Of the many benefits of a keto diet, weight loss is often considered No. 1., as it can often be substantial and happen quickly (especially for those who start out very overweight or obese). The 2013 study published in the British Journal of Nutrition found that those following a keto diet “achieved better long-term body weight and cardiovascular risk factor management when compared with individuals assigned to a conventional low-fat diet (i.e. a restricted-energy diet with less than 30 percent of energy from fat).” (2)
Bonnie J. Brehm, Randy J. Seeley, Stephen R. Daniels, and David A. D’Alessio, “A Randomized Trial Comparing a Very Low Carbohydrate Diet and a Calorie-Restricted Low Fat Diet on Body Weight and Cardiovascular Risk Factors in Healthy Women,” The Journal of Clinical Endocrinology & Metabolism: Vol 88, No 4; January 14, 2009. http://press.endocrine.org/doi/full/10.1210/jc.2002-021480.
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In this same chapter, there are also two case reports, neither very impressive. The first, written by the mother, tells the story of a four-year old child diagnosed in 2004 with a low-grade (less aggressive) but quite large and inoperable brain tumor. The parents, as the mother writes, entrusted their child into the hands of the experts, who prescribed the usual “gold standard” treatments, which are not clearly described initially but presumably mean chemotherapy and perhaps radiation.
The original therapeutic diet for paediatric epilepsy provides just enough protein for body growth and repair, and sufficient calories[Note 1] to maintain the correct weight for age and height. The classic therapeutic ketogenic diet was developed for treatment of paediatric epilepsy in the 1920s and was widely used into the next decade, but its popularity waned with the introduction of effective anticonvulsant medications. This classic ketogenic diet contains a 4:1 ratio by weight of fat to combined protein and carbohydrate. This is achieved by excluding high-carbohydrate foods such as starchy fruits and vegetables, bread, pasta, grains, and sugar, while increasing the consumption of foods high in fat such as nuts, cream, and butter. Most dietary fat is made of molecules called long-chain triglycerides (LCTs). However, medium-chain triglycerides (MCTs)—made from fatty acids with shorter carbon chains than LCTs—are more ketogenic. A variant of the classic diet known as the MCT ketogenic diet uses a form of coconut oil, which is rich in MCTs, to provide around half the calories. As less overall fat is needed in this variant of the diet, a greater proportion of carbohydrate and protein can be consumed, allowing a greater variety of food choices.
Researchers also observed that the size of VLDL particle size did not change in either of the groups. However, they noted that the total number of VLDL particles decreased by 19% from 76.2 nmol/L to 61.7 nmol/L.  More specifically, large VLDL particles reduced by 40.2% from 3.33 nmol/L to 1.74 nmol/L, medium VLDL particles decreased by 4.8% from 46.2 nmol/L to 44 nmol/L. 
"Most of the work in this field is still pre-clinical, meaning it's been conducted in animal models," Angela Poff, a research associate in the Department of Molecular Pharmacology and Physiology at the University of South Florida, told U.S. News & World Report. "It's been done in various cancer types, but most of the work has been done in brain cancer specifically. But there's very little clinical data all around. There's some case reports and very small preliminary clinical studies in small groups of patients, usually very late-stage patients with various types of cancers. So in the clinical realm, which is the most important in telling us whether this is going to be useful, we have a long way to go."
A clinical trial at Great Ormond Street Hospital in 2008, and other studies since then, showed that the diet significantly reduced the number of seizures in a proportion of children whose seizures did not respond well to AEDs. After three months, around 4 in 10 (38%) children who started the diet had the number of their seizures reduced by over half, and were able to reduce their medication. Although not all children had better seizure control, some had other benefits such as increased alertness, awareness and responsiveness.
I’m 50 and have been working out with weights and cardio for over 30 years, 6-7 days per week. I have always had controlled weight in the 180’s for 5′ 9″ due to strength training. I went on a “version” of the Keto diet—per day goals: 35 net carbs/85-95 grams protein/35-40 grams fat. I didn’t want to go all-in with high fats. I weighed 188 at the start and in 6 months dropped 26 lbs to 162, and bodyfat at 9%. My cholesterol levels have mostly been 220 with 50-75 HDL.
Feel free to practice cyclical ketosis (maybe doing a ketogenic diet five days a week and going higher in healthy carbs the other two days) or whatever works for you. I’ve never heard an expert say you should be in ketosis 24/7, and militantly sticking with this plan can ultimately stall your goals. Once you’re in a state of ketosis, you can transition to a more flexible ketogenic plan. You can rotate complex carbs, like sweet potatoes, pumpkin, and butternut squash, into the diet every three to four days to maintain your glycogen stores if you work out and lift weights regularly.
Leftovers will be another thing we will take into consideration. Not only is it easier on you, but why put yourself through the hassle to cook the same food more than once? Breakfast is something I normally do leftover style, where I don’t have to worry about it in the morning and I certainly don’t have to stress about it. Grab some food out the fridge, pre-made for me, and head out the door. It doesn’t get much easier than that, does it?
It seems strange that a diet that calls for more fat can raise “good” cholesterol and lower “bad” cholesterol, but ketogenic diets are linked to just that. It may be because the lower levels of insulin that result from these diets can stop your body from making more cholesterol. That means you’re less likely to have high blood pressure, hardened arteries, heart failure, and other heart conditions. It's unclear, however; how long these effects last.
The nerve impulse is characterised by a great influx of sodium ions through channels in the neuron's cell membrane followed by an efflux of potassium ions through other channels. The neuron is unable to fire again for a short time (known as the refractory period), which is mediated by another potassium channel. The flow through these ion channels is governed by a "gate" which is opened by either a voltage change or a chemical messenger known as a ligand (such as a neurotransmitter). These channels are another target for anticonvulsant drugs.
firstly, the LMHR profile also applies to long-term fasting studies - this is perhaps where it can be observed in its natural, unconfounded state - LDL rises in lean healthy individuals during a fast, but drops or stays stable in those with obesity or atherosclerosis (period varies from 3-21 days). This is consistent with the keto pattern; this evidence clearly shows that LDL divergence is related to burning a high % of fat, and not to eating it, which is to some extent a confounder with keto (as shown by the cholesterol drop protocol and the possible different effects of different fat types and amounts).
Getting back to the ketogenic diet, which was Kelsey’s original question, both ketogenic diet and fasting restrict the availability of glucose to tumor cells. When you eat a ketogenic diet, you’re dramatically limiting the amount of carbohydrate, and thus the amount of glucose, that comes into your body. From this metabolic theory of cancer, that would be why a ketogenic diet, and fasting, of course, which limits not only carbohydrate but everything else, and fasting produces ketones. This is why these two approaches would help with cancer if this theory is correct, because when our energy metabolism shifts to fat or ketones away from glucose, cancer cells cannot utilize ketones, but our healthy cells can. One of the main goals with cancer treatment, as I’m sure you know, is how do we address the cancer cells without also killing the healthy cells. That’s really the Shangri-La when it comes to cancer treatment, and the ketogenic diet is really interesting from that perspective because it offers a possibility of doing that. It’s a change that simply the shift in metabolism from glucose to fat means that the cancer cells won’t thrive, but the healthy cells can thrive.
Unfortunately, thanks to the widespread prevalence of the standard American diet (SAD) – characterized by high consumption of red meat, processed meat, pre-packaged foods, butter, fried foods, high-fat dairy products, refined grains, potatoes, corn, high-fructose corn syrup (HFCS), and high-sugar drinks – the incidence of obesity, insulin resistance, diabetes, cardiovascular disease, and many forms of cancer are skyrocketing in the U.S.
In the 1960s, medium-chain triglycerides (MCTs) were found to produce more ketone bodies per unit of energy than normal dietary fats (which are mostly long-chain triglycerides). MCTs are more efficiently absorbed and are rapidly transported to the liver via the hepatic portal system rather than the lymphatic system. The severe carbohydrate restrictions of the classic ketogenic diet made it difficult for parents to produce palatable meals that their children would tolerate. In 1971, Peter Huttenlocher devised a ketogenic diet where about 60% of the calories came from the MCT oil, and this allowed more protein and up to three times as much carbohydrate as the classic ketogenic diet. The oil was mixed with at least twice its volume of skimmed milk, chilled, and sipped during the meal or incorporated into food. He tested it on 12 children and adolescents with intractable seizures. Most children improved in both seizure control and alertness, results that were similar to the classic ketogenic diet. Gastrointestinal upset was a problem, which led one patient to abandon the diet, but meals were easier to prepare and better accepted by the children. The MCT diet replaced the classic ketogenic diet in many hospitals, though some devised diets that were a combination of the two.
A ketogenic diet could be an interesting alternative to treat certain conditions, and may accelerate weight loss. But it is hard to follow and it can be heavy on red meat and other fatty, processed, and salty foods that are notoriously unhealthy. We also do not know much about its long-term effects, probably because it’s so hard to stick with that people can’t eat this way for a long time. It is also important to remember that “yo-yo diets” that lead to rapid weight loss fluctuation are associated with increased mortality. Instead of engaging in the next popular diet that would last only a few weeks to months (for most people that includes a ketogenic diet), try to embrace change that is sustainable over the long term. A balanced, unprocessed diet, rich in very colorful fruits and vegetables, lean meats, fish, whole grains, nuts, seeds, olive oil, and lots of water seems to have the best evidence for a long, healthier, vibrant life.
Chronic ketosis may play a role in the KD anticonvulsant properties, since it has been shown that chronic ketosis elevates the brain energy reserve via stabilization and reduction of excitability of synapses (Devivo et al., 1978). The energy reserve is directly associated with mitochondria, which is an important element to consider in the antiepileptic effect of KD. Bough et al. (2006) demonstrated an increase in mitochondria biogenesis in an experimental model of rats fed with KD, indicating an increase in the energy stores (Bough et al., 2006). The increase in mitochondrial metabolism leads to an increase in ATP production, which activates KATP, in turn attenuating neuronal excitability. This activation may be associated with adenosine A1 receptors (Li et al., 2010) and GABAB receptors (Mironov and Richter, 2000).
On a “strict” (standard) keto diet, fats typically provides about 70 percent to 80 percent of total daily calories, protein about 15 percent to 20 percent, and carbohydrates just around 5 percent. However, a more “moderate” approach to the keto diet is also a good option for many people that can allow for an easier transition into very low-carb eating and more flexibility (more on these types of plans below).
While I would like to offer a magic bullet for all cancers, a ketogenic diet is not that. The diet does not “cure” cancer. It should not be used to replace traditional treatment. But the diet has shown promise for some cancers especially GBM. So why would a diet help? On a simplistic level, cancer “eats” glucose and needs 20 times more glucose compared to normal cells. Cancer cells cannot make the transition to using ketones, especially in the brain, making them more vulnerable to chemo and radiation.
Dr. Folkman had developed two drugs, angiostatin and endostatin, that in animal experiments reversed tumor growth by blocking new blood vessel formation, essentially starving out the cancer cells. In a November 1998, presentation of his work at the National Institutes of Health in Bethesda, Maryland, Dr. Folkman announced to the world that at least in mice, “we have not seen a tumor we cannot regress.”
Now, there’s even evidence that a low-carb, high-fat regimen (as the keto diet is) helps you live longer, compared to a low-fat diet. In a study by the medical journal The Lancet that studied more than 135,000 adults from 18 countries, high carbohydrate intake was associated with higher risk of total mortality, whereas total fat and individual types of fat were related to lower total mortality. Total fat and types of fat were not associated with cardiovascular disease, myocardial infarction or cardiovascular disease mortality.
Overall, 12 studies including 1257 patients examined the impact of a VLCKD on HDL cholesterol. When assessing the data, the individuals assigned to a VLCKD achieved an average increase in HDL of 0.12 mmol/L. This was double the average increase in HDL of the low-fat dieters who achieved an average increase in HDL of 0.06 mmol/L.  As a result, the authors concluded that carbohydrate-restricted diets confer cardiovascular benefits because they improve levels on HDL in the body. 
Aude, Y., A. S, Agatston, F. Lopez-Jimenez, et al. “The National Cholesterol Education Program Diet vs a Diet Lower in Carbohydrates and Higher in Protein and Monounsaturated Fat: A Randomized Trial.” JAMA Internal Medicine 164, no. 19 (2004): 2141–46. doi: 10.1001/archinte.164.19.2141. jamanetwork.com/journals/jamainternalmedicine/article-abstract/217514.
Long-term use of the ketogenic diet in children increases the risk of slowed or stunted growth, bone fractures, and kidney stones. The diet reduces levels of insulin-like growth factor 1, which is important for childhood growth. Like many anticonvulsant drugs, the ketogenic diet has an adverse effect on bone health. Many factors may be involved such as acidosis and suppressed growth hormone. About one in 20 children on the ketogenic diet develop kidney stones (compared with one in several thousand for the general population). A class of anticonvulsants known as carbonic anhydrase inhibitors (topiramate, zonisamide) are known to increase the risk of kidney stones, but the combination of these anticonvulsants and the ketogenic diet does not appear to elevate the risk above that of the diet alone. The stones are treatable and do not justify discontinuation of the diet. Johns Hopkins Hospital now gives oral potassium citrate supplements to all ketogenic diet patients, resulting in one-seventh of the incidence of kidney stones. However, this empiric usage has not been tested in a prospective controlled trial. Kidney stone formation (nephrolithiasis) is associated with the diet for four reasons:
Overall, cancer is a complex disease with many causes and contributors, but it is becoming less mysterious and more understandable as more research is done. Cancer can develop multiple traits that make it more and more resilient, but we also keep making more and more discoveries that provide us with clues as to how we can prevent, manage, and treat various types of cancer — even those that are the most sinister.
The ketogenic diet may have a role in treating disorders of cellular proliferation, especially cancer. Just as chemotherapy selectively targets tumors based on differences in the way they divide compared with normal cells, investigators have proposed targeting tumors on the basis of differences in their metabolism. Normal tissue can adapt readily to using ketones (instead of glucose) as a substrate, but malignant cells probably do not have the same degree of metabolic flexibility . One case report in 1995 [24, Class III] described the use of the ketogenic diet in two girls with advanced astrocytomas, based on the idea that brain tumors are less able than healthy brain tissue to use ketones as an energy source. In this report, PET studies demonstrated a 20% reduction in glucose uptake by the tumors following the initiation of the ketogenic diet. One of the patients actually showed improvement during the course of the study and has continued to be well, without evidence of tumor progression (T. Seyfried, personal communication, 2008).
You want to keep your cheats to none. Be prepared, make sure you’re eating what you need to be satiated (“full”), and make sure you’re satisfied with what you’re eating. If you have to force yourself to eat something, it will never work out in the end. This is just a guideline on how you can eat on a ketogenic diet, so you’re very welcome to change up what kind of foods you eat!
Chris, I’m missing the logic here. Even when carbohydrates are restricted, the body is going to take fats and glycogen and turn them back into blood sugar, i.e. glucose. Glucose is also the only fuel the brain can use, and when it is too high or too low, all kinds of alarm bells go off, and the body does everything it can to restore normal glucose levels. Ketogenic diet or not, blood sugar is going to stay pretty steady if all the normal regulatory mechanisms are in place. If there is glucose in the blood, there is glucose in the interstitial fluids, and cancer cells are never going to be starved for glucose. So if restricting carbs has any use in cancer therapy, it has nothing to do with preventing cancer cells from getting glucose. If there is no glucose in the blood, you are dead.
Although Kelley did prescribe a variety of diets for his cancer patients, these two exemplary patients followed a plant-based eating plan, high in carbohydrates with a minimum each day of four glasses of carrot juice, dense in nutrients but also dense in natural sugar. Each of these diets allowed considerable fruit and whole grain products, foods again loaded with carbs. According to Seyfried’s hypothesis, both should have died quick miserable deaths.
This review aimed to investigate the effect of ketogenic diets on seizure control, cognition (e.g. learning, concentration and academic performance in children; learning, concentration and memory in adults) and behaviour. We also investigated the side effects of the diet and the number of participants who dropped out of the studies and the reasons for this.
Otto Warburg was a leading cell biologist who led to the discovery that cancer cells are unable to flourish using energy produced from cellular respiration, but instead from glucose fermentation. Dr. Thomas Seyfried and other cancer researchers agree, and have further discovered that cancer cells are also fueled from the fermentation of the amino acid glutamine.
The ketogenic diet is designed to allow an individual to feel satisfied easily as a result of optimal insulin and leptin sensitivity. For example, a man weighing 150 pounds should consume 30-50g/day of carbohydrates and less than 70g/day of protein to maintain an optimal state of ketosis. When only a single meal or two is consumed consisting of approved ketogenic foods, this is easy. The ideal blood sugar concentration for weakening cancer cells is between 60-70mg/dl, and ketone levels are recommended between 4-7mM.
To get the most benefit from the Keto diet, you should stay physically active. You might need to take it easier during the early ketosis period, especially if you feel fatigued or lightheaded. Walking, running, doing aerobics, weightlifting, training with kettlebells or whatever workout you prefer will boost your energy further. You can find books and online resources on how to adapt Keto meals or snacks for athletic training.
And finally, there is increasing debate over the importance of the standard (i.e., calculated) LDL cholesterol level relative to the sum of other cardiovascular risk factors. This controversy makes it difficult for the individual patient to weigh the evidence from the various known risk factors. If you are uncertain, it is a good idea to follow up with your physician, who may recommend performing the most up-to-date assessment of your blood lipids, including the size and amounts of your LDL cholesterol fractions with a NMR or VAP lipoprotein test.
I am a board-certified medical oncologist with 30 years experience in caring for cancer patients and another 20 years of research in cancer medicine dating back to 1963. Seyfried’s “Cancer as a Metabolic Disease” is the most significant book I have read in my 50 years in this field. It should be required reading of all cancer specialists, physicians in general, scientific researchers in the field of cancer and for medical students. I cannot overstate what a valuable contribution Thomas Seyfried has made in writing this masterpiece.
Our bodies are incredibly adaptive to what you put into it – when you overload it with fats and take away carbohydrates, it will begin to burn ketones as the primary energy source. Optimal ketone levels offer many health, weight loss, physical and mental performance benefits.1There are scientifically-backed studies that show the advantage of a low-carb, ketogenic diet over a low-fat diet. One meta-analysis of low-carbohydrate diets showed a large advantage in weight loss. The New England Journal of Medicine study resulted in almost double the weight loss in a long-term study on ketone inducing diets.
20•. Marsh EB, Freeman JM, Kossoff EH, et al. The outcome of children with intractable seizures: a 3- to 6-year follow-up of 67 children who remained on the ketogenic diet less than one year. Epilepsia. 2006;47:425–430. These long-term follow-up studies from the large Johns Hopkins series outline seizure-free rates and medication use after the ketogenic diet has been stopped. [PubMed] [Google Scholar]
Ketosis is a natural metabolic state where the body uses fat as its primary fuel source. In our studies and others, the ketogenic diet has shown to significantly lower blood glucose. This can trigger anti-inflammatory processes that enhance cellular function and improve overall dog health. The remarkable case studies we saw at the KetoPet Sanctuary indicate that the ketogenic diet can improve outcomes for dog cancer and support overall dog health.
Here’s what happens when you eat low carb, high fat, keto. The small LDLP number goes way down. Along with the triglycerides dropping, along with the HDL going up, along with all those other great markers that improve that nobody’s paying attention to in the medical profession, your small LDL goes down. The question that comes into play here is “What about the number of total particles?” That’s the debate that nobody’s going to answer until we do some studies on it.
One of the primary culprits of chronic inflammation in our society is a poor diet full of sugars and processed vegetable oils. In fact, blood sugar and measurements of insulin resistance are a much more accurate predictor of heart disease risk. I often look at values such as fasting glucose, HbA1c, and fasting insulin as a means of determining the inflammatory state of someone’s body.
Dr. Campos, it is unfortunate that you retain the medical community’s negative stance on the ketogenic diet, probably picked up in medical school when you studied ketoacidosis, in the midst of an obesity and type II diabetes epidemic that is growing every year, especially among populations who will never see the Harvard Health Letter. The medical community has failed in reversing this trend, especially among children, and the public is picking up the tab, in the form of higher health insurance premiums to treat chronic metabolic diseases which doctors cannot cure. The ketogenic diet does not bid its adherents to eat unhealthy processed meats, and the green leafy vegetables that it emphasizes are important in a number of nutritional deficiencies. People lose weight on the ketogenic diet, they lose their craving for sugar, they feel more satiety, they may become less depressed, their insulin receptors sensitivity is improved, and these are all the good outcomes you fail to mention. There is a growing body of research which demonstrates the neuroprotective effects of the ketogenic diet to slow cancer progression, as well as diseases like Parkinson’s and Alzheimer’s, for which there are no effective medical treatments. Please respect your patients by providing them with evidence-based medical outcomes, not opinions.
I actually went on a ketogenic diet last year to see if it would help my migraines. I have a history of chronic migraines which would usually last 3 days, sometimes longer. Triptans help a lot but I don’t like having to take them. I stayed in ketosis for about 8 months and experienced a significant reduction in migraines, from feeling some type of headache (mild o r severe) almost everyday to 1 or 2x per month while in ketosis. Although I’m very healthy otherwise, I do think my migraines may have something to do with blood sugar fluctuations (despite previously eating a whole foods diet and no refined carbs), and keto totally stabilized this. I eventually came off of Keto because I’m not really a meat lover. When I came off, but remained low carb, my migraines stayed under control for the most part. When I increase carbs, they do return.
Keto diets are high in healthy fats and protein also tend to be very filling, which can help reduce overeating of empty calories, sweets and junk foods. (4) For most people eating a healthy low-carb diet, it’s easy to consume an appropriate amount of calories, but not too many, since things like sugary drinks, cookies, bread, cereals, ice cream or other desserts and snack bars are off-limits.
There is no hard evidence that meat itself causes cancer. There is evidence that people who eliminate meat have a slightly lower cancer rate. This can be explain bc people who eliminate meat are usually doing so bc it is perceived to be “healthy” which means they are also eliminating/limiting foods such as coke, junk food, and other highly processed/high in sugar foods. These same people are also more likely to do some type of exercise where as the “meat-eaters” they are comparing them against are eating a highly processed, junk food, standard American diet and are also more likely to smoke and have limited exercise. Correlation is not causation.
With all due respect Dr. Kresser, I’m not aware of any cancer is reversed under Ketogenic diet. It’s all just a bunch of pretty theory but nothing in practice. As we speak there are probably thousands of people tried and done Ketogenic diet both for “health” reason and cancer cure. And yet… no report ever surface of the success of Keto diet in reversing cancer.
The body excretes more salt on a keto diet than on a standard diet due to reductions in insulin, which normally promotes a certain degree of water retention. Once you’re in ketosis, add an extra three to five grams of Himalayan, sea, or Redmond Real salt to your diet every day. (Five grams is about one teaspoon, but that may vary depending on the type of salt and the size of the grain.)
In another parallel experiment the mice used did not have cancer at the start, but were bred to have a genetic predisposition toward breast cancer. Almost half of these mice, when fed on the Western diet, showed cancer within the first year (the average life span of these mice is two years). Only one of the mice in this group reached its normal life expectancy, and 70% ultimately died of cancer. Of the group on the ketogenic diet, only 30% ever developed cancer, and over half reached their normal life expectancy or exceeded it.
Yes, they're technically a fruit, but we think olives deserve a shout-out all of their own, since they're also a great source of healthy fats and are one of a few keto-approved packaged foods. Plus, they're a great source of antioxidants, will satisfy your craving for something salty, and are blissfully low-carb. “About a palm's worth only has 3 grams of net carbs,” Sarah Jadin, RD, told Health in a previous interview.