In a recently published case report, we see a West Virginia hospital strive toward a new standard of care for approaching patients with type 2 diabetes. What therapeutic agent is at the center of this inpatient intervention? A ketogenic diet. Dr. Mark Cucuzzella is the change agent at this community hospital, supported by open-minded administrators and countless hospital employees. The publication of this case report is an important step toward establishing a new standard of care for reversing type 2 diabetes with carbohydrate restriction.

Can lower-carb eating lead to the common heart arrhythmia atrial fibrillation? Headlines might lead you to believe this is the case, but cardiologist Bret Scher explains why an observational study of this sort is weak evidence. When you layer a compromised definition of low-carb itself, unreliable food frequency questionnaires, a weak association, and many potential confounding variables, the concerning headlines fade away.

The New York Times reports that a new, observational study suggests a meaningful increased incidence of diabetes onset in patients taking a statin, regardless of brand and dose. Although the quality of this evidence is weak, other research — some of it from randomized clinical trials — confirms that this risk is real and meaningful, but puts the absolute increase in risk of diabetes at a much lower level than these headlines suggest. 

A lengthy article in The Mail on Sunday calls out three UK experts for publicly questioning the efficacy of statins. The article suggests that thousands of people who could be helped by statins are not taking them because of these “statin deniers.” But the record of statins to meaningfully protect allpatients from cardiovascular disease is spotty. Cardiologist Bret Scher unpacks the bitter controversy between the pro- and anti-statin camps.

A new study compared a pork cheeseburger to a plant-based burger, but with an added twist: a sugary drink was added to the pork cheeseburger but not to the other meal. This study design suggests obvious bias, yet it got through peer review. It’s just another reminder of how agendas can impact otherwise “scientific” studies and their results.

You may have seen multiple online articles about the perils of “keto crotch” — a condition featuring unpleasant vaginal odors purported to be caused by the keto diet. Dr. Evelyne Bourdua-Roy, a family doctor who treats patients with low-carb diets, looks into the rumors, and concludes that “keto crotch” is perhaps misinformation or misdiagnosis, but is NOT a chronic or significant ongoing problem women experience when in ketosis.

A new op-ed published in Minnesota’s largest newspaper, the Star Tribune, christens the keto diet as “The risk-reversal diet.” With a very engaging style, the author focuses on the type 2 diabetes epidemic, including its shocking scale and crippling cost. He builds a strong case for his thesis: “Errant beliefs about food and health engineered a diabetes crisis, and a simple, sustainable way of eating can end it.” That way of eating is keto. A must read.

According to CNN, Weight Watchers is “getting crushed by keto.” A surprisingly poor quarter led Weight Watchers’ CEO to mention a “keto surge” as one of the company’s challenges. Her company’s stock has tanked, down almost 80% from its high less than a year ago. Even bigger news: CNN also reports that a Wall Street analyst named Diet Doctor as part of the reason she is concerned about Weight Watcher’s future performance. Another must read!

Headlines about a new, randomized study out of China suggest that a higher level of dietary fat is bad for the gut. Fear not. The diet in the experiment was not low carb, and the added fat was mostly soybean oil, rather than healthy, real-food fats. Dr. Bret Scher explains all of the red flags in this new study.

A post-PREDIMED world… Agarwal and Ioannidis weigh in (via this analysis in the journal BMJ) on lessons learned from the retraction of a landmark Mediterranean diet study, and the repercussions and way forward. Also, Vox asks how researchers will reassess the revised and reissued study, and raises questions about how other medical journals will deal with their newer studies that cite and rely on the old PREDIMED.

MedPage reports on a new observational study, just published in Neurology, that finds elevated inflammation in midlife is associated with steeper cognitive decline, particularly memory decline. The subjects with the highest quartile of blood levels of a systemic inflammation marker experienced 11.6% steeper decline in memory than the subjects in the lowest quartile. This data comes out of Atherosclerosis Risk in Communities cohort study, and suggests that midlife inflammation may pose a greater cognitive risk than midlife hypertension.

A new, National Institutes of Health funded and American Heart Association sanctioned analysis of old, observational data finds subjects with type 2 diabetes who ate at least five servings of nuts each week experienced 20% less heart disease and about a third less premature death than those who ate almost no nuts. This sort of weak, observational finding doesn’t mean much, but regardless, the popular press is scrambling to cast nuts as a “better for you” substitute for foods high in saturated fat rather than a replacement for refined carbohydrates. 🙄