The CKD and its variants should be considered as an alternative for non-surgical pharmacoresistant patients with epilepsy, of any age. Each patient must have an individually designed diet; however, adult patients have more difficulty in maintaining the CKD. It is essential to inform the patient and the family about the efficacy and AE related to the KD, and the use of websites and videos may help in this education. Although several theories exist regarding the mechanisms of action, further study is needed nevertheless the positive results are probably due to several mechanisms.
Compared to TBI, the amount of scientific literature documenting the beneficial effects of a ketogenic diet for epilepsy is vast. The ketogenic diet was first introduced as a therapy in the 1920s, when doctors learned it could successfully treat seizures in children with refractory epilepsy. (27) Interest in the ketogenic diet waned when antiepileptic drugs were introduced in the 1960s and ’70s; however, the ketogenic diet has experienced a recent resurgence in popularity in the epilepsy community, particularly among those suffering from drug-resistant epilepsy.
When I was six years old, I was diagnosed with temporal lobe, partial-complex epilepsy.  Over the years, I have seen multiple doctors and neurologists and I have been on every medication created to treat epilepsy, but I still continued to have seizures about every 6-8 weeks. For the most part, I have been able to lead a normal life achieving my college degree, getting married and having two happy, healthy kids but every time I had a seizure it was a cruel reminder that I was not everything I needed to be for my family. Many times after a seizure, I would be unable to work and care for them for days at a time.
The ketogenic diet for epilepsy is a very high-fat diet, with just enough protein for body maintenance and growth, and very low amounts of carbohydrate. In the ketogenic state, the body generates molecules called ketones (also called ketone bodies) when fats are metabolized. The goal of the KDE is for the brain to use ketones for energy rather than glucose as much as possible. Ketones are (largely) water-soluble, so they are easily transported to the brain. The brain cannot use fatty acids for energy, but it can use ketones for a large portion of its energy requirements.
The ketogenic diet for epilepsy is a very high-fat diet, with just enough protein for body maintenance and growth, and very low amounts of carbohydrate. In the ketogenic state, the body generates molecules called ketones (also called ketone bodies) when fats are metabolized. The goal of the KDE is for the brain to use ketones for energy rather than glucose as much as possible. Ketones are (largely) water-soluble, so they are easily transported to the brain. The brain cannot use fatty acids for energy, but it can use ketones for a large portion of its energy requirements.

The ketogenic diet for epilepsy (KDE) was developed in the 1920s by Dr. Hugh Conklin in Michigan. But once effective medications were developed, the diet was used less frequently. It has regained recognition and study and is now a standard backup plan for children whose epilepsy symptoms are difficult to control with medication. With over 300,000 children in the U.S. with seizure disorders, this has become an important addition to the arsenal of treatments for epilepsy. Researchers are beginning to see how it might help adults and people with a variety of neurologic disorders.


Hi Stacey, I can’t give medical advice and definitely recommend following your doctor’s recommendations. You can ask him/her if low carb would be better suited for you. Also, you may want to double check with him/her if the kidney concern was related to high protein, because that is a common misconception about keto – it is not a high protein diet/lifestyle.
Children who discontinue the diet after achieving seizure freedom have about a 20% risk of seizures returning. The length of time until recurrence is highly variable, but averages two years. This risk of recurrence compares with 10% for resective surgery (where part of the brain is removed) and 30–50% for anticonvulsant therapy. Of those who have a recurrence, just over half can regain freedom from seizures either with anticonvulsants or by returning to the ketogenic diet. Recurrence is more likely if, despite seizure freedom, an electroencephalogram shows epileptiform spikes, which indicate epileptic activity in the brain but are below the level that will cause a seizure. Recurrence is also likely if an MRI scan shows focal abnormalities (for example, as in children with tuberous sclerosis). Such children may remain on the diet longer than average, and children with tuberous sclerosis who achieve seizure freedom could remain on the ketogenic diet indefinitely.[46]
7. Raygan, F., Bahmani, F., Kouchaki, E., Aghadavod, E., Sharifi, S., Akbari, E., . . . Asemi, Z. (2016). Comparative effects of carbohydrate versus fat restriction on metabolic profiles, biomarkers of inflammation and oxidative stress in overweight patients with Type 2 diabetic and coronary heart disease: A randomized clinical trial. PMID: 28607566
David Book graduated with a PharmD from Drake University. After completing a Drug Information Residency in the greater Atlanta area with Mercer University's College of Pharmacy and InpharmD, he now works full time at an independent pharmacy. Drawn towards innovation and entrepreneurship, his interests include the business of pharmacy, healthcare advocacy, diet & nutrition, and health information technology.
There are some treatment centers like Care Oncology Clinic in the UK and ChemoThermia Oncology Center in Istanbul that are using ketogenic diet and fasting along with glucose inhibitors and conventional treatment like chemo. They claim to be getting good results, but I don’t know much about these cancer centers above and beyond what I just told you. Note that keto only seems to work with the faster-growing cancers like breast cancer, but not as much with slower-growing cancers like prostate cancer.
Hi Maya. I LOVE your site!! Interesting, informative with fab recipes and ideas. Hubby and I have just started eating low carb and I have to say, we are not finding it too difficult and I already feel sooo much better!! I find the hardest part is choosing low carb veg, I feel as if we are not eating enough. Any suggestions on how to get more veggies into our diet?

If you want to take a deep dive, Dr. Gonzalez masterfully dismantles the ketogenic diet for cancer in the lengthy article below. This is not a scientific rebuttal, quibbling over theories about Warburg, glycosis, cell respiration, and ATP, rather it is a thoughtful, well-reasoned reflection from a medical doctor who was in the trenches of nutritional cancer treatment for nearly three decades. His real world experience with patients, insider knowledge, historical perspective and common sense put him head and shoulders above the lab-rat researchers and theorizers, no offense guys/gals.
Additionally, HDL cholesterol may have anti-inflammatory effects. A recent research study published by De Nardo et al shows that HDL may be responsible in reducing inflammatory activity by regulating immune system cells called macrophages. [5] Furthermore, epidemiological studies have noted an inverse association between levels of HDL and certain forms of cancer. [6, 7]

The ketogenic diet keeps this process going. It forces the child’s body to burn fat round the clock by keeping calories low and making fat products the primary food that the child is getting. In fact, the diet gets most (80 percent) of its calories from fat. The rest comes from carbohydrates and protein. Each meal has about four times as much fat as protein or carbohydrate. The amounts of food and liquid at each meal have to be carefully worked out and weighed for each person.
Although the high-fat, calorie-restricted ketogenic diet (KD) has long been used to prevent childhood epileptic seizures that are unresponsive to drugs, physicians have not really understood exactly why the diet works. New studies by a research team at Emory University School of Medicine show that the diet alters genes involved in energy metabolism in the brain, which in turn helps stabilize the function of neurons exposed to the challenges of epileptic seizures. This knowledge could help scientists identify specific molecular or genetic targets and lead to more effective drug treatments for epilepsy and brain damage.
Research here is conflicting. While you might think reducing insulin-triggering carbohydrate foods would improve insulin sensitivity, that isn’t always the case. Rodent studies found at least in the short-term, ketogenic diets increased glucose intolerance and insulin resistance. Researchers speculate part of this insulin resistance occurs because of keto-adaptation, and once your body adjusts to ketosis, you become more insulin sensitive. Your mileage will vary, of course, and I believe going too low-carb could create these and other potential dangers.
Dr. Gorski's full information can be found here, along with information for patients. David H. Gorski, MD, PhD, FACS is a surgical oncologist at the Barbara Ann Karmanos Cancer Institute specializing in breast cancer surgery, where he also serves as the American College of Surgeons Committee on Cancer Liaison Physician as well as an Associate Professor of Surgery and member of the faculty of the Graduate Program in Cancer Biology at Wayne State University. If you are a potential patient and found this page through a Google search, please check out Dr. Gorski's biographical information, disclaimers regarding his writings, and notice to patients here.
The "classic" ketogenic diet is a special high-fat, low-carbohydrate diet that helps to control seizures in some people with epilepsy. It is prescribed by a physician and carefully monitored by a dietitian. It is usually used in children with seizures that do not respond to medications. It is stricter than the modified Atkins diet, requiring careful measurements of calories, fluids, and proteins. Foods are weighed and measured.
Usually the body uses glucose (a form of sugar) from carbohydrates (found in foods like sugar, bread or pasta) for its energy source. Chemicals called ketones are made when the body uses fat for energy (this is called ‘ketosis’). With the ketogenic diet, the body mostly uses ketones instead of glucose for its energy source. Research has shown that a particular fatty acid, decanoic acid, may be involved in the way the diet works. 
Use fat as a lever.  We’ve been taught to fear fat, but don’t! Both keto and low carb are high fat diets. Fat is our source of energy as well as satiety. The key to understand, though, is that fat is a lever on a low carb or keto diet. Carbs and protein stay constant, and fat is the one you increase or decrease (push the lever up or down) to gain or lose weight, respectively. So if your goal is weight loss, eat enough fat to be satisfied, but there’s no need to “get your fats in” once you’re satisfied.
Jimmy Moore: 300 is the normal. Yes. That’s 100 points higher than authorities today would say is “normal”. Yet if they put them on cholesterol lowering medication, do you know they would have been at greater risk for heart disease if they took that pill then they’re total cholesterol being 300. I think it all circles back around to it’s not about the cholesterol people, it really is about the inflammation.
It seems to me that your’re presenting conflicting information. Your series had T. Colin Campbell and his research from the China Study. And the healing benefits of a plant based diet. Animal protein causes inflammation. Is there specific science on the ketogenic diet? I know people doing keto long term and they look awful and seem to be sick all the time. I have heard of the keto flu.
Keep eating low carb to continue losing weight, feeling good and becoming healthier!Try making any of our hundreds of recipes available on the site. We make sure each and every recipe is delicious, nutritious and will keep you under your daily carb limit, even if you go for seconds. In addition, we provide step-by-step instructions to make the process as easy as possible. If you ever run into any issues or have any questions, be sure to leave a comment or contact us directly! We’re always happy to help.
The only issue with keto, is really that I’m afraid that it might be hard to up my calories to a maintenance weight now that I’ve gotten a taste preference for the rich assortment of foods with no carbs in them. I’m satisfied with less calories than I will need after my excess fat is burned off… but , maybe I bet my body will send more hunger signs once there isn’t anymore body fat in the cupboard to use instead of what goes down my throat.
The Johns Hopkins Hospital protocol for initiating the ketogenic diet has been widely adopted.[43] It involves a consultation with the patient and their caregivers and, later, a short hospital admission.[19] Because of the risk of complications during ketogenic diet initiation, most centres begin the diet under close medical supervision in the hospital.[9]
Spices are an easy way of adding more flavor, vitamins and antioxidants into your food. Furthermore, they are low in carbohydrates. Make sure that you're using fresh, organic spices for maximum flavor and nutrients. Some spices sold in packets found at the local grocery should not be used, as they often contain fillers that can increase your carbohydrate consumption, thus putting you out of ketosis.26
One study assessed the effect of dietary interventions on quality of life, cognition and behavioural functioning, reporting participants in the KD group to be more active, more productive and less anxious after four months, compared to the control group. However, no significant difference was found in quality‐adjusted life years (QALYs) between the KD group and control group at four or 16 months (GRADE rating very low).
The bottom line here is that the ketogenic diet is a powerful metabolic tool for treating a wide range of illnesses. It is not a fad diet, and if it is implemented correctly, it corrects metabolic function at the cellular level.  This website discusses in detail the mechanisms of a ketogenic diet, including side effects, benefits and other information.
Jimmy Moore: We’ll talk about that here in a second. The main point is triglycerides and HDL really are the two ones on your panel you really should be paying attention. A lot of the research is pointing to what’s called the triglyceride to HDL ratio. You take your triglycerides and you divide it by your HDL and if that number is under 1.0, hello, you are rocking it with lowering your cardiovascular risks no matter what your LDL and total cholesterol is. That’s a new way to look at things, and people don’t understand that there’s … what we’re doing looking at total cholesterol and LDL as a measure for heart disease risk is actually 50 years old.
Then you’ve got "keto-approved" junk foods like cookies, candy, and bread that promise to keep you in ketosis even as you indulge in your favorite comfort foods. The flip side is ketogenic diets that include almost no plant foods, focusing instead on meat, meat, and more meat. Bring on the bacon. Slather your steak in butter. Who needs vegetables? (Hint: You do!) Ketogenic diets are a practical invitation for vegetable-phobic people, and when you skip out on gut-healing plant foods, you create microbiome mayhem.

Therefore, when you’re following a ketogenic diet plan for beginners, your body is burning fat for energy rather than carbohydrates, so in the process most people lose weight and excess body fat rapidly, even when consuming lots of fat and adequate calories through their daily food intake. Another major benefit of the keto diet is that there’s no need to count calories, feel hungry or attempt to burn loads of calories through hours of intense exercise.
Your glycogen stores can still be refilled while on a ketogenic diet. A keto diet is an excellent way to build muscle, but protein intake is crucial here. It’s suggested that if you are looking to gain mass, you should be taking in about 1.0 – 1.2g protein per lean pound of body mass. Putting muscle on may be slower on a ketogenic diet, but that’s because your total body fat is not increasing as much.5Note that in the beginning of a ketogenic diet, both endurance athletes and obese individuals see a physical performance for the first week of transition.
Notably, there is a relationship between metabolic and epigenetic modifications. Shimazu et al. (2013) observed that βOHB inhibits class I histone deacetylases. During the KD, the elevation of βOHB causes changes in large-scale gene transcription but particularly those linked to oxidative-stress resistance factors. This result emphasizes that the KD has a potential role as a disease-modifying treatment in epilepsy.
The first study looking at the ketogenic diet and cancer was published in 1995 in the Journal of the American College of Nutrition. In it, researchers recruited two young female patients at the University Hospitals of Cleveland. Both had Glioblastoma Multiforme (GBM), a form of cancer that starts in the brain and rapidly spreads throughout the body.

It’s a habit to enjoy a brie cheese for desert instead of a piece of chocolate cake but each are favored deserts in France. I’m personally more satisfied after a 350 calorie sized wedge of brie than the same number of calories of cake.. which will give me sugar crash and .. really I’d like two slices of cake(I’ve got a sweet tooth that once I get going it wants to keep being fed)
While I can appreciate Mr. Feldman's efforts and I am also a hyper responder, I have no doubt that cholesterol levels are merely an artifact / symptom of the real cause of CVD which is hyperinsulinemia which for type 2 diebetics or pre-diabetics (which are simply undiagnosed diabetics) is due to high carbohydrate diets causing high blood glucose levels as well as other known causes of infllammation such as trans fat and high omega 6 to omega 3 ratios. In other words, there is no need to try and cure the symptom which is controlling lipoprotein levels directly.  
A recent 2017 study of over 2,500 adults looked at fasting insulin and high-sensitivity C-reactive protein (hs-CRP), an inflammatory marker considered a strong predictor of heart attack risk. In this study, people with the highest insulin levels were more than four times as likely to have an elevated hs-CRP value compared to those with the lowest insulin levels. By contrast, elevated LDL cholesterol levels showed no association with hs-CRP (4).
Con: Results can vary depending on how much fluid you drink. By drinking more water, you dilute the concentration of ketones in the urine and thus a lower level of ketones will be detected on the strips. The strips don’t show a precise ketone level. Finally, and most importantly, as you become increasingly keto-adapted and your body reabsorbs ketones from the urine, urine strips may become unreliable, even if you’re in ketosis.
The ketogenic diet has many potential effects and is likely to have different mechanisms in different diseases [8]. In metabolic conditions, cancer, trauma, and ischemia, the ketogenic diet may confer a protective effect by providing an additional energy substrate to tissue at risk of cell death. However, ketosis may have more complicated effects. In one model, rats fed the ketogenic diet show marked upregulation of both the ketone transporter and the glucose transporter type 1 (GLUT-1), promoting the influx of nutrients into the brain [9]. These authors provided evidence that the ketogenic diet increases capillary density without increasing overall blood flow, providing a way that the diet may help nourish tissue at risk. This finding is particularly interesting in light of findings in animals with tumors, in which the diet is associated with an anti-angiogenic effect [10,11]. These discordant results eventually will need to be reconciled; they may be due to differences in angiogenic stimuli in normal cells versus malignant cells.

Certainly Dr. Seyfried has put together a most impressive achievement, chronicling in great detail his belief that cancer does not develop from genetic alterations – as is generally believed – but as a result of changes in fundamental cell physiology, specifically changes in energy production, that in turn lead to the cancer phenotype. In essence, the genes remain intact, but metabolism goes awry.


There is not one “standard” ketogenic diet with a specific ratio of macronutrients (carbohydrates, protein, fat). The ketogenic diet typically reduces total carbohydrate intake to less than 50 grams a day—less than the amount found in a medium plain bagel—and can be as low as 20 grams a day. Generally, popular ketogenic resources suggest an average of 70-80% fat from total daily calories, 5-10% carbohydrate, and 10-20% protein. For a 2000-calorie diet, this translates to about 165 grams fat, 40 grams carbohydrate, and 75 grams protein. The protein amount on the ketogenic diet is kept moderate in comparison with other low-carb high-protein diets, because eating too much protein can prevent ketosis. The amino acids in protein can be converted to glucose, so a ketogenic diet specifies enough protein to preserve lean body mass including muscle, but that will still cause ketosis.
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.
The Emory research team studied the link between diet and epileptic seizures on the behavioral, cellular and genetic level. They found, as had others, that in rats fed the KD the resistance to seizures develops slowly, over one to two weeks, in contrast to rats treated with conventional anticonvulsant drugs. On the cellular level, they found that the anticonvulsant effect of the ketogenic diet did not correlate with a rise in plasma ketone levels or with a decrease in plasma glucose. Because longer treatment with the KD was necessary to increase the resistance to seizures, they concluded that changes in gene expression might hold the key to the diet's anticonvulsant effects.

Lazy keto diet: Last but not least, the Lazy keto diet often gets confused with dirty keto … but they’re different, as the “lazy” refers to simply not carefully tracking the fat and protein macros (or calories, for that matter). Meanwhile, the one aspect that remains strict? Not eating over 20 net carb grams per day. Some people find this version less intimidating to start with or end with … but I will caution that your results will be less impressive.
One notes that the patient who didn’t survive 12 months wasn’t much mentioned; so I assume she didn’t demonstrate any clinical improvement. In any case, this study doesn’t really show anything, other than that a ketogenic diet might decrease glucose uptake in some brain tumors. It’s like a Burzynski case report, in which we have no idea whether the patient did better than expected because of the intervention or because she had less aggressive disease.
In its 2016 report “Healthy Eating Guidelines & Weight Loss Advice,” the Public Health Collaboration, a U.K. nonprofit, evaluated evidence on low-carbohydrate, high-fat diets. (The Keto diet falls under the LCHF umbrella.) Among 53 randomized clinical trials comparing LCHF diets to calorie-counting, low-fat diets, a majority of studies showed greater weight loss for the Keto-type diets, along with more beneficial health outcomes. The collaboration recommends weight-loss guidelines that include a low-carbohydrate, high-fat diet of real (rather than processed) foods as an acceptable, effective and safe approach.

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.”


Today, you’ll see ketogenic diets promoted to prevent disease, increase energy, boost physical and mental performance, and so much more. But let’s face it: Most people want to try keto to lose weight. While that’s not a bad thing—you can lose weight doing it—ketogenic diets were never designed for weight loss, and done incorrectly, a side effect can actually make you gain weight.
If a person with familial hypercholesterolemia is then put on a high-fat diet,  they will become even more vulnerable to heart disease as the increased saturated fat and cholesterol content of the diet provokes higher cholesterol levels. And it gets even worse — since this person lacks the ability to clear LDL cholesterol out of their blood normally — their cholesterol levels will stay elevated for an even longer period of time. This will make it much more likely that the LDL particles will become damaged and stimulate plaque build up in the blood vessels.
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)!
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.”
I had some eggs and some meat and all this stuff. Then they tested me literally every 30-60 minutes for five hours. I got to see literally what was happening real time after a low carb meal. I think that’s where having the right nutrition really is the basis for knowing where you stand. The other thing for people that are worried about this morning reading, check your A1C. That’s the average of the last 3 months worth of all of your blood sugars, not just the ones in the morning that you’re testing and freaking out about. By the way, when you freak out that also raises your blood sugar.
Despite the initial warning signs, the media continued its relentless promotion of interleukin-2 for a number of years. In 1992, perhaps due to political pressure more than scientific evidence, the FDA approved the drug for use against cancer, despite the lack of comprehensive controlled trials. Then in the late 1998 a clinical study – completed some 13 years after the initial reporting – showed that interleukin-2, at least with advanced kidney cancer, worked no better than placebo.

Let’s go back to the research assessing how the low-carb, high-fat diets such as the ketogenic diet affect your LDL levels. In the meta-analysis by Bueno et al., low-carb diets were shown to increase HDL twice as much as low-fat diets after randomized controlled interventions. It also showed that there was a small increase in LDL-C in low-carb subjects compared to low-fat diet subjects who experienced no increase.


https://draxe.com/about-dr-josh-axe/ Here are Dr Axe’s credentials. We in the UK know him from when he came to UK with the USA Olympic team for the 2012 London Olympics. He is a musco-skeleton specialist, but he has studied nutrition to functional medicine Doctor level, so knows what he is talking about when discussing diet/nutrition – as he does for USA athletes. Many GP type Doctors will tell you that they do only a few hours in their years of Medical training on diet and nutrition – I know as I was given totally useless diet information from my own Doctor when I was diagnosed diabetic 5 years ago. I got worse until I looked up functional medicine practitioners in USA like Dr Axe and diabetic specialist Dr Brian Mowll. I resolved my bleeding retina, neuropathy starting in my feet and have no need for the usual medications they needlessly push type 2 diabetics on. My Doctor was annoyed and thought I was crazy back then, but how he directs me to the diabetic clinic nurse and I tell her about how to do this low carb.ketogenic diet and she, also diabetic, has started on it and wants me to come to clinic classes to tell others.
To some ears, last week’s exultation over interleukin-2 has a familiar but discordant ring. Something similar happened about five years ago with a substance called interferon, the “magic bullet” of cancer research, featured on magazine covers and in articles with titles like “To Save Her Life – And Yours.” … But by 1984 the magic bullet had misfired; now the articles were called “The Myth of Interferon.”
Apoptosis Induction. Studies show that dietary energy restriction enhances phosphorylation of adenosine monophosphate kinase (AMPK), which has been found to induce apoptosis in glycolytic-dependent brain cells and protect normal brain cells from death. One way to naturally restrict energy consumption is with a keto diet because most keto dieters spontaneously eat fewer calories than they do when they are on a higher carb diet. Altogether, this may explain why most of the research on keto and cancer has shown the keto diet to be effective in the treatment of brain tumors (glioblastomas and gliomas).

At KetoPet, our mission is to help dogs everywhere live longer, happier lives by teaching pet parents how to feed a raw ketogenic diet. Based on our studies, we believe that a raw ketogenic diet for dogs is the optimal diet for dog health and longevity. Unfortunately, each year about 6 million dogs in the US alone will be diagnosed with cancer. We’re focused on changing those statistics by changing your dog’s diet.


A great deal of exciting research is emerging regarding the application of a ketogenic diet in the treatment of neurodegenerative diseases, including Alzheimer’s and Parkinson’s disease. (17) Neurodegenerative diseases are characterized by brain insulin resistance, a condition that starves neurons of the glucose they normally need to function correctly. Scientists have found that ketones are an excellent alternative fuel for the insulin-resistant brain. In addition, ketones reduce brain oxidative stress and mitochondrial dysfunction, two significant factors in the neurodegenerative disease process.
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).
Animal proteins (meat, fish, etc.) have very little, if any, carbs. You can consume them in moderate amounts as needed to control hunger. Overall, choose fattier cuts of meat rather than leaner ones. For example, chicken thighs and legs are preferable to chicken breasts because they contain much more fat. We’ve got quick keto diet chicken recipes to help.

Several studies have shown that the MAD, besides being more palatable, is as effective as the KD in the treatment of drug-resistant epilepsy in children (Miranda et al., 2011; Martin et al., 2016). A study performed using 20 children receiving 10 g of carbohydrates daily showed that 65% of the children had a >50% seizure reduction, 35% of the children had >90% improvement, and four children were seizure-free at 6 months (Kossoff et al., 2006). In a study in South Korea, 36% of 14 children treated with the MAD showed improvement of >50% in seizures and 12% were seizure-free (Kang et al., 2007). A recent meta-analysis performed using 70 studies concluded that the MAD and classical KD do not differ in reduction of seizure frequency at month 3 and month 6, with ≥50% and ≥90% reductions, respectively (Rezaei et al., 2017). A retrospective study showed >50% of seizure reduction in 65% of the 10 children who remained on the diet for up to 6 months, and 20% of them were seizure-free (Park et al., 2018).

She learned about Kelley’s work, began the program, regained her health, and avoided all conventional doctors for many years. In 1984, nine years after coming under Kelley’s care, she returned to her primary care physician who was quite perplexed she was still alive after all this time. A chest x-ray showed total resolution of her once widespread lung metastases.
A lifestyle of fasting may involve an individual eating for a period of only 4-8 hours in one day. A 20-hour fast may involve eating food between 3pm and 7pm each day. This regular intermittent fasting lifestyle allows the body to produce ketones in order to fuel the entire body. The 20-hour fast may be optimal for individuals with the diagnosis of cancer, but may otherwise be incorporated into your lifestyle using a 16 to 18 hour fasting period.
The ketogenic diet is usually initiated in combination with the patient's existing anticonvulsant regimen, though patients may be weaned off anticonvulsants if the diet is successful. Some evidence of synergistic benefits is seen when the diet is combined with the vagus nerve stimulator or with the drug zonisamide, and that the diet may be less successful in children receiving phenobarbital.[18]
Just this week as I write this, one of my newer patients, a wonderful, creative inventor and computer whiz from the Washington, DC area, came into my office for his regularly scheduled six month re-evaluation appointment. When he started with me in January 2010, three and a half years ago, he had been diagnosed with stage IV metastatic squamous cell carcinoma of the lung, with multiple tumors in both lungs and with evidence of metastases in his ribs. His local doctors in DC had explained he had terminal disease, for which chemotherapy would be useless.

Although the exact role of the keto diet in mental and brain disorders is unclear, there has been proof of its efficacy in patients with schizophrenia. And, to boot, it works to reverse many conditions that develop as a side effect of conventional medications for brain disorders, like weight gain, type 2 diabetes and cardiovascular risks. More research is needed to understand the role of the ketogenic diet in treating or improving schizophrenia, as the current available studies are either animal studies or case studies, but the benefits of a low carbohydrate, high-fat diet in neurology is promising.
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.

Wondering how many carb foods you can eat and still be “in ketosis”? The traditional ketogenic diet, created for those with epilepsy consisted of getting about 75 percent of calories from sources of fat (such as oils or fattier cuts of meat), 5 percent from carbohydrates and 20 percent from protein. For most people a less strict version (what I call a “modified keto diet”) can still help promote weight loss in a safe, and often very fast, way.


My writer friend had been in touch with Dr. Kelley, thinking that with all the attention around him he might make a good subject for a successful book. But she wanted me to meet in person with Kelley, who happened to be in New York to discuss her book project. Frankly, as she explained to me, she needed my take on the man, whom she really couldn’t decipher – was he truly onto something useful and extraordinary with his odd therapy, or was he simply a huckster, taking advantage of vulnerable cancer patients, as the media had been insisting.
Regardless of the efficacy of the KD, most patients discontinue the diet because of its unpalatable and restrictive features. In the last 20 years, new variants of the KD diet have emerged, including the Modified Atkins diet (MAD), a low-glycemic-index diet, which although it has a high fat content, allows more protein and does not restrict calories and fluids. Several studies have shown that the new variants of the KD have a similar efficacy to the CKD (Kossoff et al., 2006; Tonekaboni et al., 2010; Coppola et al., 2011; Miranda et al., 2012; El-Rashidy et al., 2013). As presently understood, the KD is involved in multiple mechanisms responsible for biochemical alterations, including cellular substrates and mediators responsible for neuronal hyperexcitability. However, it is not yet known with certainty whether the success of the KD is due to a single or several mechanisms (Bough and Rho, 2007; Lutas and Yellen, 2013; Rho, 2017; Youngson et al., 2017).

This means that pilot studies are smaller in scale than a standard clinical trial, but they still yield important evidence and indicate which treatments should be assessed further. Typically, scientists perform pilot studies after case studies and animal studies yield promising results, which is exactly what was done regarding the keto diet and cancer.
In adults, the type of ketogenic diet typically used is the modified Atkins diet. Carbohydrates are limited to 20 grams per day and the intake of foods containing fat is required to get into the state of ketosis. For example, foods such as heavy cream, oils, avocado, eggs, butter and meats are encouraged; whereas conventional breads, pastas, cereals and cakes are restricted. 

It starts with limiting carbohydrate intake to just 20–30 net grams per day. “Net carbs” describes the amount of carbs remaining once dietary fiber is taken into account. Because fiber is indigestible once consumed, simply don’t count grams of fiber toward their daily carb allotment. So that means subtracting grams of fiber from total carb games, to give you the total net carbs.
The ketogenic diet may also worsen some mitochondrial diseases, pyruvate carboxylase deficiency, or organic acidurias. In general a metabolic screen, including urine amino and organic acids, serum amino acids, lactate, pyruvate, and carnitine profile, should be performed before starting the ketogenic diet to make sure children do not have a contraindication to using it.

I had been working with Dr. Donna Andrews and was able to understand that my seizures had to do with a lot more than the former doctors had explained to me. I was learning about how my blood sugar and stress levels affected my health and had experienced multiple stretches of three months without seizures but it was never consistent. Even though I knew I was headed in a better direction, I didn’t believe I could really be well.
A popular keto supplement are exogenous ketones (popularly called “keto diet pills”) that may help you achieve results earlier as well as remain in that state. (Don’t confuse exogenous ketones with raspberry ketones, as the latter don’t raise ketone levels in the body or mimic endogenous ketones, so you wouldn’t use raspberry ketones in your regimen.)
Physicians of ancient Greece treated diseases, including epilepsy, by altering their patients' diet. An early treatise in the Hippocratic Corpus, On the Sacred Disease, covers the disease; it dates from c. 400 BC. Its author argued against the prevailing view that epilepsy was supernatural in origin and cure, and proposed that dietary therapy had a rational and physical basis.[Note 3] In the same collection, the author of Epidemics describes the case of a man whose epilepsy is cured as quickly as it had appeared, through complete abstinence of food and drink.[Note 4] The royal physician Erasistratus declared, "One inclining to epilepsy should be made to fast without mercy and be put on short rations."[Note 5] Galen believed an "attenuating diet"[Note 6] might afford a cure in mild cases and be helpful in others.[11]
Thanks for this article. I just started a Keto diet so found it appropriate to my current lifestyle. Though I don’t believe your bottom line is strong enough since you simply stating that the diet is “hard to follow” and food is “notoriously unhealthy” without evidence going deeper into why those “notoriously unhealthy” foods are worse than keeping carbohydrate-heavy food that are addictive and give the body a quick sugar high for energy. I believe “hard to follow” is your opinion only, since acceptable Keto foods are found at all restaurants easily and also all grocery stores. All the foods you mention: “rich in very colorful fruits and vegetables, lean meats, fish, whole grains, nuts, seeds, olive oil, and lots of water” are all Keto-friendly. Many people have been on a Keto-diet for years. A healthy lifestyle is a healthy mindset change and making right choices – it’s not going to be easy.
Animal research indicates that a ketogenic diet reduces levels of brain amyloid-beta, a misfolded protein that contributes to Alzheimer’s disease, while also restoring mitochondrial function and improving learning and memory. (18, 19, 20) Although fewer studies on a ketogenic diet have been done in humans with Alzheimer’s disease, a recent trial found a ketogenic diet to be both safe and effective for mild Alzheimer’s disease. (21)
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.
Keto is not hard to follow at all. See, this is why I took my diet and nutrition into my own hands. I have PCOS and the ketogenic diet has worked wonders for me. I’m finally pregnant at the age of 32 and after 11 years of marriage because the ketogenic diet made me lose over 100 lbs and brought my insulin resistance under control. I feel better than I’ve ever felt. Sometimes doctors don’t seem to know as much as they should, or as much as they assume they do, and that’s pretty disturbing. Just like they’re still using the old school and very inaccurate BMI charts that are just pure bs. I’ll just take care of myself outside of certain situations involving illness or injury. I’m doing great on my own.
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.

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


Thank you, Dr. Jockers. I really appreciate your reply. I was wondering if insulin resistance would make my cholesterol go up on the ketogenic diet from a total of 220 before I went on it to 378 after being on it for six months. I have always been in a healthy weight range for my height, but I have always been extremely hungry most of the time. I really got on the ketogenic diet hoping that this would be regulated after being on it for some time, but it hasn’t helped that much. Would this signify that insulin resistance may be the culprit for my sudden rise in cholesterol even though I am following the ketogenic diet perfectly?

A side benefit of the diet is that many parents say their children are more alert and make more progress when on the diet, even if seizures continue. If the diet seems to be helping, doctors will usually prescribe it for about two years. Then, they may suggest that parents slowly begin including regular food in the child’s diet to see if the seizures can still be controlled, even with a normal diet.
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.
Unfortunately, there’s no long-term data on ketogenic diets versus other diets. In a 2015 Italian study, those on a ketosis diet lost 26 pounds in three months. About half of the participants stayed on the diet for a year but lost little additional weight in the next nine months. People in a 2014 Spanish study who followed a very-low-calorie ketogenic diet lost an average of 44 pounds in a year—but a third of them dropped out, possibly because it was too hard to maintain.
This is so important. I think people need to know just because you lower your LDL doesn’t mean you’ve necessarily made yourself healthier. What it does when you have the vegetable oils and you lower your LDLC, you could see your total cholesterol go to 150 for example. Okay, you think you’ve done something good, what you’ve done though is you totally eliminated all of those healthy pattern A, the large fluffy kind, you’ve totally eliminated those drinking these vegetable oils because you’ve oxidized the LDL, making them into more of those small LDL and you’re at great risk for heart disease.
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.
Health Impact News has reported on many of the disease reversing results of the ketogenic (high fat-moderate protein-low carb) diet. Now, a new study is looking at the positive effects of gut bacteria among those following a ketogenic diet for epilepsy. Even though Johns Hopkins used a ketogenic diet for curing epilepsy over 80 years ago, when medical drugs did not help epilepsy effectively, mainstream medicine continues to rely on new and expensive toxic drugs for epileptic children. The “cocktail” combinations of pharmaceutical drugs prescribed often worsens childhood epilepsy. Health Impact News previously published a report on how a four year old child with refractory epilepsy (not treatable with pharmaceutical medications), was treated at the Rochester, Minnesota Mayo Clinic using a ketogenic diet. At first, the child was also kept on pharmaceuticals. The results were poor until he was taken off the medications; then he began healing completely. A new Chinese study on pediatric epileptic cases may even draw the attention of mainstream medical professionals, due to the results seen in children's gut microbiota structure when following a high-fat ketogenic diet.
There are three instances where there’s research to back up a ketogenic diet, including to help control type 2 diabetes, as part of epilepsy treatment, or for weight loss, says Mattinson. “In terms of diabetes, there is some promising research showing that the ketogenic diet may improve glycemic control. It may cause a reduction in A1C — a key test for diabetes that measures a person’s average blood sugar control over two to three months — something that may help you reduce medication use,” she says.
Initial studies indicate that the ketogenic diet appears effective in other metabolic conditions, including phosphofructokinase deficiency and glycogenosis type V (McArdle disease). It appears to function in these disorders by providing an alternative fuel source. A growing body of literature suggests the ketogenic diet may be beneficial in certain neurodegenerative diseases, including Alzheimer disease, Parkinson’s disease, and amyotrophic lateral sclerosis. In these disorders, the ketogenic diet appears to be neuroprotective, promoting enhanced mitochondrial function and rescuing adenosine triphosphate production.
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.”
Intermittent fasting, an eating style in which you eat within a specific period each day and fast the rest of the time, is a great way to reduce the amount of time your body needs to enter nutritional ketosis. (48) Intermittent fasting accelerates the time to ketosis by keeping insulin levels low and raising ketone levels. If you’re new to intermittent fasting, start by limiting your eating to an eight- to 10-hour window each day and fasting for the remaining 14 to 16 hours of the day (and night).

I think we obsess about numbers because we have been given a range that is supposedly the healthy, right range. Unfortunately there are a lot of mechanisms that we don’t know a lot about right now, that could be going on that makes that happen for some people in the mornings. I’ve just talked to too many of the experts, who say “Don’t worry about that. It’s really not the big deal. Keep an eye on your fasting insulin levels in the morning and even if you want to do a five hour glucose tolerance test, it’s call a 5 hour GTT, could go down to your doctor, please don’t drink that crappy glucose serum, because that will mess you up.” I actually did it one time with my co-author, he actually ran it with me … I wanted to see what would happen to my blood sugar and insulin levels when I had a low carb meal.
The CKD is rich in lipids (90%) and low in carbohydrates and protein, in order to produce ketosis, and simulates a starvation state. It is a rigid diet, mathematically and individually calculated, and medically monitored (Armeno et al., 2014). It must also provide adequate vitamins and minerals. The shift in the energy metabolism from glycolytic energy production to energy generation through oxidative phosphorylation (fatty acid b-oxidation and ketone-body production) is part of the anticonvulsant mechanism of the KD (Bough, 2008; Liu et al., 2018). This is discussed in more detail in the section on the mechanism of action.
They need to make a lot of ATP, and quickly, to support their high requirements for energy. Adenosine triphosphate, also known as ATP, is a compound that provides energy to drive hundreds of thousands of biochemical processes in living cells. Found in all forms of life, ATP is often referred to as the chemical energy “currency” that powers metabolic activity.
"It's a cocktail of drugs and procedures and foods and they all work synergistically to gradually eliminate the tumor while maintaining the health and vitality of our normal organs. The whole goal of this metabolic therapy, which involves the ketogenic diet, is to gradually degrade and eliminate tumor cells without toxicity so the patient emerges from the therapy healthier than when they started."
Tumors have hypoxic zones and normoxic (aerobic) zones, with a symbiotic relationship between the two. Hypoxic cancer cells derive energy from fermentation of glucose, and secrete lactate. Normoxic cancer cells prefer and attract lactate as fuel for the TCA cycle, sparing glucose for the hypoxic cells. [NCBI, “Tumor cell metabolism: an integral view”]
Apoptosis Induction. Studies show that dietary energy restriction enhances phosphorylation of adenosine monophosphate kinase (AMPK), which has been found to induce apoptosis in glycolytic-dependent brain cells and protect normal brain cells from death. One way to naturally restrict energy consumption is with a keto diet because most keto dieters spontaneously eat fewer calories than they do when they are on a higher carb diet. Altogether, this may explain why most of the research on keto and cancer has shown the keto diet to be effective in the treatment of brain tumors (glioblastomas and gliomas).
The word "ketogenic" refers to ketone bodies that come from the breakdown of fat. The ketogenic diet is specifically planned to meet all of your child's calorie needs for growth and development, but it does contain high fat, low carbohydrate, and adequate protein. Instead of getting energy from sugar, the brain will get energy from the breakdown of fat. Exactly how this helps to control seizures is not known; both high fat and low carbohydrate may be important for seizure control. About half of the patients on this diet have more than 50% reduction in the number of seizures; about 20-30% may have more than 90% reduction in seizures. Less than 10% of patients on the ketogenic diet may have no seizures at all.
Being in ketosis can help you feel more alert, avoid sugar crashes that steal your energy, and possibly let you reach your goal weight. I say possibly because it doesn’t work for everyone. If you’re eating too many inflammatory calories you won’t lose weight, and furthermore, some people get bored with the lack of variety on keto diets. That’s where eating more complex carbs can rescue the plan. Try cyclical ketosis.
However, this doesn't happen in every case or even most cases. In fact, many people see little to no increase in their LDL cholesterol while experiencing beneficial changes in other markers, such as an increase in HDL cholesterol and a decrease in triglycerides, blood sugar, and insulin levels – all of which are associated with reduced risk of CVD.
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