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).
Unfortunately that’s wrong. Unfortunately total cholesterol doesn’t tell the whole story. It includes one number that you want to have higher. That is you HDL good cholesterol. When you start eating low carb, high fat, keto, one of the tell tale signs that you’ve done it very well is your HDL, especially you ladies, you’re lucky Leanne … you ladies can make your HDL just go really high. I have to work hard as a guy to get mine in the 70-80 range, which is pretty good for a guy. Most people walking around their HDL is sub 40, and most of them probably sub 20 if they’re not eating enough fat. You have to eat saturated fat in order to raise that good HDL cholesterol. Okay?
Research has indicated that a ketogenic diet raises the stress hormone cortisol to increase energy levels in the face of reduced carbohydrate availability. However, it is still up for debate whether this increase in cortisol is harmful or innocuous. Nonetheless, I recommend taking extra care to manage your stress while on a ketogenic diet. Getting plenty of sleep, exercising, and engaging in a regular stress-reduction practice can help you keep your baseline stress levels low and reduce the potential for chronically elevated cortisol.
Chris: Okay. Thanks, Kelsey, for sending that question in. It’s a really great question, one that’s been on my mind a lot recently, actually, and I’ve been diving into the research on. Most of you probably know that cancer dogma holds that malignancies are caused by DNA mutations inside the nuclei of cells and that these mutations ultimately lead to runaway cellular proliferation, which is the hallmark feature of cancer.
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.
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 terms of our specific discussion, diet as cancer treatment, Dr. Kelley demonstrated more recently in his Dallas, Texas, and Winthrop, Washington offices, no one diet suits all patients diagnosed with the disease, quite the contrary. Over a 20 year period working in the trenches treating many thousands of people, Dr. Kelley came to learn that each patient who walked into his office required a diet designed specifically for his or her metabolic needs, and these dietary requirements could vary enormously from patient to patient.
Thank you, Thank you, Thank you!!!!! Your article couldn't have been timed any better. I got my blood panel back from my "western" doctor two days ago and the numbers had me very worried. After reading your post yesterday I felt so much better and sent the results off to my naturopath knowing that everything should be fine. I printed it out for my own reference and for any others, doctors included, who may have doubts and questions. Again, a big thanks for all your research and putting it out there for the rest of us trying to live a longer, healthier life!!

Your current cholesterol levels l is higher than I would personally feel comfortable with. I would consider making a few dietary changes (i.e., increasing fiber and net carbs, reducing saturated fat, and increasing protein), especially given your lack of improved cognition and decreased ability to work out. I wish you the best of luck going forward. - Franziska
This is because the triglycerides from those fat cells are metabolized for energy while the cholesterol is not. The cholesterol is simply released into the blood where it will remain until removed by the liver, making it appear that our cholesterol has suddenly skyrocketed. Many people are quick to assume that this is due to an increase in dietary fat and cholesterol intake.
Jimmy Moore: Just removing the infections that were in the mouth and the mercury amalgam poisoning that was probably happening. Was raising my cholesterol because it was trying to be that fire fighter to put out the fire. Of course it never showed up in my inflammation because the cholesterol was taking care of it, had I been taking a Staten drug Leanne, I would have been at great risk. I would have been in really bad shape. Anyway, I thought okay that was maybe an anomaly, that was in October. Let me have it run again, I had it run again last month … 289 again. Not a fluke, and that’s one of the things we did in Cholesterol Clarity, was you said, “why aren’t doctors asking why the cholesterol is high?” All they know is that it’s high. Therefore you have a Staten deficiency and please take this drug.
In one study, a variant of the ketogenic diet was applied to children with autism [51, Class III]. This diet was a modified John Radcliffe diet, which substitutes medium-chain triglycerides for some fat, but it was administered for only 4 of every 6 weeks during this 6-month trial (ie, cycles of 4 weeks “on diet” and 2 weeks “off diet” were used for the duration of the study). This group studied children on Crete, an island with a relatively isolated population and a significant number of autistic children. Behavior was rated on the standardized Childhood Autism Rating Scale (CARS) by a blinded child psychiatrist. Of the 18 children who completed the study, 2 demonstrated significant improvement (ie, CARS score reduced by > 12 points), 8 had moderate improvement (CARS score reduced by 8–12 points), and 8 showed minor improvement (CARS score reduced by 2–8 points). Children with lower starting CARS scores (less severe autism) appeared to respond better than those more severely affected. These findings should be interpreted with caution for a number of reasons. Given the geographic isolation of Crete, there may have been a strong genetic contribution to autism in this population. Methodologically, the CARS score was not designed as a longitudinal test, making its meaning in this study unclear. Additionally, intermittent administration of the ketogenic diet has not been examined in other disorders, making it difficult to compare this intervention with other studies of the ketogenic diet. Finally, any structured intervention may be associated with improved performance in patients with autism. Further study with appropriate controls (structured diet plans, vitamin administration) is needed to confirm these findings.
Dr. Vincent M. Pedre, medical director of Pedre Integrative Health and president of Dr. Pedre Wellness, is a board-certified internist in private practice in New York City since 2004. His philosophy and practices are a blend of both Western and Eastern medical traditions. He is a clinical instructor in medicine at the Mount Sinai School of Medicine and is certified in yoga and medical acupuncture. His unique methodology is best described as integrative or defined by a functional, systems-based approach to health. With his holistic understanding of both sides of the equation, he can help each patient choose the best course of action for their ailments to provide both immediate and long-term relief. His holistic approach incorporates positive, preventive health and wellness lifestyle choices. Dr. Pedre Wellness is a growing wellness platform offering health-enhancing programs along with informative social media and lifestyle products, such as dietary supplements, books, and weight-loss programs.
Once a child is considered a candidate for the diet, a screening evaluation by selected members of the team responsible for implementing the diet is initiated. This screening includes a comprehensive evaluation by the dietitians and nursing staff. The purpose of this evaluation is to educate the family and to assess their ability to maintain the diet. At the same time, the different types of meal plans and foods that the child can eat are discussed, along with their preparation. Children traditionally are fasted for 24 hours prior to the initiation of the diet, beginning after the dinner on the day prior to admission. Occasionally, medically complex children will not be fasted. There are many ketogenic diet centers now that do not fast children, and research indicates that there is no difference in efficacy between fasted and non-fasted children. However, a more rapid reduction of seizures often seen with earlier ketosis can lead to a quicker response . Evidence also suggests that fasting is not the same as the diet in terms of mechanism of action and so may be of additional help. The decision to fast should be individualized and also at the comfort level of the ketogenic diet team.
A ketogenic diet promotes healing of the brain following TBI by increasing the activity of genes genes involved in energy metabolism, stimulating the generation of new mitochondria, and inhibiting the production of damaging reactive oxygen species in the brain. (24) In animal models of TBI, a ketogenic diet reduces cerebral edema and neuronal cell death while improving behavioral outcomes. (25, 26) While individual success stories of people using a ketogenic diet for TBI are easy to find on the internet, formal clinical trials are still needed.
For the study I reviewed thousands of Kelley’s charts, interviewed over a thousand of his patients, and evaluated 455 of them in some detail. I eventually put my information into monograph form under Dr. Good’s direction, including 50 lengthy case reports of patients with 26 different types of appropriately diagnosed, poor-prognosis cancer who had responded to Kelley’s nutritional regimen.
Here’s an interesting thing that came out in Cholesterol Clarity. One of my experts, and we had 29 experts in the book that I quoted from, was Chris Masterjohn, and he said in traditional cultures, where there’s no heart disease at all, the normal level of total cholesterol for people in 6o-80s, want to guess? Of course if you read my book, you know.

In fact, once all our our reserved glucose/glycogen runs out after several days on a low-carb, keto diet, our bodies create compounds called ketone bodies (or ketones) from our own stored body fat, as well as from fats in our diet. In addition, researchers have discovered that ketones contain main benefits, such as fat loss, suppressing our appetites, boosting mental clarity and lowering the risk for a number of chronic diseases.


The precise mechanisms behind the physiological effects of the ketogenic diet and ketones are not fully understood. It is believed that the ketogenic diet is anti-inflammatory, that it decreases free radical production while enhancing production of the body’s own natural anti-oxidants, and it improves metabolic efficiency.8 9 10 11 12 Specific conditions a ketogenic diet may benefit include:

You’re very welcome, Judy! I’m glad it’s helpful. If you are keto (as opposed to low carb), unfortunately peaches would not allow you to stay in ketosis. You can check my keto food list to help determine what is keto friendly. Of course, there are worse things than fresh fruit 🙂 but in the end our bodies still see the sugar. That being said, it doesn’t mean you sabotaged the whole day. Just pick up again – you got this!! (And for next time, try some fresh berries in moderation when you’re craving fruit.)


Polycystic ovary syndrome (PCOS) is the most common endocrine disorder, and it affects women of reproductive age. Symptoms include obesity, hyperinsulinemia and insulin resistance. A pilot study took 11 women through 24 weeks of a low-carbohydrate ketogenic diet (20 grams or less per day). Among the five who completed the study, they lost 12 percent of their weight on average and reduced fasting insulin by 54 percent. Additionally, two women who previously experienced infertility problems became pregnant. (6)
You can make the argument that high cholesterol leads to atherosclerosis because the plaques are created by cholesterol build-up. However, the root cause of the issue is inflammation and arterial scarring in the first place. If you’d have lower CRP, then cholesterol would simply be transported around the body by VLDL and if it’s not needed for nutrition it’d be transited back to the liver by HDL.
If you're new to keto, watch out for hidden carbs. Generally, dairy products and nuts are a good way to meet your daily fat intake, but know that some of those items may contain more carbohydrates than you think. For example, yogurt topped with nuts may seem like a great keto-friendly snack, but a 5.3 ounce serving of plain yogurt has 12 grams of carbohydrates. Vanilla flavored yogurt has 24 grams of carbohydrates. Add an ounce of cashews, weighing in at nearly nine grams of carbs, and you’re up to 21 to 33 grams of carbs for that snack, which could knock you out of ketosis. Be sure to read nutrition labels carefully and pay careful attention to serving sizes. Track foods using a keto-specific app like Senza or KetoDiet can help you stay within your recommended daily carb intake.
Traditionally, the KD has been considered the gold standard for the treatment of metabolic diseases such as Glucose Transporter Protein 1 (GLUT-1) deficiency syndrome and Pyruvate Dehydrogenase Deficiency. At present, the KD has been consistently reported as more beneficial, with more than 70% patients showing positive responses, as opposed to the average 50% response in several conditions such as infantile spasms (Table 1). The KD has also been used in other conditions with less evidence, but possible benefits (Table 2) (Kossoff et al., 2018). Additionally, the KD is an important alternative treatment for patients with refractory epilepsy (Rho, 2017) that are not surgery candidates.
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.
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/
A number of patients previously refractory to multiple anticonvulsant medications become seizure-free or maintain a significant reduction in seizure frequency even after the ketogenic diet has been discontinued, suggesting the diet may have disease-modifying effects in some people with epilepsy [19,20•, Class III]. No clinical factors have been identified that predict which patients will benefit most in this regard.
The authors defined a VLCKD as a diet lower in 50g of carbohydrates – lower than the daily recommended grams of carb consumption clinicians recommend to diabetics. They included 13 randomized controlled studies with a total of 1,415 subjects. All studies took place for at least a full year and all subjects included were over 18 years old and had a BMI of at least 27.5 kg/m2. In each of these studies, VLCKD diets were compared to low-fat diets.
Hi Jenn, I would not recommend the medication as it is not going to address the root cause of any sort of dysfunction that may be leading to what we are seeing on the lab. When I see elevated cholesterol levels with good Triglyceride:HDL ratios, I most commonly see an underlying thyroid issue with low free T3 levels. I would want to test your thyroid in detail and you may need some additional thyroid hormone support. With very high HDL over 90, I will also see chronic infections and food sensitivities as an issue.
A ketogenic diet has been observed to raise cortisol, the body’s primary stress hormone. If you struggle with high levels of stress or HPA axis dysfunction, a ketogenic diet may push your stress-response system into overdrive and cause burnout. A diet that includes a moderate intake of carbohydrates is typically a better fit for those with high-stress lifestyles or HPA axis dysfunction.

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...
A meta-analysis of 13 randomized controlled trials following overweight and obese participants for 1-2 years on either low-fat diets or very-low-carbohydrate ketogenic diets found that the ketogenic diet produced a small but significantly greater reduction in weight, triglycerides, and blood pressure, and a greater increase in HDL and LDL cholesterol compared with the low-fat diet at one year. [10] The authors acknowledged the small weight loss difference between the two diets of about 2 pounds, and that compliance to the ketogenic diet declined over time, which may have explained the more significant difference at one year but not at two years (the authors did not provide additional data on this).
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.
I’m following the ketogenic diet and I find it very easy, pleasant and varied. I can even say that my diet today is more varied than the previous one. I do not intend to leave this diet and I cannot really see why. My initial focus was not to lose weight, I’ve always been lean, but to feel better, well disposed. And I got it! I am very pleased, I have read a lot about it (including scientific literature) and I have influenced other people who need to lose weight or improve some aspects of their health. But from the beginning I went on my own way, without the help of a nutritionist because I did not want to suffer the influence of others’ ideas.
Chapter 6 continues with advice on customizing the diet, foods that are allowed or disallowed, meal preparation, and how to follow the diet when away from home, such as restaurant or travel dining. Chapter 7 presents a number of diverse topics of great practical importance especially to a cancer patient but seldom mentioned in popular diet books: alcohol consumption: how to handle incidental illnesses; sick days and menstrual cycles; stress; exercise; acidity and alkalinity; and vegetarianism. Finally there are 12 appendices that provide convenient worksheets and a wealth of advice and information that will save many telephone calls, and trips to the library or internet.
Gluconeogenesis is the endogenous production of glucose in the body, especially in the liver primarily from lactic acid, glycerol, and the amino acids alanine and glutamine. When glucose availability drops further, the endogenous production of glucose is not able to keep up with the needs of the body and ketogenesis begins in order to provide an alternate source of energy in the form of ketone bodies. Ketone bodies replace glucose as a primary source of energy. During ketogenesis due to low blood glucose feedback, stimulus for insulin secretion is also low, which sharply reduces the stimulus for fat and glucose storage. Other hormonal changes may contribute to the increased breakdown of fats that result in fatty acids. Fatty acids are metabolized to acetoacetate which is later converted to beta-hydroxybutyrate and acetone. These are the basic ketone bodies that accumulate in the body as a ketogenic diet is sustained. This metabolic state is referred to as "nutritional ketosis." As long as the body is deprived of carbohydrates, metabolism remains in the ketotic state. The nutritional ketosis state is considered quite safe, as ketone bodies are produced in small concentrations without any alterations in blood pH. It greatly differs from ketoacidosis, a life-threatening condition where ketone bodies are produced in extremely larger concentrations, altering blood ph to acidotic a state.
The end result of the “ketone diet” is staying fueled off of circulating high ketones (which are also sometimes called ketone bodies) — which is what’s responsible for altering your metabolism in a way that some people like to say turns you into a “fat-burning machine.” Both in terms of how it feels physically and mentally, along with the impact it has on the body, being in ketosis is very different than a “glycolytic state,” where blood glucose (sugar) serves as the body’s energy source.
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.
About 59% of participants completed the 12-month trial: 33 in the low-carb group and 36 in the low-fat group. Both groups lost similar amount of body weight and body fat. The subjects who participated in the low-fat intervention experienced an average increase in HDL cholesterol of 0.07 mmol/L from 1.36 mmol/L to 1.43 mmol/L. [12] This represents a 4.9% increase.
Salad mixes, fermented things like sauerkraut and kimchi, unsweetened yogurt, unsweetened coconut yogurt, coconut oil, cultured cottage cheese and cultured sour cream. I am not eating meat or carbs except what is present in some vegetable juices. I started exercising a little and hot baths, having less pain and feeling like I have control over symptoms. Of course using some supplements. For me, dessert will be surviving long enough to see old friends and make new ones.
Within 7 days of initiating the ketogenic diet, blood glucose levels declined to low-normal levels and blood ketones were elevated twenty to thirty fold. Results of PET scans indicated a 21.8% average decrease in glucose uptake at the tumor site in both subjects. One patient exhibited significant clinical improvements in mood and new skill development during the study. She continued the ketogenic diet for an additional twelve months, remaining free of disease progression.
May this letter find you and your loved ones happy and healthy for without you I would not be in such an improved state of physical health? It is not often I get to put pencil to paper for not only could I not concentrate due to opiate pharmaceuticals (couldn't express oneself due to lack of cognitive thinking) but the pain, inability to get comfortable due to lymphodemia and anxiety from stress (from lack of cash flow for food, bills, medicines plus the high expense of bandages & ointments) have prevented me from making contact but ....still after this prolonged period of time, I feel it necessary to write personally to mention just how dramatically you changed the world my two children and I live in. My sister Casey Lee Smith, arrived 6 months ago from the USA to run my household and it is through "Phoenix Tears" website she was able to make contact with you and learn all about the many wondrous benefits of medicinal Cannabis oil. When the treatment arrived, I was overwhelmed for I am a single Mother and your generosity brought tears to my eyes (even now it is hard to fight tears as I write) It has been rough to say the least. Feeling helpless, overly tired and frustrated by the lack of qualified physicians in my local town. I became depressed. My ex-husband felt he should prepare the kids for my untimely death. The location of my cancer spread throughout my left quadrant into my lymph and into the brain. I became bed ridden and lost hope. I will lose my house shortly but now i know it won't be my life. So, "THANK YOU" for the gracious gift and know you are loved! Sending love to you forever and always.
Cyclical ketosis means you’re sometimes in ketosis and sometimes aren’t. A few days each week—the night before workout days to build glycogen stores in your muscles—try increasing your intake of berries, higher complex carb veggies (like sweet potatoes), and non-gluten grains. It might knock you out of ketosis temporarily, but it also provides a wealth of nutrients to keep you lean, healthy, and happy. This is also called flexible ketosis, which creates metabolic flexibility—the holy grail of metabolism management. I’ve also talked about cycling ketosis with intermittent fasting, which provides a win-win strategy to reach your health goals.

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


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]


However different these diets might be, each of these groups, and the many other traditional peoples Price studied, enjoyed excellent enduring health, free from the diseases of civilization – cancer, diabetes, heart disease, and hypertension. In his extraordinary and very detailed 1945 book Nutrition and Physical Degeneration, Dr. Price documented his thesis that we humans over the millennium adapted to and thrived on not one, as the experts usually claim, but a variety of different diets.
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]

The ketogenic diet achieved national media exposure in the US in October 1994, when NBC's Dateline television programme reported the case of Charlie Abrahams, son of Hollywood producer Jim Abrahams. The two-year-old suffered from epilepsy that had remained uncontrolled by mainstream and alternative therapies. Abrahams discovered a reference to the ketogenic diet in an epilepsy guide for parents and brought Charlie to John M. Freeman at Johns Hopkins Hospital, which had continued to offer the therapy. Under the diet, Charlie's epilepsy was rapidly controlled and his developmental progress resumed. This inspired Abrahams to create the Charlie Foundation to promote the diet and fund research.[10] A multicentre prospective study began in 1994, the results were presented to the American Epilepsy Society in 1996 and were published[17] in 1998. There followed an explosion of scientific interest in the diet. In 1997, Abrahams produced a TV movie, ...First Do No Harm, starring Meryl Streep, in which a young boy's intractable epilepsy is successfully treated by the ketogenic diet.[1]
In 1921, Rollin Turner Woodyatt reviewed the research on diet and diabetes. He reported that three water-soluble compounds, β-hydroxybutyrate, acetoacetate, and acetone (known collectively as ketone bodies), were produced by the liver in otherwise healthy people when they were starved or if they consumed a very low-carbohydrate, high-fat diet.[10] Dr. Russell Morse Wilder, at the Mayo Clinic, built on this research and coined the term "ketogenic diet" to describe a diet that produced a high level of ketone bodies in the blood (ketonemia) through an excess of fat and lack of carbohydrate. Wilder hoped to obtain the benefits of fasting in a dietary therapy that could be maintained indefinitely. His trial on a few epilepsy patients in 1921 was the first use of the ketogenic diet as a treatment for epilepsy.[10]
A randomised, parallel-group trial among 307 obese participants demonstrated that a low-carbohydrate, high-fat diet resulted in lower levels of diastolic blood pressure, triglyceride, and LDL cholesterol levels in the first 6 months compared to the low-fat diet group. Moreover, the HDL cholesterol increased by 23% after 2 years in the low-carbohydrate, high-fat diet group (14).
The ketogenic diet has been shown to produce beneficial metabolic changes in the short-term. Along with weight loss, health parameters associated with carrying excess weight have improved, such as insulin resistance, high blood pressure, and elevated cholesterol and triglycerides. [2,7] There is also growing interest in the use of low-carbohydrate diets, including the ketogenic diet, for type 2 diabetes. Several theories exist as to why the ketogenic diet promotes weight loss, though they have not been consistently shown in research: [2,8,9]
In fact, ketogenic diets have been used for nearly a century to treat seizures, says Gary Yellen, a professor or neurobiology at Harvard Medical School. “It dates back to studies from the 1920s that found this kind of diet was like a sustainable form of fasting, which we’ve known, supposedly since antiquity, to be beneficial for epilepsy,” he says.
Fairly recently, the diet was introduced as a weight-loss diet by an Italian professor of surgery, Dr. Gianfranco Cappello of Sapienza University in Rome. In his 2012 study, about 19,000 dieters received a high-fat liquid diet via a feeding tube inserted down the nose. The study showed an average weight loss of more than 20 pounds in participants, most of whom kept it off for at least a year. The researchers reported a few minor side effects, like fatigue.
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 [23]. 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).
In terms of our specific discussion, diet as cancer treatment, Dr. Kelley demonstrated more recently in his Dallas, Texas, and Winthrop, Washington offices, no one diet suits all patients diagnosed with the disease, quite the contrary. Over a 20 year period working in the trenches treating many thousands of people, Dr. Kelley came to learn that each patient who walked into his office required a diet designed specifically for his or her metabolic needs, and these dietary requirements could vary enormously from patient to patient.
But no fear, there’s always a new miracle around the corner, and in 1998 the newspaper reporters and TV newscasters, having effortlessly drifted away from interferon and interleukin-2 and the bone marrow transplant craze, were all in a tizzy over the newest “final” solution to cancer, anti-angiogenesis, based on the pioneering work of the late Dr. Judah Folkman of Harvard. Dr. Folkman had spent decades studying the process of angiogenesis in cancer tissues, the formation of new blood vessels that allow tumors to grow quickly and invade through normal tissues and organs with deadly effect.
HDL is still low and stuck on 45 even after hoping strongly with more healthy saturated fats organic bone broth from lamb bones, etc. LDL way up 170 and triglycerides a a record high of 170, Non HDL choleseterol at 203. Kinda surprizd I cannot more that HDL number aftyer all the keto stuff. And unsure why the LDL has exploded since stress has always been with me these last 9 years.

Some practitioners have raised the concern that long-term adherence to a ketogenic diet may shift the composition of the microbiota (the beneficial microbes that live in our bodies) in an undesirable direction and may even encourage the overgrowth of ‘bad’ bacteria. These beneficial bacteria feed on prebiotics (such as fiber and resistant starch), both of which are likely to be low in a low-carbohydrate ketogenic diet. Without prebiotics, beneficial bacteria are not able to produce substances like butyrate and other short chain fatty acids that keep the intestinal cells healthy, and long-term disruption of the microbiota can lead to a host of health problems throughout the body. 57 58


Thank you, Thank you, Thank you!!!!! Your article couldn't have been timed any better. I got my blood panel back from my "western" doctor two days ago and the numbers had me very worried. After reading your post yesterday I felt so much better and sent the results off to my naturopath knowing that everything should be fine. I printed it out for my own reference and for any others, doctors included, who may have doubts and questions. Again, a big thanks for all your research and putting it out there for the rest of us trying to live a longer, healthier life!!

Sharon M. Nickols-Richardson, PhD, RD, , Mary Dean Coleman, PhD, RD, Joanne J. Volpe, Kathy W. Hosig, PhD, MPH, RD, “Perceived Hunger Is Lower and Weight Loss Is Greater in Overweight Premenopausal Women Consuming a Low-Carbohydrate/High-Protein vs High-Carbohydrate/Low-Fat Diet,” The Journal of Pediatrics: Vol 105, Issue 9: 1433–1437; September 2005. http://www.sciencedirect.com/science/article/pii/S000282230501151X.
We know now that plaque formation is a culmination of inflammation at the plaque formation site along with a white blood cell mediated interaction between calcium, cholesterol and other biological substances. In fact, it is thought that cholesterol is actually used by the body as a kind of internal bandage when our arterial lining becomes damaged by inflammation. This means that cholesterol build up in the arteries may actually be a protective mechanism.
I was a Corpsman (not a corpse-man as some recent somewhat fanatical president would say), and I can tell you many stories of Marines and Sailors who maintained restrictive diets (aka picky eaters). Most obvious was lack of sustaining energy (hypoglycemia) at mile 15 (with 80lbs of gear including a 6.5lb rifle and 200 rnds of ammo, etc.) and depletion of essential vitamins, electrolyte imbalance. They were always the first to collapse and have to hear me scold “see I told you so.” An IV of D5W usually does the trick (D is for dextrose, OMG!)

It’s also interesting that the cancers used to produce the basic science cited by Dr. Seyfried are virtually all brain cancers and that virtually all the evidence comes from rodent tumor models. For one thing, if there is a tumor type that exhibits the Warburg effect and a high degree of metabolic derangement, it’s brain tumors. It’s no coincidence that dichloroacetate was first tested in brain tumors. In this study, VM/Dk mice were used, and a mouse histiocytoma cell line resembling human glioblastoma multiforme with macrophage/microglial properties derived from that same mouse strain (VM-M3) was implanted subcutaneously. This cell line has the property of metastasizing quickly and widely when implanted under the skin and allowed to grow, which actually makes it not very much like brain tumors, which seldom metastasize and usually kill through local invasion and taking up increasing volume in the closed space of the skull, something the brain most definitely does not like. The results showed that a ketogenic diet increased mean survival time by over 56%, while a combination of a ketogenic diet and hyperbaric oxygen therapy (HBOT) increased survival time 78%. The result is interesting, but it is a mouse tumor model, not a human tumor model, and that makes its applicability to humans tenuous, particularly given the nature of the murine tumor, but probably worth investigating further.
It’s not as though Dr. Seyfried doesn’t cite clinical evidence. It’s just that the evidence is so darned thin and unconvincing thus far. For instance, in this talk, the first study he presents is a very small case series (two patients, actually) performed in 1995 in which two girls with inoperable astrocytomas were placed on a ketogenic diet in order to “determine if a ketogenic state would decrease glucose availability to certain tumors, thereby potentially impairing tumor metabolism without adversely affecting the patient’s overall nutritional status.” Interestingly (to me, at least) these case reports came from University Hospitals of Cleveland, where I did my general surgery residency. In fact, I was still there in 1995. Unfortunately, I don’t have access to the journal back to 1995; so I’m stuck with just the abstract. However, the abstract is pretty clear:
Leanne: Billion. Okay, let’s talk a little bit about Staten, I can’t remember what book it was but they were saying that cholesterol is really important for brain health. You mentioned that too, the cholesterol uses the nutrient and moves it up to your brain, it’s really important. What I was reading is that as we age our cholesterol actually increases slightly to help with that aging process. You often meet people that are in their 40s, 50s, I know a lot of people in my family are now on Staten because their cholesterol is increasing. I always say, “Maybe that’s your body’s way of protecting yourself against aging.”
Discuss this treatment option with your neurologist. If your neurologist feels that the ketogenic diet is a possible option, then bloodwork tests and other investigations may be required to determine if the ketogenic diet can be safely implemented. You may then meet members of the ketogenic diet team such as a registered dietitian, nurse, nurse practitioner, social worker, child life specialist and pharmacist who may offer their assessment on how best to plan for the ketogenic diet. Please note that many centres may have a waiting list.
Ketogenic diet is one of the oldest forms of medical treatment for epilepsy. Most ketogenic diet centres have traditionally specialized in treating children ages 0 to 18 years of age. However, there is growing evidence that shows its usefulness in controlling seizures in adults. In the content below, you will find answers to frequently asked questions about the benefits and challenges of this diet therapy. Please note, the ketogenic diet should never be attempted on your own. It should only be attempted with the support of a trained medical team.
In addition to seizures, the KD has been suggested to treat neurodegenerative disorders (eg, Alzheimer’s, Parkinson’s), metabolic defects, migraines, and other disease states.3 Although the KD isn’t a mainstream form of treatment, the possibility that there may be clinical significance in using dietary means for certain medical conditions can’t be ruled out. This isn’t an endorsement for the KD as much as an expression of interest that, depending on nutritional intake, the body can make astounding adaptations to help control debilitating conditions.
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!
While KD and MAD have demonstrated efficacy in reducing the extent and degree of seizures in epileptic patients, the dietary approaches have been tied to risk of adverse events in both adults and children, although most are treatable and are nearly all  preventable. Adverse effects include constipation, low blood sugar, and gastrointestinal reflux.5,6 Other side effects, such as kidney stones and high cholesterol, can often be improved with supplements or dietary changes.1 These also tend to improve over the long term. Kossoff and colleagues found that both total cholesterol and LDL cholesterol normalized within a year of treatment after initial increases during the first three months of MAD.5
Some negative side effects of a long-term ketogenic diet have been suggested, including increased risk of kidney stones and osteoporosis, and increased blood levels of uric acid (a risk factor for gout). Possible nutrient deficiencies may arise if a variety of recommended foods on the ketogenic diet are not included. It is important to not solely focus on eating high-fat foods, but to include a daily variety of the allowed meats, fish, vegetables, fruits, nuts, and seeds to ensure adequate intakes of fiber, B vitamins, and minerals (iron, magnesium, zinc)—nutrients typically found in foods like whole grains that are restricted from the diet. Because whole food groups are excluded, assistance from a registered dietitian may be beneficial in creating a ketogenic diet that minimizes nutrient deficiencies.
Collectively, these findings suggest that LDL particle size is a more precise indicator of future cardiovascular illness than total LDL cholesterol even when people have high levels of one but not the other. That being said, LDL-C is still a useful indicator for future cardiovascular illness and ideally you want to have both low LDL-C and LDL-P. (Click here to find optimal ranges for LDL-C and here for LDL-P) 

One approach to this question has been to examine the variations in the size of the LDL particles in the blood. With a well-formulated ketogenic diet, we see a shift away from the small dangerous LDL even when the total LDL goes up, so most of this increase is in the ‘good’ or ‘buoyant’ LDL fraction (Hallberg, 2018). Another factor to be taken into account is that during rapid weight loss, cholesterol that you had stored in your adipose tissue (ie, body fat) is mobilized as the fat cells shrink (Phinney 1990). This will artificially raise serum LDL as long as the weight loss continues, but it then comes back down once weight loss stops. To avoid being misled by this, the best strategy is to hold off checking blood lipids until a couple of months after weight loss ceases.
In the absence of glucose, which is normally used by cells as a quick source of energy, the body starts to burn fat and produces ketone bodies instead (it’s why the keto diet is often referred to as the ketone diet). Once ketone levels in the blood rise to a certain point, you enter into a state of ketosis — which usually results in quick and consistent weight loss until you reach a healthy, stable body weight. See this keto diet review, a before and after trying keto for 30 days.
Similarly, in a 2015 study, mice receiving a combination of hyperbaric oxygen and dietary ketone supplementation showed a clear reduction in tumor growth rate and metastasis.20 Also, these mice lived twice as long as control animals. Based on these results, the study authors state that further investigation into the effectiveness of this combination therapy as a potential treatment for late-stage metastatic cancers is urgently required.
In other words, clinical data should be rolling in fairly soon, and that’s a good thing. In the meantime Dr. Seyfried and other advocates who so passionately believe that ketogenic diets will greatly help patients with brain cancer do no one any favors by claiming unequivocally that cancer is a metabolic disease and saying that ketogenic diets are more beneficial than chemotherapy for patients with brain tumors.
Leanne: Okay. Let’s chat a little bit about cholesterol in relation to high fat living. If somebody is planning to go high fat, low carb, keto, a lot of people say “What can I expect my cholesterol?” For me, it went up. Can it go down? What sort of things can we expect when we transition from maybe a plant-based, maybe we’re vegan, maybe we’re just eating paleo or something, to this specific high fat, low carb, keto eating style.
High-protein ketogenic diet (HPKD): This version of the keto diet is often followed by folks who want to preserve their muscle mass like bodybuilders and older people. Rather than protein making up 20 percent of the diet, here it’s 30 percent. Meanwhile, fat goes down to 65 percent of the diet and carbs stay at 5 percent. (Caution: folks with kidney issues shouldn’t up their protein too much.)

Fanatic? Someone with T2D, a disease usually claimed to be progressive and a never ending stream of problems and medications, was REVERSED. That’s something to shout from the rooftops. The drop in medication use alone, but the big pharma companies would prefer that people’s stories of reversing (well, putting it into remission) T2D get called fanatical instead of insightful.


Along with slashing carbs, a ketogenic plan also calls for limiting your protein consumption. If you know your macronutrients, you recognize that cutting carbs and restricting protein means seriously upping your fat intake. And that’s exactly what a true ketogenic diet entails. “You’d want healthy fats to account for about 80% of your calories, and protein around 20%,” Westman says. (For comparison’s sake, the average American gets roughly 50% of her calories from carbs, 15% from protein, and 30% from fat, per the CDC.) 
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