When you’re eating the foods that get you there (more on that in a minute), your body can enter a state of ketosis in one to three days, she adds. During the diet, the majority of calories you consume come from fat, with a little protein and very little carbohydrates. Ketosis also happens if you eat a very low-calorie diet — think doctor-supervised, only when medically recommended diets of 600 to 800 total calories.
However, in most cases, avoiding all foods that contain cholesterol (like eggs or cheese) isn’t necessary to support heart health, especially since some sources of cholesterol can be nutrient-dense foods. What’s important is practicing moderation and finding balance in your diet, as well as eating a combination of natural foods that fight inflammation.
You’re very welcome, Judy! I’m glad it’s helpful. If you are keto (as opposed to low carb), unfortunately peaches would not allow you to stay in ketosis. You can check my keto food list to help determine what is keto friendly. Of course, there are worse things than fresh fruit 🙂 but in the end our bodies still see the sugar. That being said, it doesn’t mean you sabotaged the whole day. Just pick up again – you got this!! (And for next time, try some fresh berries in moderation when you’re craving fruit.)
“Net carbs” and “impact carbs” are familiar phrases in ketogenic diets as well as diabetic diets. They are unregulated interchangeable terms invented by food manufacturers as a marketing strategy, appearing on some food labels to claim that the product contains less “usable” carbohydrate than is listed.  Net carbs or impact carbs are the amount of carbohydrate that are directly absorbed by the body and contribute calories. They are calculated by subtracting the amount of indigestible carbohydrates from the total carbohydrate amount. Indigestible (unabsorbed) carbohydrates include insoluble fibers from whole grains, fruits, and vegetables; and sugar alcohols, such as mannitol, sorbitol, and xylitol commonly used in sugar-free diabetic food products. However, these calculations are not an exact or reliable science because the effect of sugar alcohols on absorption and blood sugar can vary. Some sugar alcohols may still contribute calories and raise blood sugar. The total calorie level also does not change despite the amount of net carbs, which is an important factor with weight loss. There is debate even within the ketogenic diet community about the value of using net carbs.
I also want to be clear that I’m not making any specific recommendation here for treatment of cancer using ketogenic diet or anything else. As I’ve argued earlier in the podcast, I think cancer is a complex multifactorial disease and varies from individual. The ideology and pathology vary from individual to individual, and treatment decisions should be made with the support of an oncologist and other doctors on the care team. Please don’t take anything that I’ve said in this podcast as a recommendation for your particular situation or somebody in your life that’s struggling with cancer.
Gary D. Foster, Ph.D., Holly R. Wyatt, M.D., James O. Hill, Ph.D., Brian G. McGuckin, Ed.M., Carrie Brill, B.S., B. Selma Mohammed, M.D., Ph.D., Philippe O. Szapary, M.D., Daniel J. Rader, M.D., Joel S. Edman, D.Sc., and Samuel Klein, M.D., “A Randomized Trial of a Low-Carbohydrate Diet for Obesity — NEJM,” N Engl J Med 2003; 348:2082- 2090. http://www.nejm.org/doi/full/10.1056/NEJMoa022207.
While KD and MAD have demonstrated efficacy in reducing the extent and degree of seizures in epileptic patients, the dietary approaches have been tied to risk of adverse events in both adults and children, although most are treatable and are nearly all preventable. Adverse effects include constipation, low blood sugar, and gastrointestinal reflux.5,6 Other side effects, such as kidney stones and high cholesterol, can often be improved with supplements or dietary changes.1 These also tend to improve over the long term. Kossoff and colleagues found that both total cholesterol and LDL cholesterol normalized within a year of treatment after initial increases during the first three months of MAD.5
Inadequate sleep will rapidly derail your keto efforts by increasing your blood sugar and levels of stress hormones. Getting eight to nine hours of high-quality sleep per night should be a priority. Maintain a regular bedtime schedule and practice sleep hygiene strategies such as keeping your bedroom completely dark at night, lowering the ambient temperature to around 67 degrees Fahrenheit, and avoiding blue light exposure a couple of hours before bed with blue light-blocking glasses.
As mentioned above, sometimes a rise in LDL cholesterol is temporary, especially during weight loss. However, if yours remains very high and especially if you have additional risk factors (family history of heart disease, certain genetic markers, diabetes, or smoking), you may want to look into having the some advanced testing performed. They may give a clearer indication of your risk profile and state of health, compared to conventional blood cholesterol levels alone:
After discharge, caregivers are instructed to check urine ketones daily; if necessary, the diet is individually adjusted after consultation by telephone or email to maximize seizure control. Weight is monitored by the parents and reported if significantly changed. Periodic laboratory measures are obtained every 3 months in order to monitor for side-effects (for example – lipid profile, electrolytes, anticonvulsant levels, urine calcium/creatinine). The use of a medication called Cytra-K led to a large reduction in kidney stones when provided to all children at one hospital starting the ketogenic diet. Some child neurologists recommend its use for all children on the classic ketogenic diet.
Although the ketogenic diet has been around for a long time and may be efficacious in many medical conditions, there is a surprising dearth of long-term studies on its safety. The bulk of the information comes from children using a ketogenic diet for epilepsy. Negative effects seen in children on a ketogenic diet long-term (≥2 years) are poor growth (while on the diet), kidney stones, and dyslipidemia (elevated cholesterol and/or triglycerides). Many of these effects can be overcome with careful attention to mineral intake while on the diet and/or termination of the diet.52 Most long-term studies evaluating adults using a ketogenic diet for weight loss have found very few serious adverse effects.53 54 55 56 However it should be noted that these studies only looked at one year duration on the diet, and poor adherence to the diet was frequently noted as a problem.
It’s not as though Dr. Seyfried doesn’t cite clinical evidence. It’s just that the evidence is so darned thin and unconvincing thus far. For instance, in this talk, the first study he presents is a very small case series (two patients, actually) performed in 1995 in which two girls with inoperable astrocytomas were placed on a ketogenic diet in order to “determine if a ketogenic state would decrease glucose availability to certain tumors, thereby potentially impairing tumor metabolism without adversely affecting the patient’s overall nutritional status.” Interestingly (to me, at least) these case reports came from University Hospitals of Cleveland, where I did my general surgery residency. In fact, I was still there in 1995. Unfortunately, I don’t have access to the journal back to 1995; so I’m stuck with just the abstract. However, the abstract is pretty clear:
The ketogenic diet, or even just a higher-fat, low-carb diet, has now gained massive support as a modern-day healing strategy. In fact, our ideas about fats and cholesterol seem to have been almost completely reversed in recent years. That being said, many people see their cholesterol go up after beginning more of a ketogenic lifestyle. Some people get concerned when this happens, so in this article, I am going to address the phenomena of high cholesterol on a ketogenic diet.
They also noted that some patients were more responsive to the ketogenic diet than other patients were. The best response was in a 3-year-old girl who had complete remission five years of treatment with a ketogenic diet. Two other patients also experienced complete remission after the diet, and the other two patients had disease progression after stopping keto. (Keep in mind, however, that all of these patients used conventional treatments along with the keto diet.)
This describes me, too. I am not a doctor, but after months and years of research, have decided to follow the ketogenic lifestyle and the naturopathic cancer treatments prescribed by my physician. It took a few months to find a doctor who embraced this, but he is worth it. Keto had my diabetes under control long before we realized that cancer was trying to get me as well. I take no chemical drugs for anything. Diet, exercise, and a few supplements take care of my health needs. You don’t know me, but three years ago, I needed a walker and a wheelchair. Today at 60, I walk under my own power and ride a bicycle as much as possible. Go as natural as you can, it helps. Stay away from “products” and just eat fresh, whole, natural food. (The article shows these.)