James O'Keefe (cardiologist)

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James H. O'Keefe, MD

James O'Keefe Jr. (born June 8, 1956) is an American author and cardiologist who has conducted studies in the field of cardiovascular medicine, diet and exercise. O'Keefe is a leading proponent of exercise but argues that moderate rather than extreme efforts, in a social setting-like are best for conferring longevity. He has also proposed a hypothesis regarding the evolutionary basis of homosexuality. He is currently a professor of medicine at the University of Missouri–Kansas City, Director of Preventive Cardiology at the Mid America Heart Institute of Saint Luke's hospital and Chief Medical Officer of the health supplement company Cardiotabs.


James Henry O'Keefe Jr. was born to James Henry O'Keefe Sr. and Leatrice O’Keefe in Grand Forks, North Dakota, on June 8, 1956. He graduated from the University of North Dakota where he received an undergraduate BS summa cum laude and Phi Beta Kappa in Natural Science. In 1982, he received his MD summa cum laude with his MD from Baylor College of Medicine. He was a member of Alpha Omega Alpha.

O'Keefe completed his medical residency as well as a CV fellowship at the Mayo Graduate School of Medicine in Rochester, Minnesota.[1]

At the Mid America Heart Institute, he was involved with patient care, clinical research as well as non-invasive cardiology practices.[2] He has been board-certified in cardiology, nuclear cardiology, pacemakers, cholesterol management, cardiac CT imaging, and internal medicine.[1][3]

O'Keefe has contributed over 358 articles to peer-reviewed medical literature.[4] These include his studies on the potential dangers of excessive exercise, the evolutionary basis of homosexuality, and that sugar not salt is the evil white crystal that needs to be eliminated from our diets. O'Keefe also focuses on improving sleep, post-meal spikes in blood sugar, and fatty liver to improve health and well-being.[5] He has been the lead author of several books, including, the Complete Guide to ECGs, The Forever Young Diet & Lifestyle and Let Me Tell You a Story.

Hunter-gatherer lifestyle[edit]

O'Keefe believes that a healthy lifestyle should include some features of the diet and activity patterns of our ancient ancestors.[6] He argues that this is essential because our nutritional needs were established many centuries ago in the remote pre-historic past; thus humans have been genetically adapted to thrive in a Hunter-Gatherer type of lifestyle.[6] O’Keefe believes this mismatch between the diet and lifestyle for which we are genetically adapted, and the very different conditions in which we are living, is the underlying cause for much disease, disability and unhappiness. Our ancestors survived on a diet high in fish, nuts, fruits, vegetables, wild game meat and bones. They also received a large amount of exercise from walking, bending, lifting, carrying, swimming, climbing, and other activities that were necessary to their daily routines.[7] O’Keefe recommends beverages including water, sparkling water, green tea and coffee; also, red wine can be a healthy choice if used in moderation.[8]

Evolutionary basis of homosexuality[edit]

O’Keefe gave a TEDx Talk in October 2016, on the natural origin of homosexuality. In this talk, and subsequent scientific paper, he proposes a theory about the evolutionary basis of homosexuality mediated by epigenetics.[9] This theory posits that homosexuality is a naturally intended, normal variant that evolved to improve the interconnectedness and resilience of the family. The suite of psychological traits that tend to co-occur with same-sex orientation include increased IQ, and higher emotional intelligence, with less physical aggression. Through a complex interplay of epigenetics and genetics, homosexuality occurs more often in larger families, especially in a baby boy with multiple older brothers, or at times of increased stress during the pregnancy. In these settings, homosexuality is prescribed by nature largely via epigenetic changes in the developing fetus in response to the mother's environment. This can help to reduce overpopulation pressures at the family level; the gay individual also tends to improve the emotional bonding of their family and friends, thereby improving the strength survivability of the group.


O'Keefe's research and publications have focused mostly on exercise, diet and evolution.[10] Daily exercise is one of the key components of lifestyle for promoting health and longevity, and will reduce risks for heart disease, Alzheimer's, hypertension, osteoporosis, depression and diabetes dramatically. However, excessive endurance exercise may potentially cause CV damage.[11][12] This work has garnered attention in both the cardiology world and the general public. The articles suggest that extreme endurance exercise such as marathons, ironman distance triathlons, and long distance bicycle races may, over many years to decades, in some individuals lead to adverse structural changes in the heart and large arteries, predisposing to "cardiac overuse injury."[13][11][14] CV damage can include fibrosis (scarring) in the heart muscle, accelerated plaque buildup in coronary arteries and atrial fibrillation. These papers emphasize that exercise best confers benefits to longevity and cardiac health at moderate doses.[15] O'Keefe discusses this in a TEDx Talk entitled: "Run for your life! At a comfortable pace and not too far."

O'Keefe has published papers on the CV impact of both coffee and alcohol showing evidence that supports moderate consumption of either or both substances can be potentially heart healthy. Habitual light to moderate alcohol intake (up to 1 drink per day for women and 1 or 2 drinks per day for men) is associated with decreased risks for total mortality, coronary artery disease, diabetes mellitus, congestive heart failure, and stroke. However, higher levels of alcohol consumption are associated with increased CV risk.[16] Coffee consumption may reduce the risk of CV death, type 2 diabetes mellitus, suicide and Parkinson's disease.[17]

In 2018, he published an article about an evidence-based approach to the ideal diet for health and longevity.[18]

In 2016, he published a paper entitled Nutritional strategies for skeletal and cardiovascular health: hard bones, soft arteries, rather than vice versa. This paper showed that calcium is ideally obtained from dietary sources.[19] The form of calcium in bones and bone meal is calcium-hydroxyapatite, which may be particularly effective for building bone. Increased consumption of calcium-rich foods such as bones, fermented dairy products (e.g. yogurt, kefir, cheese), leafy greens, almonds, and chia seeds may be effective for improving both skeletal and CV health.

Personal life[edit]

O'Keefe has a family legacy in the medicine profession. His great grandfather, Henry O'Keefe, practiced medicine in North Dakota from 1890 to 1935. Henry's son, Emmett (James' grandfather), was also a doctor in North Dakota.

O'Keefe met his wife, Joan, while at the Mayo Clinic. The two married in October 1984 and together they have four children: James III, Evan, Kathleen, and Caroline. Evan started medical school in January 2016.


  1. ^ a b "James H O'Keefe, Jr, MD". Saint Luke's Health Systems. Retrieved September 14, 2015.
  2. ^ "Curriculum in Cardiac Imaging" (PDF). 2011-07-20. Retrieved 2018-01-22.
  3. ^ "Most Influential Doctors database". USA Today. October 25, 2010. Retrieved March 25, 2014.
  4. ^ Search Results for author O'Keefe JH on PubMed.
  5. ^ O'Keefe, James H; Gheewala, Neil M; O'Keefe, Joan O (2008). "Dietary Strategies for Improving Post-Prandial Glucose, Lipids, Inflammation, and Cardiovascular Health". Journal of the American College of Cardiology. 51 (3): 249–55. doi:10.1016/j.jacc.2007.10.016. PMID 18206731.
  6. ^ a b [1]
  7. ^ Dr. James O'Keefe on How to Live a Heart Healthy Lifestyle on YouTube
  8. ^ Dr. James O'Keefe on The Best Diet for Preventing Heart Disease on YouTube
  9. ^ O’Keefe JH, O’Keefe EL, Hodes J (2018). "Evolutionary Origins of Homosexuality". The Gay & Lesbian Review. Retrieved 2018-01-22.CS1 maint: Multiple names: authors list (link)
  10. ^ Lee, John H; O'Keefe, James H; Bell, David; Hensrud, Donald D; Holick, Michael F (2008). "Vitamin D Deficiency". Journal of the American College of Cardiology. 52 (24): 1949–56. doi:10.1016/j.jacc.2008.08.050. PMID 19055985.
  11. ^ a b O'Keefe, James H; Patil, Harshal R; Lavie, Carl J; Magalski, Anthony; Vogel, Robert A; McCullough, Peter A (2012). "Potential Adverse Cardiovascular Effects from Excessive Endurance Exercise". Mayo Clinic Proceedings. 87 (6): 587–95. doi:10.1016/j.mayocp.2012.04.005. PMC 3538475. PMID 22677079.
  12. ^ O'Keefe, James H; Franklin, Barry; Lavie, Carl J (2014). "Exercising for Health and Longevity vs Peak Performance: Different Regimens for Different Goals". Mayo Clinic Proceedings. 89 (9): 1171–5. doi:10.1016/j.mayocp.2014.07.007. PMID 25128073.
  13. ^ Lavie, Carl J; Lee, Duck-Chul; Sui, Xuemei; Arena, Ross; O'Keefe, James H; Church, Timothy S; Milani, Richard V; Blair, Steven N (2015). "Effects of Running on Chronic Diseases and Cardiovascular and All-Cause Mortality". Mayo Clinic Proceedings. 90 (11): 1541–52. doi:10.1016/j.mayocp.2015.08.001. PMID 26362561.
  14. ^ Schnohr, Peter; Marott, Jacob L; O'Keefe, James H (2015). "Reply". Journal of the American College of Cardiology. 65 (24): 2674–2676. doi:10.1016/j.jacc.2015.04.023. PMID 26088316.
  15. ^ Schnohr, Peter; O'Keefe, James H; Marott, Jacob L; Lange, Peter; Jensen, Gorm B (2015). "Dose of Jogging and Long-Term Mortality". Journal of the American College of Cardiology. 65 (5): 411–9. doi:10.1016/j.jacc.2014.11.023. PMID 25660917.
  16. ^ O'Keefe, James H; Bhatti, Salman K; Bajwa, Ata; Dinicolantonio, James J; Lavie, Carl J (2014). "Alcohol and Cardiovascular Health: The Dose Makes the Poison…or the Remedy". Mayo Clinic Proceedings. 89 (3): 382–93. doi:10.1016/j.mayocp.2013.11.005. PMID 24582196.
  17. ^ O'Keefe, James H; Bhatti, Salman K; Patil, Harshal R; Dinicolantonio, James J; Lucan, Sean C; Lavie, Carl J (2013). "Effects of Habitual Coffee Consumption on Cardiometabolic Disease, Cardiovascular Health, and All-Cause Mortality". Journal of the American College of Cardiology. 62 (12): 1043–1051. doi:10.1016/j.jacc.2013.06.035. PMID 23871889.
  18. ^ O'Keefe, James H; Dinicolantonio, James J; Sigurdsson, Axel F; Ros, Emilio (2018). "Evidence, Not Evangelism, for Dietary Recommendations". Mayo Clinic Proceedings. 93 (2): 138–144. doi:10.1016/j.mayocp.2017.12.001. PMID 29406200.
  19. ^ "Got Bones? The Paleo Solution for Building Strong Bones : The Paleo Diet™". 2015-09-05. Retrieved 2018-01-22.

Further reading[edit]

  • DiNicolantonio JJ, Mehta V, O'Keefe. Is Salt a Culprit or an Innocent Bystander in Hypertension? A Hypothesis Challenging the Ancient Paradigm. The American Journal of Medicine. 2017;130(8):892-99.
  • O'Keefe JH Jr, Hammill SC, Freed M, The Complete Guide to ECGs. Jones and Bartlett Publishing. 2015.
  • O'Keefe JH Jr, O’Keefe J: Let Me Tell You a Story. Andrews McMeel Universal, Kansas City, MO, March, 2013.
  • O'Keefe JH Jr, O’Keefe J: The Forever Young Diet and Lifestyle. Andrews McMeel Universal, Kansas City, MO, November 2005.
  • Dinicolantonio, James J; Bhutani, Jaikrit; O'Keefe, James H (2015). "The health benefits of vitamin K". Open Heart. 2 (1): e000300. doi:10.1136/openhrt-2015-000300. PMC 4600246. PMID 26468402.
  • O'Keefe, James H; Bergman, Nathaniel; Carrera-Bastos, Pedro; Fontes-Villalba, Maélan; Dinicolantonio, James J; Cordain, Loren (2016). "Nutritional strategies for skeletal and cardiovascular health: Hard bones, soft arteries, rather than vice versa". Open Heart. 3 (1): e000325. doi:10.1136/openhrt-2015-000325. PMC 4809188. PMID 27042317.
  • DiNicolantonio JJ, Lucan SC, O’Keefe JH: The evidence for saturated fat and for sugar related to coronary heart disease. Prog Cardiovasc Dis. 2016 Jan-Feb;58(4):401-6. Epub ahead of print 2015 November. 2016 Mar-Apr;58(5):464-472. 2016 March–April.
  • Qazi, Abdul H; Zallaghi, Forough; Torres-Acosta, Noel; Thompson, Randall C; O'Keefe, James H (2016). "Computed Tomography for Coronary Artery Calcification Scoring: Mammogram for the Heart". Progress in Cardiovascular Diseases. 58 (5): 529–36. doi:10.1016/j.pcad.2016.01.007. PMID 26892393.
  • O’Keefe JH, DiNicolantonio JJ, Lavie CJ: Statins, ezetimibe, and proprotein convertase subtilsin-kexin Type 9 (PCSK9) inhibitors to reduce low-density lipoprotein-cholesterol and cardiovascular events. Am J Cardiol. Publication in 2017 January.
  • O’Keefe JH, Jacob D, Lavie CJ: Omega-3 fatty acid therapy: The tide turns for a fish story. Mayo Clin Proc. Am J Cardiol. Publication in 2017 January.

External links[edit]