Ketogenic diets represent a far more effective strategy for managing type 2 diabetes than the American Diabetes Association’s high-carb, low-fat dietary guidelines. Unlike the ADA’s guidelines, a ketogenic diet significantly reduces blood sugar, hemoglobin A1c levels, waist circumference, and triglycerides in diabetic individuals. (13) Most importantly, research indicates that the diet is sustainable for diabetic patients and that the beneficial changes can be maintained over the long term. (14)

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.
[13:30] – Why Dave had 63 blood tests in 18 months (68 up to this point)? The importance of multiple blood draws in interpreting lab results due to the 3-day window for LDL and HDL cholesterol. The same is true for particle counts (LDL-P), which are also on a 3-day window but with a 2-day gap. How the individual’s diet during that period affects the cholesterol levels significantly.
I wanted to put it out there that I made this meal plan specifically with women in mind. I took an average of about 150 women and what their macros were. The end result was 1600 calories – broken down into 136g of fat, 74g of protein, and 20g net carbs a day. This is all built around a sedentary lifestyle, like most of us live. If you need to increase or decrease calories, you will need to do that on your own terms.

Cholesterol serves a number of important roles in the body. First of all, cholesterol is a critical structural element in certain tissues such as our brain and nervous system. In fact, it is estimated that around 25% of our cholesterol can be found in the brain. Just to highlight our failed fat philosophy over the years, higher saturated fat intake and high cholesterol levels are associated with better mental function in old age (1)!

The study also found that two types of bacteria, called Akkermansia muciniphila and Parabacteroides, were elevated by the diet. When these two types of bacteria were given in combination to mice that didn't have their own gut bacteria, the anti-seizure effect of the keto diet was restored. What's more, this combination of bacteria protected against seizures even if the mice were fed a nno-keto diet.
A related clinical diet for drug-resistant epilepsy is called the medium-chain triglyceride ketogenic diet, in which MCT oil is extensively used because it’s more ketogenic than long-chain triglycerides. (13) Another dietary therapy for epilepsy called Low Glycemic Index Treatment (LGIT) was developed in 2002 as an alternative to the keto diet. LGIT monitors the total amount of carbohydrates consumed daily, and focuses on carbohydrates that have a low glycemic index.) (14)
I knew Bob quite well, and considered him a friend. We first met when I interviewed him for a nutrition story during my journalism days, and later on while I was a medical student, we kept in close contact. During my freshman year at Cornell Medical School – from which Bob had received his own medical degree – I arranged for him to speak as part of a lecture series I had set up on alternative approaches to disease.
Sign up 24 hours before the general public and increase your chances of getting a spot. We only open the certification program twice per year. Due to high demand, spots in the program are limited and have historically sold out in a matter of hours. But when you sign up for the presale list, we’ll give you the opportunity to register a full 24 hours before anyone else.
Normoxic cancer cells also have the ability to use ketones as fuel for the TCA cycle, particularly 3-hydroxy-butyrate, in what has been called “The Reverse Warburg Effect.” 3-HB can increase tumor growth rate by ~250%. Cancer cells’ ability to use ketones for fuel may explain why diabetics are at increased risk of cancer (e.g. diabetic ketosis). [NCBI, “Ketones and lactate ‘fuel’ tumor growth and metastasis”]
When you restrict your carbohydrate intake to less than 50 grams daily, you can still fit in plenty of nonstarchy vegetables, maybe some low-glycemic (meaning they don’t bump your blood sugar) blueberries and other berries, and a small amount of non-gluten grains like quinoa (actually a seed and complete protein). But you’ve got very little wiggle room there before you theoretically get knocked out of ketosis.
Recent studies show that low-carb diets such as keto are more effective at raising good (HDL) cholesterol than low-fat diets [1, 2]. However, there are also studies showing that keto can increase total cholesterol (HDL and LDL) [3]. On the other hand, low-carb, high-fat diets also decrease LDL particle concentration (LDL-P), increase the size of LDL cholesterol and decrease the amount of harmful VLDL cholesterol in the blood [2], all of which have a positive effect on cardiovascular fitness.
Meat products make up a big part of the keto diet, but experts stress the importance of choosing quality. "Since the keto diet is based a lot on animal proteins, it's important to buy organic poultry and grass-fed, organic beef," says Aimee Aristotelous, RD. "Not only do organic selections help with limiting environmental toxins, but grass-fed options of red meats even change the composition of fats." The result, she explains, is that your body is able to better absorb those healthy fats.
When there is ample glucose available (derived from dietary carbohydrates), the body will use that glucose as its main fuel source for producing ATP (the body’s main energy currency). Small amounts of glucose can be stored, but once incoming glucose has been used up and those stores run out, the body shifts gears and increases the use of fatty acids (derived from body fat stores or dietary fats) to produce energy. While most cells can directly use free fatty acids in order to produce sufficient energy, fats cannot cross the blood-brain barrier making them inaccessible to the brain as a fuel source. To overcome this, the liver converts fat into acetoacetate, acetone and beta-hydroxybutyrate (a.k.a. ketone bodies or ketones) which can be used by red blood cells and cells of the central nervous system (including the brain) as an alternative energy source when glucose levels are low. Importantly, the vast majority of other bodily tissues can also use ketones to produce energy. In fact, ketone production is a normal part of healthy metabolism and small amounts of ketones are produced regularly—such as during extended exercise or during an overnight fast. If glucose supplies continue to remain low, the body will increase its production of ketones. Using ketones as an alternative energy source reduces muscle protein breakdown, when carbohydrate is low. In addition to being used for energy, ketones have signaling functions that positively regulate genes related to aging, oxidative stress and healthy sympathetic nervous system activity. 6 7
Pattern B LDL, on the other hand, has a much smaller particle size and is much more prone to oxidation. Another thing about pattern B LDL is that it is small enough to enter into the endothelial lining of the artery where it can become oxidized and more likely to form plaque.  There is a high association between these small dense particles and cardiovascular disease.
The ketogenic diet has repeatedly been shown NOT to heal cancer as a monotherapy in rodents or humans, which has prompted researchers including D’Agostino to continue tacking on more protocols in an attempt to make it more “effective”, like fasting, calorie restriction, ketone supplements, hyperbaric oxygen, IV therapies, hyperthermia, nutraceuticals and chemo and/or radiotherapy.
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.
The information you share, including that which might otherwise be Protected Health Information, to this site is by design open to the public and is not a private, secure service. You should think carefully before disclosing any personal information in any public forum. What you have written may be seen, disclosed to, or collected by third parties and may be used by others in ways we are unable to control or predict, including to contact you or otherwise be used for unauthorized or unlawful purposes. As with any public forum on any site, this information may also appear in third-party search engines like Google, MSN, Yahoo, etc. Your use of this site is governed by Harvard University and its affiliates Terms of Use located at www.health.harvard.edu/privacy-policy and may be amended from time to time.
A short-lived increase in seizure frequency may occur during illness or if ketone levels fluctuate. The diet may be modified if seizure frequency remains high, or the child is losing weight.[19] Loss of seizure-control may come from unexpected sources. Even "sugar-free" food can contain carbohydrates such as maltodextrin, sorbitol, starch, and fructose. The sorbitol content of suntan lotion and other skincare products may be high enough for some to be absorbed through the skin and thus negate ketosis.[31]
Hey David, You will definitely want to do everything you can to mitigate the mold issue. If you cannot remove it from your environment (or yourself from that environment) then you will want to use things like glutathione, liver support, activated charcoal, and daily detoxification strategies as much as possible. For the LDL testing, this is one of the best I know of https://drjockers.com/cardiopower-testing/
Though I would see Bob occasionally at conferences, I never mentioned any of this to him. Some years later we met for lunch in Washington, DC, at a conference where we were both scheduled to speak. To my astonishment, he told me he was closing down his cancer unit completely, to concentrate on his traditional area of expertise – obesity, diabetes, heart disease, hypoglycemia, the metabolic syndrome – problems for which he knew his nutritional approach with the ketogenic diet worked quite effectively.
I have been on a low carb keto diet for more than a year. As T2DM my A1C dropped from 9% to 5.4% & I discontinued meds. All my lipids improved even with ample healthy saturated fat. More than a year now so I wonder why this would be a short term improvement when its obvious that I will not go back to a high A1C and taking 3 diabetes medications including sulphonylureas. It is clear from this article that you lack the necessary experience that would be gained from wholeheartedly trying the diet or monitoring patients doing it properly like me. I would be probably be facing my first amputation if I believed the negativity in your article. So for people with diabetes who may be dissuaded by your article. Ignore it and take back your health by restricting carbs (<25 g a day) or as low as you reasonably can below 130g while being satisfied that you are getting adequate nutrition.
The keto diet works for such a high percentage of people because it targets several key, underlying causes of weight gain — including hormonal imbalances, especially insulin resistance coupled with high blood sugar levels, and the cycle of restricting and “binging” on empty calories due to hunger that so many dieters struggle with. In fact, these are some of the direct benefits of the keto diet.
Dr. Gonzalez and his colleague Dr. Linda Isaacs MD have had remarkable success treating cancer patients with a non-toxic nutritional protocol that incorporates some of the principles of the late Dr. Max Gerson MD along with the late Dr. William Donald Kelley’s protocol which includes high doses of pancreatic enzymes and individualized diets depending on body type and cancer type. I have huge respect for them, not because of their theories, but because they are getting RESULTS, including reversing “incurable” stage four cancers. Two volumes documenting 112 of their successful case studies can be found here.

Ketogenic diets (now being called keto diets) are powerful metabolic tools that help your body switch from burning sugar (carbs) to burning fat. The result of that switch in fuel is an improvement in all sorts of health conditions. In practice, you get to eat real foods in the form of natural fats and protein (meat, fish, poultry) while carbohydrates (sugars and starches) are restricted. On this website, I’ll talk about how the diet works, and share details on proper implementation of the diet. 
8. Van Lenten, B. J., Hama, S. Y., De Beer, F. C., Stafforini, D. M., McIntyre, T. M., Prescott, S. M., … Navab, M. (1995). Anti-inflammatory HDL becomes pro-inflammatory during the acute phase response. Loss of protective effect of HDL against LDL oxidation in aortic wall cell cocultures. Journal of Clinical Investigation, 96(6), 2758–2767. PMID: 8675645
The most convincing piece of evidence can be found in a 2003 meta-analysis. In this meta-analysis, researchers compiled the data from sixty trials that quantified the effect that feeding different types of fats to humans had on the total-to-HDL cholesterol ratio [25]. But before we look through the results, we must first understand what this ratio is.
As you might suspect, this metabolic theory of cancers is controversial in the mainstream cancer paradigm, but there’s already promising initial evidence to support it, and most traditional cancer specialists concede that this metabolic theory has merit, and it may be a piece of the puzzle. I would say that the dominant paradigm idea right now is that metabolic dysfunction is likely one of the pieces of the puzzle, but that cancer is multifactorial and probably does involve genetic mutations that may be independent of metabolic dysfunction and that there are other causes that may not be directly related to metabolic dysfunction.
Keep up electrolytes. The major electrolytes in our bodies are sodium, potassium and magnesium. Because a low carb diet (especially a keto diet!) reduces the amount of water you store, this can flush out electrolytes and make you feel sick (called “keto flu”). This is temporary, but you can avoid or eliminate it by salting your food liberally, drinking broth (especially bone broth), and eating pickled vegetables. Some people also choose to take supplements for electrolytes, but it’s best to first consult a doctor that understands and supports keto/low carb lifestyles.
Russel Wilder first used the ketogenic diet to treat epilepsy in 1921. He also coined the term "ketogenic diet." For almost a decade, the ketogenic diet enjoyed a place in the medical world as a therapeutic diet for pediatric epilepsy and was widely used until its popularity ceased with the introduction of antiepileptic agents. The resurgence of the ketogenic diet as a rapid weight loss formula is a relatively new concept the has shown to be quite effective, at least in the short run.
On the other hand, higher HDL cholesterol levels have been linked to less carotid artery intima-media thickness. In a large meta-analysis of data from more than 20,000 people, CIMT tended to decrease as HDL cholesterol increased – regardless of LDL cholesterol values (16). Importantly, although LDL response to carb restriction varies from person to person, HDL virtually always increases.
In fact, one study stated that “…the group with the highest risk for cardiovascular events had high LDL-P and LDL-C, while the group with the lowest risk had low LDL-P but higher LDL-C.” [17] As a result of prior clinical research and their findings, the researchers stated that: “While the low carb, ketogenic diet did not lower total LDL cholesterol, it did result in a shift from small, dense LDL to large, buoyant LDL, which could lower cardiovascular disease risk.” [23]
In all fairness, you can do these plans without eating all those processed foods, although (let’s face it!) convenience and cravings mean you’ll likely be tempted to try them. And they tap into that weakness for "cheating" by making these options easily available. Who would refuse comfort food that is "compliant" with a diet? You can have your cake and eat it too, literally. I call this pseudo-dieting. Even then, eating potentially reactive foods like dairy (which is allowed from the very beginning on Atkins) can either aggravate or trigger food sensitivities ("no bueno").
Take your stress hormone cortisol: It stays highest in the morning and gradually tapers throughout the day. Measuring cortisol in the morning might yield an entirely different result from testing in the evening. Researchers speculate ketogenic diets might raise this stress hormone, but many other factors also come into play here that may have nothing to do with your diet.
Conklin's fasting therapy was adopted by neurologists in mainstream practice. In 1916, a Dr McMurray wrote to the New York Medical Journal claiming to have successfully treated epilepsy patients with a fast, followed by a starch- and sugar-free diet, since 1912. In 1921, prominent endocrinologist Henry Rawle Geyelin reported his experiences to the American Medical Association convention. He had seen Conklin's success first-hand and had attempted to reproduce the results in 36 of his own patients. He achieved similar results despite only having studied the patients for a short time. Further studies in the 1920s indicated that seizures generally returned after the fast. Charles P. Howland, the parent of one of Conklin's successful patients and a wealthy New York corporate lawyer, gave his brother John Elias Howland a gift of $5,000 to study "the ketosis of starvation". As professor of paediatrics at Johns Hopkins Hospital, John E. Howland used the money to fund research undertaken by neurologist Stanley Cobb and his assistant William G. Lennox.[10]
"The message is not that children with [uncontrollable] seizures should not be on this diet, because it can be remarkably effective and most children only stay on it for a few years," Kwiterovich tells WebMD. "But our findings suggest the distinct possibility that anyone who eats a very high-fat diet may be setting themselves up for later [blood vessel] disease."
Yes, this is an evolving area. Classical (traditional) ketogenic diet, MCT oil ketogenic diet, modified Atkins diet, low glycemic index diet, modified ketogenic diet are currently used worldwide. The amount and type of fat, protein, and carbohydrate characterizes the difference between these diet types. Different ketogenic diet centres may use different versions of the ketogenic diet. Many centres offer more than one option. Your ketogenic diet trained medical team will help you determine which type of diet is best suited for you or your child. Each patient should be treated as an individual and every ketogenic diet should be tailored to meet their particular needs.
Take your stress hormone cortisol: It stays highest in the morning and gradually tapers throughout the day. Measuring cortisol in the morning might yield an entirely different result from testing in the evening. Researchers speculate ketogenic diets might raise this stress hormone, but many other factors also come into play here that may have nothing to do with your diet.
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.

In some ways, it’s similar to the Atkins diet, which similarly boosts the body’s fat-burning abilities through eating only low-carb foods, along with getting rid of foods high in carbs and sugar. Removing glucose from carbohydrate foods will cause the body to burn fat for energy instead. The major differences between the classic keto and the Atkins diet is the former emphasizes healthier keto fats, less overall protein and no processed meat (such as bacon) while having more research to back up its efficacy.

The ketogenic diet exerts antiepileptic effects by improving energy metabolism in the brain and reducing brain oxidative stress. Fascinating new research suggests that the antiseizure effects of the ketogenic diet are also mediated by modulation of the gut microbiota. (28) Consumption of a ketogenic diet increases the levels of bacteria that produce GABA, the brain’s primary inhibitory neurotransmitter; this shifts neurotransmission towards inhibition rather than excitation, thus preventing neuronal hyperexcitability and seizure onset.


This has been very comforting for me to read as I’ve been on a Keto diet for 8mo, loving my results which were weight loss (initially) but now the sustained clarity & sharpness of mind. I am lean (58kg) and very active. I had a blood test last week just to see where I’m at & my LDL is very high. Of course my doctor wants me to stop Keto but I just feel so great. I’m torn...
The first signs of ketosis are known as the “keto flu” where headaches, brain fogginess, fatigue, and the like can really rile your body up. Make sure that you’re drinking plenty of waterand eating plenty of salt. The ketogenic diet is a natural diuretic and you’ll be peeing more than normal. Take into account that you’re peeing out electrolytes, and you can guess that you’ll be having a thumping headache in no time. Keeping your salt intake and water intake high enough is very important, allowing your body to re-hydrate and re-supply your electrolytes. Doing this will help with the headaches, if not get rid of them completely.
The ketogenic diet is proposed as a potential adjuvant therapy by exploiting these differences between cancer and normal cells. Consuming a ketogenic diet reduces blood glucose levels through a drastic reduction in the amount of carbohydrates consumed.1,2 As a result of decreased blood glucose levels, less insulin is secreted, which downregulates signaling pathways that are frequently constitutively active in tumor cells.2 Because glucose metabolism is inhibited, energy must be primarily derived from fats.1 Fat metabolism results in the production of ketone bodies and β-hydroxybutyrate by the liver, which are used to fuel energy production. Cancer cells have difficulty using these pathways because they rely on glucose; the metabolism of fat increases oxidative stress. 

Available research on the ketogenic diet for weight loss is still limited. Most of the studies so far have had a small number of participants, were short-term (12 weeks or less), and did not include control groups. A ketogenic diet has been shown to provide short-term benefits in some people including weight loss and improvements in total cholesterol, blood sugar, and blood pressure. However, these effects after one year when compared with the effects of conventional weight loss diets are not significantly different. [10]
A study of 183 children in whom the diet was discontinued determined that the speed of  the wean did not matter: children tapered over several weeks did just as well as those in whom the diet was stopped more slowly. Children in whom there was a good, but not complete seizure reduction with the diet (50-99% seizure reduction) were at highest risk for seizure worsening with the diet discontinuation . Should seizures worsen, many of these families elect to continue a low-carbohydrate diet versus new anticonvulsants . Some child neurologists opt to stop the diet over 4-6 weeks with close email contact.
In some ways, it’s similar to the Atkins diet, which similarly boosts the body’s fat-burning abilities through eating only low-carb foods, along with getting rid of foods high in carbs and sugar. Removing glucose from carbohydrate foods will cause the body to burn fat for energy instead. The major differences between the classic keto and the Atkins diet is the former emphasizes healthier keto fats, less overall protein and no processed meat (such as bacon) while having more research to back up its efficacy.
The ketogenic diet is a medical nutrition therapy that involves participants from various disciplines. Team members include a registered paediatric dietitian who coordinates the diet programme; a paediatric neurologist who is experienced in offering the ketogenic diet; and a registered nurse who is familiar with childhood epilepsy. Additional help may come from a medical social worker who works with the family and a pharmacist who can advise on the carbohydrate content of medicines. Lastly, the parents and other caregivers must be educated in many aspects of the diet for it to be safely implemented.[5]
Multiple mechanisms of action may explain why the modification of the KD can be effective even without ketosis. Importantly, the KD systemic action can have a broad spectrum of effects that may be beneficial in the treatment of different types of epilepsy and associated comorbidities such as cognition impairment, psychiatric disturbance, and sudden unexplained death.
Jimmy Moore: Yeah, this is such a discouraging topic and I’ve gotten pretty upset about it when I talk to people like you, in interviews, because imagine this. Grandma is turning 65, and she’s starting to see her cholesterol get a little bit higher, so she goes to see her doctor, “Oh my gosh, your cholesterol going high, we need to put you on Staten drug.” She starts taking the Staten drug and removes the very element that was keeping her faculties about her in her head, and over the next four or five, even ten years you start to see a mental decline. What do we call it?
A study of 183 children in whom the diet was discontinued determined that the speed of  the wean did not matter: children tapered over several weeks did just as well as those in whom the diet was stopped more slowly. Children in whom there was a good, but not complete seizure reduction with the diet (50-99% seizure reduction) were at highest risk for seizure worsening with the diet discontinuation . Should seizures worsen, many of these families elect to continue a low-carbohydrate diet versus new anticonvulsants . Some child neurologists opt to stop the diet over 4-6 weeks with close email contact.
Bulk buy and cook. If you’re someone who doesn’t like to spend a lot of time in the kitchen, this is the best of both worlds. Buying your food at bulk (specifically from wholesalers) can reduce the cost per pound tremendously. Plus, you can make ahead food (bulk cook chicken thighs for pre-made meat, or cook entire meals) that are used as leftovers, so you spend less time cooking.
One dubious practice of some keto diet adherents is using urine, blood or breath test kits to check their circulating ketone levels. While those kits can tell you if your body is indeed burning ketones instead of glucose, Westman says there’s no good evidence that one ketone level is better than another. “The level of water in a stream doesn’t necessarily tell you how much water is flowing through it,” he says. “In the same way, measuring the level of ketones in the blood doesn’t tell you the whole story.”

Everyone talks about upping their fats… I do not think that is the key to sweeping LDL out of the system. Upping cruciferous fiberous veggies… the fiber, vitamins and minerals contained in veggies bind with the LDL and move it on out. You would have to eat literally a truck load to make any serious dent in your daily carb allowance since most are very low net carb anyways.


Most condiments below range from 0.5–2 net carb grams per 1–2 tablespoon serving. Check ingredient labels to make sure added sugar is not included, which will increase net carbs. (Stevia and erythritol will become your go-to sweeteners because neither raise your blood sugar — combine for a more natural sweet taste and, remember, a little goes a long way!)
In order to be successful, this therapy calls for strict compliance and plenty of patience, especially in the beginning. Most important, patients with epilepsy should only use the diet with the support of a knowledgeable ketogenic diet team, including a doctor and a licensed dietitian who can correctly calculate and monitor the diet for each individual.
×