The ketogenic diet is proposed as a potential adjuvant therapy by exploiting these differences between cancer and normal cells. Consuming a ketogenic diet reduces blood glucose levels through a drastic reduction in the amount of carbohydrates consumed.1,2 As a result of decreased blood glucose levels, less insulin is secreted, which downregulates signaling pathways that are frequently constitutively active in tumor cells.2 Because glucose metabolism is inhibited, energy must be primarily derived from fats.1 Fat metabolism results in the production of ketone bodies and β-hydroxybutyrate by the liver, which are used to fuel energy production. Cancer cells have difficulty using these pathways because they rely on glucose; the metabolism of fat increases oxidative stress. 
Seyfried agrees that there is clear evidence that cancer is a genetic disease, since we can inherit mutations that are clearly associated with increased cancer risk. That’s not at all controversial. That’s well established, and even Seyfried agrees with that. But he argues that many of these mutations that we can inherit are mutations that actually disturb cellular respiration, maybe that the heritable aspect of cancer is not mutation that drives itself—cellular proliferation—but instead are mutations that actually cause mitochondrial dysfunction and defects in cellular respiration. He also points out that many of the non-inherited causes of cancer that have been identified and are clearly recognized, like radiation, impair mitochondrial function. That may be a common mechanism that is shared between these non-inherited causes of cancer and inherited causes of cancer.

So sugar feeds the cancer cells- you dont have to go full keto just stop eating sugar? I keep reading meat causes cancer and a vegan diet is best! When you cut out sugar and all grains you end up eating dairy and meat, with nuts for a treat. Friut is off the list, honey and some root veg like potatos so if you cut down on meat what the feck are we left with? you can only eat so many eggs,avocados and spinach. I also am yet to find a keto dessert I like, coconut flour and stevia dosent make a cake.
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).
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
Type 2 Diabetes:  Although the current mainstream diabetes treatment advice to eat 45-65% of calories from carbohydrate is starting to change, many practitioners are still giving out the old advice. Since carbohydrate is the prime driver of higher blood sugar, this advice is detrimental to diabetic health because it results in blood sugar spikes and crashes, which in turn causes a greater need for medication and insulin. Those high blood sugars also result in the complications of diabetes.  In contrast, a ketogenic diet reduces and in many cases, eliminates the need for diabetic medications and lowers the number of insulin units needed to manage blood sugar.  For people with Type 2 diabetes, ketogenic diets remove the trigger (carbohydrate intake) and reverse the underlying insulin resistance which causes the disease. As a result, long term complications are reversed or avoided.  Learn more in our Conquer Type 2 Diabetes e-Book  or click on the book cover.

The ketogenic diet is a natural, nontoxic metabolic therapy being studied and utilized for cancer prevention and treatment. It works because cancer cells are dependent upon a constant supply of blood sugar (glucose) to stay alive. Normal cells can make energy from both glucose and ketones (metabolic by-products of burning fat), but most cancer cells can only use glucose. Avoiding carbohydrates (starch and sugar) while enjoying delicious and healthy protein and fats will lower blood glucose and increase blood-ketone levels, resulting in a normal body state called nutritional ketosis. Research has shown that nutritional ketosis starves cancer cells while nourishing normal cells and strengthening total body health.

When ketone bodies accumulate in the blood, this is called ketosis. Healthy individuals naturally experience mild ketosis during periods of fasting (e.g., sleeping overnight) and very strenuous exercise. Proponents of the ketogenic diet state that if the diet is carefully followed, blood levels of ketones should not reach a harmful level (known as “ketoacidosis”) as the brain will use ketones for fuel, and healthy individuals will typically produce enough insulin to prevent excessive ketones from forming. [2] How soon ketosis happens and the number of ketone bodies that accumulate in the blood is variable from person to person and depends on factors such as body fat percentage and resting metabolic rate. [3]
What are those lines of evidence? Well, there are drugs which lower insulin and glucose, like metformin. It’s a commonly used drug in diabetes that has shown promising results in cancer treatment. This is not fringe stuff here. Metformin is being studied. There is an article about it for cancer treatment on the NIH Cancer Institute website and on the MD Anderson website, which are two prominent mainstream cancer treatment organizations. There are several studies to support that as well.
Multiple mechanisms of action may explain why the modification of the KD can be effective even without ketosis. Importantly, the KD systemic action can have a broad spectrum of effects that may be beneficial in the treatment of different types of epilepsy and associated comorbidities such as cognition impairment, psychiatric disturbance, and sudden unexplained death.
Another study from 2014 suggests that the ketogenic diet is a safe, effective treatment to manage aggressive cancers when used with conventional therapies. For their retrospective study, researchers reviewed 53 patients with glioma, a tumor that starts in glial cells in the brain and spinal cord. These patients were treated with chemoradiotherapy and other standard treatments from August 2010 to August 2013. Six of these patients also consumed a ketogenic diet while on treatment.
Epilepsy is a disabling and common neurological disease, which can be controlled successfully in most patients with one or more antiepileptic drugs. Approximately 30% of patients with epilepsy have refractory epilepsy, that is, have a failure of adequate trials of two tolerated, appropriately chosen and used antiepileptic drug schedules to achieve sustained relief of seizures (Picot et al., 2008; Kwan et al., 2009). Some of these patients are not surgery candidates, so it is necessary to search for alternative treatments for epilepsy such as palliative surgery, neuromodulation, and a ketogenic diet (KD).
After reading Grain Brain by Dr. Perlmutter, I called his office and was able to meet with him in person. When he read my past medical history he confidently prescribed the Ketogenic diet for me and his nutritionist worked to develop just the right set-up for my BMI. It seemed like a big change at first but really it has been much easier than I originally thought it would be. Now, after being on the diet, along with probiotics and supplements, I can say that I have been seizure free for over 4 months for the first time in over 20 years! My whole world is changing! I can work on getting my driver’s license! I can be what my family needs me to be! I believe God has used the Ketogenic diet to heal my epilepsy and I want to make sure everyone out there who is suffering from seizures has the opportunity to know about and try this amazing, risk-free treatment!
A popular keto supplement are exogenous ketones (popularly called “keto diet pills”) that may help you achieve results earlier as well as remain in that state. (Don’t confuse exogenous ketones with raspberry ketones, as the latter don’t raise ketone levels in the body or mimic endogenous ketones, so you wouldn’t use raspberry ketones in your regimen.)
A more recent clinical trial comparing a ketogenic diet (33.5% protein, 56% fat, 9.6% carbohydrate) to a low-fat diet (22% protein, 25% fat,55.7% carbohydrate) among 55 obese adults, showed that the ketogenic diet resulted in improved cholesterol levels compared to the low-fat diet. More specifically, the group following the ketogenic diet reported higher increases in HDL cholesterol and higher decreases in triglyceride levels compared to the control group (15).

As I ponder this enthusiasm, I have to think that perhaps I am just a little slower, or more cautious, than most. The day after I first met Dr. Kelley in New York in July 1981, I was on a plane to Dallas to begin my review of Kelley’s charts. As previously discussed, I quickly found among Kelley’s records case after case of appropriately diagnosed poor-prognosis and/or terminal cancer, patients alive five, ten, even 15 years later, with no possible explanation for such survival other than Kelley’s odd nutritional treatment.
The Modified Atkins diet and modified ketogenic diet (sometimes called 'modified ketogenic therapy') use a high proportion of fats and a strict control of carbohydrates. These are often considered more flexible than the classical or MCT ketogenic diets, as more protein can be eaten, and approximate portion sizes may be used in place of weighed recipes.

Low-carbohydrate high fat diets (LCHF diets) consistently improve all other markers of cardiovascular risk — lowering elevated blood glucose, insulin, triglyceride, ApoB and saturated fat (especially palmitoleic acid) concentrations, reducing small dense LDL particle numbers, glycated haemoglobin (HbA1c) levels, blood pressure and body weight while increasing low HDL-cholesterol concentrations and reversing non-alcoholic fatty liver disease (NAFLD).
Cancer cells need to carefully maintain their “redox status”. Redox status is the balance between oxidants and antioxidants. Oxidants, including free radicals and other “reactive” chemical species, are made continuously in every living cell as a byproduct of metabolic activities. Several antioxidant systems have evolved in our body to specifically counter the harmful actions of these oxidants.

Initial studies indicate that the ketogenic diet appears effective in other metabolic conditions, including phosphofructokinase deficiency and glycogenosis type V (McArdle disease). It appears to function in these disorders by providing an alternative fuel source. A growing body of literature suggests the ketogenic diet may be beneficial in certain neurodegenerative diseases, including Alzheimer disease, Parkinson’s disease, and amyotrophic lateral sclerosis. In these disorders, the ketogenic diet appears to be neuroprotective, promoting enhanced mitochondrial function and rescuing adenosine triphosphate production.


Some experts now feel that impaired energy metabolism may be the defining common factor in nearly all cancers, regardless of their origin.12,14 They believe that cancer, rather than being caused by errors in DNA, is fundamentally a metabolic disease caused by a disruption in a cancer cell’s ability to get the energy it needs from mitochondrial respiration like a normal cell would.
As you might suspect, this metabolic theory of cancers is controversial in the mainstream cancer paradigm, but there’s already promising initial evidence to support it, and most traditional cancer specialists concede that this metabolic theory has merit, and it may be a piece of the puzzle. I would say that the dominant paradigm idea right now is that metabolic dysfunction is likely one of the pieces of the puzzle, but that cancer is multifactorial and probably does involve genetic mutations that may be independent of metabolic dysfunction and that there are other causes that may not be directly related to metabolic dysfunction.
In his talk, Dr. Seyfried begins with what he refers to as a “provocative question”: Is cancer a genetic or metabolic disease? Actually, whether he realizes it or not, his question is not quite as provocative as he thinks it is, nor is the answer anywhere near as clear-cut as he thinks it is or as he characterizes oncologists and cancer researchers as thinking it is. I’ll tell you what I think the answer to the question is after I’ve discussed Dr. Seyfried’s hypothesis. In the meantime, not surprisingly, his answer is that cancer is a metabolic disease, while everyone else’s answer—according to him, at least—is that it is a genetic disease, making him the brave maverick doctor, who says things like:
Though most of our cells can utilize fatty acids of all stripes via beta oxidation to create ATP energy, our central nervous system is at somewhat of a disadvantage. In fact, long chain fatty acids with 14 or more carbons, which can yield the most ATP from beta oxidation, do not cross the blood-brain barrier. However, in a state of prolonged dietary carbohydrate depletion, the liver begins converting acetyl coenzyme A into various ketone bodies, such as acetoacetate and beta hydroxy butyric acid, which easily penetrate into the brain and which can, like acetyl coenzyme A, be shunted into the citric acid cycle and then the electron transport chain, providing the brain with ATP.
Over one-third of Americans have metabolic syndrome, a constellation of complications including increased blood pressure, elevated blood sugar, excess abdominal fat, and abnormal triglyceride and cholesterol levels that significantly increase one’s risk of heart disease, diabetes, and stroke. (8) The conventional treatment of metabolic syndrome typically involves cholesterol-, blood sugar-, and blood pressure-lowering medications, along with vague advice to “eat better.” Given that heart disease is still the number one cause of death in the United States, that diabetes is considered to be at epidemic proportions, and that strokes disable or kill someone every 40 seconds on average, this treatment paradigm leaves much to be desired. (9)
Rezaei, S., Abdurahman, A. A., Saghazadeh, A., Badv, R. S., and Mahmoudi, M. (2017). Short-term and long-term efficacy of classical ketogenic diet and modified Atkins diet in children and adolescents with epilepsy: a systematic review and meta-analysis. Nutr. Neurosci. doi: 10.1080/1028415X.2017.1387721 [Epub ahead of print]. doi: 10.1080/1028415X.2017.1387721
Perhaps the first person to really put ketogenic diets on the map was Dr. Robert C. Atkins, a cantankerous medical doctor who began experimenting with a low-carb diet in 1963. His first book, Dr. Atkins Diet Revolution, was published in 1972. Dr. Atkins died in 2003 from a tragic fall (interestingly, the Atkins website’s timeline does not mention his death), but his diet plan lives on today.
Apoptosis Induction. Studies show that dietary energy restriction enhances phosphorylation of adenosine monophosphate kinase (AMPK), which has been found to induce apoptosis in glycolytic-dependent brain cells and protect normal brain cells from death. One way to naturally restrict energy consumption is with a keto diet because most keto dieters spontaneously eat fewer calories than they do when they are on a higher carb diet. Altogether, this may explain why most of the research on keto and cancer has shown the keto diet to be effective in the treatment of brain tumors (glioblastomas and gliomas).
I want to be very clear, though, that I don’t believe claims that are made on some websites that the ketogenic diet beats chemotherapy for all cancer treatment. There’s simply no research to support that. I don’t know where those websites are getting that idea, and there’s a lot of snake oil when it comes to cancer treatment out there. It’s a really vulnerable population. Someone who’s diagnosed with cancer, particularly a late-stage cancer that might be terminal, understandably we often feel pretty desperate and might not have the capacity at that moment in time to go through the proper vetting process to make sure that some of the more alternative therapies that are suggested are legitimate, and so you see a lot of wacky stuff recommended for cancer treatment.
By the time I began medical school in 1979 I had read the pioneering work of Weston A. Price, DDS, the American dentist and researcher. Beginning in the late 1920s, Dr. Price, accompanied by his wife, spent seven years traveling the world evaluating isolated groups of people living and eating according to long-standing tradition. Today such a study would be impossible, since just about everyone everywhere has adopted the “Western” way of living and eating, down to jeans and junk food.
In practice, a ketogenic diet is one that keeps net carbohydrates below 50 grams per day, although the absolute number necessary to achieve ketosis will vary from individual to individual and may be as high as 100 grams/day for some. 46 (Because fiber is indigestible when eaten, it is usually not included in the carbohydrate count on a ketogenic diet, therefore net carbohydrates equals the total amount of carbohydrate minus the fiber.) Including some protein and carbohydrate on a ketogenic diet is important too since it supplies the needed substrate for the body to produce ketones, but too much can interfere with ketosis.47 48 A ketogenic diet usually includes low-moderate amounts of meat, fish, poultry, and eggs, moderate amounts of low-carb vegetables such as leafy greens and broccoli, and lots of healthy fats like avocados, nuts, and seeds, coconut oil, olive oil, etc. For those intent on ensuring they are in ketosis, home devices for testing ketone levels are available.
Cancer cells need to carefully maintain their “redox status”. Redox status is the balance between oxidants and antioxidants. Oxidants, including free radicals and other “reactive” chemical species, are made continuously in every living cell as a byproduct of metabolic activities. Several antioxidant systems have evolved in our body to specifically counter the harmful actions of these oxidants.
If your LDL cholesterol has significantly increased on a keto or low-carb diet, it's completely understandable if you're at least somewhat concerned. However, you might be reluctant to make any changes to your diet given the benefits you've experienced. On the other hand, you may decide that you want to try to lower your LDL values while still following a keto/low-carb lifestyle.
The vast majority of claims regarding the ketogenic diet and cancer are drawn from lab and animal studies. Findings from animal studies are revealing. A study published in July’s Nature found that in mice, the ketogenic diet enhanced the effects of a specific cancer treatment. The drugs in that treatment targeted a signaling network guided by an enzyme (abbreviated P13K), which is commonly mutated in cancers.

This equates to about 20 grams of carbohydrates on a 2000 kcal diet per day – a more stringent application of carbohydrate restriction use than the meta-analysis above. The second group consumed primarily a low-fat diet with 46%, 24%, and 30% energy from respectively from carbohydrate, protein, and fat per day. Both diets contained an equal number of calories.
However, this diet is gaining considerable attention as a potential weight-loss strategy due to the low-carb diet craze, which started in the 1970s with the Atkins diet (a very low-carbohydrate, high-protein diet, which was a commercial success and popularized low-carb diets to a new level). Today, other low-carb diets including the Paleo, South Beach, and Dukan diets are all high in protein but moderate in fat. In contrast, the ketogenic diet is distinctive for its exceptionally high-fat content, typically 70% to 80%, though with only a moderate intake of protein.
Protein consumption can also stimulate a little protein present in the body called mTOR (short for mammalian target of rapamycin) which helps regulate cell growth, proliferation, survival, and protein synthesis (among other things). Something as simple as a big juicy steak will cause our body to upregulate (stimulate the increase of) mTOR — and when this happens, the cells can “forget” to do some very important things (like controlling and preventing cancer growth).
Your child will begin the ketogenic diet within 24 hours of being admitted to the hospital. The diet contains a fixed amount of calories, carbohydrate, fat, and protein. Each meal has to be measured exactly and all the ingredients weighed in this diet. For young infants, pre-made, ready-to-use ketogenic formulas are available for use. Your child may also need supplements such as vitamins and extra calcium.
Animal research indicates that a ketogenic diet reduces levels of brain amyloid-beta, a misfolded protein that contributes to Alzheimer’s disease, while also restoring mitochondrial function and improving learning and memory. (18, 19, 20) Although fewer studies on a ketogenic diet have been done in humans with Alzheimer’s disease, a recent trial found a ketogenic diet to be both safe and effective for mild Alzheimer’s disease. (21)
Type 1 Diabetes: Lowering carb intake and increasing fat intake is also beneficial for people with Type 1, Type 1.5 diabetes and LADA. A low carb diet can help reduce the number and severity of hypoglycemic episodes, lower HbA1c test results and minimize future diabetic complications. Learn more in The Ketogenic Diet for Type 1 Diabetes e-Book or click on the book cover.  These benefits are also possible for children with Type 1 and their parents should know that they have options.
While I can appreciate Mr. Feldman's efforts and I am also a hyper responder, I have no doubt that cholesterol levels are merely an artifact / symptom of the real cause of CVD which is hyperinsulinemia which for type 2 diebetics or pre-diabetics (which are simply undiagnosed diabetics) is due to high carbohydrate diets causing high blood glucose levels as well as other known causes of infllammation such as trans fat and high omega 6 to omega 3 ratios. In other words, there is no need to try and cure the symptom which is controlling lipoprotein levels directly.  
Patients diagnosed with the immune based “blood cancers” like leukemia, lymphoma, and myeloma, as well as the sarcomas, a type of connective tissue malignancy, required a lower carb, high animal fat, moderate animal protein diet. Other patients, usually with problems other than cancer, thrived on a more “balanced” diet, incorporating a variety of plant and animal foods.
Diets aren’t just for weight loss. What, how much, and even when we eat all affect the way our brains work. For people with epilepsy, diet can reduce the likelihood of seizures. Mackenzie Cervenka, a neurologist and director of the Adult Epilepsy Diet Center at Johns Hopkins Hospital, explains what the ketogenic diet is and how it can benefit people with epilepsy.
Dr. Jockers, thank you so much for this clear and detailed article! I began a keto-style diet around August 2019. By late November, I had fallen from 197 lbs. to under 175 lbs., dropped from 28% to 18% body fat, and anecdotally felt much better in all aspects of my health. All of this occurred exclusively due to diet, I believe– I had almost no exercise routine to speak of, and my desk-based job is pretty sedentary. My family practice doc was surprised and happy with the results as well when I met with him in January… until my blood work came back showing total cholesterol at 257, triglycerides at 236, LDL-C at 162, and HDL at 50.
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.
As you might suspect, this metabolic theory of cancers is controversial in the mainstream cancer paradigm, but there’s already promising initial evidence to support it, and most traditional cancer specialists concede that this metabolic theory has merit, and it may be a piece of the puzzle. I would say that the dominant paradigm idea right now is that metabolic dysfunction is likely one of the pieces of the puzzle, but that cancer is multifactorial and probably does involve genetic mutations that may be independent of metabolic dysfunction and that there are other causes that may not be directly related to metabolic dysfunction.
First, a little background: Eric Westman, MD, director of the Duke Lifestyle Medical Clinic, explained to Health in a previous interview that in order to successfully follow the keto diet, you need to eat moderate amounts of protein, reduce your carb intake, and increase fats. When you reduce your carb consumption, your body turns to stored fat as its new fuel source—a process called ketosis. To stay in ketosis, followers of the keto diet must limit their carbs to 50 grams a day, Dr. Westman says.

However, this diet is gaining considerable attention as a potential weight-loss strategy due to the low-carb diet craze, which started in the 1970s with the Atkins diet (a very low-carbohydrate, high-protein diet, which was a commercial success and popularized low-carb diets to a new level). Today, other low-carb diets including the Paleo, South Beach, and Dukan diets are all high in protein but moderate in fat. In contrast, the ketogenic diet is distinctive for its exceptionally high-fat content, typically 70% to 80%, though with only a moderate intake of protein.

What this shows is that there is very little difference in heart disease risk relative to total cholesterol above and below 200. In fact, no significant increase in risk was measured until total cholesterol reached an excess of 240. There also seems to be a protective role that having a total cholesterol above 180 serves both for heart disease and healthy mental function.

When our blood ketone levels reach a certain point, our body is said to enter a state of ketosis, typically three to four days after eliminating carbs or minimizing their consumption. Ketosis has been shown to help people lose weight and excess body fat rapidly – along with making many significant health gains – even while consuming lots of healthy fats and sufficient calories for their needs.
Salad mixes, fermented things like sauerkraut and kimchi, unsweetened yogurt, unsweetened coconut yogurt, coconut oil, cultured cottage cheese and cultured sour cream. I am not eating meat or carbs except what is present in some vegetable juices. I started exercising a little and hot baths, having less pain and feeling like I have control over symptoms. Of course using some supplements. For me, dessert will be surviving long enough to see old friends and make new ones.
Patients diagnosed with the immune based “blood cancers” like leukemia, lymphoma, and myeloma, as well as the sarcomas, a type of connective tissue malignancy, required a lower carb, high animal fat, moderate animal protein diet. Other patients, usually with problems other than cancer, thrived on a more “balanced” diet, incorporating a variety of plant and animal foods.
During the 1920s and 1930s, when the only anticonvulsant drugs were the sedative bromides (discovered 1857) and phenobarbital (1912), the ketogenic diet was widely used and studied. This changed in 1938 when H. Houston Merritt, Jr. and Tracy Putnam discovered phenytoin (Dilantin), and the focus of research shifted to discovering new drugs. With the introduction of sodium valproate in the 1970s, drugs were available to neurologists that were effective across a broad range of epileptic syndromes and seizure types. The use of the ketogenic diet, by this time restricted to difficult cases such as Lennox–Gastaut syndrome, declined further.[10]

Over one-third of Americans have metabolic syndrome, a constellation of complications including increased blood pressure, elevated blood sugar, excess abdominal fat, and abnormal triglyceride and cholesterol levels that significantly increase one’s risk of heart disease, diabetes, and stroke. (8) The conventional treatment of metabolic syndrome typically involves cholesterol-, blood sugar-, and blood pressure-lowering medications, along with vague advice to “eat better.” Given that heart disease is still the number one cause of death in the United States, that diabetes is considered to be at epidemic proportions, and that strokes disable or kill someone every 40 seconds on average, this treatment paradigm leaves much to be desired. (9)
Now intrigued, I asked why he would want to change jobs, since our practice was by design slower paced, whereas Bob ran a very busy clinic and active IV unit which would seem perfectly suited for this nurse’s expertise. He then explained, with obvious disappointment, that none of the hundreds of cancer patients they had treated or had been treating had responded to any significant degree, with the exception of those he had referred to me. 
×