It’s coming up to my two-year anniversary since I started on a ketogenic diet. I thought the timing was perfect to share what I have learnt, the good, the bad and the opportunity this dietary strategy offers. Over the last two years I have collected data on my spirometry, blood work including blood glucose and ketone levels. I have had cytokine profiles tests all in the name of monitoring inflammation. But before I go into what I have found, it’s important to know why I have taken the journey down the ketosis road.
Over the last two years I have been in communication with world renowned respiratory disease researchers as well as those leading the charge into the use of ketosis to manage chronic disease. You don’t have to have a degree to come to the simple conclusion systemic inflammation is what researchers want to suppress.
Chronic inflammation is now being recognised as the major driver in so many diseases and the race is on to find a way to treat it. Sadly, due to predominately funding issues, respiratory research is lagging behind other diseases. The key inflammasome NLRP3, a driver to many diseases including respiratory disease is the target of researchers.
While respiratory researchers struggle to find a safe pharmaceutical solution to this problem, researchers in other fields are getting closer to this holy grail. What has become apparent to me during my dive into nutritional strategies and respiratory research is it’s likely the cure/major breakthrough in respiratory disease will possibly come from researchers of another disease state.
Indeed, if you listen to my podcast with Professor Peter Barnes and Dr Dominic D’Agostino on this very topic you’ll soon understand a major breakthrough in respiratory disease could come from a collaboration of these two outstanding researchers. However, funding to carry out the studies required to investigate the application of ketosis to respiratory disease is unlikely.
In the time I have been using the ketogenic diet as a strategy to help manage my COPD, I have seen a significant improvement in my symptoms and quality of life. However, telling you how I feel and showing the evidence which supports my improved status are two different things.
Pulmonary function testing (PFT) is used not only to diagnose respiratory disease, it can be used to monitor the progression of the disease. When I compare my PFT’s since being diagnosed with COPD seven years ago you can see an interesting pattern. Whilst eating what would be deemed to be a healthy diet my PFT’s remained constant. I competed in Ironman events and marathons but no matter how fit I was my PFT’s wouldn’t shift. That’s not to say the exercise wasn’t improving my ‘symptoms’, it was, but not my PFT’s.
At the beginning of 2016 I started trying different dietary approaches to manage my disease. I started off following a paleo type diet, reducing my carbs and sugar, and processed foods. By October 2016 I was using a ketogenic diet and was noticing a positive change in how I felt. By April 2017 after 7 months on the ketogenic diet I went to my local hospital to have PFT and exercise stress testing carried out. This was the turning point for me as these tests showed a significant improvement to my FEV1 result and less oxygen desaturation under stress. Two weeks after these tests were carried out I ran the London marathon recording my personal best time.
One positive PFT result is by no means conclusive, so in July this year while in high range ketosis I went back to the same respiratory clinic for more pulmonary function testing. This time I wanted to see if I could replicate my 2017 tests by using a double dose of the HVMN ketone ester. For those of you who don’t know what a ketone ester is, simply, it is a liquid dose of a ketones which can put you in high range ketosis within 30 minutes. Click here for an article on my previous experience with ketone esters.
When I received the results of my PFT’s it brought a smile to my face. This time my results recorded were my best since being diagnosed with COPD. When you consider COPD is a progressive disease the 2017 and 2018 tests while in ketosis are significant.
The question is what has changed? In my uneducated opinion – it’s all about inflammation. My blood results since starting the ketogenic diet have showed a continual reduction in my inflammation markers. If you told any respiratory researcher a severe COPD patient had a CRP (marker of inflammation) of 1, they would be shocked. A common trait of a patient with a chronic inflammatory disease is a high CRP blood result – over 5 is considered high.
It is my opinion in relation to respiratory disease you cannot repair the structural damage to our lungs, but you can significantly reduce the systemic inflammation which drives the disease. The main ketone body produced when on a ketogenic diet – beta-hydroxybutyrate (BHB) has been shown in studies to suppress the NLRP3 inflammasome, a major driver in respiratory disease.
We now have a supplement available for sale which has the potential to improve the quality of life in respiratory patients. Unfortunately, at this stage the cost of this ketone ester makes it inaccessible to the average patient. That aside and given the fact BHB is formed naturally in the body, research into BHB as a treatment option for respiratory disease is a must.
Over the last two years I have spent a lot of time and money on observing and testing the role a ketogenic diet on my COPD. I have now reached the point as a patient with limited resources where I cannot test anything else. In the last 20+ years little has changed in how we treat COPD. Respiratory researchers have a focus on pharmaceutical interventions, as much of their funding is sourced from pharmaceutical companies.
At the time of writing this article there are 51 COPD studies on the NIH website and not one in relation to nutrition. While I have found a strategy, which has significantly improved my quality of life, my heart breaks for the many who are suffering far more than they need to be. Until such time as healthcare professionals and researchers in the respiratory space start taking nutrition seriously the status quo will continue.
We need our respiratory professionals to start looking outside the box, to be ground breakers. A glimpse back through research papers show the potential of specific dietary strategies and their effects on pulmonary patients. These studies have been either forgotten or ignored. Question is will anyone ever take up the running?
Despite what some have said when I first wrote about the ketogenic diet, I’m still here, I haven’t died or developed cardiovascular disease. In fact, I’m thriving. See the thing is with a nutritional strategy, if you are not doing well on it you can simply stop. You don’t actually have to wait for clinical trials which can take years.
There are a growing number of registered dieticians who are well educated in using either low carbohydrate, high fat or ketogenic diets. A patient could potentially liaise with their doctor and dietician to safely and effectively implement these dietary changes. Once a patient understands the types of foods and quantities which can be eaten they can continue managing their diet themselves.