Research Review: "The Ketogenic Diet and Cardiovascular Diseases" (Dyńka et al., 2023)

Dr. Lee Now today let's look at several research papers showing that blood pressure was normalized through a ketogenic diet. The first paper we'll examine is The Ketogenic Diet and Cardiovascular Diseases (Dyńka et al., 2023). This study presents and summarizes the results of various previous studies on the beneficial effects of the ketogenic diet on cardiovascular disease. The authors stated that the ketogenic diet provides cardioprotective function through four effects: first, the anti-inflammatory effect of ketones themselves; second, the anti-inflammatory effect of reduced sugar; third, the anti-inflammatory effect of carbohydrate restriction; and fourth, the anti-inflammatory effect from abundant omega-3 fatty acid intake.

The authors then listed nine reasons why the ketogenic diet benefits endothelial cell health. Blood vessels are essentially hollow tubes, and these tubes are made up of layers of various cell types. Among these layers, the vascular endothelial cells form the inner lining of the vessel and are in direct contact with the blood. They are elastic and can stretch or contract depending on the situation. In other words, the endothelial layer regulates blood flow, fluidity, and vascular tone, thereby influencing blood pressure. If endothelial cells lack omega-3 fatty acids, they become rigid and lose their ability to expand and contract, so even small changes in pressure may cause vessels to rupture. But the ketogenic diet provides smooth energy supply to endothelial cells, improves their function, and helps them function properly. Ketones also have anti-inflammatory effects and increase the activity of nitric oxide synthase, thereby enhancing vascular elasticity. When inflammation occurs in vessels, plaques form, leading to blockage and rigidity. Ketones prevent this. Furthermore, ketones prevent premature aging of endothelial cells, suppress inflammatory activity, and inhibit the expression of inflammation-related genes. They also lower blood glucose and reduce glycated hemoglobin (HbA1c), thereby protecting endothelial cells.

Susan I understand glycated hemoglobin as glucose attached to red blood cells. But does a high level of HbA1c raise blood pressure?