As far back as the 5th century, Hippocrates noted that fasting reduced seizures, and in the 1920s a diet was developed to mimic changes brought on by fasting that could be maintained long-term, specifically to treat seizures, and thus the ketogenic diet was born.1 This original ketogenic diet was very low in carbohydrates and protein and supplied 80-90% of the calories as fat.2 3 While the original ketogenic diet was successful in treating intractable childhood epilepsy, it fell out of favor when the modern antiepileptic drugs became available. In the 1990s the diet began to see a resurgence as people once again turned to it for difficult-to-treat cases of childhood epilepsy, such as those that do not respond to medication, and as a weight loss tool. The most recent research on the benefits of the ketogenic diet and ketones, in particular, have expanded to examine its possible therapeutic effects on other neurological diseases, cardiovascular disease, diabetes and even cancer.
This has been very comforting for me to read as I’ve been on a Keto diet for 8mo, loving my results which were weight loss (initially) but now the sustained clarity & sharpness of mind. I am lean (58kg) and very active. I had a blood test last week just to see where I’m at & my LDL is very high. Of course my doctor wants me to stop Keto but I just feel so great. I’m torn...
Having first read Dr. Price’s book during my journalism days, I knew that according to his exhaustive work, humans were a varied species, in the past living in and adapting to all ecological niches excepting the Antarctic, offering a variety of food sources. To me, his work offered a solution to the conflicting dietary advice even then being offered to the world. It didn’t make sense as Nathan Pritikin insisted or as Bob Atkins argued, that all humans should follow one specific type of diet: It just didn’t seem reasonable, to me at least.
A meta-analysis of 13 randomized controlled trials following overweight and obese participants for 1-2 years on either low-fat diets or very-low-carbohydrate ketogenic diets found that the ketogenic diet produced a small but significantly greater reduction in weight, triglycerides, and blood pressure, and a greater increase in HDL and LDL cholesterol compared with the low-fat diet at one year.  The authors acknowledged the small weight loss difference between the two diets of about 2 pounds, and that compliance to the ketogenic diet declined over time, which may have explained the more significant difference at one year but not at two years (the authors did not provide additional data on this).
To make sure the diet is nutritionally balanced, an experienced dietitian works out exactly how much of which foods the person can eat each day. To help with this, people have individual recipes, are given support on how to plan meals, and are guided on which foods should be avoided. As the diet can be quite restrictive, the dietitian will recommend any vitamin and mineral supplements that are needed.
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.
Achieving ketosis is a pretty straightforward, but it can seem complicated and confusing with all of the information out there.4If you want to learn more about ketosis and the scientific process around it, you can visit a very in-depth discussion about on Dr. Peter Attia’s website. Here’s the bottom line on what you need to do, ordered in levels of importance:
When a person first starts onto a low-carbohydrate ketogenic diet, it takes the body several days to a few weeks to shift from relying on glucose to instead rely on fat. During this transition, people may experience what is sometimes referred to as the “keto-flu”—muscle cramps, headaches, fatigue, dizziness, nausea, and sugar and carbohydrate cravings.49 There may also be increased urination which can result in a loss of minerals, such as sodium and potassium. To counter these effects one should strive to get more minerals and in particular, more sodium and potassium, drink plenty of water, get some exercise and ensure adequate caloric intake. Once the body becomes keto-adapted, these symptoms largely resolve, and many people report increased energy, decreased cravings and weight loss.
The Emory research team studied the link between diet and epileptic seizures on the behavioral, cellular and genetic level. They found, as had others, that in rats fed the KD the resistance to seizures develops slowly, over one to two weeks, in contrast to rats treated with conventional anticonvulsant drugs. On the cellular level, they found that the anticonvulsant effect of the ketogenic diet did not correlate with a rise in plasma ketone levels or with a decrease in plasma glucose. Because longer treatment with the KD was necessary to increase the resistance to seizures, they concluded that changes in gene expression might hold the key to the diet's anticonvulsant effects.
People suffering from diabetes and taking insulin or oral hypoglycemic agents suffer severe hypoglycemia if the medications are not appropriately adjusted before initiating this diet. The ketogenic diet is contraindicated in patients with pancreatitis, liver failure, disorders of fat metabolism, primary carnitine deficiency, carnitine palmitoyltransferase deficiency, carnitine translocase deficiency, porphyrias, or pyruvate kinase deficiency. People on a ketogenic diet rarely can have a false positive breath alcohol test. Due to ketonemia, acetone in the body can sometimes be reduced to isopropanol by hepatic alcohol dehydrogenase which can give a false positive alcohol breath test result.
The popular low-carb diets (such as Atkins or Paleo) modify a true keto diet. But they come with the same risks if you overdo it on fats and proteins and lay off the carbs. So why do people follow the diets? "They're everywhere, and people hear anecdotally that they work," McManus says. Theories about short-term low-carb diet success include lower appetite because fat burns slower than carbs. "But again, we don't know about the long term," she says. "And eating a restrictive diet, no matter what the plan, is difficult to sustain. Once you resume a normal diet, the weight will likely return."
Recent animal studies suggest a role for the ketogenic diet as a potential therapy for amyotrophic lateral sclerosis (ALS). ALS results from the death of motor neurons in the brain and spinal cord. A small number of cases are caused by an inherited mutation in the gene encoding the Cu/Zn superoxide dismutase I (SOD1). Mice expressing the mutated gene recapitulate the progressive muscle weakness and death due to respiratory failure seen in humans with ALS. Various lines of evidence suggest that mitochondrial dysfunction may play a role in the pathogenesis of ALS. A recent study suggests that ketosis induced by the ketogenic diet might affect progression of the disease . Transgenic SOD1 mice fed a high-fat diet (60% of calories from fat, compared with < 10% fat in standard rodent chow and > 90% of calories from fat in a typical rodent ketogenic diet) preserved their performance on a standard rotorod test longer than those fed a regular diet. Mice were fed ad lib, and mice fed the high-fat diet gained more weight than those on the standard diet, so overall caloric restriction was unlikely to be a factor in this study. When spinal cords were examined, significantly more motor neurons were preserved in the mice fed the ketogenic diet than in those fed a regular diet. However, the ketogenic diet did not significantly prolong survival.
firstly, the LMHR profile also applies to long-term fasting studies - this is perhaps where it can be observed in its natural, unconfounded state - LDL rises in lean healthy individuals during a fast, but drops or stays stable in those with obesity or atherosclerosis (period varies from 3-21 days). This is consistent with the keto pattern; this evidence clearly shows that LDL divergence is related to burning a high % of fat, and not to eating it, which is to some extent a confounder with keto (as shown by the cholesterol drop protocol and the possible different effects of different fat types and amounts).
Disturbing statistics indicate that weight problems have reached epidemic proportions in the United States, with nearly 72 percent of American adults 20 and over categorized as overweight or obese. (1) The mandate that overweight and obese individuals should merely “eat less and exercise more” is failing miserably; it does little to correct the underlying metabolic disturbances driving obesity, trapping people in a vicious cycle of weight loss and regain. However, all hope is not lost! The ketogenic diet is emerging as a powerful, sustainable tool for weight loss in overweight and obese individuals.
Studies assessing the efficacy of the MAD reported seizure freedom rates of up to 25% and seizure reduction rates of up to 60% in children. One study used a simplified MAD (sMAD) and reported seizure freedom rates of 15% and seizure reduction rates of 56% in children. One study utilised a MAD in adults and reported seizure reduction rates of 35%, but no patients became seizure free (GRADE rating low).
So what do you do about GBM? Standard treatment begins with surgery. After surgery, you are given radiation and chemo. In the meantime, you take other medications to control the side effects. Tick, tick, tick, GBM makes you acutely aware of clocks ticking. You start searching for medical trials. There are many rules to qualify, most extend life by only a few months. Some have a substantial chance of killing you.
When mitochondria were isolated from these SOD1 mice, β-hydroxybutyrate rescued ATP production in the presence of a complex I inhibitor. It also helped to preserve neurons in culture exposed to the same inhibitor, paralleling the findings found for PD. In these neurodegenerative disorders, the ketogenic diet may be providing substrate to bypass impaired or poorly functioning complex I. Another hypothesis on enhanced ATP production includes increased mitochondrial biogenesis [48•]. Alternatively, decreased reactive oxygen species generation (which protects the process of oxidative phosphorylation) could be the result of an effect on NADH oxidation or preventing adverse events in the handling of calcium overload in mitochondria, such as the mitochondrial permeability transition [48•,49,50].
The glowing TV stories followed, including a memorable prime time, one-hour special about the subject on ABC hosted by the late Peter Jennings. The other networks, in quick succession, picked up the cause. However, not too long after, word broke that Times’ reporter Kolata had been, through her agent, hawking to publishers an idea for a book about anti-angiogenesis and cancer.
Researchers also observed that the size of VLDL particle size did not change in either of the groups. However, they noted that the total number of VLDL particles decreased by 19% from 76.2 nmol/L to 61.7 nmol/L.  More specifically, large VLDL particles reduced by 40.2% from 3.33 nmol/L to 1.74 nmol/L, medium VLDL particles decreased by 4.8% from 46.2 nmol/L to 44 nmol/L. 
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder, and it affects women of reproductive age. Symptoms include obesity, hyperinsulinemia and insulin resistance. A pilot study took 11 women through 24 weeks of a low-carbohydrate ketogenic diet (20 grams or less per day). Among the five who completed the study, they lost 12 percent of their weight on average and reduced fasting insulin by 54 percent. Additionally, two women who previously experienced infertility problems became pregnant. (6)
Advocates for the diet recommend that it be seriously considered after two medications have failed, as the chance of other drugs succeeding is only 10%. The diet can be considered earlier for some epilepsy and genetic syndromes where it has shown particular usefulness. These include Dravet syndrome, infantile spasms, myoclonic-astatic epilepsy, and tuberous sclerosis complex.
Yancy WS Jr, Westman EC, McDuffie JR, Grambow SC, Jeffreys AS, Bolton J, Chalecki A, Oddone EZ, “A randomized trial of a low-carbohydrate diet vs orlistat plus a lowfat diet for weight loss,” Arch Intern Med. 2010 Jan 25;170(2):136-45. http://www.ncbi.nlm.nih.gov/pubmed/20101008?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=2.
Normally, our bodies run on energy from glucose, which we get from food. We can’t store large amounts of glucose, however. We only have about a 24-hour supply. When a child has no food for 24 hours — which is the way the diet begins, usually in a hospital — he or she uses up all the stored glucose. With no more glucose to provide energy, the child’s body begins to burn stored fat.
In a recent review of studies of the MAD, there were 31 studies completed from multiple centers with a total of 423 children and adults enrolled across those studies. Adding everyone together, 47% of patients had a >50% reduction in their seizures, which is comparable to the results found for the ketogenic diet. It is important to understand that for children under the age of 2 years and those who receive formula-only nutrition the classic ketogenic diet is preferable. For older adolescents and adults, the MAD is often a better option due to increased tolerability.
David Book graduated with a PharmD from Drake University. After completing a Drug Information Residency in the greater Atlanta area with Mercer University's College of Pharmacy and InpharmD, he now works full time at an independent pharmacy. Drawn towards innovation and entrepreneurship, his interests include the business of pharmacy, healthcare advocacy, diet & nutrition, and health information technology.
The classic ketogenic diet is not a balanced diet and only contains tiny portions of fresh fruit and vegetables, fortified cereals, and calcium-rich foods. In particular, the B vitamins, calcium, and vitamin D must be artificially supplemented. This is achieved by taking two sugar-free supplements designed for the patient's age: a multivitamin with minerals and calcium with vitamin D. A typical day of food for a child on a 4:1 ratio, 1,500 kcal (6,300 kJ) ketogenic diet comprises three small meals and three small snacks:
Other genetic disorders caused by mutations limit the availability of energy substrates but do not necessarily cause seizures. One such disease is phosphofructokinase (PFK) deficiency. PFK is the rate-limiting enzyme in glycolysis for the conversion of fructose-6-phosphate to fructose-1,6-bisphosphate. Patients with mutations in the muscle isoform of PFK demonstrate exercise intolerance with myalgias and stiffness. There also are rare infantile forms, such as a case reported by Swoboda et al. [21, Class III], with myopathy and arthrogryposis. This patient displayed marked gains in muscle strength and improvement in his developmental milestones after being placed on the ketogenic diet.
I recall so well, this time sitting in my mid-Manhattan office, reading that famous May 3, 1998 front page lead New York Times article (in the upper left of the page reserved for wars, revolutions, and, yes, miracles) by reporter Gina Kolata, announcing Folkman’s preliminary findings to the world, extolling anti-angiogenesis in a tone that one more skeptical writer, Jack Breibart, described as “breathless.”
Jimmy Moore: 300 is the normal. Yes. That’s 100 points higher than authorities today would say is “normal”. Yet if they put them on cholesterol lowering medication, do you know they would have been at greater risk for heart disease if they took that pill then they’re total cholesterol being 300. I think it all circles back around to it’s not about the cholesterol people, it really is about the inflammation.
The ketogenic diet also has been used in glycogenosis type V (McArdle disease), which is caused by a defect in the muscle-specific isozyme of glycogen phosphorylase. Glycogen phosphorylase is necessary to break down glycogen into free glucose for use as an energy source in muscles. When the ketogenic diet was applied to a patient with this disorder (presumably providing an alternative means of energy production), the patient’s exercise tolerance improved and there was a trend toward decreased baseline creatine kinase levels [22, Class III].
What is the ketogenic diet exactly? The classic ketogenic diet is a very low-carb diet plan that was originally designed in the 1920s for patients with epilepsy by researchers working at Johns Hopkins Medical Center. Researchers found that fasting — avoiding consumption of all foods for a brief period of time (such as with intermittent fasting), including those that provide carbohydrates — helped reduce the amount of seizures patients suffered, in addition to having other positive effects on body fat, blood sugar, cholesterol and hunger levels. (1)
A recent systemic review and meta-analysis of randomized controlled trials comparing the long-term effects (greater than 1 year) of dietary interventions on weight loss showed no sound evidence for recommending low-fat diets. In fact, low-carbohydrate diets led to significantly greater weight loss compared to low-fat interventions. It was observed that a carbohydrate-restricted diet is better than a low-fat diet for retaining an individual’s BMR. In other words, the quality of calories consumed may affect the number of calories burned. BMR dropped by more than 400 kcal/day on a low-fat diet when compared to a very low-carb diet.
Red flags or no red flags, it is, of course, possible that Dr. Seyfried is on to something and has let his enthusiasm overwhelm his judgment with respect to whom he associates with and the sorts of statements he makes, many of which sound as though they could have come from Stanislaw Burzynski, Ralph Moss, or Joe Mercola. In actuality, he isn’t totally wrong, but he isn’t totally right, either. As is typical of someone without a medical background, in particular an oncology background, he is, basically, putting the cart before the horse, as you will see.
It is very interesting to read about the keto/low card diet.I love to change my lifestyle as I an TYPE 2 Diabetic.I subscribed for a free printable low carb meal .The initial email stated that that I will receive an email for instructions to access the members area .Your free download will be there.However it is very deceiving ,I never got the 2nd email with instructions which is frustrating and not good .Hopefully this is not a way to get us to pay to get the printable version.
The ketogenic diet for epilepsy (KDE) was developed in the 1920s by Dr. Hugh Conklin in Michigan. But once effective medications were developed, the diet was used less frequently. It has regained recognition and study and is now a standard backup plan for children whose epilepsy symptoms are difficult to control with medication. With over 300,000 children in the U.S. with seizure disorders, this has become an important addition to the arsenal of treatments for epilepsy. Researchers are beginning to see how it might help adults and people with a variety of neurologic disorders.
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?