Discuss this treatment option with your neurologist. If your neurologist feels that the ketogenic diet is a possible option, then bloodwork tests and other investigations may be required to determine if the ketogenic diet can be safely implemented. You may then meet members of the ketogenic diet team such as a registered dietitian, nurse, nurse practitioner, social worker, child life specialist and pharmacist who may offer their assessment on how best to plan for the ketogenic diet. Please note that many centres may have a waiting list.
Because KD is not a physiological diet, it is necessary to recognize and closely manage AE (Kossoff et al., 2009). Acute AE include dehydration, hypoglycemia, lethargy, metabolic acidosis, and gastrointestinal symptoms. However, most of the side effects involve weight loss, high levels of low-density lipoprotein, and elevated total cholesterol (Liu et al., 2018). Other important AE are gastrointestinal symptoms, which include constipation, diarrhea, vomiting, and abdominal pain.

Here are a few of the most common side effects that I come across when people first start keto. Frequently the issues relate to dehydration or lack of micronutrients (vitamins) in the body. Make sure that you’re drinking enough water (close to a gallon a day) and eating foods with good sources of micronutrients. To read more on micronutrients, click here >
When ketone bodies accumulate in the blood, this is called ketosis. Healthy individuals naturally experience mild ketosis during periods of fasting (e.g., sleeping overnight) and very strenuous exercise. Proponents of the ketogenic diet state that if the diet is carefully followed, blood levels of ketones should not reach a harmful level (known as “ketoacidosis”) as the brain will use ketones for fuel, and healthy individuals will typically produce enough insulin to prevent excessive ketones from forming. [2] How soon ketosis happens and the number of ketone bodies that accumulate in the blood is variable from person to person and depends on factors such as body fat percentage and resting metabolic rate. [3]
Although studies have shown that the keto diet can reduce seizures for children with epilepsy, there is no evidence indicating that keto helps with other brain disorders or improves mental cognition, according to Harvard Health Publishing. Some studies show that keto may lower blood sugar for people with type 2 diabetes, but there is not enough long-term research to determine whether it’s safe and effective for diabetics.
They need to make a lot of ATP, and quickly, to support their high requirements for energy. Adenosine triphosphate, also known as ATP, is a compound that provides energy to drive hundreds of thousands of biochemical processes in living cells. Found in all forms of life, ATP is often referred to as the chemical energy “currency” that powers metabolic activity.
I have lost 20lbs, feel great, but feel deprived since this diet is so prohibitive of many fruits and vegetables. Not only that, my ldl is high! My Dr. recommended Avorstatin (20 mg). I will continue with a sensible eating routine – a small portion of foods and, yes, I will take the cholesterol med and see how the LDL measures in 6 months. I walk 10,000 steps or more daily and drink 2 bottles of water.

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.
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.
Dr. David Jockers is a functional nutritionist, corrective care chiropractor, exercise physiologist, and certified strength & conditioning specialist. He runs one of the hottest natural health websites: DrJockers.com and is the author of "SuperCharge Your Brain," the complete guide to radically improve your mood, memory, and mindset, and the "SuperCharged Recipe book" with over 180 full-color recipes to help you take back control of your health. He is a regular contributor to thetruthaboutcancer.com and has well over 1,200 professionally published natural health articles on the web and in print magazines. Dr. Jockers is a sought after speaker around the country on such topics as weight loss, brain health, functional exercise, natural detoxification, and disease prevention. He currently owns and operates Exodus Health Center in Kennesaw, Georgia.
Each of these groups Dr. Price studied seemed well adapted to the available food supply. The Eskimos, as Stefansson earlier had reported and as Price confirmed, thrived on their high fat, no carb, animal-based diet. The Inca descendents, on the other hand, had done quite well consuming grains like quinoa, along with tubers, fruits, and some animal protein and dairy. The Masai flourished on a rather extreme diet consisting, for an adult warrior, of a gallon of raw milk a day with some blood and occasional meat, but no fruits, vegetables, nuts, seeds, or grains.
Our normal healthy cells, be they situated in the brain or the skin of our feet, do prefer glucose as their primary energy source, obtained from the sugar circulating in the blood. That “blood sugar” comes from a variety of sources, including dietary carbohydrates occurring in fruits, starchy vegetables like potatoes, and grains. The complex carbohydrates in such foods are broken down into glucose during the digestive process, catalyzed by a variety of carb-specific enzymes like amylase.
A ketogenic diet may be an option for some people who have had difficulty losing weight with other methods.  The exact ratio of fat, carbohydrate, and protein that is needed to achieve health benefits will vary among individuals due to their genetic makeup and body composition. Therefore, if one chooses to start a ketogenic diet, it is recommended to consult with one’s physician and a dietitian to closely monitor any biochemical changes after starting the regimen, and to create a meal plan that is tailored to one’s existing health conditions and to prevent nutritional deficiencies or other health complications. A dietitian may also provide guidance on reintroducing carbohydrates once weight loss is achieved.
The CKD and its variants should be considered as an alternative for non-surgical pharmacoresistant patients with epilepsy, of any age. Each patient must have an individually designed diet; however, adult patients have more difficulty in maintaining the CKD. It is essential to inform the patient and the family about the efficacy and AE related to the KD, and the use of websites and videos may help in this education. Although several theories exist regarding the mechanisms of action, further study is needed nevertheless the positive results are probably due to several mechanisms.
Neurological Function– A ketogenic diet may be neuroprotective since it increases energy production in the brain, limits the production of free radicals, limits neuronal excitability and increases production of GABA in the brain.27 28 Researchers have hypothesized that a ketogenic diet and, in particular, ketones might benefit neurological function in several conditions and situations, including Alzheimer’s, Parkinson’s, Friedreich’s ataxia, autism and traumatic brain injury. 29 30 In Alzheimer’s disease, it appears that brain cells become unable to use glucose for energy production; a ketogenic diet can provide an alternative fuel for the brain. 31 Several studies have found that giving patients with mild to moderate Alzheimer’s medium chain triglycerides (MCTs), a type of fat that is readily accessible for ketone formation, improves cognition, but the effects are more pronounced in those that do not carry the APOE e4 gene variant that is associated with increased risk of Alzheimer’s.32 33 34 Research is just beginning to explore these conditions, and a better understanding of how effective the ketogenic diet is in treating certain neurological conditions will likely be available in the near future.
In 2005, he would eventually die with his dream of academic acceptance unrealized. But my colleague Dr. Linda Isaacs and I have worked diligently over the past 26 years, keeping the Kelley idea alive, that different people may require completely different diets. In the next installment, I will address my own experience treating patients diagnosed with advanced cancer with a Kelley based approach. Our therapy involves, oftentimes, diets high in carbohydrates, which proponents of the ketogenic diet would predict should fuel, not stop, cancer.
Fight Cancer with a Ketogenic Diet is not an academic exercise in what a ketogenic rendition of an anticancer diet should be. The information is firmly based on the science and research of Dr. Thomas Seyfried, who proposes that cancer is a metabolic disease, and on consultation with both Drs. Seyfried and Dominic D’Agostino on design and implementation of a ketogenic diet. Sound biochemical and physiological sciences support the book’s explanations and recommendations.
The remaining calories in the keto diet come from protein — about 1 gram (g) per kilogram of body weight, so a 140-pound woman would need about 64 g of protein total. As for carbs: “Every body is different, but most people maintain ketosis with between 20 and 50 g of net carbs per day,” says Mattinson. Total carbohydrates minus fiber equals net carbs, she explains.
Since its origin, the ketogenic diet has been effective for raising energy levels, lowering weight, and increasing quality of life. But like any other diet and exercise program, it’s up to you to keep it going long-term. Get in touch with the Diet Doc team today for guidance, tips, and help losing weight with the ketogenic diet or other effective diets.
In recent years stem cells have been a hot topic in the research world, and a hot topic, for better or worse, in the media. These headline-grabbing stem cells are primitive undifferentiated cells, located as nests in every tissue and organ in the body, that serve as a reserve supply to replace cells in the tissue or organ lost due to normal turnover (as in the bone marrow or along the intestinal lining), disease, injury, or cell death.
When mitochondria were isolated from these SOD1 mice, β-hydroxybutyrate rescued ATP production in the presence of a complex I inhibitor. It also helped to preserve neurons in culture exposed to the same inhibitor, paralleling the findings found for PD. In these neurodegenerative disorders, the ketogenic diet may be providing substrate to bypass impaired or poorly functioning complex I. Another hypothesis on enhanced ATP production includes increased mitochondrial biogenesis [48•]. Alternatively, decreased reactive oxygen species generation (which protects the process of oxidative phosphorylation) could be the result of an effect on NADH oxidation or preventing adverse events in the handling of calcium overload in mitochondria, such as the mitochondrial permeability transition [48•,49,50].

Collectively, these findings suggest that LDL particle size is a more precise indicator of future cardiovascular illness than total LDL cholesterol even when people have high levels of one but not the other. That being said, LDL-C is still a useful indicator for future cardiovascular illness and ideally you want to have both low LDL-C and LDL-P. (Click here to find optimal ranges for LDL-C and here for LDL-P)


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.
Over one-third of Americans have metabolic syndrome, a constellation of complications including increased blood pressure, elevated blood sugar, excess abdominal fat, and abnormal triglyceride and cholesterol levels that significantly increase one’s risk of heart disease, diabetes, and stroke. (8) The conventional treatment of metabolic syndrome typically involves cholesterol-, blood sugar-, and blood pressure-lowering medications, along with vague advice to “eat better.” Given that heart disease is still the number one cause of death in the United States, that diabetes is considered to be at epidemic proportions, and that strokes disable or kill someone every 40 seconds on average, this treatment paradigm leaves much to be desired. (9)
Con: Results can vary depending on how much fluid you drink. By drinking more water, you dilute the concentration of ketones in the urine and thus a lower level of ketones will be detected on the strips. The strips don’t show a precise ketone level. Finally, and most importantly, as you become increasingly keto-adapted and your body reabsorbs ketones from the urine, urine strips may become unreliable, even if you’re in ketosis.
Our normal healthy cells, be they situated in the brain or the skin of our feet, do prefer glucose as their primary energy source, obtained from the sugar circulating in the blood. That “blood sugar” comes from a variety of sources, including dietary carbohydrates occurring in fruits, starchy vegetables like potatoes, and grains. The complex carbohydrates in such foods are broken down into glucose during the digestive process, catalyzed by a variety of carb-specific enzymes like amylase.
Leanne: Yeah, that’s amazing that you took your health into your own hands. I think that’s so empowering for so many people. When we just say “enough is enough and we need to change.” For me I came at this from the hormone piece, but also we have a strong line of dementia in our family. Very, very strong. For me, it was how can I be as good to my brain as possible? Not only is this good for your heart and everything else, but also looking at the health of your brain, which we talked about with having enough cholesterol is important for our brain function, too.
The diet has been in use since 1930, so it is hardly a fad. While people who eat a lot of meat may have a shorter life, a ketogenic diet is not a meat diet. There have been many studies of this diet for serious medical conditions, and they have shown it can be sustained over time. Diet commercial will tell you; it is all about the food. Here are some sample ketogenic meals that I think anyone would enjoy. You eat lots of good healthy oils, fish, eggs, cheese, some meat, and vegetables. The diet is satisfying and easy to prepare.
Despite continuous advances in the medical world, obesity continues to remain a major worldwide health hazard with adult mortality as high as 2.8 million per year. The majority of chronic diseases like diabetes, hypertension, and heart disease are largely related to obesity which is usually a product of unhealthy lifestyle and poor dietary habits. Appropriately tailored diet regimens for weight reduction can help manage the obesity epidemic to some extent. One diet regimen that has proven to be very effective for rapid weight loss is a very-low-carbohydrate and high-fat ketogenic diet.[1][2][3]
The keto diet also appears to help induce autophagy, which helps clear damaged cells from the body, including senescent cells that serve no functional purpose but still linger inside tissues and organs. In animal studies when rats are put on the ketogenic diet, autophagic pathways are created that reduce brain injury during and after seizures. (21)
When mitochondria were isolated from these SOD1 mice, β-hydroxybutyrate rescued ATP production in the presence of a complex I inhibitor. It also helped to preserve neurons in culture exposed to the same inhibitor, paralleling the findings found for PD. In these neurodegenerative disorders, the ketogenic diet may be providing substrate to bypass impaired or poorly functioning complex I. Another hypothesis on enhanced ATP production includes increased mitochondrial biogenesis [48•]. Alternatively, decreased reactive oxygen species generation (which protects the process of oxidative phosphorylation) could be the result of an effect on NADH oxidation or preventing adverse events in the handling of calcium overload in mitochondria, such as the mitochondrial permeability transition [48•,49,50].

On the ketogenic diet, carbohydrates are restricted and so cannot provide for all the metabolic needs of the body. Instead, fatty acids are used as the major source of fuel. These are used through fatty-acid oxidation in the cell's mitochondria (the energy-producing parts of the cell). Humans can convert some amino acids into glucose by a process called gluconeogenesis, but cannot do this by using fatty acids.[57] Since amino acids are needed to make proteins, which are essential for growth and repair of body tissues, these cannot be used only to produce glucose. This could pose a problem for the brain, since it is normally fuelled solely by glucose, and most fatty acids do not cross the blood–brain barrier. However, the liver can use long-chain fatty acids to synthesise the three ketone bodies β-hydroxybutyrate, acetoacetate and acetone. These ketone bodies enter the brain and partially substitute for blood glucose as a source of energy.[56]


Leanne: Totally, awesome, perfect. Today we’ve really come together to talk about cholesterol. It is a huge topic. Yeah, Cholesterol Clarity right there. A lot of my readers who are adopting this high fat, keto eating style are getting really nervous about cholesterol and you know if I eat too many eggs is my cholesterol going to go up and so a lot of people that are watching this show today, I bet you about 80% of them have their blood work in front of them.
For the latest update we searched the Cochrane Epilepsy Group's Specialized Register (11 April 2017), the Cochrane Central Register of Controlled Trials (CENTRAL) via the Cochrane Register of Studies Online (CRSO, 11 April 2017), MEDLINE (Ovid, 11 April 2017), ClinicalTrials.gov (11 April 2017) and the WHO International Clinical Trials Registry Platform (ICTRP, 11 April 2017). We imposed no language restrictions. We checked the reference lists of retrieved studies for additional reports of relevant studies.
Implementing the diet can present difficulties for caregivers and the patient due to the time commitment involved in measuring and planning meals. Since any unplanned eating can potentially break the nutritional balance required, some people find the discipline needed to maintain the diet challenging and unpleasant. Some people terminate the diet or switch to a less demanding diet, like the modified Atkins diet or the low-glycaemic index treatment diet, because they find the difficulties too great.[42]
Jimmy Moore: The thing here is I also always had high cholesterol. Cholesterol goes to … think of cholesterol like a fire fighter and inflammation is the fire. If a fire fighter goes to the scene of a fire, blows the water onto … you burning the house and it puts it out. Let’s say the neighbors house is on fire, and there’s no fire fighter that comes, what happens? Destruction, right?
Close attention to growth measurements, laboratory data, and medical supervision is indicated in infants on the ketogenic diet. A prospective cohort study of 237 children, with an average length of follow-up of 308 days, analyzed height and weight measurements over time on the ketogenic diet. A small decrease in height scores was observed in the first 6 months, with bigger changes by 2 years. There was a drop in weight in the first 3 months; after this, the weight remained constant in children who started the diet below the 50th percentile for their weight, while it continued to decrease in children starting above the 50th percentile. Very young children (0–2 years) grew poorly on the diet, while older children (7–10 years) grew almost normally. Recent studies of children who discontinued the diet suggest that growth will catch up once the diet is discontinued.
During that first meeting, Kelley described in some detail the tenets of his therapy. In summary, it involved three basic components: individualized diet, individualized supplement programs with large doses of pancreatic enzymes Kelley believed had an anti-cancer effect, and detoxification routines such as the coffee enemas. He fervently believed that each patient required a protocol designed for his or her particular metabolic, physiologic, and biochemical needs, and that one diet would never be suitable for all.
The oxygen-free pathway used by cancer cells needs a lot more glucose to produce the same amount of energy as an oxygen-using cell. This realization led to imaging techniques where cancer cells can be detected by spotting where large amounts of a glucose tracer accumulate in the body. The glucose used in this technique contains a small amount of radioactive material that lights up in the image.
The predominant use of glucose anaerobically by cancer cells (Warburg effect) may be the most important characteristic the majority of these cells have in common and, therefore, a potential metabolic pathway to be targeted during cancer treatment. Because this effect relates to fuel oxidation, dietary manipulation has been hypothesized as an important strategy during cancer treatment. As such, the concept of a ketogenic diet (KD) in cancer emerged as a metabolic therapy (ie, targeting cancer cell metabolism) rather than a dietary approach. The therapeutic mechanisms of action of this high-fat, moderate-to-low protein, and very-low-carbohydrate diet may potentially influence cancer treatment and prognosis. Considering the lack of a dietetics-focused narrative review on this topic, we compiled the evidence related to the use of this diet in humans with diverse cancer types and stages, also focusing on the nutrition and health perspective. The use of KD in cancer shows potentially promising, but inconsistent, results. The limited number of studies and differences in study design and characteristics contribute to overall poor quality evidence, limiting the ability to draw evidence-based conclusions. However, the potential positive influences a KD may have on cancer treatment justify the need for well-designed clinical trials to better elucidate the mechanisms by which this dietary approach affects nutritional status, cancer prognosis, and overall health. The role of registered dietitian nutritionists is demonstrated to be crucial in planning and implementing KD protocols in oncology research settings, while also ensuring patients’ adherence and optimal nutritional status.
Dr. Kossoff is a Professor of Neurology and Pediatrics at Johns Hopkins University in Baltimore, MD.  He received his medical degree from SUNY at Buffalo School of Medicine in New York, followed by a residency in pediatrics at Eastern Virginia Medical School in Norfolk, Virginia. He completed a fellowship in child neurology and then pediatric epilepsy and clinical neurophysiology at The Johns Hopkins Hospital in Baltimore.  He has been at Johns Hopkins since 1998.
Patients diagnosed with the immune based “blood cancers” like leukemia, lymphoma, and myeloma, as well as the sarcomas, a type of connective tissue malignancy, required a lower carb, high animal fat, moderate animal protein diet. Other patients, usually with problems other than cancer, thrived on a more “balanced” diet, incorporating a variety of plant and animal foods.
It seems to me that your’re presenting conflicting information. Your series had T. Colin Campbell and his research from the China Study. And the healing benefits of a plant based diet. Animal protein causes inflammation. Is there specific science on the ketogenic diet? I know people doing keto long term and they look awful and seem to be sick all the time. I have heard of the keto flu.
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.
For cells to maintain a healthy status, oxidants and antioxidants have to be in balance with each other. When this equilibrium is tilted toward an oxidized state, it leads to oxidative stress, in which an excess of oxidants can damage cellular structures and affect the health of the cell. Even cancer cells need to safeguard themselves against this.
• Fighting inflammation — The human body can use both sugar and fat as fuel sources. However, the latter is preferred because it is a cleaner, healthier fuel that releases far fewer reactive oxygen species (ROS) and secondary free radicals. By eliminating sugar from your daily food consumption, you're decreasing your risk of developing chronic inflammation throughout your body.
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To sum up decades of Warburg briefly, mammalian cells create and store usable energy in the form of the adenosine triphosphate (ATP) molecule. Production of ATP is a complex affair involving three distinct and sequential series of cellular reactions that begin with the breakdown of the six-carbon sugar glucose. The first of these processes, glycolysis, does not require oxygen and occurs in the cytoplasm; the second, the citric acid cycle, occurs within the mitochondria, the oval shaped organelles dispersed within the cytoplasm, and requires oxygen; and the third, and most productive in terms of ATP generation, electron transport, proceeds in the membranes of mitochondria and also needs oxygen.
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.
A study of 183 children in whom the diet was discontinued determined that the speed of  the wean did not matter: children tapered over several weeks did just as well as those in whom the diet was stopped more slowly. Children in whom there was a good, but not complete seizure reduction with the diet (50-99% seizure reduction) were at highest risk for seizure worsening with the diet discontinuation . Should seizures worsen, many of these families elect to continue a low-carbohydrate diet versus new anticonvulsants . Some child neurologists opt to stop the diet over 4-6 weeks with close email contact.
The most common side effects are constipation that can be supported with some dietary adjustments and laxatives. Other side effects that may occur that are relatively minor and transient include: kidney stones, low sugars, nausea, vomiting, diarrhea, sleepiness. There are some reports of longer term side effects that may include higher cholesterol, reduced bone health, kidney stones, slower linear growth velocity and abnormal heart rhythm.
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