Unfortunately, thanks to the widespread prevalence of the standard American diet (SAD) – characterized by high consumption of red meat, processed meat, pre-packaged foods, butter, fried foods, high-fat dairy products, refined grains, potatoes, corn, high-fructose corn syrup (HFCS), and high-sugar drinks – the incidence of obesity, insulin resistance, diabetes, cardiovascular disease, and many forms of cancer are skyrocketing in the U.S.
There are indications that the way the ketogenic diet produces “ketones”, or the “ketogenic effect”, is being studied in order to produce pharmaceutical products (drugs or vaccines) that can mimic the same effect. With years of experience now documented in using the ketogenic diet with children suffering from seizures, one of the most common complaints is that the diet is difficult to adhere to, as the child has to abstain from refined carbohydrates and typical childhood sweets such as cakes and candies. The reasoning is that a drug would make life more bearable instead of following such a strict diet.
[52:25] – How increasing the amount of carbs lead to a decrease in cholesterol levels, but not in the way expected. The relationship was not linear, there was no noticeable difference in cholesterol levels until a certain threshold was crossed. Dave discusses some of the theories behind this. As hyper-responders do we need a certain amount of insulin to bring down total lipid numbers?
More recently, the famed New York diet doctor, Robert Atkins, MD, popularized the ketogenic diet, not for cancer, but as the ultimate weight loss plan with his books over the decades selling in the tens of millions of copies. The original version of the Diet Revolution published in 1972 sold at one point more than 100,000 hard copies a week, in those days the fastest selling book in the history of United States publishing.
Dieter beware: U.S. News & World Report, in its high-profile January cover story on "best diets," calls the DASH and Mediterranean diets tops for health, though these regimens represent the failed nutritional status quo of the last 50 years. It's clear that U.S. News — which employed an expert panel to rate 40 diets on various criteria — merely recapitulated questionable dietary advice that has gone by a succession of names since the 1970s — "low-fat," "DASH," "USDA-style," "plant-based." The basic set of recommendations have remained the same, emphasizing plant foods (grains, cereals, fruits and vegetables) over animal products (eggs, regular dairy, meat), and vegetable oils over natural animal fats such as butter. According to government data, Americans have largely followed these recommendations over the last 50 years, notably increasing their consumption of grains, vegetables and fruits and eating less whole milk, butter, meat and eggs. The outcome? In that time, rates of obesity and Type 2 diabetes have skyrocketed. Something has gone terribly wrong. Why would 25 doctors, dietitians and nutritionists on the U.S. News panel choose a dietary philosophy that has — so far, at least — failed us?
The weight and body mass index of the patients decreased significantly (P<0.0001). The level of total cholesterol decreased from week 1 to week 24. HDL cholesterol levels significantly increased, whereas LDL cholesterol levels significantly decreased after treatment. The level of triglycerides decreased significantly following 24 weeks of treatment. The level of blood glucose significantly decreased. The changes in the level of urea and creatinine were not statistically significant.
A study with an intent-to-treat prospective design was published in 1998 by a team from the Johns Hopkins Hospital and followed-up by a report published in 2001. As with most studies of the ketogenic diet, no control group (patients who did not receive the treatment) was used. The study enrolled 150 children. After three months, 83% of them were still on the diet, 26% had experienced a good reduction in seizures, 31% had had an excellent reduction, and 3% were seizure-free.[Note 7] At 12 months, 55% were still on the diet, 23% had a good response, 20% had an excellent response, and 7% were seizure-free. Those who had discontinued the diet by this stage did so because it was ineffective, too restrictive, or due to illness, and most of those who remained were benefiting from it. The percentage of those still on the diet at two, three, and four years was 39%, 20%, and 12%, respectively. During this period, the most common reason for discontinuing the diet was because the children had become seizure-free or significantly better. At four years, 16% of the original 150 children had a good reduction in seizure frequency, 14% had an excellent reduction, and 13% were seizure-free, though these figures include many who were no longer on the diet. Those remaining on the diet after this duration were typically not seizure-free, but had had an excellent response.
There are other studies, but little or nothing in the way of randomized clinical trials. For instance, a recent retrospective study of 53 patients, of whom only six followed a ketogenic diet while being treated for GBM, concluded that the diet was safe, but no suggestion of efficacy was noted. More recently, a German group examined the effect of a ketogenic diet on 16 patients with advanced cancer of various types who had exhausted all therapeutic options. The treatment didn’t result in any serious side effects, although subjects found it very difficult to maintain the diet, particularly in the context of family life. Only five were able to complete the three month treatment period, and it was reported that these five didn’t have progression while on the diet. Of the remaining 11, two died early, one was unable to tolerate the diet and dropped out very quickly, two dropped out for personal reasons, one couldn’t continue the diet for more than a month and three had disease progression within less than 2 months of starting the diet and one dropped out to resume chemotherapy. As a whole, this study was well-nigh uninterpretable due to the different kinds of cancer, other than to conclude that less than 50% of patients with advanced cancer could adhere to the diet, and that those who could generally had no significant side effects. Of course, it’s unclear whether the diet helped the five who could adhere to it or whether those who adhered to it could do so because they had more indolent, less aggressive disease.
At the time I finished my monograph in 1986, I hoped that with its publication, fair-minded researchers might begin taking Dr. Kelley and his nutritional therapy seriously. As I was to learn, I completely and rather naively misjudged the animus of the scientific community toward unconventional cancer treatment approaches that didn’t fit the “accepted” model. Even with Dr. Good’s support, after two years of trying I could not get the book published, either in its entirety, or in the form of individual case reports appropriate for the conventional medical journals.
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.
After scouring the literature, he became quite attracted to the “good science” behind the ketogenic hypothesis, so under Dr. Seyfried’s direct supervision, he began the diet. Though the patient seems quite enthusiastic about his response, he admits in his note that with the diet there has been “no progression,” presumably in terms of x-ray studies, and some improvement in the blood studies. He still considers his disease as “incurable.”
Bob wasn’t the only physician, his clinic not the only place, where the ketogenic diet has been applied in modern times. At the Johns Hopkins Medical Center, for many years a group of researchers and neurologists have prescribed a very strict ketogenic diet for children with intractable seizures, that is, seizures unresponsive to currently available medications. For this particular indication, in adults as well as children, the diet works quite well.
All trials applied an intention‐to‐treat analysis with varied randomisation methods. The 11 studies recruited 778 patients; 712 children and adolescents and 66 adults. We assessed all 11 studies to be at low to unclear risk of bias for the following domains: random sequence generation, allocation concealment and selective reporting. For the other domains (blinding, incomplete outcome data, other bias) assessments were varied (low, unclear and high risk of bias). We could not conduct a meta‐analysis due to the heterogeneity of the studies and the quality of the evidence was low to very low (GRADE ratings).
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
They’re totally ignoring HDL. They’ll say, “Oh yeah, it looks good. But oh my god your LDL is bad or your total cholesterol is bad.” The other thing that they’re ignoring about your cholesterol panel which doesn’t necessarily show up in your numbers that they look at is the triglycerides. If you’ve got your numbers and you’re looking at them now, go grab them and let’s look at them. If you have a triglyceride number over 100, I know they say the range is 150 or below but over 100 means you’re eating way too many carbohydrates in your diet still. The tell tale sign that you’re eating low carb, high fat, keto very well is your triglycerides will be sub 100 and then sub 70 optimally.
The nerve impulse is characterised by a great influx of sodium ions through channels in the neuron's cell membrane followed by an efflux of potassium ions through other channels. The neuron is unable to fire again for a short time (known as the refractory period), which is mediated by another potassium channel. The flow through these ion channels is governed by a "gate" which is opened by either a voltage change or a chemical messenger known as a ligand (such as a neurotransmitter). These channels are another target for anticonvulsant drugs.
They included participants who were 35-75 years of age and who were not born in Canada but had lived there for at least 5 years. Subjects who suffered from moderate to severe medical conditions such as diabetes, heart diseases, and active cancer were not included. Subjects of all different weights and BMIs were included as long as they were considered healthy.
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.
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.
Drink lots of water. This is especially crucial on a low carb or keto diet. Why? When you eat carbohydrates, your body stores the extra as glycogen in the liver, where they are bound to water molecules. Eating low carb depletes this glycogen, which allows you to burn fat – but it also means you are storing less water, making it easier to get dehydrated. Instead of the traditional recommendation of 8 cups of water per day, aim for 16 cups when following a low carb lifestyle.
Additionally, research suggests that during menopause, women may experience an increased thickening of the carotid intima and media layers of the arteries, a marker of subclinical atherosclerosis. In a study of 249 middle-aged women, those who were postmenopausal or in the late stages of perimenopause were much more likely to show progression of carotid intima-media thickness (CIMT) than those in early perimenopause (11).
Frederick F. Samaha, M.D., Nayyar Iqbal, M.D., Prakash Seshadri, M.D., Kathryn L. Chicano, C.R.N.P., Denise A. Daily, R.D., Joyce McGrory, C.R.N.P., Terrence Williams, B.S., Monica Williams, B.S., Edward J. Gracely, Ph.D., and Linda Stern, M.D., “A Low-Carbohydrate as Compared with a Low-Fat Diet in Severe Obesity,” N Engl J Med 2003; 348:2074-2081. http://www.nejm.org/doi/full/10.1056/NEJMoa022637.
One of the biggest concerns when it comes to following the ketogenic diet is that some people are afraid to try this way of eating simply because they think it can increase their cholesterol and clog their arteries. From the solid scientific studies we will talk about below, a low-carb ketogenic diet is shown to improve your cholesterol levels and can be an incredibly healthy choice.
As of the moment, there is no industry standard as to how many calories should be consumed in a restricted ketogenic diet, but there are published studies that provide estimates. In one example, a 65-year-old woman who was suffering from glioblastoma multiforme (GBM), an aggressive type of brain cancer, was put into a restricted ketogenic diet that started with water fasting and then proceeded to consuming 600 calories a day only.
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.
They also noted that some patients were more responsive to the ketogenic diet than other patients were. The best response was in a 3-year-old girl who had complete remission five years of treatment with a ketogenic diet. Two other patients also experienced complete remission after the diet, and the other two patients had disease progression after stopping keto. (Keep in mind, however, that all of these patients used conventional treatments along with the keto diet.)
Thanks for this article. I just started a Keto diet so found it appropriate to my current lifestyle. Though I don’t believe your bottom line is strong enough since you simply stating that the diet is “hard to follow” and food is “notoriously unhealthy” without evidence going deeper into why those “notoriously unhealthy” foods are worse than keeping carbohydrate-heavy food that are addictive and give the body a quick sugar high for energy. I believe “hard to follow” is your opinion only, since acceptable Keto foods are found at all restaurants easily and also all grocery stores. All the foods you mention: “rich in very colorful fruits and vegetables, lean meats, fish, whole grains, nuts, seeds, olive oil, and lots of water” are all Keto-friendly. Many people have been on a Keto-diet for years. A healthy lifestyle is a healthy mindset change and making right choices – it’s not going to be easy.
Fortunately, patients have an alternative—a ketogenic diet. Research indicates that a ketogenic diet improves multiple aspects of metabolic syndrome, inducing significant reductions in body fat percentage, BMI, hemoglobin A1c levels, blood lipids, and blood pressure. (10, 11, 12) The ketogenic diet produces these beneficial effects by reversing the pathological processes underlying metabolic syndrome, including insulin resistance and chronic inflammation.
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.
Given that the consumption of a high carbohydrate diet promotes inflammation and in turn causes CVD, is it any wonder then that our bodies would produce LDL particles which work to repair vascular damage, as they are needed to patch up the damage? Unfortunately LDL can only do so much under the constant onslaught of inflammation but had it not been there in the first place the person would not have survived as long as they did.
And don’t associate yourself with Ralph Moss, the number one promoter of laetrile quackery and make easily refuted claims such as the claim that “chemo and radiation do not cure cancer or extend life, although cancer physicians often make this claim” and that radiation “often does more harm than good to the patient.” Given that all Dr. Seyfried has is a couple of case studies as clinical support for his treatment (see below) and I can produce reams of studies over nearly 50 years demonstrating that chemotherapy can cure specific cancers and prolong life when used appropriately, the “2% gambit” notwithstanding, it’s not a winning proposition, and it sure doesn’t help your credibility to use the language of cancer quacks to promote your idea.
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.
Epilepsy Ontario is the voice of epilepsy in the province. Since 1956, we have been serving the province as a registered health charity incorporated under the statutes of Ontario as a non-profit and non-governmental organization. We aim to raise public awareness and improve education through publications, conferences, outreach initiatives and our website.
The ketogenic or “keto” diet is a low-carbohydrate, fat-rich eating plan that has been used for centuries to treat specific medical conditions. In the 19th century, the ketogenic diet was commonly used to help control diabetes. In 1920 it was introduced as an effective treatment for epilepsy in children in whom medication was ineffective. The ketogenic diet has also been tested and used in closely monitored settings for cancer, diabetes, polycystic ovary syndrome, and Alzheimer’s disease.
Jimmy Moore: I know right? What they didn’t realize was they were putting me at a greater risk for heart disease and they were putting me at a greater risk for having depression and all these kind of mental health issues. Your brain literally needs that cholesterol to run. If you’re not giving it the cholesterol in your diet, and you’re not allowing the natural progression of cholesterol to take place in the body, you’re actually causing harm to your body. This is the analogy I used in Cholesterol Clarity about the role that cholesterol plays in the body, so you say “What is the real problem that we should be paying attention to if it’s not cholesterol?” It’s the inflammation, stupid. Inflammation is really what we need to be paying attention to.
In addition to neuroblastoma, various researchers have investigated the efficacy of KDs as an adjuvant therapy for other types of cancer. The strongest evidence (> 3 studies) for a tumor-suppressing effect has been reported for glioblastoma, whereas little or no benefit was found for two other brain tumors (astrocytoma and medulloblastoma). Good evidence (2 - 3 studies) is available for prostate, colon, pancreatic and lung cancer ; neuroblastoma also falls into this category (Figure 1). Some of those studies report a tumor-suppressing effect of KD alone and/or in combination with classic therapy and/or caloric restriction. One study on prostate cancer applied the KD in a preventive, instead of a therapeutic, study setting. Only limited evidence (1 study) supports the anti-tumor effect of an unrestricted KD on breast, stomach, and liver cancer.
Following a ketogenic diet puts your body into a state of “ketosis,” which is a metabolic state that occurs when most of the body’s energy comes from ketone bodies in the blood, rather than from glucose from carbohydrate foods (like grains, all sources of sugar or fruit, for example). This is in contrast to a glycolytic state, where blood glucose (sugar) provides most of the body’s fuel (or energy).
After I finished my conventional immunology training under Dr. Good, in 1987 Bob graciously offered me a job in his clinic, not to work with patients seeking dietary or general nutritional advice, but to help supervise a cancer unit he was then in the process of establishing. Though I was grateful for the proposal, I turned him down, determined to set up my own practice.