A new meta-analysis based on multiple cohort studies found that elevated concentrations of trimethylamine N-oxide (TMAO)—a gut microbiota-derived metabolite of choline, L-carnitine or betaine—were associated with increased risks of major adverse cardiovascular events (MACE) and all-cause mortality. 1 Choline, L-carnitine and betaine are metabolized by intestinal bacteria to form trimethylamine, which is then oxidized to TMAO by the enzyme flavin monooxygenase 3 in the liver. Because there is an increasing number of studies investigating the association of circulating levels of…

Coronary artery disease (CAD) is the most common form of heart disease and is a leading cause of death in the US among both men and women. CAD develops when plaque forms in the coronary arteries, limiting and blocking blood flow. Another cause of CAD, in addition to arterial plaques, is arterial inflammation.  A study by Tarec K. Elajami and colleagues found resolution of inflammation in the body may also lead to clot remodeling and reduce the incidence of CAD and coronary events in at risk…

by Bianca Garilli, ND  Often considered a disease of the older population, recent reports are indicating that an estimated 10% of stroke victims are less than 50 years of age and, according to a recent study published in the Journal of the American Medical Association (JAMA), ischemic stroke rates have risen in young adults aged between 24-50 years.1 The study further points out that hospitalization rates for stroke have also increased for both women and men—nearly double in the case of men. Research conducted…

by Bianca Garilli, ND  Obesity rates have reached epidemic proportions globally and have been shown to adversely influence many clinical markers of health However, the data are sparse with regards to the effect maternal obesity may have on fetal and neonatal outcomes.    A recent report in Lancet, by Di Cesare et al, showed that the number of women aged 18 years and older with a BMI of > 35 (obesity class II and III) doubled from approximately 50 million to 100 million worldwide between…

In Part 2 of this 2-part series, ketogenic diet expert Jeff Volek, PhD, RD, reviews the critical need for nutritionally based management options in obesity treatment. Dr. Volek discusses the ketogenic diet and its safety, efficacy, and outcomes in patients with obesity. In this presentation you will learn how to personalize and implement a safe and effective ketogenic diet in a real-world clinical practice. Dr. Volek is a Professor in the Department of Human Sciences at The Ohio State University. For…

Recent data have indicated rates for cardiovascular disease (CVD) and coronary heart disease (CHD) are declining but still more than a third of all deaths in the US, and nearly half of the deaths in the EU, can be linked to heart disease. Fiber has long been proposed as a possible cardioprotectant; there have been studies that assessed dietary fiber and its effects on hypertension, obesity, increased serum cholesterol and insulin sensitivity. It has been suggested that other components of…

The presence of excess inflammation is the main driver behind metabolic diseases such as insulin resistance, obesity, metabolic syndrome (MS), type 2 diabetes (T2D), cardiovascular disease (CVD) and non-alcoholic fatty liver disease (NAFLD). C-reactive protein (CRP), an inflammatory marker produced by the liver and adipocytokines (bioactive molecules produced in fat tissue) such as interleukin-6 (IL-6) and tumor necrosis factor- α (TNF- α) are molecules which are key in this inflammatory process. Treatment options focused on dampening inflammation by reducing these…

by Milene Brownlow, PhD The metabolism of exogenous ketones, in ester vs. salt forms, are explored. Highlights Ketone ester (KE) drinks elevated blood βHB to a greater extent (>50%) than Ketone salt (KS) drinks, while KS drinks increased blood levels of L-βHB, which was metabolized more slowly Both drinks had similar effects on FFA, TG, glucose and electrolyte concentrations, although only KE significantly decreased blood pH below normal range Consumption of a meal prior to KE intake decreased total blood…

Ketogenic diets—diets that restrict carbohydrates to usually < 50 g/day to induce ketosis—are gaining popularity, for nutritional ketosis has been shown to lead to metabolic advantages including weight management and improvements in glycemic control and blood lipids. However, adhering to such a strict diet to sustain ketosis may be difficult for many. As a result, there has been growing interest in maintaining nutritional ketosis via consumption of exogenous ketone drinks such as ketone esters (KE) and ketone salts (KS). The…