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.
An overwhelming majority (90%) of parents said that they would. Even though the keto diet is extremely restrictive, time consuming, and requires rigid maintenance, most parents found the potential benefits outweighed its drawbacks. Many parents in the study were more concerned about the side effects of the medications―and were grateful for the opportunity to explore an alternative option. Further, 55% would consider trying the diet again.
In order to be successful, this therapy calls for strict compliance and plenty of patience, especially in the beginning. Most important, patients with epilepsy should only use the diet with the support of a knowledgeable ketogenic diet team, including a doctor and a licensed dietitian who can correctly calculate and monitor the diet for each individual.
Pattern B LDL, on the other hand, has a much smaller particle size and is much more prone to oxidation. Another thing about pattern B LDL is that it is small enough to enter into the endothelial lining of the artery where it can become oxidized and more likely to form plaque. There is a high association between these small dense particles and cardiovascular disease.
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.  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).
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.
The mainstay of treatment for epilepsy is pharmaceutical intervention. As I recently noted, more and more we are seeing surgical procedures being performed for those individuals who have not had a significant improvement with drugs. I indicated that at least some individuals are gluten sensitive and may benefit from a gluten-free diet which potentially could keep them from undergoing potentially life-threatening surgery as a treatment for their epilepsy.
A randomised, controlled clinical trial among 120 overweight adults with high levels of cholesterol compared the effects of a ketogenic diet against a low-fat diet. After 24 weeks, the group following the keto diet reported greater weight loss and declines in the triglyceride levels and higher increases in the HDL cholesterol levels compared to the low-fat group (11).
The MAD aims to provide increased flexibility and palatability, with a 1:1 ratio of fat to carbohydrates and protein, and contains around 65% fat, 25% protein, and 10% carbohydrate (Payne et al., 2018). Fat is encouraged and the carbohydrate intake is limited to 10–20 g/day in children and 15–20 g/day in adults (Kossoff, 2004; Kossoff and Dorward, 2008). Because of carbohydrate restriction, the MAD can also produce urinary ketones (Carrette et al., 2008). The MAD does not require weighing food on a gram scale, or restriction of calories, protein or liquids, and may be a good option for patients who are unable to tolerate a more restrictive diet such as the classical ketogenic diet (KD) (Cervenka et al., 2012). Low-carbohydrate multivitamin and calcium carbonate supplementation is recommended in the MAD (Kossoff et al., 2009).
The KetoPet Sanctuary was started in 2014 to rescue shelter dogs with terminal cancer and give them a forever home. Once at KetoPet, each dog was placed on a raw ketogenic diet (high fat, adequate protein, very low carbohydrates). We then did something that was never done before: we used PET (positron emission tomography) to image disease and validate our nutrition-first approach. While not a cure, we found a raw ketogenic diet to be effective in improving outcomes for dogs with cancer. Even more, these case studies support our belief that all dogs should eat a raw ketogenic diet optimal health.
Basically, carbohydrates are the primary source of energy production in body tissues. When the body is deprived of carbohydrates due to reducing intake to less than 50g per day, insulin secretion is significantly reduced and the body enters a catabolic state. Glycogen stores deplete, forcing the body to go through certain metabolic changes. Two metabolic processes come into action when there is low carbohydrate availability in body tissues: gluconeogenesis and ketogenesis.
It’s not heart healthy because it’s raising inflammation. The reason they put in on there though is it does one thing on your cholesterol panel that they think is good. It lowers the LDLC number. It does. It will do it all day everyday. You can sit there and drink Canola oil, and your LDL will go down, your LDLC. That LDLC is just a calculated number using this thing called the Friedewald equation and it’s not directly measured. That’s another thing people don’t realize. LDLC is just totally an estimated number. When your triglycerides are under 100 and your HDL is over 50, it totally miscalculates what your LDL is. That’s why that NMR lipo profile test to know the particles is so important. I know I’m talking fast and saying a lot of technical terms.
The goal is to reach a ratio of four portion of fat to one portion of protein plus carbohydrate, described as “4:1.” To achieve this level, one of two approaches, with or without fasting, may be used. In the former approach, the patient must be hospitalized for 12–48 h, or when ketones are present in the urine (Rubenstein, 2008), to prevent the development of hypoglycemia and dehydration. This method tends to accelerate the development of ketosis although it can generate more stress on the patient (Armeno et al., 2014). When ketosis is reached, the meals are calculated to maintain a constant KD ratio, while calories are added until full-calorie meals are tolerated (Kossoff et al., 2009). The latter approach requires no hospitalization and the KD ratio increases weekly, from 1:1, 2:1 and 3:1 to 4:1 (Bergqvist et al., 2005). Most of the literature suggests that there is no significant difference between the two approaches in terms of the time needed to reach ketosis and the occurrence of hypoglycemia (Kim et al., 2004), so nowadays patients tend to not fast.
This describes me, too. I am not a doctor, but after months and years of research, have decided to follow the ketogenic lifestyle and the naturopathic cancer treatments prescribed by my physician. It took a few months to find a doctor who embraced this, but he is worth it. Keto had my diabetes under control long before we realized that cancer was trying to get me as well. I take no chemical drugs for anything. Diet, exercise, and a few supplements take care of my health needs. You don’t know me, but three years ago, I needed a walker and a wheelchair. Today at 60, I walk under my own power and ride a bicycle as much as possible. Go as natural as you can, it helps. Stay away from “products” and just eat fresh, whole, natural food. (The article shows these.)