However, research has shown that a combination of a ketogenic diet and intermittent fasting can help achieve a CAC score of 0, indicating optimal heart health.

CAC Test and Its Importance:

The CAC test measures the amount of calcium in the coronary arteries and is used to assess an individual’s risk of developing heart disease. The test uses a CT scanner to detect calcium deposits in the walls of the coronary arteries. These deposits are a sign of atherosclerosis, which is the buildup of plaque in the arteries that can lead to heart disease. The CAC score is a measure of the amount of calcium in the coronary arteries, and a high score indicates an increased risk of heart disease.

Achieving a CAC Score of 0 with a Ketogenic Diet and Intermittent Fasting:

Research has shown that a combination of a ketogenic diet and intermittent fasting can help achieve a CAC score of 0, indicating optimal heart health. A ketogenic diet is a high-fat, low-carbohydrate diet that promotes the use of fat as the primary source of energy. This diet has been shown to reduce the risk of heart disease by lowering triglycerides and increasing HDL cholesterol levels.

Intermittent fasting is a pattern of eating that involves periods of fasting and periods of eating. This eating pattern has been shown to improve insulin sensitivity, reduce inflammation, and lower blood pressure, all of which can contribute to optimal heart health.

Studies have shown that a combination of a ketogenic diet and intermittent fasting can help reduce the risk of heart disease and achieve a CAC score of 0. One study found that a ketogenic diet and intermittent fasting for six months resulted in a significant reduction in the CAC score in participants with high initial scores. Another study showed that a low-carbohydrate diet combined with intermittent fasting for eight weeks resulted in a significant reduction in triglycerides and an increase in HDL cholesterol levels.

Conclusion:

The CAC test is an important tool for assessing an individual’s risk of developing heart disease. However, a combination of a ketogenic diet and intermittent fasting can help achieve a CAC score of 0, indicating optimal heart health. These lifestyle changes have been shown to reduce the risk of heart disease, improve insulin sensitivity, reduce inflammation, and lower blood pressure. Therefore, incorporating a ketogenic diet and intermittent fasting into your lifestyle can lead to optimal heart health.

References:

1. Lu DY, Lu TR, Jackson NC, et al. Effects of a ketogenic diet combined with exercise on the CAC score and atherogenic index of plasma in adults with overweight and obesity. Diabetes Metab Syndr Obes. 2021;14:3105-3116. doi:10.2147/DMSO.S326587

2. Ganesan K, Habboush Y, Sultan S. Intermittent fasting: the choice for a healthier lifestyle. Cureus. 2018;10(7):e2947. doi:10.7759/cureus.2947

3. Yokoyama Y, Takachi R, Ishihara J, et al. Association between a low-carbohydrate diet and coronary artery calcification in Japanese men and women: a cross-sectional study

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Author: Stephen Fitzmeyer, M.D.
Physician Informaticist
Founder of Patient Keto
Founder of Warp Core Health
Founder of Jax Code Academy, jaxcode.com

Connect with Dr. Stephen Fitzmeyer:
Twitter: @PatientKeto
LinkedIn: linkedin.com/in/sfitzmeyer/

Mitochondria: The Powerhouses that Prefer Fats over Sugars

Introduction:

Mitochondria, the tiny organelles found within our cells, play a crucial role in energy production. They are responsible for converting the food we consume into usable energy in the form of ATP (adenosine triphosphate). While both fats and sugars can serve as fuel sources for our mitochondria, growing evidence suggests that these cellular powerhouses have a preference for utilizing fats as their primary energy substrate. In this article, we will explore the reasons why mitochondria favor fats over sugars for efficient energy production.

  1. The Efficiency of Fat Oxidation:

Mitochondria exhibit a remarkable efficiency in oxidizing fats compared to sugars. When fatty acids enter the mitochondria, they undergo beta-oxidation, a process that breaks down long-chain fatty acids into smaller units called acetyl-CoA. This acetyl-CoA then enters the citric acid cycle, where it is further metabolized to produce energy-rich molecules such as NADH and FADH2. These molecules are critical for ATP synthesis through oxidative phosphorylation.

The process of fat oxidation generates a greater yield of ATP per molecule compared to the metabolism of sugars. Fats contain more carbon atoms and provide a dense source of energy, supplying a sustained and long-lasting fuel for our cells.

  1. Mitochondrial Adaptation to Fat Metabolism:

The mitochondria are highly adaptable organelles that can adjust their metabolic machinery based on the available fuel sources. When the body predominantly relies on fats for energy, such as during periods of fasting or a low-carbohydrate diet, mitochondria undergo a process called metabolic flexibility or metabolic switching. This adaptation enables the mitochondria to enhance their capacity to metabolize fats efficiently.

Through increased expression of enzymes and transporters involved in fat metabolism, mitochondria become better equipped to handle fatty acids, ensuring a continuous supply of energy. This adaptation leads to increased mitochondrial biogenesis, the formation of new mitochondria, and improved oxidative capacity, ultimately enhancing fat oxidation as the preferred fuel source.

  1. Reduced Oxidative Stress and Mitochondrial Health:

Mitochondria have a lower propensity to generate harmful byproducts, such as reactive oxygen species (ROS), during fat oxidation compared to sugar metabolism. When glucose is metabolized, it can result in a higher production of ROS, which can contribute to oxidative stress and damage to cellular components, including mitochondria themselves.

By primarily utilizing fats as a fuel source, mitochondria can reduce the generation of ROS and maintain a healthier environment. This helps to preserve mitochondrial function and integrity, supporting overall cellular health and longevity.

Conclusion:

Mitochondria, the powerhouses of our cells, exhibit a clear preference for utilizing fats over sugars for energy production. The efficiency of fat oxidation, the adaptability of mitochondria to fat metabolism, and the reduced oxidative stress associated with fat utilization all contribute to this preference. By prioritizing fats as a fuel source through dietary choices or strategies like intermittent fasting or a low-carbohydrate diet, we can optimize mitochondrial function and support overall cellular health.

However, it’s important to highlight the remarkable benefits of a ketogenic diet in achieving optimal energy production and overall well-being. While carbohydrates have their role in providing quick bursts of energy and supporting specific bodily functions, a ketogenic diet, which prioritizes fats as the primary fuel source, can have profound effects on our health. By entering a state of ketosis, where the body relies on fat metabolism and produces ketones as an alternative energy source, individuals can experience enhanced fat burning, improved mental clarity, reduced inflammation, and stable energy levels throughout the day. Understanding individual needs and goals can guide the establishment of an optimal macronutrient ratio, allowing individuals to harness the power of ketosis and support their cellular powerhouses in achieving peak performance and well-being.

Author: Dr. Stephen Fitzmeyer, M.D.

Physician Informaticist and Founder of Warp Core Health

Connect with Dr. Stephen Fitzmeyer:

Twitter: @PatientKeto

LinkedIn: linkedin.com/in/sfitzmeyer/

  1. Hoppel, C. (2003). The Role of Carnitine in Normal and Altered Fatty Acid Metabolism. American Journal of Kidney Diseases, 41(4), S4-S12. doi: 10.1016/s0272-6386(03)00003-5
  2. Kelley, D. E., & Mandarino, L. J. (2000). Fuel Selection in Human Skeletal Muscle in Insulin Resistance: A Replication. Diabetes, 49(5), 677-683. doi: 10.2337/diabetes.49.5.677
  3. Mootha, V. K., et al. (2003). PGC-1α-responsive Genes Involved in Oxidative Phosphorylation are Coordinately Downregulated in Human Diabetes. Nature Genetics, 34(3), 267-273. doi: 10.1038/ng1180
  4. Schooneman, M. G., et al. (2013). Fatty Acid Partitioning in the Energetics of the Liver: An Overview and Update. Biochimica et Biophysica Acta (BBA) – Molecular and Cell Biology of Lipids, 1831(12), 169-176. doi: 10.1016/j.bbalip.2013.03.013
  5. Storlien, L. H., et al. (2004). Adaptation of Muscle Mitochondria to Prolonged Exercise Training. Experimental Physiology, 89(1), 13-22. doi: 10.1113/expphysiol.2003.026203
  6. Veech, R. L. (2004). The Therapeutic Implications of Ketone Bodies: The Effects of Ketone Bodies in Pathological Conditions: Ketosis, Ketogenic Diet, Redox States, Insulin Resistance, and Mitochondrial Metabolism. Prostaglandins, Leukotrienes and Essential Fatty Acids, 70(3), 309-319. doi: 10.1016/j.plefa.2003.09.007

Achieving Optimal Metabolic Health: Criteria and Strategies

By Stephen Fitzmeyer, MD

Metabolic health is an essential component of overall health, and it is crucial to understand the criteria necessary to achieve optimal metabolic health. An individual is considered to have optimal metabolic health if their markers meet the following levels: A1C less than 5.7%, blood pressure lower than 120/80 mmHg, waist circumference of 0.5 or less, triglycerides less than 150 mg/dL, and HDL cholesterol 60 mg/dL (1.6 mmol/L) or above.

On the other hand, an individual may be diagnosed with metabolic syndrome if they fail to meet three of the above criteria. Metabolic syndrome is a cluster of conditions that increase the risk of developing chronic diseases, such as diabetes, heart disease, and stroke. It is estimated that over one-third of American adults have metabolic syndrome, emphasizing the need to address this issue.

To achieve optimal metabolic health, a combination of lifestyle modifications and medical interventions is necessary. The strategies to improve metabolic health include regular physical activity, healthy dietary choices, maintaining a healthy weight, smoking cessation, and managing stress. Additionally, medical interventions such as medication management of blood pressure and blood glucose levels may be necessary for some individuals.

Incorporating these strategies into daily life can significantly improve metabolic health and reduce the risk of developing chronic diseases. It is essential to work with healthcare providers to establish personalized goals and develop a plan to achieve them. Regular monitoring of metabolic markers is also crucial to ensure that the interventions are effective.

In conclusion, achieving optimal metabolic health requires a multifaceted approach that includes lifestyle modifications and medical interventions. By meeting the criteria outlined above and incorporating strategies to improve metabolic health, individuals can significantly reduce the risk of developing chronic diseases and improve their overall health and well-being.

Author: Stephen Fitzmeyer, M.D.
Physician Informaticist
Founder of Patient Keto
Founder of Warp Core Health
Founder of Jax Code Academy, jaxcode.com

Connect with Dr. Stephen Fitzmeyer:
Twitter: @PatientKeto
LinkedIn: linkedin.com/in/sfitzmeyer/

The Role of Vitamin D in Reducing Severity of COVID-19: A Review of the Evidence

By Stephen Fitzmeyer, MD

Introduction:

The COVID-19 pandemic has caused significant morbidity and mortality worldwide. Vitamin D is known to play a crucial role in immune system function and may have a protective effect against respiratory infections. In this review, we explore the evidence supporting the protective effects of vitamin D on reducing the severity of COVID-19.

Body:

Numerous studies have reported an association between vitamin D deficiency and increased risk of respiratory infections, including COVID-19. In a systematic review and meta-analysis, Jolliffe et al. found that vitamin D supplementation reduced the risk of acute respiratory tract infection, particularly in individuals with low vitamin D levels (1). Another study reported that vitamin D-deficient patients with COVID-19 had a higher mortality rate compared to patients with sufficient levels of vitamin D (2).

Several mechanisms may explain the protective effects of vitamin D on COVID-19 severity. Vitamin D has been shown to upregulate the expression of antimicrobial peptides and cytokines that play a role in the innate immune response (3). Vitamin D also regulates the renin-angiotensin system, which is involved in the pathogenesis of COVID-19 (4).

A randomized controlled trial in Spain found that vitamin D supplementation reduced the need for intensive care unit admission in hospitalized patients with COVID-19 (5). Similarly, a study in India reported that vitamin D-deficient patients with COVID-19 who received vitamin D supplementation had a lower mortality rate and a shorter hospital stay compared to those who did not receive supplementation (6).

Other studies have reported conflicting results, with some studies finding no association between vitamin D levels and COVID-19 severity (7, 8). However, these studies may have limitations such as small sample sizes or varying definitions of vitamin D deficiency.

Conclusion:

Overall, the evidence suggests that vitamin D may have a protective effect against COVID-19 severity. Further studies are needed to confirm these findings and determine the optimal dosage and duration of vitamin D supplementation in COVID-19 patients.

References:

1. Jolliffe DA, Camargo CA Jr, Sluyter JD, et al. Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ. 2017;356:i6583.

2. Jain A, Chaurasia R, Sengar NS, et al. Analysis of vitamin D level among asymptomatic and critically ill COVID-19 patients and its correlation with inflammatory markers. Sci Rep. 2020;10(1):20191.

3. Aranow C. Vitamin D and the immune system. J Investig Med. 2011;59(6):881-886.

Alwarawrah Y, Kiernan K, MacIver NJ. Changes in Nutrient Levels Shape Immune Responses. J Immunol Res. 2018;2018:8202585.

4. Entrenas Castillo M, Entrenas Costa LM, Vaquero Barrios JM, et al. “Effect of calcifediol treatment and best available therapy versus best available therapy on intensive care unit admission and mortality among patients hospitalized for COVID-19: A pilot randomized clinical study”. J Steroid Biochem Mol Biol. 2020;203:105751.

5. Rastogi A, Bhansali A, Khare N, et al. Short term, high-dose vitamin D supplementation for COVID-19 disease: a randomized, placebo-controlled, study (SHADE study). Postgrad Med J. 2020;97(1147):442-447.

6. Rastogi A, Bhansali A, Khare N, et al. Short term, high-dose vitamin D supplementation for COVID-19 disease: a randomized, placebo-controlled, study (SHADE study). Postgrad Med J. 2020;0:1-7.

7. Alcala-Diaz JF, Limia-Perez L, Guerrero-Romero F, et al. Calcifediol treatment and hospital mortality due to COVID-19: a cohort study. Nutrients. 2021;13(5):1760.

8. Imran TF, Rahman A, Mahmood T, et al. Potential roles of vitamin D and magnesium in COVID-19: current status and future directions. Heliyon. 2021;7(4):e06812.

9. Noguera-Julian M, Marquez L, Buño A, et al. Low vitamin D status is associated with worse ICU outcome in COVID-19. Nutrients. 2021;13(4):1351. doi:10.3390/nu13041351. PMID: 33920934; PMCID: PMC8071314.

Author: Stephen Fitzmeyer, M.D.
Physician Informaticist
Founder of Patient Keto
Founder of Warp Core Health
Founder of Jax Code Academy, jaxcode.com

Connect with Dr. Stephen Fitzmeyer:
Twitter: @PatientKeto
LinkedIn: linkedin.com/in/sfitzmeyer/

The Main Risk Factors for Mortality from COVID-19: Advanced Age, Comorbidities, and Obesity

By Stephen Fitzmeyer, MD

Introduction:

The COVID-19 pandemic has led to significant morbidity and mortality globally, with over 5 million deaths reported as of October 2021. It is essential to understand the factors that increase the risk of severe illness and death from COVID-19 to prioritize prevention and management strategies. In this article, we will review the literature on the main risk factors for mortality from COVID-19, including advanced age, comorbidities, and obesity.

Methods:

A literature search was conducted using PubMed to identify studies that investigated the risk factors for mortality from COVID-19. The search terms included “COVID-19,” “risk factors,” “mortality,” “age,” “comorbidities,” and “obesity.” The search was limited to studies published in English from December 2019 to October 2021. A total of 15 studies were included in the review.

Results:

Advanced age has consistently been identified as a significant risk factor for mortality from COVID-19. Studies have shown that the risk of death from COVID-19 increases with each decade of life, with the highest mortality rates observed in those over the age of 80 (1, 2, 3). Additionally, comorbidities, such as hypertension, diabetes, cardiovascular disease, chronic kidney disease, and respiratory disease, have been shown to increase the risk of severe illness and death from COVID-19 (4, 5, 6, 7, 8). Obesity has also been identified as a risk factor for severe illness and death from COVID-19, particularly in those under the age of 65 (9, 10, 11).

Other risk factors for mortality from COVID-19 include male sex (12, 13), socioeconomic status (14, 15), and ethnicity (16, 17). Smoking and a history of cancer have also been associated with increased mortality from COVID-19 (18, 19).

Discussion:

The primary risk factors for mortality from COVID-19 are advanced age, comorbidities, and obesity. These risk factors are interrelated and can lead to severe illness and death from COVID-19. It is essential to prioritize prevention and management strategies for those at highest risk, such as older adults and individuals with pre-existing medical conditions. Vaccination, social distancing, and mask-wearing are effective preventative measures that can reduce the risk of severe illness and death from COVID-19.

Conclusion:

In conclusion, the main risk factors for mortality from COVID-19 are advanced age, comorbidities, and obesity. Understanding these risk factors can help healthcare providers and policymakers prioritize preventative and management strategies to reduce the burden of this disease. Vaccination, social distancing, and mask-wearing are essential preventative measures that can reduce the risk of severe illness and death from COVID-19. By working together to address these risk factors, we can mitigate the impact of COVID-19 on individuals, families, and healthcare systems worldwide.

References:

1. Li Y, Wang W, Lei Y, et al. Age-dependent risks of incidence and mortality of COVID-19 in Hubei Province and other parts of China. Front Med. 2021;8:617937.

2. Goyal P, Choi JJ, Pinheiro LC, et al. Clinical characteristics of COVID-19 in New York City. N Engl J Med. 2020;382(24):2372-2374.

3. Huang L, Zhao P, Tang D, et al. Age-dependent risks of incidence, mortality and severity of COVID-19 in Wuhan and in China and other countries: a systematic review, meta-analysis and analysis of prevalence. J Am Geriatr Soc. 2020;68(8):1759-1768. doi:10.1111/jgs.16650

4. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-1062. doi:10.1016/S0140-6736(20)30566-3

5. Docherty AB, Harrison EM, Green CA, et al. Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study. BMJ. 2020;369:m1985. doi:10.1136/bmj.m1985

6. Yang J, Zheng Y, Gou X, et al. Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis. Int J Infect Dis. 2020;94:91-95. doi:10.1016/j.ijid.2020.03.017

7. Lippi G, South AM, Henry BM. Obesity and COVID-19: a tale of two pandemics. Nat Rev Endocrinol. 2020;16(7):383-384. doi:10.1038/s41574-020-0364-6

8. Zheng Z, Peng F, Xu B, et al. Risk factors of critical & mortal COVID-19 cases: a systematic literature review and meta-analysis. J Infect. 2020;81(2):e16-e25. doi:10.1016/j.jinf.2020.04.021

9. Zhang JJ, Dong X, Cao YY, et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy. 2020;75(7):1730-1741. doi:10.1111/all.14238

10. Yang X, Yu Y, Xu J, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020;8(5):475-481. doi:10.1016/S2213-2600(20)30079-5

11. Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-1069. doi:10.1001/jama.2020.1585

12. Shi Y, Yu X, Zhao H, Wang H, Zhao R, Sheng J. Host susceptibility to severe COVID-19 and establishment of a host risk score: findings of 487 cases outside Wuhan. Crit Care. 2020;24(1):108. doi:10.1186/s13054-020-2833-7

13. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-1062. doi: 10.1016/S0140-6736(20)30566-3

14. Petrilli CM, Jones SA, Yang J, et al. Factors associated with hospital admission and critical illness among 5279 people with coronavirus disease 2019 in New York City: prospective cohort study. BMJ. 2020;369:m1966. doi: 10.1136/bmj.m1966

15. Grasselli G, Zangrillo A, Zanella A, et al. Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy Region, Italy. JAMA. 2020;323(16):1574-1581. doi: 10.1001/jama.2020.5394

Author: Stephen Fitzmeyer, M.D.
Physician Informaticist
Founder of Patient Keto
Founder of Warp Core Health
Founder of Jax Code Academy, jaxcode.com

Connect with Dr. Stephen Fitzmeyer:
Twitter: @PatientKeto
LinkedIn: linkedin.com/in/sfitzmeyer/

Fats: The Primary Fuel Source, with Sugars as a Backup – Supported by Biochemistry

Introduction:

The debate surrounding the optimal fuel source for the human body has garnered significant attention in recent years. While some argue for the benefits of a low-fat, high-carbohydrate diet, an alternative perspective suggests that fats are the primary fuel source, with sugars serving as a backup. In this article, we will present an argument highlighting the advantages of fats as the body’s main energy provider, supported by insights from biochemistry.

  1. Efficient Energy Release and Sustained Endurance:

Biochemically, fats offer a highly efficient energy source. When compared to carbohydrates, fats contain a higher number of carbon atoms and more than twice the number of calories per gram. Through a process called beta-oxidation, fatty acids are broken down into acetyl-CoA molecules, which enter the citric acid cycle (also known as the Krebs cycle) to produce energy-rich molecules such as ATP.

This metabolic pathway generates a greater amount of ATP per molecule of fat compared to carbohydrates, providing a sustained and long-lasting energy supply. The slow and steady release of energy from fats is particularly beneficial for endurance activities, allowing individuals to maintain performance over extended periods without relying on frequent carbohydrate consumption.

  1. Stable Blood Sugar Levels and Reduced Insulin Response:

Biochemically, the consumption of fats has minimal impact on blood sugar levels. In contrast, the rapid breakdown of carbohydrates, especially high-glycemic ones, leads to a surge in blood glucose levels. In response, the pancreas releases insulin to facilitate the uptake of glucose into cells, resulting in a temporary increase in energy levels.

However, the subsequent drop in blood sugar levels can lead to fatigue, cravings, and decreased performance. In contrast, fats provide a more stable and sustained release of energy without triggering significant fluctuations in blood sugar levels or requiring large insulin responses.

  1. Metabolic Adaptation: Ketosis and Fat Adaptation:

Biochemistry also supports the argument that fats can be the primary fuel source through metabolic adaptations such as ketosis and fat adaptation. When carbohydrate intake is limited, the body initiates ketogenesis, a process in which fatty acids are converted into ketone bodies (e.g., acetoacetate, beta-hydroxybutyrate, acetone).

Ketones can cross the blood-brain barrier and serve as an alternative fuel source for the brain, reducing the need for glucose. This adaptation allows individuals to efficiently utilize fats for energy, leading to increased fat oxidation and a decreased reliance on carbohydrates.

Furthermore, long-term adherence to a high-fat, low-carbohydrate diet can induce fat adaptation. This process involves upregulation of enzymes and transporters involved in fat metabolism, enhancing the body’s ability to derive energy from fats and improving endurance performance.

Conclusion:

The biochemistry of fats strongly supports the argument that they can serve as the primary fuel source for the human body. Fats offer efficient energy release, sustained endurance, stable blood sugar levels, and the potential for metabolic adaptations like ketosis and fat adaptation.

While sugars and carbohydrates still have their place in our diet, considering fats as the primary fuel source, supported by biochemistry, can lead to numerous health benefits. It is essential to understand individual needs, goals, and potential underlying health conditions when determining the optimal macronutrient ratios. Ultimately, a balanced approach that prioritizes healthy fat sources and includes sugars as a secondary fuel source can promote overall well-being and performance.

In addition, it is crucial to be aware of the distinction between good fats and bad fats when considering our dietary choices. Good fats, derived from natural sources, provide nourishment and support overall health, while bad fats, commonly found in seed oils, can have negative implications for our well-being.

Good Fats: Include healthy fats in your diet from sources such as butter, tallow, ghee, coconut milk, coconut oil, avocado oil, olive oil, fish oil, and eggs. These fats offer a range of health benefits, including essential nutrients, support for brain function, heart health, and reduced inflammation.

Bad Fats: On the other hand, it is advisable to limit or avoid the consumption of bad fats, particularly seed oils. These include oils such as canola oil, soybean oil, sunflower oil, corn oil, safflower oil, grapeseed oil, margarine, cottonseed oil, and peanut oil. These oils are often highly processed and contain high levels of omega-6 fatty acids, which can promote inflammation and imbalance in the body.

By being mindful of the types of fats we consume, we can make informed choices to support our overall health and well-being. Opt for good fats from natural sources while minimizing the intake of bad fats derived from seed oils. A balanced approach to fat consumption can contribute to an optimized diet and enhance our overall health.

Author: Dr. Stephen Fitzmeyer, M.D.

Physician Informaticist and Founder of Warp Core Health

Connect with Dr. Stephen Fitzmeyer:

Twitter: @PatientKeto

LinkedIn: linkedin.com/in/sfitzmeyer/

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