{"version":1,"type":"rich","provider_name":"Libsyn","provider_url":"https:\/\/www.libsyn.com","height":90,"width":600,"title":"A Cardiologist\u2019s Thoughts on the Ketogenic Diet, Heart Disease & Metabolic Health: Ep 126","description":"Doug Reynolds welcomes listeners back to the LowCarbUSA\u00ae Podcast with a guest who works in one of the most specialized\u2014and most misunderstood\u2014corners of cardiovascular medicine: the heart\u2019s electrical system.  Dr. David Nabert is an electrophysiologist (\u201cEP\u201d doctor), focused on heart rhythm disorders, and he\u2019s one of the featured speakers at the Boca Symposium for Metabolic Health (January 23\u201325)\u2014including the event\u2019s full day-plus dedicated to cardiovascular conditions. What gives this episode its pull is the combination of clinical depth and lived experience. David isn\u2019t just talking about rhythm problems from a textbook perspective\u2014he\u2019s explaining how his own curiosity about metabolic health evolved, what shifted when he started questioning conventional assumptions, and why those questions matter for real patients in the real world. David describes how his entry point into metabolic health didn\u2019t begin in a clinic\u2014it began with a random Google search. In 2021, while looking up a cardiology formula, he accidentally landed on a Nina Teicholz talk at the Cato Institute. \u201cI started to watch it, and all of a sudden, an hour and a half passed,\u201d he says\u2014one of those moments where interest turns into momentum. He listened to Teicholz\u2019s book, The Big Fat Surprise, then began searching for more voices in the low-carb space and quickly reconnected with familiar names, including Dr. Robert Cywes and Dr. Eric Westman (both will also be presenting in Boca), whom he calls mentors. That exploration ultimately led him to the Society of Metabolic Health Practitioners (The SMHP) and, importantly, a willingness to test ideas on himself. David is candid about his own weight journey. He describes a time when a body mass index under 25 felt \u201cskinny\u201d to him, and he\u2019s open about losing weight, regaining some after a series of hip surgeries, and continuing to work on it. What ultimately shifted, though, wasn\u2019t just the number on the scale\u2014it was how he began to rethink what \u201cdoing everything right\u201d actually means. For years, he approached weight loss the way many clinicians were trained to: low-fat, high willpower, endure the hunger. He describes his old strategy bluntly: \u201cThe only way I had lost weight\u2026 was by doing protein sparing modified fast\u2026 I was just eating almost no fat.\u201d Predictably, it wasn\u2019t sustainable. When he later shifted to a lower-carb, higher-fat approach\u2014\u201cbacon, eggs, hamburger\u201d\u2014he was \u201camazed at how quickly I started to lose weight,\u201d and he began seeing changes in markers that traditional cardiology often de-emphasizes. After stopping long-term statin therapy (which he had been on for 25 years), he saw his LDL return to roughly where it had been earlier in life, but other changes caught his attention: triglycerides dropped to the lowest he\u2019d ever seen, HDL improved, and fasting insulin improved as well. Just as meaningful were the changes he felt: \u201cEvery 10 or 20 pounds I lost, my hips got better,\u201d he says, attributing it not only to less load, but \u201calso part of it was less inflammation.\u201d From there, the episode moves into the heart of why David is speaking during the cardiovascular-focused programming in Boca: rhythm, electricity, and the surprising overlap between conditions that seem unrelated\u2014like seizures and arrhythmias. David explains that early ketogenic diet research in the 1920s focused on refractory seizures, and he argues the connection matters because many antiarrhythmic drugs and antiseizure drugs overlap mechanistically. In his view, these aren\u2019t separate worlds. \u201cTreating seizures or treating cardiac arrhythmias is basically two faces of the same coin,\u201d he says\u2014and that opens a practical question: if ketosis can help reduce seizures, might it also influence certain rhythm symptoms? He shares a striking clinical example that stuck with him: a former submariner with PTSD and episodes of fast heart rates who said, \u201cI know when I\u2019m\u2026 ketogenic\u2026 when I fall off the wagon\u2026 then I start having palpitations and fast heart rates.\u201d David later learned the patient was experiencing atrial fibrillation, and while he\u2019s careful not to overpromise, he describes a pattern he\u2019s observed: in earlier stages of rhythm problems, being in a ketogenic state may reduce symptoms and potentially slow progression for some people. \u201cIt doesn\u2019t cure atrial fibrillation,\u201d he emphasizes, but he\u2019s seen ketosis \u201cimproves symptoms,\u201d not only in AFib, but in other rhythm issues like SVT and PVCs\u2014especially early on. From there, David widens the frame to what he\u2019s seeing in younger patients\u2014particularly young women\u2014showing up with palpitations, rapid heart rate, anxiety, and signs of metabolic dysfunction even when they don\u2019t \u201clook\u201d unhealthy by BMI alone. \u201cOnly 90% of them are metabolically unhealthy,\u201d he says, describing a familiar cluster: A1C not quite normal, resting heart rates high, daytime heart rates that shouldn\u2019t be running 100\u2013120, and a nervous system dialed up in what he calls a \u201chyper adrenergic state.\u201d The mainstream response is often medication\u2014beta blockers, for example\u2014but David argues metabolic context matters, and he\u2019s exploring how nutritional strategies (including ketosis, sometimes even supplemental ketones) may reduce symptom burden in certain cases. He also discusses POTS (Postural Orthostatic Tachycardia Syndrome), noting it can be associated with viral infections and has become more common since \u201cthe bad virus we had five years ago.\u201d Again, he\u2019s measured in his claims: ketosis isn\u2019t a cure, but he\u2019s seen it help reduce symptoms in select patients who have tried many other standard approaches first. The second half of the conversation touches on medications and the tension between \u201clower the number\u201d cardiology and whole-person outcomes. David brings up PCSK9 inhibitors and recalls being troubled by early data patterns: \u201cYou were less likely to die from that, but you\u2019re more likely to die from cancer or infection\u2026 And\u2026 the overall mortality was the same.\u201d That line of thinking captures what pushed him toward metabolic health: a concern that focusing on a single marker can obscure the bigger picture of risk, resilience, and long-term outcomes. He also discusses SGLT2 inhibitors (like Jardiance and Farxiga) as potentially useful tools\u2014especially in heart failure and diabetes\u2014while stressing the importance of monitoring and hydration. In a moment that captures both his clinical caution and his enthusiasm for empowered patients, he tells people who go low carb on these meds to \u201cget a Keto Mojo to check your ketone levels,\u201d because the goal is to use tools intelligently, not blindly. As the episode closes, Doug returns to the bigger mission behind the upcoming Boca program: helping attendees develop a confident, educated response to the most common fear tactic people face when they change their diet\u2014LDL, heart attacks, and the assumption that low carb automatically means danger. Doug notes there are still \u201cso few that really do get it and support it and talk about it,\u201d which is exactly why the cardiovascular-focused day-plus at the Boca Symposium for Metabolic Health (January 23\u201325) matters. David, for his part, is grateful to be part of it\u2014and to be healthy enough to show up differently than last time. He reminds Doug that at previous events he was \u201ceither walking with one or two canes,\u201d but now, \u201cI\u2019m actually not going to run up on the stage, but I\u2019ll be moving pretty quickly.\u201d That moment captures the heart of the episode: metabolic health isn\u2019t theoretical. It\u2019s lived. And in Boca, that lived experience meets serious clinical discussion\u2014especially for anyone trying to better understand cardiovascular risk, rhythm disorders, and the metabolic foundations that too often go unaddressed. If this conversation sparks your curiosity, the next step is obvious: join the community in Boca January 23\u201325 and immerse yourself in a day and a half of cardiovascular-focused talks designed to help you think more clearly, speak more confidently, and act more effectively\u2014whether you\u2019re a clinician, a patient, or someone trying to help the people you love. Learn more about the Boca Symposium and register here. ","author_name":"LowCarbUSA Podcast","author_url":"https:\/\/www.lowcarbusa.org\/","html":"