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Dr. Tro

@doctortro

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Physician. Patient advocate. Toward Health founder.
Looking for root causes. Building a plan around you.
Explore care below.

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A CAC score is more than one number. Cardiologist Dr. Ryan Daly explains why the percentile matters for heart risk. Watch the clip. For more, search “Understanding CAC Scans” in the Toward Health Learning Hub. by @doctortro

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Do GLP-1s protect arthritic knees or just reduce mechanical load? STEP 9 showed real pain relief, but cartilage repair is unproven. Read what human trials show. GLP-1s FOR KNEE PAIN? IS WEIGHT LOSS THE WHOLE STORY? Dr. Tro beside an illustration of a knee joint. by @doctortro

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Yes … I was on PBS newshour talking about how to actually eat nutritious food and get off GLP1s by @doctortro

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Do you eat low carb and worry about your heart? The ADA recognizes lower-carb eating for people with diabetes or prediabetes. New federal guidelines say it may help some people with chronic disease. Yet the AHA puts keto in its lowest tier for diet-guideline alignment. We used its PREVENT calculator: in our paired cohort, calculated 10-year ASCVD risk fell 29% after one year. Watch what we found. Read the full study article on Toward Health. by @doctortro

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The AHA encourages clinicians to use its PREVENT calculator. So we did!

But we took a dietary approach the AHA ranks near the bottom... ketogenic diets.
What did we find?
After one year in TOWARD’s continuous metabolic care program, which includes keto-carnivore diet education, estimated 10-year cardiovascular disease risk fell 28%, and estimated heart failure risk fell 42%.
Their calculator. Our approach. Lower estimated risk. comparingTowardresults by @doctortro

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Can extending sleep cut calorie intake? Adults sleeping under 6.5 hours who added 1.2 hours of rest ate 270 fewer calories daily without dieting. Pale blue linen pillows and bedding in soft morning light beside a navy headboard. by @doctortro

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Low testosterone is more than a lab number. In this LowCarbMD clip, Dr. José Carlos Souto explains how symptoms and metabolic health shape his approach. by @doctortro

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#weightloss #medicine #wellness by @doctortro

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#weightloss #medicine #wellness by @doctortro

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The American Heart Association ranks ketogenic diets in its lowest tier.

So what happens when we evaluate ketogenic metabolic care using the AHA’s own cardiovascular risk calculator?

Our new peer-reviewed paper:

https://doi.org/10.1016/j.ajpc.2026.102087

After one year of TOWARD Health’s physician-led metabolic care, estimated 10-year cardiovascular risk fell:

✅ ASCVD: 29%

✅ Total cardiovascular disease: 28%

✅ Heart failure: 42%

The cohort included 120 adults

Results included:

• 12.2% median weight loss

• Systolic blood pressure down 10.7 mmHg

• HbA1c down 0.48 percentage points

• Triglycerides down 34 mg/dL

• Weight loss in 89 of 90 participants

Meat stayed on the menu. Our dietary approach emphasizes animal protein, animal fats and non-starchy vegetables, without a prescribed saturated-fat cap.

And this was comprehensive care: physicians, health coaches, remote monitoring, ongoing messaging, AI-assisted technology and our patient app.

For perspective, a separate study published in the AHA’s own journal reported a 29% reduction in PREVENT-estimated ASCVD risk one year after bariatric surgery. But that magnitude of improvement deserves attention.

Our study measured predicted risk, not heart attacks, and had no randomized control group. The next step is a direct trial comparing these dietary approaches with equal medical support.

We agree with the AHA that cardiovascular risk should be evaluated comprehensively. We disagree that its preferred dietary pattern should define the boundaries of effective metabolic care.

Steak and eggs should not end the conversation. These results should start one.

Read the paper, share it and send it to your cardiologist.
Also read our blog about this: https://toward.health/real-food-keto-cuts-heart-risk-toward-health/ by @doctortro

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#weightloss #medicine #wellness by @doctortro

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Get this... steak and eggs stayed on the menu, and estimated heart risk went DOWN.

What happens when TOWARD’s metabolic telemedicine care is evaluated using the AHA’s own PREVENT calculator?
In our 120-patient cohort, estimated 10-year ASCVD risk fell 29% after one year.
Steak. Eggs. Good metabolic medicine. Lower estimated risk. Comparing Toward in Cardiometabolic risk by @doctortro

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