First of all, myeloma patients, even when diagnosed with an aggressive form, often linger for years before the disease advances. I would never have included such a two-year survivor in One Man Alone, or in any other book I have written or plan to write – unless, possibly, there has been documented significant regression of disease, not apparent in this case. I do include a case of multiple myeloma treated by Dr. Kelley in my monograph, a woman diagnosed with extensive cancer throughout her skeleton with evidence of multiple fractures.
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!
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.
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.

Although 86% of people who have undergone the protocol have experienced a decrease in LDL cholesterol after ramping up their calorie and fat intake for three days, my own LDL cholesterol increased, the first time by 47 mg/dL and the second time by 15 mg/dL. At this point, I'm the only one who had both an increase in LDL and a decrease in triglycerides after the high-fat, high-calorie portion of the experiment. All of my other markers, including HDL and small LDL particle counts, were excellent for both the low-calorie and high-calorie days.
Great article! I have been diagnosed with familial hypercholesterolemia, however, I am not concerned at all. I continue to follow a restricted calorie, zero carb ketogenic diet, that I have been doing strictly for the last year and a half. All of my health markers are excellent, except for LDL particle number and total, and it is the large buoyant type. I am middle-aged (46). I did get both a CT scan and tri-vascular scan, and got perfect scores for both. That alleviated any concerns that I might have previously had. Since this diet has improved my gut issues, bodyfat, blood pressure, insulin, blood glucose, mood, energy, A1C, CRP, etc., - basically every single health parameter I have tested, I am sticking with it! Thank you for clearing up the confusion surrounding LDL!
Essentially, the keto diet for beginners works by “tricking” the body into acting as if its fasting (while reaping intermittent fasting benefits), through a strict elimination of glucose that is found in carbohydrate foods. Today the standard keto diet goes by several different names, including the “low-carbohydrate” or “very-low-carbohydrate ketogenic diet”(LCKD or VLCKD for short).
Another possible concern with long term adherence to a ketogenic diet is that some people are ‘hyper-responders’ to high fat intake. In these people, (estimated to be around 25-30% of the population) a high fat intake may lead to increased cholesterol and triglyceride levels. While this may be cause for concern in some people, in others this increase might be temporary, and still others may find, after considering things such as inflammation levels, total cholesterol:HDL ratio, and triglyceride:HDL ratio, the increase is not cause for concern.
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?
Calorie restriction, while more difficult than intermittent fasting for some, has shown promising results in preventing and starving cancer for the same reasons as intermittent fasting. Basically, calorie restriction will cause cancer to run itself out of fuel because of its constant need for glucose and lack of metabolic flexibility. Once that happens, the cancer may begin to starve and die off.

However, our glycogen supplies in the liver and muscle are quite limited, providing only an 8-12 hour emergency supply. So during a fast, or starvation, or on a diet providing no carbohydrates in any form, we quickly run out of glycogen. In this situation, through a variety of neural and hormonal signaling, our fat cells, or adipocytes, begin releasing free fatty acids into the blood stream. These fatty acids can in turn be used by our cells in the alternate ATP producing process of beta oxidation.
Dietary choices to help prevent breast cancer There are many different causes of breast cancer, including age, genetics, and family history. There are also some factors that people can control, such as diet, smoking, and exercise. In this article, we take a look at the healthful foods that may help prevent breast cancer and also explain which foods to avoid. Read now
One of the difficult things about science-based medicine is determining what is and isn’t quackery. While it is quite obvious that modalities such as homeopathy, acupuncture, reflexology, craniosacral therapy, Hulda Clark’s “zapper,” the Gerson therapy and Gonzalez protocol for cancer, and reiki (not to mention every other “energy healing” therapy) are the rankest quackery, there are lots of treatments that are harder to classify. Much of the time, these treatments that seemingly fall into a “gray area” are treatments that have shown promise in animals but have never been tested rigorously in humans or are based on scientific principles that sound reasonable but, again, have never been tested rigorously in humans. (Are you sensing a pattern here yet?) Often these therapies are promoted by true believers whose enthusiasm greatly outstrips the evidence base for their preferred treatment. Lately, I’ve been seeing just such a therapy being promoted around the usual social media sources, such as Facebook, Twitter, and the like. I’ve been meaning to write about it for a bit, but, as is so often the case with my Dug the Dog nature—squirrel!—other topics caught my attention.

Epilepsy – Using a ketogenic diet for seizures in children is a well-established treatment. In a 2010 study done at Johns Hopkins, one-third of children with difficult-to-treat epilepsy became either seizure-free or had a greater than 90% reduction in seizure frequency, and 44% of them were free of medications.13 A Cochrane review found that the classic ketogenic diet led to seizure freedom in as high as 55% of participants and seizure reduction in up to 85%.14 Results are similar for adults, and one review found that 32% of patients on a ketogenic diet and 29% on a modified Atkins diet had a greater than 50% reduction in seizures with 9% and 5% experiencing a greater than 90% reduction respectively. 15 For many patients, the benefits of the diet often extend for years, even after the diet is discontinued.16 17
"The message is not that children with [uncontrollable] seizures should not be on this diet, because it can be remarkably effective and most children only stay on it for a few years," Kwiterovich tells WebMD. "But our findings suggest the distinct possibility that anyone who eats a very high-fat diet may be setting themselves up for later [blood vessel] disease."
During the first half of the 20th century, physicians and researchers studying the traditional Eskimo (Inuit) culture were amazed by the health of these people subsisting on a very peculiar – at least to the Western academic mind – high fat ketogenic diet. The famed Arctic explorer Stefansson first documented the traditional Eskimo diet, which was later studied in some detail in the early 1930s by a research team from McGill University in Montreal.

Weight loss was also irresistible. I actually tried not to lose weight. Based on advanced bro science, I was supposed to maintain my weight if I ate at least 2,000 calories a day. Yet my efforts to stuff myself with gloriously fatty food were futile. I lost 10 kilos and got abs — “blurry” ones though. You still need a bit of imagination to count six.
Neurological Function– A ketogenic diet may be neuroprotective since it increases energy production in the brain, limits the production of free radicals, limits neuronal excitability and increases production of GABA in the brain.27 28 Researchers have hypothesized that a ketogenic diet and, in particular, ketones might benefit neurological function in several conditions and situations, including Alzheimer’s, Parkinson’s, Friedreich’s ataxia, autism and traumatic brain injury. 29 30 In Alzheimer’s disease, it appears that brain cells become unable to use glucose for energy production; a ketogenic diet can provide an alternative fuel for the brain. 31 Several studies have found that giving patients with mild to moderate Alzheimer’s medium chain triglycerides (MCTs), a type of fat that is readily accessible for ketone formation, improves cognition, but the effects are more pronounced in those that do not carry the APOE e4 gene variant that is associated with increased risk of Alzheimer’s.32 33 34 Research is just beginning to explore these conditions, and a better understanding of how effective the ketogenic diet is in treating certain neurological conditions will likely be available in the near future.
What we haven’t talked about is what raised inflammation yet. It’s two main things. I call them the twin villains in your health. Number one is, not surprising coming out of my mouth, carbohydrates are dastardly, especially the refined ones. Grains, starches, sugars, they’re just bad news for you and avoid if at all possible because they’re going to raise your inflammation the most. The second one, a lot of my low carb, keto friends are still eating. It disappoints me Leanne, because I think they don’t realize the negative impact that they’re having. It’s in just about every packaged food, even the so called low carb, keto foods. That’s vegetable oils. You really have to eliminate Canola oil, soy bean oil, cotton seed oil, corn oil … I don’t care if the American Heart Association has their stupid heart health symbol on it, it’s not heart healthy. The reason it’s not heart healthy … I’ll tell you why it’s heart healthy in a minute, why they think it is.
The keto diet (also known as ketogenic diet, low carb diet and LCHF diet) is a low carbohydrate, high fat diet. Maintaining this diet is a great tool for weight loss. More importantly though, according to an increasing number of studies, it helps reduce risk factors for diabetes, heart diseases, stroke, Alzheimer’s, epilepsy, and more1-6.On the keto diet, your body enters a metabolic state called ketosis. While in ketosis your body is using ketone bodies for energy instead of glucose. Ketone bodies are derived from fat and are a much more stable, steady source of energy than glucose, which is derived from carbohydrates.

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.


Researchers believe that the ketogenic diet can also help patients with schizophrenia to normalize the pathophysiological processes that are causing symptoms like delusions, hallucinations, lack of restraint and unpredictable behavior. One study found that the keto diet lead to elevated concentrations of kynurenic acid (KYNA) in the hippocampus and striatum, which promotes neuroactive activity. Some studies even point to the elimination of gluten as a possible reason for improved symptoms, as researchers observed that patients with schizophrenia tended to eat more carbohydrates immediately before a psychotic episode. (19)
The ketogenic diet is designed to allow an individual to feel satisfied easily as a result of optimal insulin and leptin sensitivity. For example, a man weighing 150 pounds should consume 30-50g/day of carbohydrates and less than 70g/day of protein to maintain an optimal state of ketosis. When only a single meal or two is consumed consisting of approved ketogenic foods, this is easy. The ideal blood sugar concentration for weakening cancer cells is between 60-70mg/dl, and ketone levels are recommended between 4-7mM.
Having a coronary artery calcium (CAC) scan or CIMT test can provide information about actual heart disease that lab tests can't. Some people with extremely high levels of LDL cholesterol have calcium scores showing no plaque accumulation in the arteries and normal intima-media thickness, whereas others demonstrate mild to moderate atherosclerosis even when LDL cholesterol is within the normal range.

I have great respect for Harvard Medical School. I notice that they support their readers posting comments and I am most appreciative of the article and all the many thoughtful comments by the readers. The readers seem to have the most expertise here and I hope that the doctor who wrote the article will think long and hard about the comments by readers. After 35 years of clinical practice in mental health, I notice that all issues of emotion involve medical issues, nutrition, and the gut bacteria. I would say that these issues and all of the executive brain functions seem to improve with ketogenic principles. For those that apply it in a flexible and smart manner, it appears to improve every area of their lives. I strongly encourage the author of the article to take one class via The Institute for Functional Medicine. If he is open to more learning he can take more classes and get certified. I’m sure a fine doctor, he will be an even better doctor and personally healthier, if he gets more training. Are we all open to new learning(especially us healthcare providers)?
The ketogenic diet may seem like the Jekyll to the Hyde-like low-fat craze of the 1990s. The bulk of current research finds that the middle ground between the two extremes is more beneficial for overall health. Make it easy for yourself: Eat at least two servings a week of fatty fish (salmon, sardines, mackerel) and cook with a variety of quality fats (olive oil, canola oil, avocado oil) throughout the week.
Neurological Function– A ketogenic diet may be neuroprotective since it increases energy production in the brain, limits the production of free radicals, limits neuronal excitability and increases production of GABA in the brain.27 28 Researchers have hypothesized that a ketogenic diet and, in particular, ketones might benefit neurological function in several conditions and situations, including Alzheimer’s, Parkinson’s, Friedreich’s ataxia, autism and traumatic brain injury. 29 30 In Alzheimer’s disease, it appears that brain cells become unable to use glucose for energy production; a ketogenic diet can provide an alternative fuel for the brain. 31 Several studies have found that giving patients with mild to moderate Alzheimer’s medium chain triglycerides (MCTs), a type of fat that is readily accessible for ketone formation, improves cognition, but the effects are more pronounced in those that do not carry the APOE e4 gene variant that is associated with increased risk of Alzheimer’s.32 33 34 Research is just beginning to explore these conditions, and a better understanding of how effective the ketogenic diet is in treating certain neurological conditions will likely be available in the near future.

A study of 183 children in whom the diet was discontinued determined that the speed of  the wean did not matter: children tapered over several weeks did just as well as those in whom the diet was stopped more slowly. Children in whom there was a good, but not complete seizure reduction with the diet (50-99% seizure reduction) were at highest risk for seizure worsening with the diet discontinuation . Should seizures worsen, many of these families elect to continue a low-carbohydrate diet versus new anticonvulsants . Some child neurologists opt to stop the diet over 4-6 weeks with close email contact.
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.
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.

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.
I just got to know too that my Cholesterol raised a lot, I've been on keto for a little more than 3 months and before that always had a low carb diet. I don't know if the 3 day fast I did before taking the blood test only " aggravated" the situation. The total is 302, LDL is 214! But since the triglycerides are 94 and HDL 57, it seems to be OK. I read that a low rate of TG/HDL may indicate that the LDL particles are of the bigger, fluffier type less dangerous.
There is nothing inherently difficult about following a ketogenic diet. We have many patients who do this very easily over many years. The metabolic benefits significantly outway any perceived challenges from limiting particular food types. Uptake would be far more widespread if nutrition professionals left their predujical opinions of SFA’s behind. Finally, given the expertise in Ketogenic Diets at Harvard, Dr David Ludwig, for one springs to mind, I am surprised the author did not avail themselves of the local expertise.
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).
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.
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.

The reason you’re hungry is that was not a high fat diet. That was a high protein meal that you had. While yes adding a little bit of fat is good, maybe a little more might be helpful in order to stay down those hunger things and what the hunger is, is your blood sugar being so high you can’t get it down because there’s this big long G word we talked about in my book Keto Clarity, called gluconeogenesis. When you eat more protein than your body can use, it actually can’t store protein. What it does is it sends that excess protein to the liver. The liver squirts out glucose, which is sugar. If you’re trying to be ketogenic, if you’re trying to control your blood sugar levels, you absolutely need to keep carbs low. That’s duh. You also need to moderate down on the protein. Especially if you’re insulin-resistant.

"The message is not that children with [uncontrollable] seizures should not be on this diet, because it can be remarkably effective and most children only stay on it for a few years," Kwiterovich tells WebMD. "But our findings suggest the distinct possibility that anyone who eats a very high-fat diet may be setting themselves up for later [blood vessel] disease."
This device measures the amount of acetone (another ketone) you release in your breath when you are in ketosis. (Acetone is also the ketone responsible for bad breath when you’re in ketosis.) There are a number of kits on the market. One study showed they are as effective as ketone strips for testing ketone levels, but critics argue both have drawbacks including testing for only one specific ketone.
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).

• High-protein ketogenic diet — This method is a variant of the SKD. In a high-protein diet, you increase the ratio of protein consumption to 10 percent and reduce your healthy fat consumption by 10 percent. In a study involving obese men that tried this method, researchers noted that it helped reduce their hunger and lowered their food intake significantly, resulting in weight loss.11
In general, cholesterol is traditionally misunderstood. I am going to show why high cholesterol is not inherently bad, and how to lookout for some real warning signs that you are in an inflammatory state. Knowing how cholesterol works in the body and how to interpret your cholesterol numbers will empower you to move forward on your ketogenic journey with confidence.
A small Feb. 20, 2017, study looked at the impact of a six-week ketogenic diet on physical fitness and body composition in 42 healthy adults. The study, published in the journal Nutrition & Metabolism, found a mildly negative impact on physical performance in terms of endurance capacity, peak power and faster exhaustion. Overall, researchers concluded, “Our findings lead us to assume that a [ketogenic diet] does not impact physical fitness in a clinically relevant manner that would impair activities of daily living and aerobic training.” The “significant” weight loss of about 4.4 pounds, on average, did not affect muscle mass or function.

You can still eat plenty of healthy dietary fats and also include gut-healing foods like leafy and cruciferous greens, prebiotic-rich foods like garlic and dandelion greens, and probiotic rock stars including kimchi and unpasteurized sauerkraut. Even with a daily 50-gram carb allowance, you can find a lot of anti-inflammatory, gut-supporting foods.


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]

[1:53] – Explaining the concept of “hyper-responder”. Dave talks about his own experiences after discovering he was pre-diabetic and switching to the low carb, ketogenic diet. Are there concerns about the possibility of high cholesterol with this diet? For most people, there is a very small change in cholesterol levels. However, after 7 months on a keto diet Dave found he suddenly had a very high increase in his cholesterol scores.
About 20% of children on the ketogenic diet achieve freedom from seizures, and many are able to reduce the use of anticonvulsant drugs or eliminate them altogether.[18] Commonly, at around two years on the diet, or after six months of being seizure-free, the diet may be gradually discontinued over two or three months. This is done by lowering the ketogenic ratio until urinary ketosis is no longer detected, and then lifting all calorie restrictions.[46] This timing and method of discontinuation mimics that of anticonvulsant drug therapy in children, where the child has become seizure-free. When the diet is required to treat certain metabolic diseases, the duration will be longer. The total diet duration is up to the treating ketogenic diet team and parents; durations up to 12 years have been studied and found beneficial.[9]
Contemporary researchers like Dr. Thomas Seyfried and Dominic D’Agostino have argued that this dysregulated cellular energy production, or cellular metabolism, is actually what induces malignancy and that by extension, if we limit the fuels available for this process of fermentation, and the fuels are glucose, which is derived from carbohydrate in the diet, and glutamine, which is derived from protein in the diet, then we can actually starve cancer cells and either improve the results of conventional treatment or perhaps even address some cancers independently without conventional treatment.
As these battles waged in the early 1990s, I had long left Dr. Good’s group, having returned to New York and private practice. Nonetheless, this story had a personal ring to it, as had the interferon story, since Dr. Good had completed the first bone marrow transplant in history, in 1969, and long hoped this technology would be, yes, an answer to cancer.
The ketogenic diet exerts anticancer effects by inducing a metabolic shift in malignant tissues that promotes apoptosis (self-programmed death) of cancer cells, inhibiting angiogenesis (the growth of new tumor-supporting blood vessels), reducing oxidative stress and inflammation, suppressing mTOR (a protein in humans involved in the regulation of cell growth and regeneration), and increasing the sensitivity of certain cancer cell types to chemotherapy. (38)
More specifically, subjects in the lowest third of carbohydrate consumption had an HDL concentration of 1.21 mmol/L while subjects in the highest third had HDL concentration of 1.08 mmol/L. [13] According to the authors, “every 100-g/d increment of carbohydrate (approximately the difference between the top and bottom tertiles) was associated with 0.15-mmol/L less of HDL.” [13]

The KD-induced synaptic stabilization is additionally related to changes in critical amino acids as a result of ketone metabolism. It has been proposed that KD interferes with the concentration of gamma-aminobutyric acid (GABA), the major inhibitory neurotransmitter. There is evidence in clinical practice of increased GABA levels in the CSF of patients on the KD diet (Wang et al., 2003). The decrease in aspartate levels promoted by KB lead to the synthesis of GABA. This occurs because of the inhibitory effect of aspartate on glutamate decarboxylase and the facilitation of the conversation of glutamate to glutamine in the astrocytes (Yudkoff et al., 2008). Not only can GABA be increased, but also other neurotransmitters such as adenosine A1 can be implicated in the anti-seizure effect of the KD (Szot et al., 2001). However, more evidence is needed.
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.
Now that we have a superficial understanding of the total-to-HDL cholesterol ratio, let’s look at the results of the meta-analysis. The two findings that the researcher’s highlight most are the effects that lauric acid (found in high quantities in coconut oil) and stearic acid (found in high quantities in animal fats) have on the total-to-HDL cholesterol ratio. Both of these fatty acids improved the total-to-HDL cholesterol ratio more favorably than carbohydrates [25]. (A similar pattern emerges for blood sugar and triglyceride levels when we replace carbs with fat as well.)

The understanding of the mechanisms of action of KD is incomplete; however, some theories have been advanced about how it modifies the neuronal metabolism and excitability in order to reduce the seizure frequency. Possibly, the real mechanism of reduction of cortical hyperexcitability involves multiple factors. Some of the systems involved in seizure reduction are related to metabolic changes in the blood and cerebrospinal fluid (CSF), including a decrease in glucose levels and an increase in KB. The mitochondria function and energy reserve may also play a role in the KD mechanisms, resulting in synapse stabilization and excitatory decrease.

But there are some cancer biologists out there that feel that while mutations are ubiquitous in cancer, they may not be the primary driving force of the disease and, as we’ll discuss later, they may actually be secondary effects of a deeper underlying process. They believe that cancer is as much a disorder of altered energy metabolism or energy production as it is genetic damage. This goes back to the work of German physician Otto Warburg in the 1920s and 1930s, and we know that healthy cells generate energy using an oxygen-based process of respiration. This is what we refer to as cellular respiration, but Warburg was the first to note that cancer cells prefer an anaerobic, or oxygen-free, process of producing cellular energy known as fermentation.
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.
So, what evidence does Dr. Seyfried himself provide to prove his point that the best diet for all cancer patients, whatever the type, is the ketogenic, high fat, no carb diet? Well, very little. Certainly the 400 plus pages of elaborate biochemistry and theory are impressive and informative. But in terms of practicalities, that is, results with actual human patients diagnosed with cancer, there is next to no evidence.
• Your body is still growing — In one study, epileptic children experienced a reduction in symptoms and improved cognitive performance when a ketogenic diet was introduced.49 However, this may have a negative effect on the growth of their bodies in the long run, according to a study published in the journal Developmental Medicine & Child Neurology.50
Another mouse study cited by Seyfried is one in which dietary restriction was reported to promote vessel maturation in a mouse astrocytoma model. Given that tumor angiogenesis is one of my scientific interests and I have a fair number of publications on the topic, I was interested. Unfortunately, I ended up being disappointed. This was another syngeneic model (i.e., a mouse tumor implanted in mice of the same strain from which the tumor was isolated as a cell line, like the one discussed above). Although it showed increased tumor vessel maturation (which is one mechanism by which inhibitors of angiogenesis work), I wasn’t quite convinced, because there was a distinct lack of quantification of the phenomenon, and the microscopy appears not to have been blinded, something that’s critical to avoid unconscious bias in the results. It’s not surprising that this result, which, if more convincing evidence had been obtained, could easily have appeared in Cancer Research, was published in a low tier journal. It’s an OK study, but not fantastic. Certainly it didn’t lead me to smacking myself in forehead and saying, “Of course!”
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.
Around this time, Bernarr Macfadden, an American exponent of physical culture, popularised the use of fasting to restore health. His disciple, the osteopathic physician Dr. Hugh William Conklin of Battle Creek, Michigan, began to treat his epilepsy patients by recommending fasting. Conklin conjectured that epileptic seizures were caused when a toxin, secreted from the Peyer's patches in the intestines, was discharged into the bloodstream. He recommended a fast lasting 18 to 25 days to allow this toxin to dissipate. Conklin probably treated hundreds of epilepsy patients with his "water diet" and boasted of a 90% cure rate in children, falling to 50% in adults. Later analysis of Conklin's case records showed 20% of his patients achieved freedom from seizures and 50% had some improvement.[10]
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Like any trendy diet worth its balanced portion of salt, the keto diet is said to hold transformative powers. Proponents say it can help people lose weight, improve mood and experience fewer epileptic seizures. For the most part, the science seems to back these claims up — though, to be sure, it's not completely understood how exactly the keto diet affects mood (particularly depression), despite anecdotal evidence the diet might lead to clearer thinking and fewer symptoms of depression.
The original therapeutic diet for paediatric epilepsy provides just enough protein for body growth and repair, and sufficient calories[Note 1] to maintain the correct weight for age and height. The classic therapeutic ketogenic diet was developed for treatment of paediatric epilepsy in the 1920s and was widely used into the next decade, but its popularity waned with the introduction of effective anticonvulsant medications. This classic ketogenic diet contains a 4:1 ratio by weight of fat to combined protein and carbohydrate. This is achieved by excluding high-carbohydrate foods such as starchy fruits and vegetables, bread, pasta, grains, and sugar, while increasing the consumption of foods high in fat such as nuts, cream, and butter.[1] Most dietary fat is made of molecules called long-chain triglycerides (LCTs). However, medium-chain triglycerides (MCTs)—made from fatty acids with shorter carbon chains than LCTs—are more ketogenic. A variant of the classic diet known as the MCT ketogenic diet uses a form of coconut oil, which is rich in MCTs, to provide around half the calories. As less overall fat is needed in this variant of the diet, a greater proportion of carbohydrate and protein can be consumed, allowing a greater variety of food choices.[4][5]
Based on this logic, the keto diet appears to be a safe, inexpensive, easily implementable, and effective approach to selectively target cancer cells. Promisingly, multiple studies show that the keto diet reduces tumor growth and improves survival in animal models of multiple cancers, along with enhancing the effects of other forms of anticancer therapy.11,15 Similarly, fasting has been shown to enhance responsiveness to chemotherapy, along with reducing some of the side effects in preclinical cancer therapy models.11
Leanne: Yeah totally, chill out. Do a little meditation if you need to get into the zone. Exactly. You mentioned vegetable oils causing inflammation, are there specific fats that will help us, like we’ve talked a little bit about saturated fats, we all know trans fats don’t even go there … the mono poly saturated, unsaturated, is there a certain ratio that we should be aiming for. I know you’re the guy that will just slice off butter and eat it … I am too, a little bit of Himalayan rock salt on there never hurt anyone. Are there specific facts that we should be focusing on?
Mitochondria generate reactive oxygen species (ROS) during their metabolic activities. In normal cells, the production of ROS and their elimination by antioxidants are kept in balance.10 Intriguingly, a higher incidence of errors, or mutations, in mitochondrial DNA have been observed in many human cancers, likely as a result of uncontrolled ROS production and oxidative stress.11
The take-home message here is that patients with epilepsy have options beyond simple pharmaceutical intervention, and these include dietary changes which well-respected science is now validating as having significant efficacy. A fundamental cornerstone of the Grain Brain Program is profound reduction of carbohydrates and sugars while increasing “good” dietary fats. This approach tends to favor a low grade of ketosis which may well be the normal state of human metabolism. I have written extensively both on the site and in Grain Brain how this dietary approach has profound health-related benefits that relates to weight loss, metabolism, energy, reduction of inflammation, and even reduce risk for diabetes and cancer. This new report offers up yet another benefit to a higher fat lower carbohydrate dietary approach, in this case, for a disease that is devastating for so many.
After Kelly closed down his practice, in late 1987 I returned to New York and began treating patients with advanced cancer, using a Kelley-based enzyme approach, with immediate good results. One of the first patients who consulted me had been diagnosed two years earlier, after a series of mishaps, with inflammatory breast cancer, the most aggressive form of the disease.
"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."
The first signs of ketosis are known as the “keto flu” where headaches, brain fogginess, fatigue, and the like can really rile your body up. Make sure that you’re drinking plenty of waterand eating plenty of salt. The ketogenic diet is a natural diuretic and you’ll be peeing more than normal. Take into account that you’re peeing out electrolytes, and you can guess that you’ll be having a thumping headache in no time. Keeping your salt intake and water intake high enough is very important, allowing your body to re-hydrate and re-supply your electrolytes. Doing this will help with the headaches, if not get rid of them completely.
I actually clicked on the story just to see if they included anything about it’s use in managing chronic migraine. I have chronic migraine, basically intractable. Nothing has helped. I’ve tried medications, meditations, and everything in between including a bunch of dietary changes. Keto is my next consideration. I’m happy to hear it helped you! Thanks for sharing
These studies are all in combination with either radiation or chemotherapy. My preference is to start metabolic therapy with GBM (glioblastoma multiforme). This is a devastating type of brain cancer. Metabolic therapy with a restricted KD could be done with a few tumors where you know the conventional standard of care doesn’t work at all. You would choose those kinds of patients and do a clinical trial based on historical controls and see what the outcome would be and see if you could get some level of survival that would match or be better than the conventional standard of care.
Bulk buy and cook. If you’re someone who doesn’t like to spend a lot of time in the kitchen, this is the best of both worlds. Buying your food at bulk (specifically from wholesalers) can reduce the cost per pound tremendously. Plus, you can make ahead food (bulk cook chicken thighs for pre-made meat, or cook entire meals) that are used as leftovers, so you spend less time cooking.
However, our glycogen supplies in the liver and muscle are quite limited, providing only an 8-12 hour emergency supply. So during a fast, or starvation, or on a diet providing no carbohydrates in any form, we quickly run out of glycogen. In this situation, through a variety of neural and hormonal signaling, our fat cells, or adipocytes, begin releasing free fatty acids into the blood stream. These fatty acids can in turn be used by our cells in the alternate ATP producing process of beta oxidation.

One of the primary culprits of chronic inflammation in our society is a poor diet full of sugars and processed vegetable oils. In fact, blood sugar and measurements of insulin resistance are a much more accurate predictor of heart disease risk. I often look at values such as fasting glucose, HbA1c, and fasting insulin as a means of determining the inflammatory state of someone’s body.


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?
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.
Numerous preclinical studies have provided evidence for an anti-tumor effect of KDs [1] (Figure 1). For example, our laboratory intensively studied the anti-tumor effect of KDs in combination with or without low-dose chemotherapy on neuroblastoma. We found that the growth of neuroblastoma xenografts was significantly reduced by a KD consisting of a 2:1 ratio of fat to carbohydrate + protein when combined with caloric restriction [2]. However, caloric restriction, despite its anti-tumor effect and potential to sensitize cancer cells to chemotherapy, would be contraindicated in a range of cancer patients, particularly those with cachexia. Thus, we further focused on optimizing the KD composition to address this issue. We found that an ad libitum KD (8:1) with a fat content of 25% medium-chain triglycerides and 75% long-chain triglycerides produced a stronger anti-tumor effect compared to a KD (8:1) with all long-chain triglycerides, and was as efficacious against neuroblastoma as the above-described KD (2:1) combined with caloric restriction [3]. These results stress the importance of an optimized KD composition to suppress tumor growth and to sensitize tumors to chemotherapy without requiring caloric restriction.
Recent findings Although most preclinical studies indicate a therapeutic potential for ketogenic diets in cancer treatment, it is now becoming clear that not all tumors might respond positively. Early clinical trials have investigated ketogenic diets as a monotherapy and – while showing the safety of the approach even in advanced cancer patients – largely failed to prove survival prolonging effects. However, it gradually became clear that the greatest potential for ketogenic diets is as adjuvant treatments combined with pro-oxidative or targeted therapies initiated in early stages of the disease. Beneficial effects on body composition and quality of life have also been found.
Make things yourself. While it’s extremely convenient to buy most things pre-made or pre-cooked, it always adds to the price per pound on items. Try prepping veggies ahead of time instead of buying pre-cut ones. Try making your stew meat from a chuck roast. Or, simply try to make your mayo and salad dressings at home. The simplest of things can work to cut down on your overall grocery shopping.

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.
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 [27]. Prins et al. [27] 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.
It seems strange that a diet that calls for more fat can raise “good” cholesterol and lower “bad” cholesterol, but ketogenic diets are linked to just that. It may be because the lower levels of insulin that result from these diets can stop your body from making more cholesterol. That means you’re less likely to have high blood pressure, hardened arteries, heart failure, and other heart conditions. It's unclear, however; how long these effects last.
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).
Just from researching that I have been doing, this information seems to make a lot of sense and I may have found some information that is pertinent as to why many of you have experienced a rise in LDL levels. VLDL become LDLs when they drop the triglyceride. So, as we consume less carbs we start to lose triglycerides and the VLDLs start to become LDLs. I am no professional by any means, but as I read that article it made sense as well. It takes a while for some people’s livers to start to get the picture and send out more HDL to round up the LDL and there are things that we can do to aid that process such as adding olive oil and coconut oil to our diets as well as eating purple produce and exercising, but the LDL count will probably rise at first and slowly drop from thereafter. It will probably drop faster if we are taking steps to raise our HDL. The longer our body (liver) has been exposed to an unhealthy diet, the longer it will take to recover from it.

The ketogenic diet initially was developed in the 1920s in response to the observation that fasting had antiseizure properties [1]. During fasting, the body metabolizes fat stores via lipolysis and then the fatty acids undergo beta-oxidation into acetoacetate, β-hydroxybutyrate, and acetone—ketone bodies the cell can then use as precursors to generate adenosine triphosphate (ATP). The ketogenic diet, which is very high in fat and low in carbohydrates, is thought to simulate the metabolic effects of starvation by forcing the body to use primarily fat as a fuel source. The ketogenic diet fell out of favor with the development of new anticonvulsant agents, starting with phenytoin in 1938, but it has experienced a resurgence in use over the past 20 years, particularly in the treatment of refractory epilepsy.
Close attention to growth measurements, laboratory data, and medical supervision is indicated in infants on the ketogenic diet. A prospective cohort study of 237 children, with an average length of follow-up of 308 days, analyzed height and weight measurements over time on the ketogenic diet. A small decrease in height scores was observed in the first 6 months, with bigger changes by 2 years. There was a drop in weight in the first 3 months; after this, the weight remained constant in children who started the diet below the 50th percentile for their weight, while it continued to decrease in children starting above the 50th percentile. Very young children (0–2 years) grew poorly on the diet, while older children (7–10 years) grew almost normally. Recent studies of children who discontinued the diet suggest that growth will catch up once the diet is discontinued.
Keep up electrolytes. The major electrolytes in our bodies are sodium, potassium and magnesium. Because a low carb diet (especially a keto diet!) reduces the amount of water you store, this can flush out electrolytes and make you feel sick (called “keto flu”). This is temporary, but you can avoid or eliminate it by salting your food liberally, drinking broth (especially bone broth), and eating pickled vegetables. Some people also choose to take supplements for electrolytes, but it’s best to first consult a doctor that understands and supports keto/low carb lifestyles.
That plan didn’t allow much variety or leeway. Eggs, two small green salads a day, gelatin for dessert, cheese (up to 4 ounces daily), bone broth, no-calorie liquids, and lots of meat: That was pretty much it for the first week. After level one, you added vegetables like broccoli. Yes, you would be in ketosis doing the original Atkins diet, but for most people, that spartan plan would get boring quickly.
Recently, many of my patients have been asking about a ketogenic diet. Is a ketogenic diet safe? Would you recommend it? Despite the recent hype, a ketogenic diet is not something new. In medicine, we have been using it for almost 100 years to treat drug-resistant epilepsy, especially in children. In the 1970s, Dr. Atkins popularized his very-low-carbohydrate diet for weight loss that began with a very strict two-week ketogenic phase. Over the years, other fad diets incorporated a similar approach for weight loss.
Here are a few of the most common side effects that I come across when people first start keto. Frequently the issues relate to dehydration or lack of micronutrients (vitamins) in the body. Make sure that you’re drinking enough water (close to a gallon a day) and eating foods with good sources of micronutrients. To read more on micronutrients, click here >
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