At the core of the classic keto diet is severely restricting intake of all or most foods with sugar and starch (carbohydrates). These foods are broken down into sugar (insulin and glucose) in our blood once we eat them, and if these levels become too high, extra calories are much more easily stored as body fat and results in unwanted weight gain. However, when glucose levels are cut off due to low-carb intake, the body starts to burn fat instead and produces ketones that can be measured in the blood (using urine strips, for example).
Leanne: Even a lot of my friends who went to the dietetics route, as oppose to the holistic nutrition route, we both were taught the exact same thing when it came to protein. Even my physio and my naturopath, there’s been a lot of misconception about protein. Getting back to the cholesterol and heart disease, if somebody has a history of heart disease in their family and they want to try eating high fat, low carbohydrate, keto … awesome. What you’re saying is perhaps for those types of people, look at your inflammation. Get that under control, while you do the high fat, low carb, keto thing and you’re actually doing your body a major service by switching to that eating style, especially if you have a history of heart disease in your family.

3. The Low Glycemic Index Treatment (LGIT, uses a liberalized but still low carbohydrate intake, with carbohydrates supplied only in the form of low-glycemic index foods (glycemic index of less than 50 relative to glucose). Of the 20 patients initially studied on this diet in 2005, 10 experienced a greater than 90% reduction in seizure frequency. The LGIT can be started as an outpatient without a fasting period. An updated study in 2009 included 76 children, of which 50% of those remaining on the diet at 3 months had a >50% seizure reduction.

The current body of research on metabolic cancer treatments using a keto diet continues to grow. Keto or metabolic cancer therapy is somewhat different than the treatment for other illnesses, and is discussed in detail in my book Fight Cancer with a Ketogenic Diet, which is based on the metabolic therapy research of Dr. Thomas Seyfried  and Dr. Dominic D'Agostino. The main idea behind the use of a ketogenic diet to treat cancer is to starve cancer cells of the sugar and other fuels they need to survive, and to provide support and protection for normal energy processes in healthy cells. The advantage of this treatment protocol is that it is non-toxic to the body, and in "wait and see" cases, it can provide an major health support advantage to the patient. The book was written for the patient and has all the details and research in an easy-to-use format.
The role of gut microbiota has recently been studied for its effect on several diseases, especially those with some inflammatory involvement. Several metabolic pathways are known to be modulated by the gut microbiota. Olson et al. (2018) demonstrated the impact of gut microbiota on the anti-seizure effect of KD. She found that KD modifies the gut microbiota, with a decrease in alpha-diversity and increases in the putatively beneficial bacteria Akkermansia muciniphila and Parabacteroides spp. This microbiota transformation leads to changes in the colonic luminal metabolome, with a decrease in gamma-glutamyl amino acids. This increases the GABA/glutamate content in the brain by decreasing gamma-glutamyl amino acids in the blood (Olson et al., 2018). In an acute electroshock model, it is reported that KD confers protection against seizures. Moreover, KD decreases the frequency of spontaneous seizures in Kcna1 knockout mice (Kim et al., 2015). In summary, changes in the gut microbiota seem to be important for the KD-mediated seizure protection.

“Keto” is one of the MOST SEARCHED words on the internet today, and for good reason. Ketones help you burn fat for energy, powerfully reduce inflammation and show promise in preventing and eradicating diabetes, cancer, autoimmune and neurodegenerative diseases like Alzheimer’s and Parkinson’s, and many, many other health concerns. The Keto Edge Summit is online and FREE from May 7-13, 2018. During The Keto Edge Summit, you’ll discover: What is ketosis (and how does it work)? Myths, and how to separate fact from fiction! How to overcome the challenges of being “keto adapted.” Whether you should start a keto diet (or not!). How to shop, live and eat on a ketogenic lifestyle. And more! Your host, Dr. David Jockers, overcame skin cancer in part by switching to a ketogenic diet. Within 6 months of diagnosis, his cancerous nodule had vanished — and, he gained significantly more energy and mental clarity. Now, he teaches patients how a ketogenic lifestyle can give them the edge to conquer disease, return to health and upgrade quality of life.

One potential confounder of ketogenic diet studies is another direct effect of the diet—increased levels of fatty acids. Dietary supplementation of essential fatty acids can improve cognitive dysfunction, including in patients with AD [44, Class II]. This suggests that something other than ketone bodies (in this case, essential fatty acids) may have beneficial effects in neurodegenerative diseases. Essential fatty acids may have a beneficial effect on learning in rodent models, raising the possibility that they may have neuromodulatory properties of their own [45,46].

In terms of seizure recurrence among children, the risk of seizures returning in those who are seizure free and stop the diet is 15 to 20%, according to Kossoff. In children who experience less frequent seizures, but are not seizure free, about one-third will have some worsening of seizures when the diet is stopped, though this is sometimes transient.
Your current cholesterol levels l is higher than I would personally feel comfortable with. I would consider making a few dietary changes (i.e., increasing fiber and net carbs, reducing saturated fat, and increasing protein), especially given your lack of improved cognition and decreased ability to work out. I wish you the best of luck going forward. - Franziska
Now a report, appearing several weeks ago in the journal Neurology, reveals that in fact, a ketogenic diet is also profoundly helpful in adults as well in terms of treating epilepsy. This research, published by investigators in Maryland, found that there was at least a 50% reduction in seizures in 32% of patients treated with a ketogenic diet as well as in 29% of patients who went on a modified Atkins diet. In fact, 9% of those placed on the ketogenic diet and 5% of those placed on the modified Atkins diet had a greater than 90% reduction in the frequency of their epileptic seizures. These diets were designed such that the bulk of calories, between 67% and 75%, came from fat. The study revealed that “the anticonvulsant effect occurs quickly with both diets, within days to weeks.” Interestingly, the most common side effect was weight-loss which the office indicated “maybe advantageous inpatients with obesity.”
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
I just got to know too that my Cholesterol raised a lot, I've been on keto for a little more than 3 months and before that always had a low carb diet. I don't know if the 3 day fast I did before taking the blood test only " aggravated" the situation. The total is 302, LDL is 214! But since the triglycerides are 94 and HDL 57, it seems to be OK. I read that a low rate of TG/HDL may indicate that the LDL particles are of the bigger, fluffier type less dangerous. 

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.

Normal dietary fat contains mostly long-chain triglycerides (LCTs). Medium-chain triglycerides (MCTs) are more ketogenic than LCTs because they generate more ketones per unit of energy when metabolised. Their use allows for a diet with a lower proportion of fat and a greater proportion of protein and carbohydrate,[18] leading to more food choices and larger portion sizes.[4] The original MCT diet developed by Peter Huttenlocher in the 1970s derived 60% of its calories from MCT oil.[15] Consuming that quantity of MCT oil caused abdominal cramps, diarrhea, and vomiting in some children. A figure of 45% is regarded as a balance between achieving good ketosis and minimising gastrointestinal complaints. The classical and modified MCT ketogenic diets are equally effective and differences in tolerability are not statistically significant.[9] The MCT diet is less popular in the United States; MCT oil is more expensive than other dietary fats and is not covered by insurance companies.[18]

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.
In children who can be successfully withdrawn from anti-convulsant therapy and are seizure-free for 2 years on the ketogenic diet (about 10 percent of treated children), an EEG is repeated and the ketogenic diet is slowly withdrawn. However, the diet is often stopped earlier if not successful. Similarly, after 2 years in children with continued seizures, most ketogenic diet centers will at least try to have the children come off the diet and see if it is no longer necessary for control.

People use a ketogenic diet most often to lose weight, but it can help manage certain medical conditions, like epilepsy, too. It also may help people with heart disease, certain brain diseases, and even acne, but there needs to be more research in those areas. Talk with your doctor first to find out if it’s safe for you to try a ketogenic diet, especially if you have type 1 diabetes.

One potential confounder of ketogenic diet studies is another direct effect of the diet—increased levels of fatty acids. Dietary supplementation of essential fatty acids can improve cognitive dysfunction, including in patients with AD [44, Class II]. This suggests that something other than ketone bodies (in this case, essential fatty acids) may have beneficial effects in neurodegenerative diseases. Essential fatty acids may have a beneficial effect on learning in rodent models, raising the possibility that they may have neuromodulatory properties of their own [45,46].
The nutritional world then, as it is today, was surely confusing, with various scientists, physicians, and lay authors promoting one diet or another, often – as in the case of Atkins and Pritikin – offering completely contradictory dietary recommendations. Fortunately, when in 1987 Dr. Atkins offered me a job, I had already found what I thought represented a solution to the dilemma of dueling dietary dogma.

[29:44] – There is increasing evidence for what Dave likes to call, the Alternative Glycogen Store Theory. Do leaner, athletic types of individuals seem to be more likely to be hyper-responders, in particular those with lower levels of triglycerides and high levels of LDL-C and LDL-P? Gary mentions Dr William Davis, from Wheat Belly, post on Lp(a) traits.

"It's a cocktail of drugs and procedures and foods and they all work synergistically to gradually eliminate the tumor while maintaining the health and vitality of our normal organs. The whole goal of this metabolic therapy, which involves the ketogenic diet, is to gradually degrade and eliminate tumor cells without toxicity so the patient emerges from the therapy healthier than when they started."
I had some eggs and some meat and all this stuff. Then they tested me literally every 30-60 minutes for five hours. I got to see literally what was happening real time after a low carb meal. I think that’s where having the right nutrition really is the basis for knowing where you stand. The other thing for people that are worried about this morning reading, check your A1C. That’s the average of the last 3 months worth of all of your blood sugars, not just the ones in the morning that you’re testing and freaking out about. By the way, when you freak out that also raises your blood sugar.

Jimmy Moore: Or B-B sized, exactly. You can have that particular test run to see all the sub-fractions of your LDL. It’s called NMR lipo profile, it’s only 1 lab in the entire world that does it, they’re in Raleigh, North Carolina called Lipo Science. Your doctor again, any doctor can run the NMR lipid profile test, and it shows you all the typical things that you see … HDL, triglycerides, all that is on this test as well but you get that LDL particle size breakdown. You get the total particle number, which is called LDLP, and then you get small LDLP and that’s the one you want as low as possible.

Now that we have discussed the role of the primary cholesterol molecules, you should have a better understanding of how they work together. Having high LDL isn’t necessarily bad, given that you have adequate HDL to help clear it from the blood stream and that you are not dealing with chronic inflammation. It is also important to have large particle LDL (pattern A) rather than small particle LDL (pattern B).
Stock up:'s new City Grocery service (available in select markets) makes it easy to ensure you always have keto-friendly veggies in the fridge. We love their delivery scheduling tool; simply fill your cart, then decide which day and timeframe you'd like your groceries delivered. One of our faves: Urban Roots Green Squash Veggie Noodles are great for whipping up low-carb "pasta" dishes.
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]
The only issue with keto, is really that I’m afraid that it might be hard to up my calories to a maintenance weight now that I’ve gotten a taste preference for the rich assortment of foods with no carbs in them. I’m satisfied with less calories than I will need after my excess fat is burned off… but , maybe I bet my body will send more hunger signs once there isn’t anymore body fat in the cupboard to use instead of what goes down my throat.
• Restricted ketogenic diet — As mentioned earlier, a ketogenic diet can be an effective weapon against cancer. To do this, you need to be on a restricted ketogenic diet. By restricting your carbohydrate and calorie intake, your body loses glycogen and starts producing ketones that your healthy cells can use as energy. Because cancer cells cannot use these ketones, they starve to death.12

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.
Great article! I have been diagnosed with familial hypercholesterolemia, however, I am not concerned at all. I continue to follow a restricted calorie, zero carb ketogenic diet, that I have been doing strictly for the last year and a half. All of my health markers are excellent, except for LDL particle number and total, and it is the large buoyant type. I am middle-aged (46). I did get both a CT scan and tri-vascular scan, and got perfect scores for both. That alleviated any concerns that I might have previously had. Since this diet has improved my gut issues, bodyfat, blood pressure, insulin, blood glucose, mood, energy, A1C, CRP, etc., - basically every single health parameter I have tested, I am sticking with it! Thank you for clearing up the confusion surrounding LDL!

Dr. Jockers, thank you so much for this clear and detailed article! I began a keto-style diet around August 2019. By late November, I had fallen from 197 lbs. to under 175 lbs., dropped from 28% to 18% body fat, and anecdotally felt much better in all aspects of my health. All of this occurred exclusively due to diet, I believe– I had almost no exercise routine to speak of, and my desk-based job is pretty sedentary. My family practice doc was surprised and happy with the results as well when I met with him in January… until my blood work came back showing total cholesterol at 257, triglycerides at 236, LDL-C at 162, and HDL at 50.
It starts with limiting carbohydrate intake to just 20–30 net grams per day. “Net carbs” describes the amount of carbs remaining once dietary fiber is taken into account. Because fiber is indigestible once consumed, simply don’t count grams of fiber toward their daily carb allotment. So that means subtracting grams of fiber from total carb games, to give you the total net carbs.
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]
When she first consulted with Dr. Kelley in 1977 she was in a near terminal state after having failed intensive chemotherapy. Nonetheless, despite her dire situation within a year she had experienced complete regression of her extensive bony lesions, as documented by x-ray studies. Though in subsequent years her compliance with her nutritional regimen would waver and her disease would in turn recur, invariably when she resumed Kelley’s treatment the myeloma would go into remission.
Dietary choices to help prevent breast cancer There are many different causes of breast cancer, including age, genetics, and family history. There are also some factors that people can control, such as diet, smoking, and exercise. In this article, we take a look at the healthful foods that may help prevent breast cancer and also explain which foods to avoid. Read now
"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.

Apoptosis Induction. Studies show that dietary energy restriction enhances phosphorylation of adenosine monophosphate kinase (AMPK), which has been found to induce apoptosis in glycolytic-dependent brain cells and protect normal brain cells from death. One way to naturally restrict energy consumption is with a keto diet because most keto dieters spontaneously eat fewer calories than they do when they are on a higher carb diet. Altogether, this may explain why most of the research on keto and cancer has shown the keto diet to be effective in the treatment of brain tumors (glioblastomas and gliomas).
"Findings from our study reveal that treating mice chronically with specific bacteria that were enriched by the ketogenic diet protected them from seizures," study senior author Elaine Hsiao, an assistant professor of integrative biology and physiology at the University of California, Los Angeles (UCLA), told Live Science. ("Keto diet" is short for "ketogenic diet.") However, Hsiao stressed that more studies are needed before researchers know if the findings also apply to people.
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.

Jimmy Moore: So close, so far that I think they really need to latch onto what the triglycerides and what the HDL really mean. When you’re eating too many carbs, it’s going to show up in the tricks. It totally will. When you’re not eating enough fat in your diet, especially saturated fat, this is such a key point. I know you hammer this in your videos, that’s why I love them. The saturated fat is so important to raising the HDL, and it’s that HDL that you want to have higher and yet it also shows up in your total cholesterol and then makes the doctors goes bat crap crazy when they see 220 on your total cholesterol, and the only thing that went up was HDL. Come on.

We have a dedicated dietitian who provides patients with individualized nutrition education, meal planning and resources, as well as recipes including some for ketogenic-friendly breads and desserts. Cooking classes and demonstrations for patients are also currently under development. Patients on dietary therapy will be closely monitored by a neurologist, Dr. Elizabeth Felton, who was trained in adult dietary therapy at The Johns Hopkins Hospital.
Several studies have shown that the MAD, besides being more palatable, is as effective as the KD in the treatment of drug-resistant epilepsy in children (Miranda et al., 2011; Martin et al., 2016). A study performed using 20 children receiving 10 g of carbohydrates daily showed that 65% of the children had a >50% seizure reduction, 35% of the children had >90% improvement, and four children were seizure-free at 6 months (Kossoff et al., 2006). In a study in South Korea, 36% of 14 children treated with the MAD showed improvement of >50% in seizures and 12% were seizure-free (Kang et al., 2007). A recent meta-analysis performed using 70 studies concluded that the MAD and classical KD do not differ in reduction of seizure frequency at month 3 and month 6, with ≥50% and ≥90% reductions, respectively (Rezaei et al., 2017). A retrospective study showed >50% of seizure reduction in 65% of the 10 children who remained on the diet for up to 6 months, and 20% of them were seizure-free (Park et al., 2018).
As the authors write, “the protocol was not designed to reverse tumor growth or treat specific types of cancer.” The researchers also acknowledge the patient numbers were too small to allow for meaningful statistical evaluation, even for the avowed purposes. Overall, the discussion centers on the practicalities of implementing the diet and the results of the PET scans. 

Can’t you take ketone supplements? No. While it is possible to elevate ketones by taking them, “without the low-carb stimulus, there is no net increase in ketone production, no decrease in insulin, and no net increase in fat oxidation,” says Volek. Don’t trust trainers or “body hackers” who say you can induce ketosis quickly without changing your diet.
Hey David, You will definitely want to do everything you can to mitigate the mold issue. If you cannot remove it from your environment (or yourself from that environment) then you will want to use things like glutathione, liver support, activated charcoal, and daily detoxification strategies as much as possible. For the LDL testing, this is one of the best I know of
If you have chronic inflammation and/or stress, you may also have persisting high cholesterol levels which, in most cases, isn’t doing anything but causing more problems. The preponderance of this chronic inflammation and stress is typically caused by a variety of lifestyle factors, from eating foods that trigger inflammation to sleeping poorly. [27]