Low Carb Research with Dr. Volek
I worked as a Graduate Research Associate in the lab of Dr. Jeff Volek at Ohio State University. This lab group is notorious for meticulous attention to detail in their design and execution of controlled feeding studies. The body of research spans multiple decades and a multitude of populations, assessing such outcomes as lipid panels, blood markers of inflammation, body composition, athletic performance, cognition, and metastases – all looking at the potency of ketogenic diets.
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STAK
Strategies to Augment Ketosis
STAK was a 6-week controlled feeding study designed to investigate the impact of exogenous ketones on indices of keto-adaptation in obese subjects on weight reducing diets. The primary objective of STAK sought to examine if supplementation with exogenous beta-hydroxybutyrate (βHB) as part of a hypocaloric ketogenic diet subsequently affected metrics of renal function, changes in energy balance and body composition via DEXA and MRI, cognitive or behavioral adaptations, and cardio-metabolic risks observed in lipid panels.
Overweight and obese adults were provided a hypocaloric Ketogenic Diet (KD) (~75% of energy expenditure) for 6 weeks. In a double-blind manner, subjects were randomly assigned to receive ~24 g/day of a βHB-salt (KS) or placebo (PL). A matched comparison group was separately assigned to a low-fat diet. The KD induced nutritional ketosis (>1.0 mM capillary βHB) throughout the study, with higher fasting concentrations observed in KD + KS than KD + PL for the first 2 weeks. There were decreases in body mass, whole body fat and lean mass, mid-thigh muscle cross-sectional area, and both visceral and subcutaneous adipose tissues. Conclusion: Energy-matched hypocaloric ketogenic diets favorably affected body composition but were not further impacted by administration of an exogenous βHB-salt that augmented ketosis.
Overweight and obese adults were provided a hypocaloric Ketogenic Diet (KD) (~75% of energy expenditure) for 6 weeks. In a double-blind manner, subjects were randomly assigned to receive ~24 g/day of a βHB-salt (KS) or placebo (PL). A matched comparison group was separately assigned to a low-fat diet. The KD induced nutritional ketosis (>1.0 mM capillary βHB) throughout the study, with higher fasting concentrations observed in KD + KS than KD + PL for the first 2 weeks. There were decreases in body mass, whole body fat and lean mass, mid-thigh muscle cross-sectional area, and both visceral and subcutaneous adipose tissues. Conclusion: Energy-matched hypocaloric ketogenic diets favorably affected body composition but were not further impacted by administration of an exogenous βHB-salt that augmented ketosis.
Carbohydrate Restriction & Metabolic Syndrome
Metabolic syndrome is highly correlated with obesity and cardiovascular risk, but the importance of dietary carbohydrate independent of weight loss in Metabolic Syndrome treatment remains controversial. Here, we test the theory that dietary carbohydrate intolerance (i.e., the inability to process carbohydrate in a healthy manner) rather than obesity per se is a fundamental feature of Metabolic Syndrome. Individuals who were obese with a diagnosis of Metabolic Syndrome were fed three 4-week weight-maintenance diets that were low (LC), moderate (MC), and high in carbohydrate (HC). Protein was constant and fat was exchanged isocalorically for carbohydrate across all diets. Despite maintaining body mass, LC intake enhanced fat oxidation and was more effective in reversing Metabolic Syndrome, especially high triglycerides, low HDL-C, and the small LDL subclass phenotype. Consistent with the perspective that Metabolic Syndrome is a pathologic state that manifests as dietary carbohydrate intolerance, these results show that compared with eucaloric high-carbohydrate intake, LC/high-fat diets benefit Metabolic Syndrome independent of whole-body or fat mass.
KETO-CARE
Ketogenic Diet & Chemotherapy to Affect Breast Cancer Treatment
Recently published in the PLOS journal, the KETO-CARE trial investigated the potential therapeutic impact of a carbohydrate restrictive diet on cancer-based outcomes. KETO-CARE is a 6-month dietary intervention. The first 3 months is a controlled feeding study, meaning the patient is provided 100% of the food they are to consume. The second 3 months will transition to a “free-living” experiment to determine feasibility. Participants undergo advanced imaging, blood testing, body composition assessments, and are asked to complete questionnaires at baseline, midpoint (3 months) and post-testing (6 months). Daily monitoring of ketones and blood glucose via finger stick is also required.
Currently there is very little information in the scientific field related to nutrition and advanced stage breast cancer. What we do know is the majority of cancer cells use carbohydrate as its primary fuel source. Research in animal models has shown that ketogenic diets can reduce tumor burden and improve overall quality of life. Very little research exists in humans, but what does exist has demonstrated positive results! When consuming a ketogenic diet your body produces ketones, and research has shown these ketones can combat inflammation at the genetic level.
Currently there is very little information in the scientific field related to nutrition and advanced stage breast cancer. What we do know is the majority of cancer cells use carbohydrate as its primary fuel source. Research in animal models has shown that ketogenic diets can reduce tumor burden and improve overall quality of life. Very little research exists in humans, but what does exist has demonstrated positive results! When consuming a ketogenic diet your body produces ketones, and research has shown these ketones can combat inflammation at the genetic level.
PACMAN
Pancreatic Adenocarcinoma with Metabolic Adjuvant Nutrition Therapy
As the study Health Coach and part of the Research Team, this study was launched to evaluate the effects of the ketogenic diet in patients with metastatic pancreatic cancer while receiving chemotherapy. It seeks to evaluate the progression free survival in patients with metastatic pancreatic cancer on triplet therapy (nab-paclitaxel + gemcitabine + cisplatin) while on a ketogenic diet or non-ketogenic diet.
A cancer is not a cancer is not a cancer, meaning each type of tissue is a bit different in terms of its ability to proliferate and metastasize. Metabolically speaking, different tissues of the body (i.e. breast, colon, pancreas) *apparently* preferentially utilize different fuel sources at different rates to serve their own purpose. As such, this is what makes pancreatic cancer cells so formidable. Whereas breast cancer tissue may prefer glucose (for example), pancreatic tissue seemingly has the artillery to scavenge many fuel sources to serve its purpose. Like the game of whack-a-mole, hopefully the outcomes of this ongoing study clarify what substrate knocks down the cancerous pancreatic tissue.
A cancer is not a cancer is not a cancer, meaning each type of tissue is a bit different in terms of its ability to proliferate and metastasize. Metabolically speaking, different tissues of the body (i.e. breast, colon, pancreas) *apparently* preferentially utilize different fuel sources at different rates to serve their own purpose. As such, this is what makes pancreatic cancer cells so formidable. Whereas breast cancer tissue may prefer glucose (for example), pancreatic tissue seemingly has the artillery to scavenge many fuel sources to serve its purpose. Like the game of whack-a-mole, hopefully the outcomes of this ongoing study clarify what substrate knocks down the cancerous pancreatic tissue.
VICTOR
Virta Intervention in CommuniTies in ColORado
In rural communities served by Colorado Heart Healthy Solutions (CHHS), referral to a comprehensive remotely-delivered (virtual) continuous remote care to induce nutritional ketosis combined with remote medication management will improve glycemic control in patients with type 2 diabetes as compared with standard care. The study intervention is the referral. Subjects are not mandated to receive Virta treatment and are welcome to continue in the study whether or not the referral is accepted. 3 rural communities served by CHHS have been chosen as recruitment sites. Study patients were randomized at the site level.
Future Work
After watching a dear friend battle with bouts of Multiple Sclerosis (MS), I wrote a proposal on the potential of the ketogenic diet to reduce flare-ups, halt disease progression, and hopefully improve overall quality of life. I am hoping this study gains traction later this summer. We will seek to answer if acute nutritional ketosis (achieved by an exogenous ketone supplement) has an effect of cognitive and psychomotor function – both of which are hallmarks of those with MS, along with some advanced brain MRI imaging to quantify myelination and disease progression. Read my synopsis.
ExosHealth/Fitness Specialist
Working within a corporate fitness setting in groups and one-on-one, helping members meet their healthy living goals through performance assessments and program design and prescription for a wide spectrum of clientele.
Virta HealthHealth Coach/Clinical Research Associate
Virta Health has a mission to transform diabetes care and reverse the type 2 diabetes epidemic with a clinical and scientific approach in 100M people by 2025. Noting that over half of US adults have either type 2 diabetes or prediabetes, Virta helps people reverse this condition through daily biometrics, personalized nutrition, and a virtual care platform. I had the luxury of working both on the Coach Team and Research Team.
Wearing the Health Coach Team hat, I worked directly with Virta patients to reverse metabolic disease. Using science-based therapeutic tools, and a phone app sitting in the comfort of a patient's pocket, I was able to provide ongoing real time coaching and education with Virta patients daily. This focused on a personalized nutrition & care plan along with intimate collaboration with the Virta medical team, which focused on monitoring patient metrics and vitals including: weight, blood ketones, blood glucose, blood pressure, side effects, energy, cravings, hunger, and mood. Wearing the Research Team hat, I was able to collaborate with diabetes clinics, oncology sites, CRO’s, vendors and investigators around the country to initiate and manage ongoing clinical trials which implemented the Virta treatment in an attempt to determine the effectiveness of a low-carbohydrate/ketogenic diet approach in these populations. |
Bay Club
Certified Personal Trainer/Group Ex InstructorMy tenure at the Bay Club was the ultimate affirmation that my quest for a
second career had come to fruition. I was blessed to have clients that can be better described as friends and believe in my heart my time in SF will remain the pinnacle of my professional happiness. For 4 years I cannot think of a day where I dreaded going into work or eagerly clock-watched to go home. Clients ranged from young to elderly, novice to experienced gym go-ers, injured and handicapped, and perhaps most rewarding of all were those with special needs. I will always look back fondly of my time at the Bay Club! |
Fitness Works, PHL
Certified Personal Trainer/Group Ex InstructorFor those of you who are personal trainers or work with clients 1 on 1, you
probably never forgot your first client and the anxiety that tags along with what to expect from this new dynamic. My first client told me “I don’t like to sweat”. While I was unsure what to do with that at the time, it was a valuable first lesson in the process and importance of rapport-building. The owner generously encouraged me to take on small group training twice a week in a class called “Beach Bodies by Brandon”. In hindsight, it got me out of my comfort zone and was a springboard for the classes and clients I have interacted with daily since my client-zero. |