The ketogenic diet is calculated by a dietitian for each child. Age, weight, activity levels, culture, and food preferences all affect the meal plan. First, the energy requirements are set at 80–90% of the recommended daily amounts (RDA) for the child's age (the high-fat diet requires less energy to process than a typical high-carbohydrate diet). Highly active children or those with muscle spasticity require more food energy than this; immobile children require less. The ketogenic ratio of the diet compares the weight of fat to the combined weight of carbohydrate and protein. This is typically 4:1, but children who are younger than 18 months, older than 12 years, or who are obese may be started on a 3:1 ratio. Fat is energy-rich, with 9 kcal/g (38 kJ/g) compared to 4 kcal/g (17 kJ/g) for carbohydrate or protein, so portions on the ketogenic diet are smaller than normal. The quantity of fat in the diet can be calculated from the overall energy requirements and the chosen ketogenic ratio. Next, the protein levels are set to allow for growth and body maintenance, and are around 1 g protein for each kg of body weight. Lastly, the amount of carbohydrate is set according to what allowance is left while maintaining the chosen ratio. Any carbohydrate in medications or supplements must be subtracted from this allowance. The total daily amount of fat, protein, and carbohydrate is then evenly divided across the meals.[37]
The ketogenic diet is a high-fat, low-carbohydrate diet that's recently become popular for weight loss. But the diet has been used to treat epilepsy since the 1920s, according to the Epilepsy Society, a charity in the United Kingdom. Although most people with epilepsy today control their seizures with anti-epileptic drugs, the diet is sometimes prescribed to children with epilepsy who have not responded to several medications.
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.
"The keto diet is primarily used to help reduce the frequency of epileptic seizures in children. While it also has been tried for weight loss, only short-term results have been studied, and the results have been mixed. We don't know if it works in the long term, nor whether it's safe," warns registered dietitian Kathy McManus, director of the Department of Nutrition at Harvard-affiliated Brigham and Women's Hospital.

If you are from outside the Baltimore/Washington area, your your local neurologist will continue to be your primary neurologist and handle your seizure medications. We will need all your medical records in advance so we can review them and ensure the modified Atkins diet or ketogenic diet is appropriate for you. International patients should request appointments through the Johns Hopkins International Office.


Stem cells, wherever they may be found, can adapt quite nicely, and are far more flexible than originally believed. In laboratory animals, a liver stem cell placed into the bone marrow starts creating not liver, but bone marrow cells, a bone marrow stem cell transplanted into the liver begins to generate not bone marrow, but liver cells. The environment appears to be the key, ultimately determining the direction of stem cell development.
Kristin Parker is an American temporarily living in South Korea. Her role with Team Diet Doctor is customer service. If you have a question or a comment on our social media platforms, website or our Facebook group, she will likely be the one to answer you back! Kristin cooks for a family of four, including two hungry teenage sons. Her keto meal plan yields generous servings of substantial, hearty meals that they all like.
To the surprise of these investigators – at the time no Western scientist believed any human could survive on nothing but meat – this Eskimo diet consisted of virtually 100% animal products, 80% in the form of fat, with much of it saturated, 20% protein, but essentially no carbohydrates. From cradle to grave these traditional Eskimos lived in a state of ketosis.
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.
It’s understandable that you may be wondering how to sort out the facts and interpret the latest research. Who is a good candidate for keto, and who should avoid it? How does someone successfully adhere to a ketogenic diet? In this article, I’ll answer these important questions and others so you can make an educated decision about whether keto is right for you.
That’s the cool thing. There is something pretty radical that’s happening behind the scenes in the food company. They know the gig is up, they know all these years they’ve lied to us about these products, the gig is up and people are realizing what they’ve done. Course I’m shining a light on a light on a lot of those things too, with what I do. I just think people need to pay more attention, and they are.
One of the truly exciting new frontiers in nutrition therapy is the study of the high-fat low-carb ketogenic diet, especially in relation to preventing and curing cancer. The ketogenic diet as a therapeutic diet is not new. It has been around at least since the 1920s, when researchers at Johns Hopkins discovered that the diet could cure some children from epileptic seizures where drugs had failed.
Jimmy Moore: Yeah. The next book that I’m going to write with my co-author, Dr. Eric Westman, not anytime soon because I’m tired of writing books right now … when we get back to it, it’s going to be on this blood sugar topic because it is one that is so confusing to people and I think focusing so intently on blood sugar is the wrong question to ask. I think we should be looking at blood insulin. I think that will be the tell tale sign of what’s really going on in your body. Blood sugar is going to do what it’s going to do. The body is trying, especially if you’re insulin resistant which a lot of people coming into a low carb, high fat diet are, hello …
The ketogenic diet is usually initiated in combination with the patient's existing anticonvulsant regimen, though patients may be weaned off anticonvulsants if the diet is successful. Some evidence of synergistic benefits is seen when the diet is combined with the vagus nerve stimulator or with the drug zonisamide, and that the diet may be less successful in children receiving phenobarbital.[18]
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.

My son has been fighting brain cancer for 18yrs. Started st 15, now 33. He’s otherwise healthy. Never looks sick at all. In the beginning he had 6mos chemo industrial strength. He never got sick, ate 3 meals a day and gained weight. Followed by radiation, that he didn’t feel good, but he still did pretty well. PNET morphed into Ependymoma. What info can you send me specifically for brain cancer. Will the fasting, Keto diet, stop sugar intake work on brain cancer due to the Blood Brain Barrier? He is having his 8th surgery Mar 18. Previous surgery was just 6mos ago. He also was in 2 clinical trials in the last 2yrs (Car T cell therapy directly into the tumor bed area.) We have run out of options and will try anything. Please help.
For cells to maintain a healthy status, oxidants and antioxidants have to be in balance with each other. When this equilibrium is tilted toward an oxidized state, it leads to oxidative stress, in which an excess of oxidants can damage cellular structures and affect the health of the cell. Even cancer cells need to safeguard themselves against this.

Insulin is a hormone that lets your body use or store sugar as fuel. Ketogenic diets make you burn through this fuel quickly, so you don’t need to store it. This means your body needs -- and makes -- less insulin. Those lower levels may help protect you against some kinds of cancer or even slow the growth of cancer cells. More research is needed on this, though.

Ive been strict keto for over 3 months and have lost 20lbs. I got my test results back yesterday and was shocked to see how my levels had changed: total cholesterol went from 230 to 308!! All the bad went up and all the good went down. But I’ve also heard that it can take a bit longer for cholesterol levels to even out and start going down. Is this true? I don’t want to quit keto because I have another 20lbs to lose, but I don’t want to have a stroke either.


Spices are an easy way of adding more flavor, vitamins and antioxidants into your food. Furthermore, they are low in carbohydrates. Make sure that you're using fresh, organic spices for maximum flavor and nutrients. Some spices sold in packets found at the local grocery should not be used, as they often contain fillers that can increase your carbohydrate consumption, thus putting you out of ketosis.26

If any of your numbers are significantly different from what is listed, there may be deeper underlying health issues to be addressed. These are things that can be great to work on with a functional medicine or nutrition practitioner to find the root of your issues. You can get a comprehensive idea of your cholesterol and inflammation levels with our Complete Thyroid Report.
There’s a really great inflammatory marker that you can have any doctor can run this for about fifty bucks, and insurance should cover it. It’s called HSCRP, high-sensitivity C reactive protein, and that is the key marker. There’s some other inflammatory markers in the body but that one will really tell the tale of whether you have high levels of inflammation or not. Ideally you want that one optimally under 1.0, most certainly under 3.0. My recent one just a few months back, Leanne, was 0.44.
Reduced hunger. Many people experience a marked reduction in hunger on a keto diet. This may be caused by an increased ability of the body to be fueled by its fat stores. Many people feel great when they eat just once or twice a day, and may automatically end up doing a form of intermittent fasting. This saves time and money, while also speeding up weight loss.
I actually went on a ketogenic diet last year to see if it would help my migraines. I have a history of chronic migraines which would usually last 3 days, sometimes longer. Triptans help a lot but I don’t like having to take them. I stayed in ketosis for about 8 months and experienced a significant reduction in migraines, from feeling some type of headache (mild o r severe) almost everyday to 1 or 2x per month while in ketosis. Although I’m very healthy otherwise, I do think my migraines may have something to do with blood sugar fluctuations (despite previously eating a whole foods diet and no refined carbs), and keto totally stabilized this. I eventually came off of Keto because I’m not really a meat lover. When I came off, but remained low carb, my migraines stayed under control for the most part. When I increase carbs, they do return.
In terms of our specific discussion, diet as cancer treatment, Dr. Kelley demonstrated more recently in his Dallas, Texas, and Winthrop, Washington offices, no one diet suits all patients diagnosed with the disease, quite the contrary. Over a 20 year period working in the trenches treating many thousands of people, Dr. Kelley came to learn that each patient who walked into his office required a diet designed specifically for his or her metabolic needs, and these dietary requirements could vary enormously from patient to patient.
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.
There were adverse effects within all of the studies and for all KD variations, such as short‐term gastrointestinal‐related disturbances and increased cholesterol. However, study periods were short, therefore the long‐term risks associated with these adverse effects is unknown. Attrition rates remained a problem with all KDs and across all studies; reasons for this being lack of observed efficacy and dietary tolerance.

What we haven’t talked about is what raised inflammation yet. It’s two main things. I call them the twin villains in your health. Number one is, not surprising coming out of my mouth, carbohydrates are dastardly, especially the refined ones. Grains, starches, sugars, they’re just bad news for you and avoid if at all possible because they’re going to raise your inflammation the most. The second one, a lot of my low carb, keto friends are still eating. It disappoints me Leanne, because I think they don’t realize the negative impact that they’re having. It’s in just about every packaged food, even the so called low carb, keto foods. That’s vegetable oils. You really have to eliminate Canola oil, soy bean oil, cotton seed oil, corn oil … I don’t care if the American Heart Association has their stupid heart health symbol on it, it’s not heart healthy. The reason it’s not heart healthy … I’ll tell you why it’s heart healthy in a minute, why they think it is.
Although you'll be cutting way back on carbohydrates and sugar, some fruits are still okay to eat on the keto diet (though you'll still want to be mindful about quantity in order to remain in ketosis). The fruits that make the cut contain far fewer carbs than their off-limits cousins such as apples, pears, bananas, pineapples, papayas, grapes, and fruit juices in general.
Overall, 12 studies including 1257 patients examined the impact of a VLCKD on HDL cholesterol. When assessing the data, the individuals assigned to a VLCKD achieved an average increase in HDL of 0.12 mmol/L. This was double the average increase in HDL of the low-fat dieters who achieved an average increase in HDL of 0.06 mmol/L. [11] As a result, the authors concluded that carbohydrate-restricted diets confer cardiovascular benefits because they improve levels on HDL in the body. [11]

Familial hypercholesterolemia is a condition where one or more of the genes for the LDL receptor are defective. Having the right amount of properly functioning LDL receptors plays a vital role in maintaining healthy cholesterol levels by clearing LDL cholesterol out of the blood. Without an adequate amount of LDL receptors, the blood is much more likely to accumulate high levels of LDL particles, increasing the body’s vulnerability to cardiovascular disease significantly. [28]
Before embarking on the ketogenic diet, we assess the child’s nutritional status, diet preferences and calorie needs. If the diet seems like it will be feasible for the family, we customize it to each child to achieve optimal seizure control while meeting daily energy and nutrient needs. Sometimes, if extra attention is needed, we start the diet in the hospital. Special ketogenic formulas are available for infants or children who need to be fed though a tube.
In subsequent months, reports of enormous toxicity, even patient deaths began to filter through the research community, serving to temper the initial hysteria. And it wasn’t cheap, as miracles go – the very toxic drug was so potentially dangerous it had to be administered in a hospital setting under very close supervision, with costs running in excess of $100,000 for a several-week course of treatment.
The ketogenic diet reduces seizure frequency by more than 50% in half of the patients who try it and by more than 90% in a third of patients.[18] Three-quarters of children who respond do so within two weeks, though experts recommend a trial of at least three months before assuming it has been ineffective.[9] Children with refractory epilepsy are more likely to benefit from the ketogenic diet than from trying another anticonvulsant drug.[1] Some evidence indicates that adolescents and adults may also benefit from the diet.[9]
A ketogenic diet is a very high-fat low-carbohydrate diet that is designed to induce fat metabolism. When the body is depleted of glucose stores, it shifts to metabolizing fat and fatty acids, which produces compounds called ketones. Ketones cross through the blood-brain barrier and enter the brain, where they’re used as an alternative energy source.
The precise mechanisms behind the physiological effects of the ketogenic diet and ketones are not fully understood. It is believed that the ketogenic diet is anti-inflammatory, that it decreases free radical production while enhancing production of the body’s own natural anti-oxidants, and it improves metabolic efficiency.8 9 10 11 12 Specific conditions a ketogenic diet may benefit include:
What about fruits and vegetables? All fruits are rich in carbs, but you can have certain fruits (usually berries) in small portions. Vegetables (also rich in carbs) are restricted to leafy greens (such as kale, Swiss chard, spinach), cauliflower, broccoli, Brussels sprouts, asparagus, bell peppers, onions, garlic, mushrooms, cucumber, celery, and summer squashes. A cup of chopped broccoli has about six carbs.
25-30 grams a day is about my max with carbs, which my avocado … when I have avocado, that’s about half of that allotment. I have to be real careful with that. My protein is about 80-100 grams. Doesn’t sound like a lot, I’m 6 foot 3, I’m doing my standing work desk here … 6 foot three in a big guy, 80-100 grams doesn’t sound like a lot but if I go over that I start having that gluconeogenesis kick in, and I can see it on my blood sugar monitor and I can see it on my blood ketone monitor. They go in the wrong direction. You have to be real mindful. Then you’re like, okay you cut the carbs, you moderate the protein, well then what do you eat? Hmm.
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.
Leanne: I went to my naturopath, and she’s like this is awesome, this is exactly what we want to see. My issue was hormones, so I want cholesterol so that my body can build hormones, because without that cholesterol good luck. When I went to my regular GP, he was like “Statins, put you on statins. Oh my gosh it’s way too high.” What do you say to people, you’re saying 200 is always thrown out there with cholesterol. What you’re saying is that cholesterol is not really all that important in the grand scheme of things if you’re looking at your number. It’s more important to look at triglycerides in that ratio?
Carbohydrates have been linked to this skin condition, so cutting down on them may help. And the drop in insulin that a ketogenic diet can trigger may also help stop acne breakouts. (Insulin can cause your body to make other hormones that bring on outbreaks.) Still, more research is needed to determine exactly how much effect, if any, the diet actually has on acne. 
If you’ve decided to move forward in trying the keto diet, you will want to stick to the parameters of the eating plan. Roughly 60 to 80 percent of your calories will come from fats. That means you’ll eat meats, fats, and oils, and a very limited amount of nonstarchy vegetables, she says. (This is different from a traditional low-carb diet, as even fewer carbs are allowed on the keto diet.)

The predominant use of glucose anaerobically by cancer cells (Warburg effect) may be the most important characteristic the majority of these cells have in common and, therefore, a potential metabolic pathway to be targeted during cancer treatment. Because this effect relates to fuel oxidation, dietary manipulation has been hypothesized as an important strategy during cancer treatment. As such, the concept of a ketogenic diet (KD) in cancer emerged as a metabolic therapy (ie, targeting cancer cell metabolism) rather than a dietary approach. The therapeutic mechanisms of action of this high-fat, moderate-to-low protein, and very-low-carbohydrate diet may potentially influence cancer treatment and prognosis. Considering the lack of a dietetics-focused narrative review on this topic, we compiled the evidence related to the use of this diet in humans with diverse cancer types and stages, also focusing on the nutrition and health perspective. The use of KD in cancer shows potentially promising, but inconsistent, results. The limited number of studies and differences in study design and characteristics contribute to overall poor quality evidence, limiting the ability to draw evidence-based conclusions. However, the potential positive influences a KD may have on cancer treatment justify the need for well-designed clinical trials to better elucidate the mechanisms by which this dietary approach affects nutritional status, cancer prognosis, and overall health. The role of registered dietitian nutritionists is demonstrated to be crucial in planning and implementing KD protocols in oncology research settings, while also ensuring patients’ adherence and optimal nutritional status.


The most common side effects are constipation that can be supported with some dietary adjustments and laxatives. Other side effects that may occur that are relatively minor and transient include: kidney stones, low sugars, nausea, vomiting, diarrhea, sleepiness. There are some reports of longer term side effects that may include higher cholesterol, reduced bone health, kidney stones, slower linear growth velocity and abnormal heart rhythm.
A Cochrane systematic review in 2018 found and analysed eleven randomized controlled trials of ketogenic diet in people with epilepsy for whom drugs failed to control their seizures.[2] Six of the trials compared a group assigned to a ketogenic diet with a group not assigned to one. The other trials compared types of diets or ways of introducing them to make them more tolerable.[2] In the largest trial of the ketogenic diet with a non-diet control[16], nearly 38% of the children and young people had half or fewer seizures with the diet compared 6% with the group not assigned to the diet. Two large trials of the Modified Atkins Diet compared to a non-diet control had similar results, with over 50% of children having half or fewer seizures with the diet compared to around 10% in the control group.[2]
I believe (as well as the numerous experts I have interviewed) that over 90 percent of cancer cases are either preventable or treatable. The key here is to view cancer as a metabolic dysfunction, allowing you to gain control over this dreadful disease. Simply put, the right foods and strategies may help suppress cancer growth while simultaneously pushing it into remission.

This content is strictly the opinion of Dr. Josh Axe and is for informational and educational purposes only. It is not intended to provide medical advice or to take the place of medical advice or treatment from a personal physician. All readers/viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions. Neither Dr. Axe nor the publisher of this content takes responsibility for possible health consequences of any person or persons reading or following the information in this educational content. All viewers of this content, especially those taking prescription or over-the-counter medications, should consult their physicians before beginning any nutrition, supplement or lifestyle program.
Leanne: Yeah, that believed in coconut from the very beginning and they didn’t go on this campaign of ridding it from the earth. I’m totally pro coconut oil and saturated fat. It’s been so great chatting with you about this cholesterol piece. I hope that a lot of our listeners, watchers, readers are going to benefit from the information that you’ve shared. If they want to know more about you Cholesterol Clarity is awesome. Keto Clarity is great. Your podcast, just download every single podcast Jimmy’s ever made. It will keep you busy for the next two years.
Jimmy Moore: The thing here is I also always had high cholesterol. Cholesterol goes to … think of cholesterol like a fire fighter and inflammation is the fire. If a fire fighter goes to the scene of a fire, blows the water onto … you burning the house and it puts it out. Let’s say the neighbors house is on fire, and there’s no fire fighter that comes, what happens? Destruction, right?

Hi Maya. I LOVE your site!! Interesting, informative with fab recipes and ideas. Hubby and I have just started eating low carb and I have to say, we are not finding it too difficult and I already feel sooo much better!! I find the hardest part is choosing low carb veg, I feel as if we are not eating enough. Any suggestions on how to get more veggies into our diet?


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