I am trying to get back into keto. I did it before and I was so happy when I lost 10lbs (I did the keto for a month). I am ready to go back to this lifestyle. All this information is very helpful, I have written it all down so it can be easier for me to remember what is allowed and what is not. Looking forward to get back on this keto journey. Thank you for all the great info.

His research and clinical practice focuses on the diagnosis and treatment of childhood seizures and epilepsy, particularly treatments other than medications such as diet, neurostimulation and surgery. Currently the Medical Director of the Ketogenic Diet Center at Johns Hopkins, he is a world expert on the ketogenic diet and created the modified Atkins diet for children and adults in 2003.  He is dedicated to bringing the use of diet therapies for neurologic disorders to the entire world and is the head of a Task Force within the International League Against Epilepsy to help achieve this goal.  He is a coauthor of The Ketogenic and Modified Atkins Diets: Treatments for Epilepsy and Other Disorders, now in its 6th edition.  Dr. Kossoff is also published in the fields of Sturge-Weber syndrome, migraine and epilepsy, infantile spasms, Doose syndrome, and benign rolandic epilepsy.


With regard to Dr. Gonzales’ disagreement with Dr. Seyfried regarding ketogenic diets and cancer, it is known that cancer cells use glucose but not fatty acids for energy. Thus depriving cancer cells of glucose by means of a ketogenic diet is a logical approach. Beyond that, at the present time too little known about cancer metabolism to make any definitive statements about proper treatment. As lay people, we will leave the argument to medical professionals.

Dousing your steak with butter, swigging MCT oil out of the bottle, and putting grass-fed butter and MCT oil into your coffee may be more fat that your body can handle, actually leading to the opposite effect than intended—inflammation. Even on a high-fat diet, too much dietary fat can—and often will—stall fat loss. Dial down that excess dietary fat and include more fiber-rich vegetables, berries, legumes, and non-gluten grains for a healthier, more diverse gut microbiome to keep your weight within a healthy range.

For most people, a ketogenic diet leads to improvements in cholesterol, but there are sometimes transient rises in cholesterol levels during weight loss. During rapid weight loss, cholesterol that you had stored in your adipose tissue (ie, body fat) is mobilized, which will artificially raise serum LDL as long as the weight loss continues. To avoid being misled by this, the best time to check blood lipids is a couple of months after weight loss ceases. Total cholesterol includes HDL (the so called ‘good cholesterol’), which usually goes up 10-15% on a ketogenic diet. That said, some people have high calculated LDL cholesterol values even after weight loss stops. If this occurs, you should discuss further diagnostic tests with your doctor. Current research is looking at LDL cholesterol as a mix of different particle sizes, where the small ones are dangerous and the larger ones are not. With a well-formulated ketogenic diet, we see a shift away from the small dangerous LDL even when the total LDL goes up.

While the purported benefits of the keto diet for cancer patients are not evident, the potential risks are a concern. It may be difficult for keto-dieters to meet their energy and protein needs, and the diet may cause long-term issues, including kidney damage, higher cholesterol levels, unintentional weight loss, bone loss, and certain vitamin and mineral deficiencies.


I won’t sugar coat it. The diet can be hard to start. The first two weeks can be terrible. You give up a lot of comfort foods. Plus, you will need new cookbooks. So, switching to a ketogenic diet isn’t the first thing that pops into your head when you hear cancer. But the diet works. I steadily lost weight without substantial hunger or changes to my limited exercise program. My overall health improved, I slept better, felt better and hopefully look better.

Data on the efficacy of KD and the modified Atkin’s diet (MAD) in children and adults are similar.1 “Approximately one-third of adults with epilepsy that does not respond to medications may have a 50% seizure frequency reduction. Five to 10% of these adults may have a dramatic response, with greater than or equal to 90% seizure frequency reduction. This is similar to the response seen in children,” said Klein.
One downside to a ketogenic diet for weight loss is the difficulty maintaining it. “Studies show that weight loss results from being on a low-carb diet for more than 12 months tend to be the same as being on a normal, healthy diet,” says Mattinson. While you may be eating more satiating fats (like peanut butter, regular butter, or avocado), you’re also way more limited in what’s allowed on the diet, which can make everyday situations, like eating dinner with family or going out with friends, far more difficult. Because people often find it tough to sustain, it’s easy to rely on it as a short-term diet rather than a long-term lifestyle.

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 >
In 1921, Dr. R.M. Wilder at the Mayo Clinic proposed a diet for the treatment of epilepsy – which he referred to as a ketogenic diet – in which most of the calories were derived from fat, mimicking the biochemical changes of fasting.2 Today, children resistant to anti-epileptic drugs are still advised to follow keto diets to prevent seizures, always under the management of well-trained dietitians, of course. Indeed, according to the Epilepsy Society, the keto diet is considered to be a medical treatment.3
Although many hypotheses have been put forward to explain how the ketogenic diet works, it remains a mystery. Disproven hypotheses include systemic acidosis (high levels of acid in the blood), electrolyte changes and hypoglycaemia (low blood glucose).[19] Although many biochemical changes are known to occur in the brain of a patient on the ketogenic diet, it is not known which of these has an anticonvulsant effect. The lack of understanding in this area is similar to the situation with many anticonvulsant drugs.[56]
In AD, ingestion of carbohydrates may worsen memory [42]. Patients with cognitive impairment lacking the APO-ε4 allele (one of the risk factors for AD) showed improved scores on the Alzheimer Disease Assessment Scale–Cognitive Subscale after ingesting a medium-chain triglyceride shake, which induces low but measurable levels of ketosis [43, Class I]. Scores on this test for those with the APO-ε4 allele (as well as scores for all patients on some other tests administered in this study) were not improved after ingestion of the medium-chain triglyceride shake, making the generalizability of these findings to other patients with cognitive impairment (including AD) an area for further investigation.
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.
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...
Many factors can negatively affect cholesterol levels — such as genetics, inactivity, diabetes, stress and hypothyroidism — but an unhealthy diet that includes lots of processed foods and is low in nutrients is the biggest contributor. The “standard American diet” is highly inflammatory, which elevates LDL (bad cholesterol) and lowers HDL (good cholesterol), while a “clean keto diet” tends to have the opposite effect.
Try resistant starch. Resistant starch passes through the small intestine intact and therefore doesn’t count as a dietary carbohydrate. Instead, it travels to your large intestine, where it’s used to feed beneficial gut bacteria. Try adding a teaspoon of resistant starch, such as raw potato starch or green banana flour, to your keto smoothie each day to keep your gut happy.
Jimmy Moore: I did not say that. You see my Instagram account, you know how much I hate processed boxed food. The mono unsaturated fats are avocados, avocado oil, 100% olive oil … that’s key too, make sure your getting olive oil that you know is 100% olive oil, because they can sneak in some of those omega-six facts into there and not tell anybody. That screws people up trying to avoid those. Of course, nuts have mono unsaturated fats as well. You can get a well rounded amount of fat from varying sources and that is really what’s going to help you in controlling your blood sugar, controlling your cholesterol, and controlling your inflammation.
Some practitioners have raised the concern that long-term adherence to a ketogenic diet may shift the composition of the microbiota (the beneficial microbes that live in our bodies) in an undesirable direction and may even encourage the overgrowth of ‘bad’ bacteria. These beneficial bacteria feed on prebiotics (such as fiber and resistant starch), both of which are likely to be low in a low-carbohydrate ketogenic diet. Without prebiotics, beneficial bacteria are not able to produce substances like butyrate and other short chain fatty acids that keep the intestinal cells healthy, and long-term disruption of the microbiota can lead to a host of health problems throughout the body. 57 58
Meat products make up a big part of the keto diet, but experts stress the importance of choosing quality. "Since the keto diet is based a lot on animal proteins, it's important to buy organic poultry and grass-fed, organic beef," says Aimee Aristotelous, RD. "Not only do organic selections help with limiting environmental toxins, but grass-fed options of red meats even change the composition of fats." The result, she explains, is that your body is able to better absorb those healthy fats.
Dr. Campos, it is unfortunate that you retain the medical community’s negative stance on the ketogenic diet, probably picked up in medical school when you studied ketoacidosis, in the midst of an obesity and type II diabetes epidemic that is growing every year, especially among populations who will never see the Harvard Health Letter. The medical community has failed in reversing this trend, especially among children, and the public is picking up the tab, in the form of higher health insurance premiums to treat chronic metabolic diseases which doctors cannot cure. The ketogenic diet does not bid its adherents to eat unhealthy processed meats, and the green leafy vegetables that it emphasizes are important in a number of nutritional deficiencies. People lose weight on the ketogenic diet, they lose their craving for sugar, they feel more satiety, they may become less depressed, their insulin receptors sensitivity is improved, and these are all the good outcomes you fail to mention. There is a growing body of research which demonstrates the neuroprotective effects of the ketogenic diet to slow cancer progression, as well as diseases like Parkinson’s and Alzheimer’s, for which there are no effective medical treatments. Please respect your patients by providing them with evidence-based medical outcomes, not opinions.
For patients interested in Ketogenic diet, it is vitally important that you talk with your health-care providers, says Alice Bender, MS, RDN, AICR’s Director of Nutrition Programs. “A dietitian is best positioned to talk with you about what is known regarding the pros and cons – especially to learn if this diet has any research showing the reasonable application with your particular type of cancer and if the ketogenic diet may even be harmful for you.”

In all fairness, you can do these plans without eating all those processed foods, although (let’s face it!) convenience and cravings mean you’ll likely be tempted to try them. And they tap into that weakness for "cheating" by making these options easily available. Who would refuse comfort food that is "compliant" with a diet? You can have your cake and eat it too, literally. I call this pseudo-dieting. Even then, eating potentially reactive foods like dairy (which is allowed from the very beginning on Atkins) can either aggravate or trigger food sensitivities ("no bueno").


In order to transition and remain in this state, aiming for about 30–50 net grams is typically the recommended amount of total carbs to start with. This is considered a more moderate or flexible approach but can be less overwhelming to begin with. Once you’re more accustomed to “eating keto,” you can choose to lower carbs even more if you’d like (perhaps only from time to time), down to about 20 grams of net carbs daily. This is considered the standard, “strict” amount that many keto dieters aim to adhere to for best results, but remember that everyone is a bit different.
• Fighting inflammation — The human body can use both sugar and fat as fuel sources. However, the latter is preferred because it is a cleaner, healthier fuel that releases far fewer reactive oxygen species (ROS) and secondary free radicals. By eliminating sugar from your daily food consumption, you're decreasing your risk of developing chronic inflammation throughout your body.
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.
As I wrote in my book, “Nevertheless on the therapy [Kelley’s] he slowly began to improve, to the point his mental status normalized and over a period of a year, he progressed from a wheelchair to a walker to a cane.” When I completed my study in 1987, he had survived 5 years and was in excellent health, with no evidence of cancer in his brain or spinal canal.
Since this is my full-time job, donations really help me keep afloat and allow me to post as much to the website as I do. While I do really appreciate any donation you want to give, you can enter $0 in the amount given to download it for free! I’ve added in $5 as the suggested price. I think that’s a very fair price considering other websites are charging in the hundreds of dollars and I’ve seen what they are like on the inside.
The good news, however, is that following a well-formulated ketogenic diet should help increase HDL while lowering triglyceride levels. LDL will likely remain the same or potentially increase in order to efficiently transport triglycerides to cells to metabolize for energy. Again, LDL will likely become more of the pattern A type which is a highly beneficial shift.

Another memorable patient written up for the book had been diagnosed with what was thought to be localized endometrial cancer in 1969. After a course of radiation to shrink her large tumor, she underwent hysterectomy, and was told they “got it all.” Over the next few years, however, her health began to deteriorate: she experienced persistent fatigue, malaise, pelvic pain, and weight loss.
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. [10] 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).
You’re very welcome, Judy! I’m glad it’s helpful. If you are keto (as opposed to low carb), unfortunately peaches would not allow you to stay in ketosis. You can check my keto food list to help determine what is keto friendly. Of course, there are worse things than fresh fruit 🙂 but in the end our bodies still see the sugar. That being said, it doesn’t mean you sabotaged the whole day. Just pick up again – you got this!! (And for next time, try some fresh berries in moderation when you’re craving fruit.)
The ketogenic diet has repeatedly been shown NOT to heal cancer as a monotherapy in rodents or humans, which has prompted researchers including D’Agostino to continue tacking on more protocols in an attempt to make it more “effective”, like fasting, calorie restriction, ketone supplements, hyperbaric oxygen, IV therapies, hyperthermia, nutraceuticals and chemo and/or radiotherapy.
Clinical improvement was observed in Alzheimer’s patients fed a ketogenic diet, and this was marked by improved mitochondrial function. (15) In fact, a European Journal of Clinical Nutrition study pointed to emerging data that suggested the therapeutic use of ketogenic diets for multiple neurological disorders beyond epilepsy and Alzheimer’s, including headaches, neurotrauma, Parkinson’s disease, sleep disorders, brain cancer, autism and multiple sclerosis. (16)

Dr. Kossoff is a Professor of Neurology and Pediatrics at Johns Hopkins University in Baltimore, MD.  He received his medical degree from SUNY at Buffalo School of Medicine in New York, followed by a residency in pediatrics at Eastern Virginia Medical School in Norfolk, Virginia. He completed a fellowship in child neurology and then pediatric epilepsy and clinical neurophysiology at The Johns Hopkins Hospital in Baltimore.  He has been at Johns Hopkins since 1998.
Cardiovascular Disease – A ketogenic diet is often feared because of its high dependence on dietary fat for energy. This misguided fear is based on the outdated notion that eating fat negatively affects cardiovascular health, in particular, blood lipids. On the contrary, a low-carbohydrate ketogenic diet may actually improve blood lipid profiles, including decreased triglycerides and total and LDL cholesterol, and increased HDL cholesterol.39 40 41 A ketogenic diet might also alter the size and volume of the different LDL particles in a beneficial way, shifting from small, dense particles (believed to be atherogenic) to large, fluffy particles. 42 (See the Natural Grocers Customer Literature File Fats— Saturated for more information)
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.
Cancer is not a single disease, but rather a group of diseases all of which share the common feature of abnormal cell growth. Cancer cells either stay put where they are formed or spread to other parts of the body. In the U.S. alone, it is estimated that nearly 2 million new cases of cancer will have been diagnosed in 2018, while over 600,000 people will have died as a consequence of this disease.7
But in Dr. Price’s day, many groups living in many different locations still lived according to tradition largely untouched by modern Western influence. Price’s travels took him from the Eskimos of the Arctic, to the descendents of the Incas living in the high Andes, to the Masai on the plains of Kenya, to isolated Swiss herders in the Alpine mountain valleys, to Polynesians living on pristine tropical islands.

Kossoff, E. H., Zupec-Kania, B. A., Ephane Auvin, S., Ballaban-Gil, K. R., Bergqvist, A. G. C., Blackford, R., et al. (2018). Optimal clinical management of children receiving dietary therapies for epilepsy: updated recommendations of the International Ketogenic Diet Study Group. Child Neurol. Soc. Epilepsia Open 3, 175–192. doi: 10.1002/epi4.12225
Polycystic Ovary Syndrome – Since PCOS shares many symptoms and underlying causes with metabolic syndrome, it has been hypothesized that women suffering from PCOS might benefit from a ketogenic diet in a similar fashion to those suffering from metabolic syndrome. One small pilot study of overweight and obese women with PCOS following a low-carbohydrate, ketogenic diet for six months saw significant improvements in many markers of the disease, such as free testosterone, and fasting insulin.43

Children who discontinue the diet after achieving seizure freedom have about a 20% risk of seizures returning. The length of time until recurrence is highly variable, but averages two years. This risk of recurrence compares with 10% for resective surgery (where part of the brain is removed) and 30–50% for anticonvulsant therapy. Of those who have a recurrence, just over half can regain freedom from seizures either with anticonvulsants or by returning to the ketogenic diet. Recurrence is more likely if, despite seizure freedom, an electroencephalogram shows epileptiform spikes, which indicate epileptic activity in the brain but are below the level that will cause a seizure. Recurrence is also likely if an MRI scan shows focal abnormalities (for example, as in children with tuberous sclerosis). Such children may remain on the diet longer than average, and children with tuberous sclerosis who achieve seizure freedom could remain on the ketogenic diet indefinitely.[46]
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]
When you eat less than 50 grams of carbs a day, your body eventually runs out of fuel (blood sugar) it can use quickly. This typically takes 3 to 4 days. Then you’ll start to break down protein and fat for energy, which can make you lose weight. This is called ketosis. It's important to note that the ketogenic diet is a short term diet that's focussed on weight loss rather than the pursuit of health benefits. 
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.
Research has indicated that a ketogenic diet raises the stress hormone cortisol to increase energy levels in the face of reduced carbohydrate availability. However, it is still up for debate whether this increase in cortisol is harmful or innocuous. Nonetheless, I recommend taking extra care to manage your stress while on a ketogenic diet. Getting plenty of sleep, exercising, and engaging in a regular stress-reduction practice can help you keep your baseline stress levels low and reduce the potential for chronically elevated cortisol.

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

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.
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.
Taking your first step into the ketogenic diet is an exciting phase for your health. But before coming up with an actual ketogenic diet food list, it's important to first take a look at what you're eating now and take out anything that's unhealthy. This means that you have to remove sugars, grains, starches and packaged and processed foods from your diet. Basically, anything that won't add to your new eating regimen has to go. This is what I call a "pantry sweep."
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