“This is an important area of research that has the potential to significantly improve treatment responses,” said AICR’s Director of Research Nigel Brockton, Ph.D. “There are plausible mechanisms by which the ketogenic diet could help make treatment more effective, but, as we see many times, plausibility alone is not enough; it has to be tested. That’s why we are supporting research in this area.”
The ketogenic diet exerts antiepileptic effects by improving energy metabolism in the brain and reducing brain oxidative stress. Fascinating new research suggests that the antiseizure effects of the ketogenic diet are also mediated by modulation of the gut microbiota. (28) Consumption of a ketogenic diet increases the levels of bacteria that produce GABA, the brain’s primary inhibitory neurotransmitter; this shifts neurotransmission towards inhibition rather than excitation, thus preventing neuronal hyperexcitability and seizure onset.
We’re going full on fats with breakfast, just like we did last week. This time we’ll double the amount of ketoproof coffee (or tea) we drink, meaning we double the amount of coconut oil, butter, and heavy cream. It should come to quite a lot of calories, and should definitely keep us full all the way to dinner. Remember to continue drinking water like a fiend to make sure you’re staying hydrated.
The goal of this eBook is to help people affected with cancer utilize a ketogenic diet to manage the disease and better tolerate chemotherapy and radiation protocols they may face. It provides a complete resource for planning a ketogenic diet; however, it is not intended to be a self-help book but rather an adjunct to the care, treatment, and monitoring of progress on a ketogenic diet provided by the attending physician.
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.
Stock up: Jet.com'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.
In their conclusions, they stated that the favorable response could be attributed “in part” to the calorie-restricted ketogenic diet. However, the researchers emphasized that “further studies are needed to evaluate the efficacy of restricted ketogenic diets, administered alone or together with standard treatment, as a therapy for GBM and possibly other malignant brain tumors.”
The problem with this is that it’s the B particles that cause the biggest problems. Remember, since particle B molecules are very small, they are the ones that get stuck in nooks and crannies of the arterial and vascular walls. Having more B particles will be bad. But, having more A particles won’t necessarily be bad. But if all you get is the TOTAL LDL (which is typical), you have no idea of your actual particle composition. So it’s possible that a high LDL number, without any context or further testing is not a problem at all.
The ketogenic diet is proposed as a potential adjuvant therapy by exploiting these differences between cancer and normal cells. Consuming a ketogenic diet reduces blood glucose levels through a drastic reduction in the amount of carbohydrates consumed.1,2 As a result of decreased blood glucose levels, less insulin is secreted, which downregulates signaling pathways that are frequently constitutively active in tumor cells.2 Because glucose metabolism is inhibited, energy must be primarily derived from fats.1 Fat metabolism results in the production of ketone bodies and β-hydroxybutyrate by the liver, which are used to fuel energy production. Cancer cells have difficulty using these pathways because they rely on glucose; the metabolism of fat increases oxidative stress.
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.
Recent animal studies suggest a role for the ketogenic diet as a potential therapy for amyotrophic lateral sclerosis (ALS). ALS results from the death of motor neurons in the brain and spinal cord. A small number of cases are caused by an inherited mutation in the gene encoding the Cu/Zn superoxide dismutase I (SOD1). Mice expressing the mutated gene recapitulate the progressive muscle weakness and death due to respiratory failure seen in humans with ALS. Various lines of evidence suggest that mitochondrial dysfunction may play a role in the pathogenesis of ALS. A recent study suggests that ketosis induced by the ketogenic diet might affect progression of the disease . Transgenic SOD1 mice fed a high-fat diet (60% of calories from fat, compared with < 10% fat in standard rodent chow and > 90% of calories from fat in a typical rodent ketogenic diet) preserved their performance on a standard rotorod test longer than those fed a regular diet. Mice were fed ad lib, and mice fed the high-fat diet gained more weight than those on the standard diet, so overall caloric restriction was unlikely to be a factor in this study. When spinal cords were examined, significantly more motor neurons were preserved in the mice fed the ketogenic diet than in those fed a regular diet. However, the ketogenic diet did not significantly prolong survival.
And finally, there is increasing debate over the importance of the standard (i.e., calculated) LDL cholesterol level relative to the sum of other cardiovascular risk factors. This controversy makes it difficult for the individual patient to weigh the evidence from the various known risk factors. If you are uncertain, it is a good idea to follow up with your physician, who may recommend performing the most up-to-date assessment of your blood lipids, including the size and amounts of your LDL cholesterol fractions with a NMR or VAP lipoprotein test.
LDL is often referred to as “bad” cholesterol because high levels have been linked to increased heart disease risk. By contrast, HDL is frequently called “good” cholesterol. One of HDLs main functions is to carry cholesterol back to the liver to be used as needed. Higher levels of HDL have been associated with decreased cardiovascular disease (CVD) risk.
Jimmy Moore: That’s a loaded question. I’ll try to make it a little more pointed. Cholesterol and I’m really happy to hear that you went from what you say around 140 or so, to about 230 or 40. That’s actually a very good thing, and one of the key elements in the body, one of the key roles of cholesterol in the body, is for hormone regulation. A lot of good things about having more cholesterol and when you have less cholesterol in the body you actually take away some of those key things that could be happening and that’s why some people when they tend to have lower cholesterol levels … I used to take Lipitor back before my low carb, keto days, and I got my total cholesterol to around 130?
Ketone bodies, acetoacetate, and β-hydroxybutyrate (βOHB), are byproducts of fatty acid oxidation in the mitochondrial matrix of the hepatocytes. There are many theories about the role of KB, but the existence of an anticonvulsant effect is controversial. Some authors have found no relationship between KB and synaptic transmission and seizure control.
Wilder's colleague, paediatrician Mynie Gustav Peterman, later formulated the classic diet, with a ratio of one gram of protein per kilogram of body weight in children, 10–15 g of carbohydrate per day, and the remainder of calories from fat. Peterman's work in the 1920s established the techniques for induction and maintenance of the diet. Peterman documented positive effects (improved alertness, behaviour, and sleep) and adverse effects (nausea and vomiting due to excess ketosis). The diet proved to be very successful in children: Peterman reported in 1925 that 95% of 37 young patients had improved seizure control on the diet and 60% became seizure-free. By 1930, the diet had also been studied in 100 teenagers and adults. Clifford Joseph Barborka, Sr., also from the Mayo Clinic, reported that 56% of those older patients improved on the diet and 12% became seizure-free. Although the adult results are similar to modern studies of children, they did not compare as well to contemporary studies. Barborka concluded that adults were least likely to benefit from the diet, and the use of the ketogenic diet in adults was not studied again until 1999.
Jimmy Moore: I did not say that. You see my Instagram account, you know how much I hate processed boxed food. The mono unsaturated fats are avocados, avocado oil, 100% olive oil … that’s key too, make sure your getting olive oil that you know is 100% olive oil, because they can sneak in some of those omega-six facts into there and not tell anybody. That screws people up trying to avoid those. Of course, nuts have mono unsaturated fats as well. You can get a well rounded amount of fat from varying sources and that is really what’s going to help you in controlling your blood sugar, controlling your cholesterol, and controlling your inflammation.
Overweight individuals with metabolic syndrome, insulin resistance, and type 2 diabetes are likely to see improvements in the clinical markers of disease risk with a well-formulated very-low-carbohydrate diet. Glucose control improves due to less glucose introduction and improved insulin sensitivity. In addition to reducing weight, especially truncal obesity and insulin resistance, low-carb diets also may help improve blood pressure, blood glucose regulation, triglycerides, and HDL cholesterol levels. However, LDL cholesterol may increase on this diet.
If you lift weights on a ketogenic diet, you might fear losing muscle mass taking in lower amounts of protein. That doesn’t seem to be the case since your body preferentially utilizes fat rather than protein during ketosis. Growth hormone, an anabolic hormone sometimes called your fountain-of-youth hormone because it keeps you lean and toned, plays a major role in regulating muscle growth and development, stimulating muscle protein synthesis. Researchers find a very-low carbohydrate diet with sufficient protein does not affect growth hormone levels, at least in the short-term. If you’re a regular lifter, you might want to consider slightly increasing your protein intake during workout days and supplementing with a branched-chain amino acid (BCAA) supplement. Cyclical keto, where you would eat a higher-carbohydrate diet during your workout days, also makes for a smart strategy to maintain muscle.
In 1970, Robert C. Atkins developed a weight-loss diet that restricted the intake of carbohydrates (Sharma and Jain, 2014), and this diet was later evaluated for seizure treatment. The first patient was a 7-year-old girl with intractable epilepsy due to a left parietal cortical dysplasia, who used the Atkins diet for a week in order to acclimate to the CKD. After 3 days, her seizures stopped, and she remained seizure-free for 3 years with continued dietary treatment (Kossoff et al., 2013). In 2006, this diet was first formally referred to as the “MAD” to distinguish it from the Atkins diet (Kossoff et al., 2013). The MAD has three significant differences from the first version: the induction phase of limiting carbohydrates is maintained indefinitely; high-fat foods are not only allowed, but encouraged; and the primary goal of the diet is seizure control (Atkins, 2002; Sharma and Jain, 2014).
As these battles waged in the early 1990s, I had long left Dr. Good’s group, having returned to New York and private practice. Nonetheless, this story had a personal ring to it, as had the interferon story, since Dr. Good had completed the first bone marrow transplant in history, in 1969, and long hoped this technology would be, yes, an answer to cancer.
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.
Experimental studies in an animal model showed that in rats exposed to KD there was no change in synaptic plasticity, using paired-pulse modulation and long-term potentiation (Thio et al., 2010). Similarly, Likhodii et al. (2003) did not detect any anticonvulsant effects in either ketone body (Likhodii et al., 2003). In spontaneously epileptic Kcna1-null mice, KB supplementation resulted in attenuation of electrographic seizure-like events (Kim et al., 2015). These authors also observed an inhibitory effect of KB on mitochondrial permeability transition related to apoptotic and necrotic death. Moreover, in experimental models, acetoacetate exerted a broad-spectrum anticonvulsant effect (Rho et al., 2002). In another study, Rho (2017) described a relationship among KB, neurotransmitter release and ATP-sensitive potassium channels (Rho, 2017). Similarly, to these studies, injection of KB led to the reduction of seizure susceptibility (Gasior et al., 2008). Ma et al. (2007) found a decrease of the spontaneous firing rate in sections of mouse tissue, which was eliminated in the absence of ATP-sensitive potassium channels (KATP). In addition, KB can exert a direct inhibitory effect on the vesicular glutamate transport (Juge et al., 2010). It is possible that these divergent results are related to the different concentrations of KB used in these studies and the diverse seizure thresholds of the animal models. These conflicting results can be also explained by differences in diet composition.
People suffering from diabetes and taking insulin or oral hypoglycemic agents suffer severe hypoglycemia if the medications are not appropriately adjusted before initiating this diet. The ketogenic diet is contraindicated in patients with pancreatitis, liver failure, disorders of fat metabolism, primary carnitine deficiency, carnitine palmitoyltransferase deficiency, carnitine translocase deficiency, porphyrias, or pyruvate kinase deficiency. People on a ketogenic diet rarely can have a false positive breath alcohol test. Due to ketonemia, acetone in the body can sometimes be reduced to isopropanol by hepatic alcohol dehydrogenase which can give a false positive alcohol breath test result.
Having said all that, there is tremendous value in short-term ketosis. The natural process of ketosis induced by a 3-5 day water fast or the 5-day ProLon Fasting Mimicking Diet has powerful benefits in the body including autophagy, as well as stem cell activation and regeneration. Learn more about that in my interview with world-renowned scientist and longevity expert Dr Valter Longo here.
Many versions of ketogenic diets exist, but all ban carb-rich foods. Some of these foods may be obvious: starches from both refined and whole grains like breads, cereals, pasta, rice, and cookies; potatoes, corn, and other starchy vegetables; and fruit juices. Some that may not be so obvious are beans, legumes, and most fruits. Most ketogenic plans allow foods high in saturated fat, such as fatty cuts of meat, processed meats, lard, and butter, as well as sources of unsaturated fats, such as nuts, seeds, avocados, plant oils, and oily fish. Depending on your source of information, ketogenic food lists may vary and even conflict.
In other words, clinical data should be rolling in fairly soon, and that’s a good thing. In the meantime Dr. Seyfried and other advocates who so passionately believe that ketogenic diets will greatly help patients with brain cancer do no one any favors by claiming unequivocally that cancer is a metabolic disease and saying that ketogenic diets are more beneficial than chemotherapy for patients with brain tumors.
Leanne: Yeah totally, chill out. Do a little meditation if you need to get into the zone. Exactly. You mentioned vegetable oils causing inflammation, are there specific fats that will help us, like we’ve talked a little bit about saturated fats, we all know trans fats don’t even go there … the mono poly saturated, unsaturated, is there a certain ratio that we should be aiming for. I know you’re the guy that will just slice off butter and eat it … I am too, a little bit of Himalayan rock salt on there never hurt anyone. Are there specific facts that we should be focusing on?