In terms of seizure recurrence among children, the risk of seizures returning in those who are seizure free and stop the diet is 15 to 20%, according to Kossoff. In children who experience less frequent seizures, but are not seizure free, about one-third will have some worsening of seizures when the diet is stopped, though this is sometimes transient.
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).
There are several medical studies — such as two conducted by the Department of Radiation Oncology at the Holden Comprehensive Cancer Center for the University of Iowa, and the National Institutes of Health’s National Institute of Neurological Disorders and Stroke, for example — that show the ketogenic diet is an effective treatment for cancer and other serious health problems. (12)
Ketone bodies, acetoacetate, and β-hydroxybutyrate (βOHB), are byproducts of fatty acid oxidation in the mitochondrial matrix of the hepatocytes. There are many theories about the role of KB, but the existence of an anticonvulsant effect is controversial. Some authors have found no relationship between KB and synaptic transmission and seizure control.
I had the same doubt about coconut oil, I read someone recommending that the first thing to do would be dropping bulletproof coffee and changing to olive oil. Do you think is that valid? My father also has high cholesterol and had a heart attack, though he also had a smoking/drinking record. I never drink/smoke and always exercise, so I hope that compensates, since all the other markers seem to be normal..,though I'm worried and thought if I should just eat more fiber and come back to a Paleo diet including some fruit ( the same guy that recommended the olive oil instead of coconut said that, I don't know if it's valid)
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.
Kidney stones have occurred in about 6 percent of patients and may be increased in younger patients (<3 years of age), and those with hypercalciuria and low urine volume. Oral potassium citrate as a preventative supplement results in urine alkalinization, decreasing the prevalence of kidney stones. Universal supplementation appears to drop the risk of stones to nearly zero.
A study of 39 obese adults placed on a ketogenic very low-calorie diet for 8 weeks found a mean loss of 13% of their starting weight and significant reductions in fat mass, insulin levels, blood pressure, and waist and hip circumferences. Their levels of ghrelin did not increase while they were in ketosis, which contributed to a decreased appetite. However during the 2-week period when they came off the diet, ghrelin levels and urges to eat significantly increased. 
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.
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/
We searched medical databases for randomised controlled trials (clinical studies where people are randomly put into one of two or more treatment groups) of adults or children with epilepsy, where a ketogenic diet was compared with other treatments. We found 11 randomised controlled trials, with 778 participants. The trials were between two and 16 months long.
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.
GBM is the most aggressive cancer of the brain and is difficult to treat by using the conventional therapy of radiation and chemotherapy. The median survival of people with GMB with intensive, standard treatment is an average of 15 months. Both patients in this case study also had advanced stage brain tumors called “astrocytomas” that were unresponsive to conventional treatments.
The medical community has known about cancer cell’s preference for glucose for quite some time. In fact, one of the ways they get an image of a tumor is essentially by injecting a glucose-based “dye” into the body and using some sort of machine to see that “dye.” The area that lights up the most when taking the image is where the cancer tumor is – that’s because of the cancer cell’s overwhelming desire for glucose.
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 theoretically no restrictions on where the ketogenic diet might be used, and it can cost less than modern anticonvulsants. However, fasting and dietary changes are affected by religious and cultural issues. A culture where food is often prepared by grandparents or hired help means more people must be educated about the diet. When families dine together, sharing the same meal, it can be difficult to separate the child's meal. In many countries, food labelling is not mandatory so calculating the proportions of fat, protein and carbohydrate is difficult. In some countries, it may be hard to find sugar-free forms of medicines and supplements, to purchase an accurate electronic scale, or to afford MCT oils.
With this case study, it is important to note that patients with GBM rarely experience a rapid tumor regression after surgical resection and conventional therapy. Thus, the researchers emphasized that the “…response of the GBM in this patient after standard treatment alone would be unlikely, further suggesting a role for targeting energy metabolism as part of the management strategy.”
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 order to transition and remain in this state, aiming for about 30–50 net grams is typically the recommended amount of total carbs to start with. This is considered a more moderate or flexible approach but can be less overwhelming to begin with. Once you’re more accustomed to “eating keto,” you can choose to lower carbs even more if you’d like (perhaps only from time to time), down to about 20 grams of net carbs daily. This is considered the standard, “strict” amount that many keto dieters aim to adhere to for best results, but remember that everyone is a bit different.
These preliminary findings spurred Dr. Good to encourage a more thorough investigation of Kelley’s methods and results. As the project grew in scope, I continued my “Kelley Study” in my spare time during the last two years of medical school, and ultimately brought it to completion while pursuing my immunology fellowship training under Dr. Good at All Childrens’ Hospital in St. Petersburg.
"Most of the work in this field is still pre-clinical, meaning it's been conducted in animal models," Angela Poff, a research associate in the Department of Molecular Pharmacology and Physiology at the University of South Florida, told U.S. News & World Report. "It's been done in various cancer types, but most of the work has been done in brain cancer specifically. But there's very little clinical data all around. There's some case reports and very small preliminary clinical studies in small groups of patients, usually very late-stage patients with various types of cancers. So in the clinical realm, which is the most important in telling us whether this is going to be useful, we have a long way to go."
Cancer cells are unlike normal cells in many ways, but one of their traits that is most unique regards insulin receptors. They have ten times more insulin receptors on their cellular surface. This enables cancer cells to gorge themselves in glucose and nutrients coming from the bloodstream at a very high rate. As you continue to consume glucose as your primary diet source, cancer cells will continue to thrive and spread. It is no surprise that the lowest survival rate in cancer patients is among those with the highest blood sugar levels.
Acid Reflux/GERD (heartburn): people who suffer from acid reflux or chronic heartburn will find great relief after adopting a keto diet, especially if all grain and fermentable carb sources (FODMAPS) are eliminated from the diet. In fact, I believe that some of the beneficial effects of a ketogenic diet are rooted in the elimination of toxins in foods that the keto diet limits.
The traditional Atkins’ Diet was certainly high fat, in the range of 70% or more, nearly all from animal sources, and with minimal dietary carbs, less than 10%. Dr. Atkins, famed for his all-encompassing emphasis on ketosis during his early years as a diet doctor, insisted his patients routinely check the levels of ketone bodies in their urine several times a day, using special “ketone strips.”
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.
Irritatingly, during the same talk, Dr. Seyfried refers to having done a “biopsy” on the GBM when the case report clearly says that the patient underwent a partial excision of the temporal pole with incomplete debulking of the tumor, which is a different thing. When a surgeon tries to debulk a tumor, he is trying to remove as much of it as possible. When a surgeon biopsies a tumor, he is trying only to get enough tissue to make a diagnosis. He also heaps scorn on the hospital for insisting that the patient undergo standard of care therapy, clearly demonstrating that he has no understanding of clinical trial ethics. What most likely happened with this patient is that the debulking was significant, and the remaining tumor was small enough to be eliminated by the combined chemotherapy and radiation therapy—at least to the point of no longer being detectable on PET scan. Also, just because the diet appears to have decreased glucose uptake by the tumor doesn’t mean that the tumor was dying. In fact, it might have even made the PET scan less sensitive to whatever remaining viable tumor cells might still have been around, a possibility that I don’t see Dr. Seyfried as having considered.
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 1920 a New York physician, Dr. Galen, reported at the American Medical Association convention that he had had significant success in treating epilepsy by initiating a program of fasting. At that time the only pharmaceutical interventions that were available included phenobarbital and bromides. Interestingly, the patient he treated was actually a young cousin who had aggressive seizures. On the second day of fasting the child’s epilepsy abated and did not return over the next two years of follow-up. Further studies appearing in 1923, 1926, 1928, all confirmed the effectiveness of fasting as an effective treatment for seizures.
After initiation, the child regularly visits the hospital outpatient clinic where they are seen by the dietitian and neurologist, and various tests and examinations are performed. These are held every three months for the first year and then every six months thereafter. Infants under one year old are seen more frequently, with the initial visit held after just two to four weeks. A period of minor adjustments is necessary to ensure consistent ketosis is maintained and to better adapt the meal plans to the patient. This fine-tuning is typically done over the telephone with the hospital dietitian and includes changing the number of calories, altering the ketogenic ratio, or adding some MCT or coconut oils to a classic diet. Urinary ketone levels are checked daily to detect whether ketosis has been achieved and to confirm that the patient is following the diet, though the level of ketones does not correlate with an anticonvulsant effect. This is performed using ketone test strips containing nitroprusside, which change colour from buff-pink to maroon in the presence of acetoacetate (one of the three ketone bodies).
The ketogenic diet can reduce the frequency of seizures. In clinical trials of people with treatment-resistant epilepsy — meaning they’ve tried a number of antiepileptic medications and continued to experience seizures — the ketogenic diet typically reduces the number of seizures by 50 percent or more in half of patients. The number of patients that will go on to become seizure-free after adopting a ketogenic diet is much smaller — some studies say it’s as low as 0 percent of patients and in others it’s closer to 20 percent.
I recently applied for life insurance after following the ketogenic diet for about six months. I was initially quoted the lowest rate based on the fact that I have no health issues whatsoever. However, my cholesterol readings were very high so they came back and said that I had elevated total cholesterol readings of 378 which alarmed me. They have now doubled my life insurance rates because of it. Even though my total cholesterol was high everything else seems good according to this article. LDL – 272, HDL – 92, Triclycerides – 70. This all translates to an LDL/HDL ratio of slightly under 3:1 and a Triglyceride/HDL ratio of close to 1:1. I don’t know if I should be concerned that my total is well over the 300 that is sited in this article. Does anyone know?
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.
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.
The total-to-HDL cholesterol ratio is found by dividing your total cholesterol level by your HDL-C, and it is essentially the same thing as an LDL-to-HDL cholesterol ratio since most non-HDL cholesterol is LDL cholesterol . The researchers of the 2003 meta-analysis used this ratio because it is a better cardiovascular risk predictor than total cholesterol levels .
Normoxic cancer cells also have the ability to use ketones as fuel for the TCA cycle, particularly 3-hydroxy-butyrate, in what has been called “The Reverse Warburg Effect.” 3-HB can increase tumor growth rate by ~250%. Cancer cells’ ability to use ketones for fuel may explain why diabetics are at increased risk of cancer (e.g. diabetic ketosis). [NCBI, “Ketones and lactate ‘fuel’ tumor growth and metastasis”]
To date, evidence from randomized controlled clinical trials is lacking, but needed, to answer the question of whether an adjuvant KD would benefit specific cancer patients. Human data pertaining to KDs and cancer are mostly based on single case reports and a smattering of preliminary clinical studies with small study cohorts, heterogenous study designs, poor compliance to the diet, noncomparable regimens, or without standardized dietary guidance. Even so, results of the first clinical studies support the hypothesis of an anti-tumor effect of KDs. For example, 10 of the 24 (42%) clinical studies included in a recent review  provide evidence for the anti-tumor effect of KDs, whereas seven (29%) showed no effect and only one study reported a pro-tumor effect of the KD. The currently available medical literature presents strong scientific evidence for the safe application of a KD only in patients with glioblastoma. However, a clear recommendation for adjuvant use of the KD in glioblastoma patients still requires results from ongoing randomized controlled clinical trials.
Treatment with MAD was shown to be more effective in seizure control when the MAD was started with lower carbohydrate limits (Kossoff et al., 2010). In a randomized study with 20 children with drug-resistant epilepsy, 60% of them showed fewer seizures in the first 3 months on the MAD, with 10 g/day of carbohydrate intake against 10% of reduction with 20 g/day (p = 0.03). In the same study, after 3 months, an increase in carbohydrate intake to 20 g/day, maintained seizure control and improved tolerability, suggesting that a lower carbohydrate limit is important only in the first 3 months (Kossoff et al., 2007; Kossoff and Dorward, 2008).
Adverse effects of the dietary interventions were experienced in all studies. The most commonly reported adverse effects were gastrointestinal syndromes. It was common that adverse effects were the reason for participants dropping out of trials (GRADE rating low). Other reasons for dropout included lack of efficacy and non‐acceptance of the diet (GRADE rating low).
When you eat less than 50 grams of carbs a day, your body eventually runs out of fuel (blood sugar) it can use quickly. This typically takes 3 to 4 days. Then you’ll start to break down protein and fat for energy, which can make you lose weight. This is called ketosis. It's important to note that the ketogenic diet is a short term diet that's focussed on weight loss rather than the pursuit of health benefits.
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
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 story behind LDL, or low-density lipoprotein, is more complicated. LDL transports cholesterol produced by your liver and cells throughout your body. Unlike HDL, LDL molecules move slowly through the bloodstream and are vulnerable to oxidizing agents known as “free radicals.” Once oxidized, LDL can easily burrow itself into the walls of your arteries (called endothelium) and impede cardiovascular function. This triggers an inflammatory response in which white blood cells called macrophages rush to eat up the LDL.
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.
Jimmy Moore: What we’re talking about here, is genetics versus epigenetics. I have major genetics in my family, my full blood brother Kevin, 4 years older than me, at the age of 41 in 2008 he died of heart disease, diabetes, morbid obesity, it killed him. My dad had a heart attack at 48 and 50, I’m now 43. I have a genetic pre-disposition … oh, and my grandfather on my dad’s side died at 54 of a heart attack. My grandfather on my mom’s side died at 52 of a heart attack. A little bit of genetics that say I’m supposed to have a heart attack at a early age. The thing that you’re doing when you shift your nutrition is you’re changing the genetics and you’re taking an external approach to dealing with that, that’s where the epigenetics come into play.
A ketogenic diet may be an option for some people who have had difficulty losing weight with other methods. The exact ratio of fat, carbohydrate, and protein that is needed to achieve health benefits will vary among individuals due to their genetic makeup and body composition. Therefore, if one chooses to start a ketogenic diet, it is recommended to consult with one’s physician and a dietitian to closely monitor any biochemical changes after starting the regimen, and to create a meal plan that is tailored to one’s existing health conditions and to prevent nutritional deficiencies or other health complications. A dietitian may also provide guidance on reintroducing carbohydrates once weight loss is achieved.
To counteract these genetic vulnerabilities, it is may be best to eat a low to moderate fat diet that is whole food based with plenty of fiber, monounsaturated fats, polyunsaturated fats (especially omega 3s), and limited saturated fats. This, as well as a lifestyle filled with physical activity, stress relief practices, and plenty of sleep, should keep their cholesterol levels under control.
For centuries, fasting has been used to treat many diseases, including seizures. Water diets without food for days to weeks were used in the 1800s and early 1900s by many physicians treating epilepsy, but these diets and fasting could only be done for short periods of time. Dr. Russell Wilder at the Mayo Clinic suggested in July 1921 that a diet high in fat and low in carbohydrates could maintain ketosis (a metabolic state in which the body burns fat for energy – instead of carbohydrates – and turns them into ketone bodies) longer than fasting alone. In addition, Wilder suggested this metabolic state could be maintained on a long-term basis. He was the first to name this regimen “The Ketogenic Diet.”
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.
Aude, Y., A. S, Agatston, F. Lopez-Jimenez, et al. “The National Cholesterol Education Program Diet vs a Diet Lower in Carbohydrates and Higher in Protein and Monounsaturated Fat: A Randomized Trial.” JAMA Internal Medicine 164, no. 19 (2004): 2141–46. doi: 10.1001/archinte.164.19.2141. jamanetwork.com/journals/jamainternalmedicine/article-abstract/217514.
For cells to maintain a healthy status, oxidants and antioxidants have to be in balance with each other. When this equilibrium is tilted toward an oxidized state, it leads to oxidative stress, in which an excess of oxidants can damage cellular structures and affect the health of the cell. Even cancer cells need to safeguard themselves against this.
Insulin is a hormone that lets your body use or store sugar as fuel. Ketogenic diets make you burn through this fuel quickly, so you don’t need to store it. This means your body needs -- and makes -- less insulin. Those lower levels may help protect you against some kinds of cancer or even slow the growth of cancer cells. More research is needed on this, though.
• Weight loss — If you're trying to lose weight, then a ketogenic diet is one of the best ways to do it, because it helps access your body fat so that it can be shed. Obese people in particular can benefit from this method. In one study, obese test subjects were given a low-carb ketogenic diet and a low-fat diet. After 24 weeks, researchers noted that the low-carb group lost more weight (9.4 kilograms or 20.7 pounds) compared to the low-fat group (4.8 kilograms or 10.5 pounds).1
He followed her advice, refused radiation, came to see me, and over the years he has proven to be a very vigilant, determined and compliant patient. Within a year on his nutritional program, which includes a high carb diet, his pain had resolved, his energy, stamina, and concentration had improved, and scans confirmed total resolution of all his original extensive disease – in complete contradiction to what Dr. Seyfried would predict or claim possible.
Though our normal cells do just fine in the absence of carbohydrates, cancer cells, Dr. Seyfried claims, do not. These cells, he says, can never use fatty acids or ketone bodies for any significant energy production, since the citric acid cycle and electron transport in them remain basically inactive. So, he proposes, as the culmination of his exegesis, that on a high fat, moderate protein, no carb diet, a cancer patient will deprive his or her deadly abnormal cells of their only useful source of energy, blood glucose, leading to apoptosis, or cell death.
Animal data suggest a role for the ketogenic diet in protection against trauma and ischemia, as ketones may be a preferred fuel in the injured brain . Prins et al.  studied the role of the ketogenic diet in a controlled cortical impact model in rats. Young rats of varying postnatal ages underwent a small craniotomy and then, with the dura intact, were subjected to a standardized piston cylinder injury. Immediately after the impact, the rats started a standard diet or the ketogenic diet. After 1 week, a postmortem measurement of cortical contusion area was performed. The contusion area was significantly decreased in postnatal day-35 and day-45 rats that had been fed the ketogenic diet, but not in younger or older rats.
Jimmy Moore: So close, so far that I think they really need to latch onto what the triglycerides and what the HDL really mean. When you’re eating too many carbs, it’s going to show up in the tricks. It totally will. When you’re not eating enough fat in your diet, especially saturated fat, this is such a key point. I know you hammer this in your videos, that’s why I love them. The saturated fat is so important to raising the HDL, and it’s that HDL that you want to have higher and yet it also shows up in your total cholesterol and then makes the doctors goes bat crap crazy when they see 220 on your total cholesterol, and the only thing that went up was HDL. Come on.
The most common side effects are constipation that can be supported with some dietary adjustments and laxatives. Other side effects that may occur that are relatively minor and transient include: kidney stones, low sugars, nausea, vomiting, diarrhea, sleepiness. There are some reports of longer term side effects that may include higher cholesterol, reduced bone health, kidney stones, slower linear growth velocity and abnormal heart rhythm.