There’s less research, as I mentioned before, in humans, but the little that does exist, I think, is promising and should lead us to doing more. One study monitored tumor growth in response to a high-carb versus a ketogenic diet in 27 patients with cancer of the digestive tract. Tumor growth increased by 32.2 percent in patients who received the high-carb diet, but actually decreased by 24.3 in the patients on ketogenic diet. However, in this study, the difference was not statistically significant. That’s a whole other discussion about statistical significance that I won’t go into here, but that’s one potential reason to take that study with a grain of salt.
In this same chapter, there are also two case reports, neither very impressive. The first, written by the mother, tells the story of a four-year old child diagnosed in 2004 with a low-grade (less aggressive) but quite large and inoperable brain tumor. The parents, as the mother writes, entrusted their child into the hands of the experts, who prescribed the usual “gold standard” treatments, which are not clearly described initially but presumably mean chemotherapy and perhaps radiation.
Jimmy Moore: This is where the fat, fat, fat comes in. That’s why I add butter and add coconut oil and the full fat dairy, and all the things that you can add fat to your diet and it makes it taste good. That’s the thing, people are like “Well, it’s not supposed to taste good, I’m on a diet.” I’m like “no, you’re on a live-it. Please live it up and have the fat.”
There are now a number of different diets that can be used for epilepsy: the Classic Ketogenic Diet, the Modified Atkins Diet, the Medium Chain Triglyceride Diet and the Low Glycemic Index Treatment Diet. The choice is made after the initial consultation, and depends on the epilepsy diagnosis, the child’s age and feeding habits, and family needs and preferences. 
The diet’s strict limitation on starchy vegetables, whole grains, and fruits may lead to missing out on vitamins, minerals and other healthy compounds found in plant foods, which can lead to malnutrition, Bender adds. A true ketogenic diet could also lead to digestive and other unpleasant side effects. It requires monitoring and nutritional supplements. It can be difficult to follow.
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]. 

Although the exact role of the keto diet in mental and brain disorders is unclear, there has been proof of its efficacy in patients with schizophrenia. And, to boot, it works to reverse many conditions that develop as a side effect of conventional medications for brain disorders, like weight gain, type 2 diabetes and cardiovascular risks. More research is needed to understand the role of the ketogenic diet in treating or improving schizophrenia, as the current available studies are either animal studies or case studies, but the benefits of a low carbohydrate, high-fat diet in neurology is promising.
Jimmy Moore: My mamma would kill me if she know I did that. I had four root canals and then I also had some mercury amalgams that were put in way back, twenty years ago when I was in my early twenties. Anyway, I determined I bet that’s a big reason why my cholesterol has always been high since I’ve been adult. I got that taken care of the year that I wrote Cholesterol Clarity in 2013, and I got it tested my total cholesterol was over 400. Got it tested again in October, total cholesterol had dropped over 100 points.
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.
Often caused by lymph node removal or damage due to cancer treatment, lymphedema occurs because there’s a blockage in the lymphatic system and results in the swelling in leg or arm. A 2017 study involved patients who suffered from obesity and lymphedema and who embarked on a 18-week ketogenic diet. Weight and limb volume was significantly reduced. (5)
Don’t expect to turn into a muscle-bound. There is unfortunate hype surrounding this diet. There are no magical “ketone” supplements that turn you thin. But studies show it might improve your thinking, help with type 2 diabetes, dementia, seizures and inflammation. Every diet has its detractors. Recent “news” has been particularly harsh with dramatic headlines. Some considered it a “fad.” Others question sustainability. So, are they right?
Teens and young adults who are becoming more independent often find the ketogenic diet too difficult to follow. Dietary options for epilepsy have expanded in recent years to include the modified Atkins diet and the low-glycemic index treatment diet. The latter diet does not necessarily cause ketosis, and may instead curb seizures by lowering glucose levels in the blood and possibly in brain cells.
Except that it really isn’t, at least not anymore. If you do a Pubmed search on “targeting cancer metabolism,” which is what Dr. Seyfried is talking about, you’ll find over 22,000 articles, with over 3,000 in 2013 alone, with a sharply increasing curve since 2000 that only now appears to be leveling off. A search on “cancer metabolism” brings up 369,000 references, with 28,000 in 2013 alone. Cancer metabolism is an incredibly important topic in cancer research and has been for several years now, and finding means of targeting the common metabolic abnormalities exhibited by cancer cells is currently a hot area of research. From my perspective, Dr. Seyfried is exaggerating how hostile the cancer research community is towards metabolism as an important, possibly critical, driver of cancer, although, to be fair, one prominent cancer researcher, Robert Weinberg, has been very skeptical. To me, Seyfried just appears unhappy that genetics is currently thought—for good reasons, I might add—to be the primary driver of most cancers. Note that I intentionally used such phrasing, because Dr. Seyfried, in my readings, appears all too often to speak of “cancer” as if it were a monolithic single disease. As I’ve pointed out many times before, it’s not. Indeed, only approximately 60-90% of cancers demonstrate the Warburg effect.

Cyclical ketogenic diet (CKD): If you find it difficult to stick to a very low-carb diet every day, especially for months on end, you might want to consider a carb-cycling diet instead. Carb cycling increases carbohydrate intake (and sometimes calories in general) only at the right time and in the right amounts, usually about 1–2 times per week (such as on weekends).
You may find it easy to eat less when all you can eat is protein and fat. But after a while, you may grow tired of bringing your own whole salmon to parties, and wonder what the other 95% of the grocery store is up to. You may start to have fantasies about a threesome: you, Oreos, and chocolate sauce. Not only that, you may be getting some serious scurvy and other nutrient deficiencies.
The ketogenic diet is a way of treating patients with poorly controlled epilepsy. The ketogenic diet is used when a child's seizures have not been controlled with medications or when a child has had bad side effects from the various seizure drugs. The ketogenic diet requires extra time and effort and must be followed exactly, especially during the first months.

If your child is helped by the diet and seizures are better controlled, your child may remain on the ketogenic diet for 2 to 3 years, or longer. The length of time on the diet will be determined by several factors, including how well the diet helps your child, whether your child can be weaned off seizure medications, and your willingness to continue the diet.
My point here is that the warnings about the ketogenic principles are well taken and well documented. My concern is implications that this is a fad. I don’t use the word diet with my patients and I’m concerned that the principles behind the label and the real results that these readers have commented on might get minimized. I have found it best to encourage patients to read authors like: Stephen Phinney, Jeff Volek, Patricia Daly, and Charles Gant and the be partners with their doctors and check blood work as they move along. I am not for or against the article. If ketogenic principles offer people enduring, satisfying, and cohesive change then why not read about its potential and flexilbity?

The diet is also effective for children with infantile spasms. For this condition, about 70% of children will have seizure reduction with 35% becoming seizure-free. There has been one study using the ketogenic diet as initial treatment for infantile spasms. At the end of 1 month, 8 of 13 (62 percent) infants were seizure-free. Time to spasm freedom was 6.5 days, suggesting that, if the ketogenic diet is used as initial treatment, a 2-week trial period is sufficient to judge efficacy for infantile spasms.

There aren’t any studies on control groups living healthy lifestyles, eating a low carb/whole food/meat diet, that shows an increase in cancer. There are 1000’s of examples of blood work showing improvements in LDL ratios (risk of heart disease) and low/steady blood sugar levels (diabetes prevention/treatment). That is actual science. as far as anecdotal evidence, there are many accounts of vegans/vegetarians that have became extremely ill over time due to lack of complete nutrition. It is also more difficult (takes more planning) to ensure you are getting sufficient amounts of calories since plant based is not calorie dense and it takes larger quantities. Additionally, Fats and animal fats especially play a vital role hormone production as well. Look up Dr. Shawn Baker.
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.
The anti-angiogenesis love affair not only affected conventional researchers and oncologists, but infiltrated deeply into the “alternative” cancer world. During the late 1990s, I read numerous articles lauding the anti-angiogenic effect of various herbs. Some ten years ago or more, a number of alternative physicians began promoting artemesinin, an herb from Africa long used as a treatment for malaria, as a “natural” anti-angiogenesis supplement.
When your body burns its stores of fat, it can be hard on your kidneys. And starting a ketogenic diet -- or going back to a normal diet afterward -- can be tricky if you’re obese because of other health issues you’re likely to have, like diabetes, a heart condition, or high blood pressure. If you have any of these conditions, make diet changes slowly and only with the guidance of your doctor.
In the study, Barbara A. Gower, Ph.D., and her colleagues analyzed data from 45 women diagnosed with ovarian and endometrial cancers. The women were randomly assigned to either a ketogenic or a standard, healthy diet group. The ketogenic group was asked to consume 70 percent of calories from fat, 25 percent from protein and 5 percent from carbohydrates. The comparison diet was one recommended by the American Cancer Society, high in whole grains and fruit and low in added sugar.

All of this talk about energy metabolism leads us to another important finding in the cancer literature: healthy cells can also become cancerous if their mitochondria (the primary energy producer of the cell) is dysfunctional for an extended period of time. Furthermore, if the cell is already cancerous, the mitochondrial dysfunction will make the cell’s genes vulnerable to additional mutations.
Because people with type 2 diabetes are at an increased risk for cardiovascular disease, there’s a specific concern that the saturated fat in the diet may drive up LDL, or “bad,” cholesterol levels, and further increase the odds of heart problems. If you have type 2 diabetes, talk to your doctor before attempting a ketogenic diet. They may recommend a different weight-loss diet for you, like a reduced-calorie diet, to manage diabetes. Those with epilepsy should also consult their doctor before using this as part of their treatment plan.
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.

The Epilepsy Foundation has acknowledged the KD as a treatment option and provides an educational summary about the diet on its website. It’s encouraging that a major patient advocacy group is willing to publish information about a treatment option far from common practice. The health care professional is responsible for being aware of various patient treatment options so the best care possible is provided.
Chris, I’m missing the logic here. Even when carbohydrates are restricted, the body is going to take fats and glycogen and turn them back into blood sugar, i.e. glucose. Glucose is also the only fuel the brain can use, and when it is too high or too low, all kinds of alarm bells go off, and the body does everything it can to restore normal glucose levels. Ketogenic diet or not, blood sugar is going to stay pretty steady if all the normal regulatory mechanisms are in place. If there is glucose in the blood, there is glucose in the interstitial fluids, and cancer cells are never going to be starved for glucose. So if restricting carbs has any use in cancer therapy, it has nothing to do with preventing cancer cells from getting glucose. If there is no glucose in the blood, you are dead.
Keep eating low carb to continue losing weight, feeling good and becoming healthier!Try making any of our hundreds of recipes available on the site. We make sure each and every recipe is delicious, nutritious and will keep you under your daily carb limit, even if you go for seconds. In addition, we provide step-by-step instructions to make the process as easy as possible. If you ever run into any issues or have any questions, be sure to leave a comment or contact us directly! We’re always happy to help.

The conventional view of cancer is that it is caused by DNA mutations in the cell nuclei. However, the metabolic theory of cancer proposes that some cancers are caused by a dysfunction of cellular respiration and that the restriction of glucose in the diet may prevent and even reverse some cancers. Today I’ll review the research supporting this theory and explore how the ketogenic diet may impact cancer tumor growth.

Recently, many of my patients have been asking about a ketogenic diet. Is a ketogenic diet safe? Would you recommend it? Despite the recent hype, a ketogenic diet is not something new. In medicine, we have been using it for almost 100 years to treat drug-resistant epilepsy, especially in children. In the 1970s, Dr. Atkins popularized his very-low-carbohydrate diet for weight loss that began with a very strict two-week ketogenic phase. Over the years, other fad diets incorporated a similar approach for weight loss.
One of the difficult things about science-based medicine is determining what is and isn’t quackery. While it is quite obvious that modalities such as homeopathy, acupuncture, reflexology, craniosacral therapy, Hulda Clark’s “zapper,” the Gerson therapy and Gonzalez protocol for cancer, and reiki (not to mention every other “energy healing” therapy) are the rankest quackery, there are lots of treatments that are harder to classify. Much of the time, these treatments that seemingly fall into a “gray area” are treatments that have shown promise in animals but have never been tested rigorously in humans or are based on scientific principles that sound reasonable but, again, have never been tested rigorously in humans. (Are you sensing a pattern here yet?) Often these therapies are promoted by true believers whose enthusiasm greatly outstrips the evidence base for their preferred treatment. Lately, I’ve been seeing just such a therapy being promoted around the usual social media sources, such as Facebook, Twitter, and the like. I’ve been meaning to write about it for a bit, but, as is so often the case with my Dug the Dog nature—squirrel!—other topics caught my attention.
Your child will begin the ketogenic diet within 24 hours of being admitted to the hospital. The diet contains a fixed amount of calories, carbohydrate, fat, and protein. Each meal has to be measured exactly and all the ingredients weighed in this diet. For young infants, pre-made, ready-to-use ketogenic formulas are available for use. Your child may also need supplements such as vitamins and extra calcium.

In addition to sodium, levels of magnesium and potassium can also drop on a ketogenic diet due to its dehydrating effect on the body. Make sure to eat plenty of magnesium- and potassium-rich foods. Some of the best keto-friendly sources of magnesium are dark leafy greens, nuts and seeds, and cacao. Keto-friendly potassium sources include spinach, kale, avocados, and mushrooms.
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]
Cyclical ketosis means you’re sometimes in ketosis and sometimes aren’t. A few days each week—the night before workout days to build glycogen stores in your muscles—try increasing your intake of berries, higher complex carb veggies (like sweet potatoes), and non-gluten grains. It might knock you out of ketosis temporarily, but it also provides a wealth of nutrients to keep you lean, healthy, and happy. This is also called flexible ketosis, which creates metabolic flexibility—the holy grail of metabolism management. I’ve also talked about cycling ketosis with intermittent fasting, which provides a win-win strategy to reach your health goals.
I’m following the ketogenic diet and I find it very easy, pleasant and varied. I can even say that my diet today is more varied than the previous one. I do not intend to leave this diet and I cannot really see why. My initial focus was not to lose weight, I’ve always been lean, but to feel better, well disposed. And I got it! I am very pleased, I have read a lot about it (including scientific literature) and I have influenced other people who need to lose weight or improve some aspects of their health. But from the beginning I went on my own way, without the help of a nutritionist because I did not want to suffer the influence of others’ ideas.
One approach to this question has been to examine the variations in the size of the LDL particles in the blood. With a well-formulated ketogenic diet, we see a shift away from the small dangerous LDL even when the total LDL goes up, so most of this increase is in the ‘good’ or ‘buoyant’ LDL fraction (Hallberg, 2018). Another factor to be taken into account is that during rapid weight loss, cholesterol that you had stored in your adipose tissue (ie, body fat) is mobilized as the fat cells shrink (Phinney 1990). This will artificially raise serum LDL as long as the weight loss continues, but it then comes back down once weight loss stops. To avoid being misled by this, the best strategy is to hold off checking blood lipids until a couple of months after weight loss ceases.

I think we obsess about numbers because we have been given a range that is supposedly the healthy, right range. Unfortunately there are a lot of mechanisms that we don’t know a lot about right now, that could be going on that makes that happen for some people in the mornings. I’ve just talked to too many of the experts, who say “Don’t worry about that. It’s really not the big deal. Keep an eye on your fasting insulin levels in the morning and even if you want to do a five hour glucose tolerance test, it’s call a 5 hour GTT, could go down to your doctor, please don’t drink that crappy glucose serum, because that will mess you up.” I actually did it one time with my co-author, he actually ran it with me … I wanted to see what would happen to my blood sugar and insulin levels when I had a low carb meal.
Y. Wady Aude, MD; Arthur S. Agatston, MD; Francisco Lopez-Jimenez, MD, MSc; Eric H. Lieberman, MD; Marie Almon, MS, RD; Melinda Hansen, ARNP; Gerardo Rojas, MD; Gervasio A. Lamas, MD; Charles H. Hennekens, MD, DrPH, “The National Cholesterol Education Program Diet vs a Diet Lower in Carbohydrates and Higher in Protein and Monounsaturated Fat,” Arch Intern Med. 2004;164(19):2141-2146. http://archinte.jamanetwork.com/article.aspx?articleid=217514.
Let me say out front I have no problem with scientists who propose a theory, in short papers or in the case of Dr. Seyfried, in long, detailed books. I do have a problem when scientists go a step further, insisting in the absence of any significant human data or even impressive case histories they have unraveled the mystery of cancer. I am also quite surprised, in the case of Dr. Seyfried, that both alternative and conventional practitioners have risen up in a loud chorus of enthusiasm, as if indeed Dr. Seyfried’s theories are correct, and that he has solved the cancer riddle.

Ketogenic diet is one of the oldest forms of medical treatment for epilepsy. It is a high fat, adequate protein, low carbohydrate diet used in difficult to control epilepsy. There are different versions of the ketogenic diet available but the basic principles are the same. Ketogenic diet therapy may be adapted for cultural diversity, allergies and tube feeding. It is a therapy for both children and adults.


The goal is to reach a ratio of four portion of fat to one portion of protein plus carbohydrate, described as “4:1.” To achieve this level, one of two approaches, with or without fasting, may be used. In the former approach, the patient must be hospitalized for 12–48 h, or when ketones are present in the urine (Rubenstein, 2008), to prevent the development of hypoglycemia and dehydration. This method tends to accelerate the development of ketosis although it can generate more stress on the patient (Armeno et al., 2014). When ketosis is reached, the meals are calculated to maintain a constant KD ratio, while calories are added until full-calorie meals are tolerated (Kossoff et al., 2009). The latter approach requires no hospitalization and the KD ratio increases weekly, from 1:1, 2:1 and 3:1 to 4:1 (Bergqvist et al., 2005). Most of the literature suggests that there is no significant difference between the two approaches in terms of the time needed to reach ketosis and the occurrence of hypoglycemia (Kim et al., 2004), so nowadays patients tend to not fast.
When ketones are present in the body fluids at elevated concentrations, a person is said to be in ketosis. Dietary ketosis is a normal physiological response to sustained low carbohydrate intake that results in lowered blood glucose and insulin levels and stimulates the production of something known as ketone bodies. During ketosis, fats, either from the diet or from body stores, become the obligatory source of cellular energy for most body tissues while ketone bodies are produced in the liver to supply the rest of the body’s energy needs.4 Dietary ketosis should not be confused with diabetic ketoacidosis, a pathological condition that occurs mainly in type I diabetics due to an acute severe insulin deficiency (usually due to missing insulin injections) and a resulting inability to use glucose, though it is abundant. During diabetic ketoacidosis, blood ketone levels can be as high as 10-15 mM/l (significantly higher than what can be achieved in dietary ketosis). As ketone production exceeds the tissues’ ability to use them, the ketones build up and the blood pH is lowered.5 Immediate medical attention is required to prevent serious complications. This document deals with dietary ketosis only.
Y. Wady Aude, MD; Arthur S. Agatston, MD; Francisco Lopez-Jimenez, MD, MSc; Eric H. Lieberman, MD; Marie Almon, MS, RD; Melinda Hansen, ARNP; Gerardo Rojas, MD; Gervasio A. Lamas, MD; Charles H. Hennekens, MD, DrPH, “The National Cholesterol Education Program Diet vs a Diet Lower in Carbohydrates and Higher in Protein and Monounsaturated Fat,” Arch Intern Med. 2004;164(19):2141-2146. http://archinte.jamanetwork.com/article.aspx?articleid=217514.
In 1921, Rollin Turner Woodyatt reviewed the research on diet and diabetes. He reported that three water-soluble compounds, β-hydroxybutyrate, acetoacetate, and acetone (known collectively as ketone bodies), were produced by the liver in otherwise healthy people when they were starved or if they consumed a very low-carbohydrate, high-fat diet.[10] Dr. Russell Morse Wilder, at the Mayo Clinic, built on this research and coined the term "ketogenic diet" to describe a diet that produced a high level of ketone bodies in the blood (ketonemia) through an excess of fat and lack of carbohydrate. Wilder hoped to obtain the benefits of fasting in a dietary therapy that could be maintained indefinitely. His trial on a few epilepsy patients in 1921 was the first use of the ketogenic diet as a treatment for epilepsy.[10]
A randomised, parallel-group trial among 307 obese participants demonstrated that a low-carbohydrate, high-fat diet resulted in lower levels of diastolic blood pressure, triglyceride, and LDL cholesterol levels in the first 6 months compared to the low-fat diet group. Moreover, the HDL cholesterol increased by 23% after 2 years in the low-carbohydrate, high-fat diet group (14).
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.
The "classic" ketogenic diet is a special high-fat, low-carbohydrate diet that helps to control seizures in some people with epilepsy. It is prescribed by a physician and carefully monitored by a dietitian. It is usually used in children with seizures that do not respond to medications. It is stricter than the modified Atkins diet, requiring careful measurements of calories, fluids, and proteins. Foods are weighed and measured.
Practitioners from hospitals both in the U.S. and abroad who wish to start a ketogenic diet center at their institutions can participate in one of our 1- or 2-week training sessions for a fee. The training covers both the ketogenic and modified Atkins diets. Professionals affiliated with centers already using ketogenic diet programs are welcome to attend our monthly ketogenic diet follow-up clinics.

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).
To test whether energy reserves in hippocampal neurons were enhanced with the KD, they counted the number of energy "factories," or mitochondria, within cells using electron microscopy. They found that KD treatment significantly increased the number of mitochondria per unit area in the hippocampus. This finding, along with the concerted increase in the expression of genes encoding energy metabolic enzymes, led them to conclude that KD treatment enhances energy production in the hippocampus and may lead to improved neuronal stability.
This week we’re introducing a slight fast. We’re going to get full on fats in the morning and fast all the way until dinner time. Not only are there a myriad of health benefits to this, it’s also easier on our eating schedule (and cooking schedule). I suggest eating (rather, drinking) your breakfast at 7am and then eating dinner at 7pm. Keeping 12 hours between your 2 meals. This will help put your body into a fasted state.
[46:12] – Why smoking is linked to a high risk of cardiovascular disease even when cholesterol might be low. The key is to find out what it is that makes the vascular system weak or strong. Dave explains why he believes the weak association between cholesterol and atherosclerosis may be due to the body’s response to stress bringing higher levels of cholesterol.
Rezaei, S., Abdurahman, A. A., Saghazadeh, A., Badv, R. S., and Mahmoudi, M. (2017). Short-term and long-term efficacy of classical ketogenic diet and modified Atkins diet in children and adolescents with epilepsy: a systematic review and meta-analysis. Nutr. Neurosci. doi: 10.1080/1028415X.2017.1387721 [Epub ahead of print]. doi: 10.1080/1028415X.2017.1387721
The ketogenic diet field is moving in the direction of adding vitamins and supplements empirically to the regimen of all children on the ketogenic diet to prevent adverse effects before they occur. Although not mentioned in the 2009 consensus statement, many now advocate for universal treatment with oral citrates, selenium, extra vitamin D, laxatives, and even antacids . Several nutrition companies have created products which are designed for ketogenic diet patients.

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).
I’m following the ketogenic diet and I find it very easy, pleasant and varied. I can even say that my diet today is more varied than the previous one. I do not intend to leave this diet and I cannot really see why. My initial focus was not to lose weight, I’ve always been lean, but to feel better, well disposed. And I got it! I am very pleased, I have read a lot about it (including scientific literature) and I have influenced other people who need to lose weight or improve some aspects of their health. But from the beginning I went on my own way, without the help of a nutritionist because I did not want to suffer the influence of others’ ideas.
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]
In another study that involved mice with brain tumors, administration of 65 to 75 percent of the recommended daily calories helped reduce tumor growth by 35 and 65 percent among two different test groups. Total carb consumption was restricted to 30 grams only.14 A different mice study strictly limited carb consumption to 0.2 percent only, which helped reduce the growth of glucose-fermenting tumors.15

Keep eating low carb to continue losing weight, feeling good and becoming healthier!Try making any of our hundreds of recipes available on the site. We make sure each and every recipe is delicious, nutritious and will keep you under your daily carb limit, even if you go for seconds. In addition, we provide step-by-step instructions to make the process as easy as possible. If you ever run into any issues or have any questions, be sure to leave a comment or contact us directly! We’re always happy to help.

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 …


I have been on a low carb keto diet for more than a year. As T2DM my A1C dropped from 9% to 5.4% & I discontinued meds. All my lipids improved even with ample healthy saturated fat. More than a year now so I wonder why this would be a short term improvement when its obvious that I will not go back to a high A1C and taking 3 diabetes medications including sulphonylureas. It is clear from this article that you lack the necessary experience that would be gained from wholeheartedly trying the diet or monitoring patients doing it properly like me. I would be probably be facing my first amputation if I believed the negativity in your article. So for people with diabetes who may be dissuaded by your article. Ignore it and take back your health by restricting carbs (<25 g a day) or as low as you reasonably can below 130g while being satisfied that you are getting adequate nutrition.
The Johns Hopkins Hospital protocol for initiating the ketogenic diet has been widely adopted.[43] It involves a consultation with the patient and their caregivers and, later, a short hospital admission.[19] Because of the risk of complications during ketogenic diet initiation, most centres begin the diet under close medical supervision in the hospital.[9]
• Reducing appetite — Constant hunger can cause you to consume more calories than you can burn, which can eventually lead to weight gain. A ketogenic diet can help you avoid this problem because reducing carbohydrate consumption can reduce hunger symptoms. In one study, participants who were given a low-carbohydrate diet had reduced appetites, helping them lose weight easier.2
Some years ago, a patient of mine, a professor at a well-known university, became interested in oxygenation therapies for cancer, used widely in the Mexican Clinics. These “oxygen” treatments were an offshoot of Dr. Warburg’s work, i.e., that cancer cells as obligatory anaerobes can synthesize needed energy supplies only via glycolysis. Therefore, the theory goes, in the presence of oxygen, particularly ozone, a form of hyped up oxygen, cancers cells, unlike normal cells, will be poisoned.
On the other hand, higher HDL cholesterol levels have been linked to less carotid artery intima-media thickness. In a large meta-analysis of data from more than 20,000 people, CIMT tended to decrease as HDL cholesterol increased – regardless of LDL cholesterol values (16). Importantly, although LDL response to carb restriction varies from person to person, HDL virtually always increases.

Energy Deprivation. By its nature, the ketogenic diet is very low in carbohydrates (typically 20 to 50 grams/day) and naturally restricts calorie consumption. This restricts the amount of fuel that cancer cells receive, even for the cancer cells that are able to thrive off of multiple substrates. Furthermore, almost all cancer cells seem to lack the ability to use the ketones produced when carbs consumption is restricted. Thus, cancer patients who are keto-adapted will probably be the most effective at starving cancer cells.


In the 1920s, German scientist Otto Warburg found that cancer cells fuel their growth through metabolizing a large amount of glucose. Unlike the average healthy cell, he saw that cancer cells were converting glucose into energy without using oxygen, even when oxygen was readily available. Now called the Warburg effect, this phenomenon is seen in about 80 percent of cancers.
Type 2 Diabetes:  Although the current mainstream diabetes treatment advice to eat 45-65% of calories from carbohydrate is starting to change, many practitioners are still giving out the old advice. Since carbohydrate is the prime driver of higher blood sugar, this advice is detrimental to diabetic health because it results in blood sugar spikes and crashes, which in turn causes a greater need for medication and insulin. Those high blood sugars also result in the complications of diabetes.  In contrast, a ketogenic diet reduces and in many cases, eliminates the need for diabetic medications and lowers the number of insulin units needed to manage blood sugar.  For people with Type 2 diabetes, ketogenic diets remove the trigger (carbohydrate intake) and reverse the underlying insulin resistance which causes the disease. As a result, long term complications are reversed or avoided.  Learn more in our Conquer Type 2 Diabetes e-Book  or click on the book cover.
As you’ve looked into the keto diet, you’ve probably read that sugar is our primary fuel source, and this is true — but cancer cells handle glucose a bit differently. At rest, for example, our healthy cells will not produce lactic acid. Conversely, cancer cells have such an issue with normal energy metabolism that it essentially can only burn glucose in a way that produces lactic acid. By producing energy in this way, the cell will become more and more cancerous as it makes itself vulnerable to further mutations without any hope of repair.
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).
Cancer – One exciting frontier for the potential use of a ketogenic diet is as an adjunct treatment for certain types of cancers. In 1924 Otto Warburg first published his observation that, unlike healthy cells, nearly all cancer cells fuel themselves through glycolysis, a means of creating energy through the fermentation of glucose. What we now call the “Warburg Effect” has led many researchers to theorize that if cancer cells are starved of glucose, they will stop spreading, while healthy cells will continue to thrive on the alternative fuel source of ketones. In mice, a ketogenic diet is known to inhibit certain pathways and lower certain compounds involved in tumor formation.35 Research thus far is very preliminary, but because a ketogenic diet appears to target major energy pathways responsible for tumor growth and survival, it may enhance the efficacy of conventional treatments and even reduce side effects in some types of cancers. 36 37 38
The ketogenic diet also may function in a neuroprotective fashion in AD. In this progressive dementia, extracellular plaques containing amyloid protein are thought to be central to the pathogenesis of the disease. β-Hydroxybutyrate protects against the toxicity directly induced by the addition of fragments of amyloid-β (Aβ)1-42 in cultured hippocampal neurons [37]. The ketogenic diet also may protect against the deposition of amyloid. One theory of how the ketogenic diet may affect AD is that ketone bodies allow the cell to overcome amyloid-induced PDH dysfunction [37].
There is nothing inherently difficult about following a ketogenic diet. We have many patients who do this very easily over many years. The metabolic benefits significantly outway any perceived challenges from limiting particular food types. Uptake would be far more widespread if nutrition professionals left their predujical opinions of SFA’s behind. Finally, given the expertise in Ketogenic Diets at Harvard, Dr David Ludwig, for one springs to mind, I am surprised the author did not avail themselves of the local expertise.
Gluconeogenesis is the endogenous production of glucose in the body, especially in the liver primarily from lactic acid, glycerol, and the amino acids alanine and glutamine. When glucose availability drops further, the endogenous production of glucose is not able to keep up with the needs of the body and ketogenesis begins in order to provide an alternate source of energy in the form of ketone bodies. Ketone bodies replace glucose as a primary source of energy. During ketogenesis due to low blood glucose feedback, stimulus for insulin secretion is also low, which sharply reduces the stimulus for fat and glucose storage. Other hormonal changes may contribute to the increased breakdown of fats that result in fatty acids. Fatty acids are metabolized to acetoacetate which is later converted to beta-hydroxybutyrate and acetone. These are the basic ketone bodies that accumulate in the body as a ketogenic diet is sustained. This metabolic state is referred to as "nutritional ketosis." As long as the body is deprived of carbohydrates, metabolism remains in the ketotic state. The nutritional ketosis state is considered quite safe, as ketone bodies are produced in small concentrations without any alterations in blood pH. It greatly differs from ketoacidosis, a life-threatening condition where ketone bodies are produced in extremely larger concentrations, altering blood ph to acidotic a state.
It’s not heart healthy because it’s raising inflammation. The reason they put in on there though is it does one thing on your cholesterol panel that they think is good. It lowers the LDLC number. It does. It will do it all day everyday. You can sit there and drink Canola oil, and your LDL will go down, your LDLC. That LDLC is just a calculated number using this thing called the Friedewald equation and it’s not directly measured. That’s another thing people don’t realize. LDLC is just totally an estimated number. When your triglycerides are under 100 and your HDL is over 50, it totally miscalculates what your LDL is. That’s why that NMR lipo profile test to know the particles is so important. I know I’m talking fast and saying a lot of technical terms.
The ketogenic diet appears to enhance mitochondrial function via a number of potential pathways. Given the important role of mitochondrial dysfunction in many neurodegenerative diseases, it is important to outline potential mechanisms of apparent disease-modifying effects of the ketogenic diet. It is unclear whether there is something specific or direct about the ketogenic diet (ie, provision of ketone bodies or fatty acids) or, perhaps more importantly, the metabolic changes it induces.
The medical community has known about cancer cell’s preference for glucose for quite some time. In fact, one of the ways they get an image of a tumor is essentially by injecting a glucose-based “dye” into the body and using some sort of machine to see that “dye.” The area that lights up the most when taking the image is where the cancer tumor is – that’s because of the cancer cell’s overwhelming desire for glucose.
Leanne: For those of you guys who don’t know Jimmy Moore, first of all you’ve probably been living under a rock because this guy’s huge. Excited to have you here on the show today. Jimmy busted on health scene in 2004 after a phenomenal 180 pound weight loss that enabled him to come off of his prescription drugs for high cholesterol, high blood pressure, and respiratory problems. He is the co-author of Cholesterol Clarity, Keto Clarity, and the energetic personality behind the blog Living La Vida Low Carb at www.livinlavidalowcarb.com, and the voice of the top ranked podcast The Livin’ La Vida Low Carb show. He’s interviewed over 900 of the world’s top health experts, I’m pretty sure I’ve listed to at least 400 of those.

The take-home message here is that patients with epilepsy have options beyond simple pharmaceutical intervention, and these include dietary changes which well-respected science is now validating as having significant efficacy. A fundamental cornerstone of the Grain Brain Program is profound reduction of carbohydrates and sugars while increasing “good” dietary fats. This approach tends to favor a low grade of ketosis which may well be the normal state of human metabolism. I have written extensively both on the site and in Grain Brain how this dietary approach has profound health-related benefits that relates to weight loss, metabolism, energy, reduction of inflammation, and even reduce risk for diabetes and cancer. This new report offers up yet another benefit to a higher fat lower carbohydrate dietary approach, in this case, for a disease that is devastating for so many.
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]

For patients interested in the keto diet, a more moderate approach may be advised. There is evidence that cutting down on the amount of refined carbohydrates in typical diets and increasing the amount of healthy fats consumed can be beneficial to one’s overall health. Before altering your diet in any way, you should always consult with your doctor and registered dietitian.


The keto diet works for such a high percentage of people because it targets several key, underlying causes of weight gain — including hormonal imbalances, especially insulin resistance coupled with high blood sugar levels, and the cycle of restricting and “binging” on empty calories due to hunger that so many dieters struggle with. In fact, these are some of the direct benefits of the keto diet.
Use fat as a lever.  We’ve been taught to fear fat, but don’t! Both keto and low carb are high fat diets. Fat is our source of energy as well as satiety. The key to understand, though, is that fat is a lever on a low carb or keto diet. Carbs and protein stay constant, and fat is the one you increase or decrease (push the lever up or down) to gain or lose weight, respectively. So if your goal is weight loss, eat enough fat to be satisfied, but there’s no need to “get your fats in” once you’re satisfied.
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.)
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