Roger Seheult, MD of MedCram explains a new study comparing the effects of a vegan and ketogenic diet on the immune system. See all Dr. Seheult’s videos at: https://www.medcram.com/
(This video was recorded on February 7th, 2024)
Roger Seheult, MD is the co-founder and lead professor at https://www.medcram.com/
He is Board Certified in Internal Medicine, Pulmonary Disease, Critical Care, and Sleep Medicine and an Associate Professor at the University of California, Riverside School of Medicine.
LINKS / REFERENCES:
Differential peripheral immune signatures elicited by vegan versus ketogenic diets in humans (Nature Medicine) | https://www.nature.com/articles/s41591-023-02761-2
Plant-based diets, pescatarian diets and COVID-19 severity: a population-based case–control study in six countries (BMJ) | https://nutrition.bmj.com/content/bmjnph/early/2021/05/18/bmjnph-2021-000272.full.pdf
Impaired type I interferon activity and inflammatory responses in severe COVID-19 patients (Science) | https://www.science.org/doi/10.1126/science.abc6027
SARS-CoV-2 Mac1 is required for IFN antagonism and efficient virus replication in cell culture and in mice (PNAS) | https://www.pnas.org/doi/10.1073/pnas.2302083120
Early Treatment with Pegylated Interferon Lambda for Covid-19 (NEMJ) | https://www.nejm.org/doi/full/10.1056/NEJMoa2209760
Hyperthermia in humans enhances interferon-gamma synthesis and alters the peripheral lymphocyte population (Journal of interferon research) | https://pubmed.ncbi.nlm.nih.gov/3132509/
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#immunesystem #vegan #keto
What effect does Diet have on our immune system there’s some tantalizing new evidence that we’re going to get to but first of all let’s talk about the immune system and why it’s important to understand the differences between the innate immune system and the Adaptive immune system the innate immune system
Is what you start off with in terms of looking for things that are foreign so this is what causes you to have a fever this is what secretes as we’ve talked about before interferon this is what’s really important in fighting things like covid-19 but also influenza whereas the Adaptive immune system is where
Antibodies are made where you have plasma cells that make antibodies against specific antigens today we’re going to talk about which types of diets affect these different types of the immune system this is new data that’s come out that’s really quite impressive and it’s impressive because of some of the data that’s actually happened
Before but before we get to that I’m Dr Roger scheld I’m the co-founder of medcram.com where we explain medicine clearly please visit us at medcram.com where we have worldclass videos with continuing medical education so let’s get back to the topic at hand here we’ve talked about the importance of the
Innate immune system and specifically the product of the innate immune system which is interferon we’ve talked about how just about any virus needs to get around the major barrier for infection in your body which is the body’s ability to secrete interferon we also talked about it in terms of the severity of
Covid-19 we’ve shown in previous videos how increased levels of interferon were associated with more mild symptoms of covid-19 and that was pretty dramatic this study that showed that statistically significantly we also talked about SARS K2 and the Mac 1 Gene which was required for interferon antagonism and for efficient virus
Replication as was published in this research article published last year in August and what it showed was exactly what we had discussed before which was that SARS K2 has this Gene specifically Mac 1 which produces A protein that reduces the body’s ability to make interferon in fact when they tested it
Specifically in bronchial cells and Alvar cells when they compared the wild type in blue with the genetic mutation in the Mac 1 Gene in Orange notice that when they mutated this Gene Mac 1 that there were higher levels of interferon across the board and that in this
Situation they were able to kick out the virus much more easily this of course culminated in a human study which was published in the New England Journal of Medicine that showed that pegal interferon when given as a randomized control trial in patients who had covid-19 had about a 50% reduction in
Hospitalizations or ER visits and the number needed to treat was pretty low pretty reasonable about 35 with an absolute risk reduction of 2.9% even in the vaccinated and the unvaccinated population there was a significant reduction of about 50% in both in terms of hospitalizations the conclusion was the risk of covid-19 related hospitalization
Or an ed visit was approximately 50% lower in the interferon group than in the placebo group results were consistent regardless of vaccination status it made us think how can we potentially increase our innate immune systems ability to increase interferon production and we’ve talked about this before this is no surprise this was a
Paper that was published a number of years ago that showed that elevated temperatures could increase interferon gamma at least substantially even tenfold and that was significant and we talked about previous applications to this like hydrotherapy which was used at the turn of the century but we’ve also
Talked about diets and up to this point we didn’t know why this was the case but in this specific study from earlier in the pandemic where they looked at about 3,000 Healthcare providers mainly Physicians and nurses in six different countries France Germany Italy Spain UK and the United States who had
Substantial exposure risk in the early part of 2000 so this again was prior to any vaccinations participants provided in this particular study information on characteristics dietary information and covid-19 outcomes they used multivariable logistic regression models both models one two and three which we’ll talk about in just a second to see
Whether or not there were things that predicted whether or not these Physicians these nurses who were part of a network developed either mild or moderate to severe covid-19 there was 568 covid-19 cases and about 2300 control so almost 3,000 they asked these participants Physicians and nurses to self-report about whether or not they
Were following a plant-based diet a plant-based diet or pescatarian diet or if they were on a low carbohydrate high protein diet and they found in conclusion that in six countries a plant-based diet or pescatarian diet were associated with lower odds of moderate to severe covid-19 compared to
Control groups let’s take a look at that study because why this is important is going to dovetail into a new study that’s just come out that looks at the effects of a plant-based diet or vegan diet versus a low carbohydrate high fat diet let’s look at this study first they
Were looking at the control groups they had 2300 as we mentioned and then they had cases those that were very mild to mild and those that were moderate to severe with a P value if we look at these P values smoking was actually not statistically significant body mass
Index in fact in this group was not statistically significant but there were a number of things that were statistically significant and these were the self-reported diets so that’s pretty interesting these Physicians and nurses who took part in this study would tell you that they had specific plantbased or
Plant-based or pescatarian diet or low carbohydrate high protein diets and that these would be statistically significantly related to whether or not they got mild or mod to severe covid-19 in terms of the controls those that were on a plant-based diet very mild 8.6% versus the 99.2% in the control
Group and from moderate to severe it actually went down even lower to 2.9% similar to those that either had plant-base or pescaterian pescaterian by the way includes fish compared to the control 10.7% of the total had that type of diet it was less represented for in mile to moderate and even less
Represented in the moderat of severe however in the group that self-identified as low carbohydrate high protein diet in the control that was about 16.9% there were less in the very mild to mild group but there was statistically significantly more in the moderate to severe so the question that
You might have is how much can we trust self-reporting of diet and that’s a very good question let’s take a look at those that followed a plant-based diet and those that follow plant-based or a pescaterian and specifically let’s look at those P values after going through a
47 item dietary review on all of these subjects which were Physicians and nurses there was a statistically significant difference between total vegetable intake between those that followed plant-base or pescatarian and those that did not that seems to go along with a accurate representation of a self-reported diet some other things
That were statistically significant was there was more legumes in the plant-based pescatarian diet more nuts in the plant-based pescatarian diet there was less poultry in the plant-based pescatarian diet than there were in the one that was not and of course significantly less red and processed Meats in those that followed a
Plant Bas or pescatarian diet now you may say that this could be simply a marker of a healthy user effect we’re going to talk more about that especially in the next study that we’re going to talk about but in this study if we saw that there was a healthy user effect
Then in things for instance like refined grains we would have expected to be a statistically significant difference between these groups there was not in terms of sweets and deserts we would have expected there to be a statistically significant different in these groups there was not in terms of
Sugar sweeten beverages we would have expected there to be statistical significant difference between these groups there was not there was also not for fruit juices for vegetable oil use or for alcohol and for many of these other differences here we have the results and this is a graph that’s looking at
Adjusted odds ratios and 95% confidence intervals for the association between self-reported dietary patterns and moderate to severe covid-19 we’re looking at How likely were they to get moderate to severe covid-19 now this will become important as we talk about later what did we say was an important
Mitigating factor in terms of whether or not someone could get covid-19 severely interferon and what we’re going to find out here is whether or not these dietary patterns promote elevation of interferon in terms of model one and model one was adjusted for age sex race ethnicity and
Country notice here with unity being at one we had plant-based diets that were statistically significant ly less likely to get moderate to severe covid-19 even those for a combination of plant-based diets or pescatarian diets as opposed to a non-statistical significant difference here because the 95% interval crosses Unity so P equals
0.13 we see very similar results for model 2 which take into consideration everything that we took in model one but also medical specialty smoking status and physical activity even taking those into consider ation we’re not seeing any real change in terms of these values finally with model 3 which takes in all
Of these things everything that we took into model 2 plus body mass index plus medical conditions diabetes pre-diabetes cholesterol hypertension CAD heart attack heart failure cancer prior lung disease prior lung infection being overweight having asthma or autoimmune disease taking all of those things into consideration once again really we’re
Not seeing much of a difference and those that self-report having a plant-based Bas diet which we already showed actually does have some differences when we do a 47 different item list it shows that there is a statistically significant less risk of moderate to severe covid-19 could it be
Possible that taking in a plant-based or plant-based pescaterian diet might improve interferon now that’s a far-fetched question but in fact there’s been a paper that’s actually looked at just that and this was a paper that was published in the journal nature medicine titled differential peripheral immune signatures elicited by vegan versus
Ketogenic diets in humans first of all the thing I want to make sure that we’re clear on is that a vegan diet is not necessarily mutually exclusive to a ketogenic diet although that’s what they have here listed they defined that the vegan diet which was actually made up
For these groups of people that we can see here there was four women here in group a along with six men and then in group b there was five women and five men and this was a randomized control trial where they defined the vegan diet as being 10.3% fat and 75.2%
Carbohydrate with the ketogenic diet being 75.8% fat and only 10% carbohydrate so what they did was a randomized controlled crossover trial where they did this type of diet for 2 weeks and they looked at blood samples at both points and I’ll just tell you here as a
Spoiler it didn’t matter if they did the vegan diet first or the ketogenic diet first in both cases there was statistical significance and we’re going to go over those what was really interesting is that this was a very diverse group of people but the results were very consistent and standard so
Let’s go over the results of what they found this is a very confusing chart but I’m going to try to explain it to you here very carefully the change in relative amounts of these things that they have listed here is given in terms of r red and blue red means that there
Was an increase blue means that there was a decrease and the magnitude of that increase or decrease is given by the size of the circle you’ll see here that K is ketogenic and V is vegan we’re going to split this table down the middle and we’re going to look here at
Something called innate immunity and what they found was all of these things related to innate immunity went up dramatically when they were on a vegan diet as compared to the baseline or ketogenic diet in this category there was an enrichment in monocytes enrichment in neutrophils immune activation monoy signature and tlr
Signaling but here’s the key point and that’s this interferon signature was greatly increased in all of these where they were put on the vegan diet however when they were put on the ketogenic diet notied that there was a reduction that’s blue that means there was a statistically significant reduction in
Those points and notice how big the circles are there also notice that it’s not all bad for the ketogenic diet remember the ketogenic diet is simply a diet that stimulates ketones you don’t have to be on a high-fat diet to have a ketogenic diet you could have Tim restricted
Eating and that could also lead to a ketogenic diet having a vegan meal for instance in the morning and in the afternoon and then going on intermittent fasting could potentially give you not only the benefits of a vegan diet but also the benefits of a a ketogenic diet
Which were what in this case on the ketogenic side what did we have an increase on on this side notice it was te- Cell Activation B Cell Activation enrichment in B cells Etc so in other words what we’re talking about here is adaptive immunity so what it seems is
That there is an improvement in adaptive immunity with ketogenic diets but an improvement in innate immunity in vegan diets the same thing happens over here notice we’re looking at the vegan side we’re going to split this down we do a Hallmark analysis of things that we know and again looking at innate immunity
What are we seeing that’s increasing with vegan tnf signaling that interferon response that interferon response we’re even seeing Androgen response is much higher in vegans this kind of goes against the narrative that we often see with high protein high fat diets there’s an androgen response that’s actually
Higher in vegans and actually lower in the ketogenic diets proe protein secretion is actually higher in the vegan diet here’s something that really goes against the narrative that was really interesting in this study heem metabolism what they noticed in the study was that heem metabolism the production of hemopoetic cells red blood
Cells was statistically significantly higher in the vegan diet than there was in the ketogenic diet and again remember we’re not looking at people who are vegan or who are ketogenic we’re looking at people who were placed on these diets for 2 weeks and was a randomized crossover trial and these results were
Very consistent and standard there’s really no role here for the healthy user effect these are actual biomarkers and I would highly recommend that you look at this study because there’s more results and findings in the study the key here that I want you to look at is interferon
Response and what you’re noticing in the vegan group and again tie that into what we’re seeing here with imper type 1 interfering activity in covid-19 the higher the immune response the higher higher the interferent response the more mild the case of covid-19 and the question is is whether
Or not that would explain what we’re seeing here and here we’ve talked about things that could improve your health and the pneumonic that I often like to use is that of new start n e w s t a r t where n stands for nutrition e stands for
Exercise W stands for water s stands for Sunshine T stands for temperance a stands for air fresh air R stands for rest and T stands for trust relationships even spiritual relationships what we’ve talked about today is nutrition we’ve talked before about exercise we’ve certainly talked about hydrotherapy with water you know
That we’ talked about sunshine we haven’t talked too much about Temperance but I can tell you that if you look at alcohol they’re really isn’t a threshold for where damage starts to occur in the liver and we’ve talked about air and the fighti sdes that are given off by trees
In the environment we’ve shown how that actually affects the innate immune system rest is also very important we’ve talked specifically about sleep getting at least 7 hours of sleep per night and what things like obstructive sleep apnea and insomnia can do to that and why that’s important I think these are
Things that are very important in terms of your health and lifestyle especially important as we’re coming out of the winter season where a lot of us have had to deal with respiratory issues and if you want to be able to do things that will improve your immunity these are
Some places that you can start thanks for joining Us
