Tumors did not progress at all at all in the five patients that successfully completed the ketogenic trial. This is a positive outcome given the advanced stage of their cancer. Additionally, some of these patients experienced favorable changes in glucose, HDL:LDL ratio, triglycerides, and healthy levels of weight-loss. These findings further support the healthy impact a ketogenic diet may have on cancer.
At the time I finished my monograph in 1986, I hoped that with its publication, fair-minded researchers might begin taking Dr. Kelley and his nutritional therapy seriously. As I was to learn, I completely and rather naively misjudged the animus of the scientific community toward unconventional cancer treatment approaches that didn’t fit the “accepted” model. Even with Dr. Good’s support, after two years of trying I could not get the book published, either in its entirety, or in the form of individual case reports appropriate for the conventional medical journals.
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.[10][14]

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 popular belief that high-fat diets cause obesity and several other diseases such as coronary heart disease, diabetes, and cancer has not been observed in recent epidemiological studies. Studies carried out in animals that were fed high-fat diets did not show a specific causal relationship between dietary fat and obesity. On the contrary, very-low-carbohydrate and high-fat diets such as the ketogenic diet have shown to beneficial to weight loss.
8. Van Lenten, B. J., Hama, S. Y., De Beer, F. C., Stafforini, D. M., McIntyre, T. M., Prescott, S. M., … Navab, M. (1995). Anti-inflammatory HDL becomes pro-inflammatory during the acute phase response. Loss of protective effect of HDL against LDL oxidation in aortic wall cell cocultures. Journal of Clinical Investigation, 96(6), 2758–2767. PMID: 8675645
In order to be successful, this therapy calls for strict compliance and plenty of patience, especially in the beginning. Most important, patients with epilepsy should only use the diet with the support of a knowledgeable ketogenic diet team, including a doctor and a licensed dietitian who can correctly calculate and monitor the diet for each individual. 

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.
Following a very high-fat diet may be challenging to maintain. Possible symptoms of extreme carbohydrate restriction that may last days to weeks include hunger, fatigue, low mood, irritability, constipation, headaches, and brain “fog.” Though these uncomfortable feelings may subside, staying satisfied with the limited variety of foods available and being restricted from otherwise enjoyable foods like a crunchy apple or creamy sweet potato may present new challenges.

A randomised, controlled clinical trial among 120 overweight adults with high levels of cholesterol compared the effects of a ketogenic diet against a low-fat diet. After 24 weeks, the group following the keto diet reported greater weight loss and declines in the triglyceride levels and higher increases in the HDL cholesterol levels compared to the low-fat group (11).


It’s also interesting that the cancers used to produce the basic science cited by Dr. Seyfried are virtually all brain cancers and that virtually all the evidence comes from rodent tumor models. For one thing, if there is a tumor type that exhibits the Warburg effect and a high degree of metabolic derangement, it’s brain tumors. It’s no coincidence that dichloroacetate was first tested in brain tumors. In this study, VM/Dk mice were used, and a mouse histiocytoma cell line resembling human glioblastoma multiforme with macrophage/microglial properties derived from that same mouse strain (VM-M3) was implanted subcutaneously. This cell line has the property of metastasizing quickly and widely when implanted under the skin and allowed to grow, which actually makes it not very much like brain tumors, which seldom metastasize and usually kill through local invasion and taking up increasing volume in the closed space of the skull, something the brain most definitely does not like. The results showed that a ketogenic diet increased mean survival time by over 56%, while a combination of a ketogenic diet and hyperbaric oxygen therapy (HBOT) increased survival time 78%. The result is interesting, but it is a mouse tumor model, not a human tumor model, and that makes its applicability to humans tenuous, particularly given the nature of the murine tumor, but probably worth investigating further.
According to a 2015 review of the literature on the ketogenic diet for human glioma patients (32 case studies), “Prolonged remissions ranging from more than 5 years to 4 months were reported in the case reports. Only one of these patients was treated using KD as monotherapy. The best responses reported in the more recent patient series were stable disease for approximately 6 weeks.”
More research is needed to determine whether the kind of extreme carb restriction associated with keto diets is necessary to unlock all these benefits, especially if you’re healthy. “Ketogenic and other very-low-carbohydrate diets can be quite challenging to follow over the long term, and the possibility of adverse effects has not been ruled out,” says Dr. David Ludwig, a professor of nutrition at Harvard School of Public Health. “Usually, such severe restriction isn’t necessary.” He points out that not all carbs are equal, and that the speed with which a carbohydrate food affects your blood sugar—what’s known as its glycemic index—makes a difference.
She learned about Kelley’s work, began the program, regained her health, and avoided all conventional doctors for many years. In 1984, nine years after coming under Kelley’s care, she returned to her primary care physician who was quite perplexed she was still alive after all this time. A chest x-ray showed total resolution of her once widespread lung metastases.
The ketogenic diet has been studied in at least 14 rodent animal models of seizures. It is protective in many of these models and has a different protection profile than any known anticonvulsant. Conversely, fenofibrate, not used clinically as an antiepileptic, exhibits experimental anticonvulsant properties in adult rats comparable to the ketogenic diet.[58] This, together with studies showing its efficacy in patients who have failed to achieve seizure control on half a dozen drugs, suggests a unique mechanism of action.[56]

Regular readers of SBM should know the problem with this sort of approach. No IRB worth its salt would approve such a trial because it would be ethically dubious, but, even worse, it would be ethically dubious and it wouldn’t really tell us anything unless those few patients either had near-miraculous responses or died very quickly. Anything else would simply tell us that the diet is probably doing no harm. More numbers would be needed, particularly if the comparison is to historical controls, to get even an inkling of whether there might be benefit. In that case, you might as well do a proper phase I/II clinical trial, which is what is happening. For instance:
Of course, we know that genes alone are not responsible for cancer because we share many of the same genes as our hunter–gatherer ancestors and even just the same genes as our ancestors several generations ago, and yet the rate of cancer keeps going up. It’s expected to overtake cardiovascular disease as the number one cause of death in the U.S. fairly soon, and so that can’t be explained by genes alone.
But no fear, there’s always a new miracle around the corner, and in 1998 the newspaper reporters and TV newscasters, having effortlessly drifted away from interferon and interleukin-2 and the bone marrow transplant craze, were all in a tizzy over the newest “final” solution to cancer, anti-angiogenesis, based on the pioneering work of the late Dr. Judah Folkman of Harvard. Dr. Folkman had spent decades studying the process of angiogenesis in cancer tissues, the formation of new blood vessels that allow tumors to grow quickly and invade through normal tissues and organs with deadly effect.

"This is something that physicians will want to include in their discussion about the risks and benefits of this particular treatment," the director of Detroit's Henry Ford Comprehensive Epilepsy Program tells WebMD. "But we know that uncontrolled seizures carry all kinds of risks. This remains a useful treatment. But like many treatments, it is not without risks."


In fact, some researchers believe that the keto diet may be one of the best diets for preventing the growth of most cancers — especially those that are linked to obesity. This is because restricting carbs is a simple and effective way to improve mitochondrial function and protect our cells from the damage and inflammation that can lead to genetic mutation.

Other concerns that may arise from remaining on a ketogenic diet long term include mineral deficiencies, decreased bone mass, decreased thyroid function, thinning hair and/or hair loss, heart problems, and menstrual irregularities.59 While it is possible that some of these problems can be mitigated with appropriate supplementation (e.g. fiber, adaptogenic herbs and minerals), ensuring regular adequate caloric intake, and adjusting carbohydrate intake to meet personal needs, not all people will thrive on a ketogenic diet. It is wise to work with an experienced practitioner who can help monitor blood work and symptoms for unwanted changes if you plan to stay on a ketogenic diet long-term.
Leanne: Billion. Okay, let’s talk a little bit about Staten, I can’t remember what book it was but they were saying that cholesterol is really important for brain health. You mentioned that too, the cholesterol uses the nutrient and moves it up to your brain, it’s really important. What I was reading is that as we age our cholesterol actually increases slightly to help with that aging process. You often meet people that are in their 40s, 50s, I know a lot of people in my family are now on Staten because their cholesterol is increasing. I always say, “Maybe that’s your body’s way of protecting yourself against aging.”
Apoptosis Induction. Studies show that dietary energy restriction enhances phosphorylation of adenosine monophosphate kinase (AMPK), which has been found to induce apoptosis in glycolytic-dependent brain cells and protect normal brain cells from death. One way to naturally restrict energy consumption is with a keto diet because most keto dieters spontaneously eat fewer calories than they do when they are on a higher carb diet. Altogether, this may explain why most of the research on keto and cancer has shown the keto diet to be effective in the treatment of brain tumors (glioblastomas and gliomas).
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].

Dr. Campos, it is unfortunate that you retain the medical community’s negative stance on the ketogenic diet, probably picked up in medical school when you studied ketoacidosis, in the midst of an obesity and type II diabetes epidemic that is growing every year, especially among populations who will never see the Harvard Health Letter. The medical community has failed in reversing this trend, especially among children, and the public is picking up the tab, in the form of higher health insurance premiums to treat chronic metabolic diseases which doctors cannot cure. The ketogenic diet does not bid its adherents to eat unhealthy processed meats, and the green leafy vegetables that it emphasizes are important in a number of nutritional deficiencies. People lose weight on the ketogenic diet, they lose their craving for sugar, they feel more satiety, they may become less depressed, their insulin receptors sensitivity is improved, and these are all the good outcomes you fail to mention. There is a growing body of research which demonstrates the neuroprotective effects of the ketogenic diet to slow cancer progression, as well as diseases like Parkinson’s and Alzheimer’s, for which there are no effective medical treatments. Please respect your patients by providing them with evidence-based medical outcomes, not opinions.


"It's a cocktail of drugs and procedures and foods and they all work synergistically to gradually eliminate the tumor while maintaining the health and vitality of our normal organs. The whole goal of this metabolic therapy, which involves the ketogenic diet, is to gradually degrade and eliminate tumor cells without toxicity so the patient emerges from the therapy healthier than when they started."

The total-to-HDL cholesterol ratio is found by dividing your total cholesterol level by your HDL-C, and it is essentially the same thing as an LDL-to-HDL cholesterol ratio since most non-HDL cholesterol is LDL cholesterol [26]. The researchers of the 2003 meta-analysis used this ratio because it is a better cardiovascular risk predictor than total cholesterol levels [25].
We also maintain a certain amount of stored sugar as glycogen, found in the liver and muscle and formed when glucose molecules link up to one another in complex chains. In times of need and if deprived of dietary carbohydrates, our liver and muscle cells can break down glycogen into glucose for release into the bloodstream. Our liver cells can also, when necessary, convert certain amino acids such as alanine into glucose.
A more recent clinical trial comparing a ketogenic diet (33.5% protein, 56% fat, 9.6% carbohydrate) to a low-fat diet (22% protein, 25% fat,55.7% carbohydrate) among 55 obese adults, showed that the ketogenic diet resulted in improved cholesterol levels compared to the low-fat diet. More specifically, the group following the ketogenic diet reported higher increases in HDL cholesterol and higher decreases in triglyceride levels compared to the control group (15).
Low-carbohydrate high fat diets (LCHF diets) consistently improve all other markers of cardiovascular risk — lowering elevated blood glucose, insulin, triglyceride, ApoB and saturated fat (especially palmitoleic acid) concentrations, reducing small dense LDL particle numbers, glycated haemoglobin (HbA1c) levels, blood pressure and body weight while increasing low HDL-cholesterol concentrations and reversing non-alcoholic fatty liver disease (NAFLD).
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During a seizure, networks of neurons fire when they are not supposed to. This can happen because the brain cells are more excitable and are releasing lots of excitatory neurotransmitters, like glutamate. Or it could be that neighboring brain cells aren’t able to suppress the spread of excitability like they normally would using inhibitory neurotransmitters like gamma-aminobutyric acid, or GABA.
A small Feb. 20, 2017, study looked at the impact of a six-week ketogenic diet on physical fitness and body composition in 42 healthy adults. The study, published in the journal Nutrition & Metabolism, found a mildly negative impact on physical performance in terms of endurance capacity, peak power and faster exhaustion. Overall, researchers concluded, “Our findings lead us to assume that a [ketogenic diet] does not impact physical fitness in a clinically relevant manner that would impair activities of daily living and aerobic training.” The “significant” weight loss of about 4.4 pounds, on average, did not affect muscle mass or function.
In subsequent years, the boy continued on aggressive conventional therapeutics, when in 2007, the parents learned of the preliminary research of Dr. Seyfried. While continuing low-dose chemotherapy combined with the ketogenic diet, the patient experienced a “15%” reduction in tumor size. The chemo was eventually discontinued while the parents maintained their son on the ketogenic diet, and the child, sadly, eventually died.
Jimmy Moore: Yeah, this is such a discouraging topic and I’ve gotten pretty upset about it when I talk to people like you, in interviews, because imagine this. Grandma is turning 65, and she’s starting to see her cholesterol get a little bit higher, so she goes to see her doctor, “Oh my gosh, your cholesterol going high, we need to put you on Staten drug.” She starts taking the Staten drug and removes the very element that was keeping her faculties about her in her head, and over the next four or five, even ten years you start to see a mental decline. What do we call it?
Your current cholesterol levels l is higher than I would personally feel comfortable with. I would consider making a few dietary changes (i.e., increasing fiber and net carbs, reducing saturated fat, and increasing protein), especially given your lack of improved cognition and decreased ability to work out. I wish you the best of luck going forward. - Franziska

A study evaluating the effects of a ketogenic diet among 66 obese adults, from which 35 had high cholesterol levels and 31 had normal levels of cholesterol demonstrated that both groups resulted in statistically significant decreased levels of LDL cholesterol, total cholesterol, and triglycerides, whereas the HDL cholesterol levels were increased. These results show that keto diet can improve cholesterol levels and ratios of cholesterol levels among obese people regardless of their cholesterol levels before the dietary intervention. Furthermore, this study also demonstrates that low-carb diet is safe to use for a longer period of time in overweight people with a high total cholesterol level and those with normocholesterolemia (18).
"The keto diet is primarily used to help reduce the frequency of epileptic seizures in children. While it also has been tried for weight loss, only short-term results have been studied, and the results have been mixed. We don't know if it works in the long term, nor whether it's safe," warns registered dietitian Kathy McManus, director of the Department of Nutrition at Harvard-affiliated Brigham and Women's Hospital.
Gary D. Foster, Ph.D., Holly R. Wyatt, M.D., James O. Hill, Ph.D., Brian G. McGuckin, Ed.M., Carrie Brill, B.S., B. Selma Mohammed, M.D., Ph.D., Philippe O. Szapary, M.D., Daniel J. Rader, M.D., Joel S. Edman, D.Sc., and Samuel Klein, M.D., “A Randomized Trial of a Low-Carbohydrate Diet for Obesity — NEJM,” N Engl J Med 2003; 348:2082- 2090. http://www.nejm.org/doi/full/10.1056/NEJMoa022207.

These preliminary findings spurred Dr. Good to encourage a more thorough investigation of Kelley’s methods and results. As the project grew in scope, I continued my “Kelley Study” in my spare time during the last two years of medical school, and ultimately brought it to completion while pursuing my immunology fellowship training under Dr. Good at All Childrens’ Hospital in St. Petersburg.

In the case of Parkinson’s disease (PD) and Alzheimer disease (AD) models, there are data suggesting that calorie restriction itself is protective [31,32••], raising the question of whether manipulations of some critical metabolic pathways also may possess disease-modifying properties. The ketogenic diet originally was designed to mimic fasting, and thus it may regulate a family of proteins known as sirtuins, which play a major role in mediating “anti-aging” effects of calorie restriction [33•]. Alternatively, the ketogenic diet may regulate a master energy-sensing protein in the cell, 5′-adenosine monophosphate (AMP)–activated kinase [34]. Both proteins have a number of downstream effectors that may possess neuroprotective properties.
If I was diagnosed with cancer or one of my relatives or friends were diagnosed, I would certainly put the ketogenic diet and fasting at the top of the list of potential treatments to investigate because I see a high potential for benefit and very little downside. You can’t say that about many cancer therapies. As we talked about earlier, the goal with cancer treatment is to find something that inhibits the growth of cancer cells but doesn’t damage healthy cells. Again, there just aren’t that many therapies out there that do that.
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]
Gary D. Foster, Ph.D., Holly R. Wyatt, M.D., James O. Hill, Ph.D., Brian G. McGuckin, Ed.M., Carrie Brill, B.S., B. Selma Mohammed, M.D., Ph.D., Philippe O. Szapary, M.D., Daniel J. Rader, M.D., Joel S. Edman, D.Sc., and Samuel Klein, M.D., “A Randomized Trial of a Low-Carbohydrate Diet for Obesity — NEJM,” N Engl J Med 2003; 348:2082- 2090. http://www.nejm.org/doi/full/10.1056/NEJMoa022207.
Leanne: Okay. Let’s chat a little bit about cholesterol in relation to high fat living. If somebody is planning to go high fat, low carb, keto, a lot of people say “What can I expect my cholesterol?” For me, it went up. Can it go down? What sort of things can we expect when we transition from maybe a plant-based, maybe we’re vegan, maybe we’re just eating paleo or something, to this specific high fat, low carb, keto eating style.
There are several studies where researchers implanted human gliomas into the bodies of rats (a completely unrealistic scenario) and reported that the rats put on a ketogenic diet lived longer. In one study, rats with human brain cancer implanted in their bodies lived 56% longer on a ketogenic diet combined with hyperbaric oxygen therapy. “56% longer” sounds huge until you learn that the mean keto/oxygen therapy survival was 55 days compared to the control rats who lived 31 days. And all the rats still died of cancer.

Compared to TBI, the amount of scientific literature documenting the beneficial effects of a ketogenic diet for epilepsy is vast. The ketogenic diet was first introduced as a therapy in the 1920s, when doctors learned it could successfully treat seizures in children with refractory epilepsy. (27) Interest in the ketogenic diet waned when antiepileptic drugs were introduced in the 1960s and ’70s; however, the ketogenic diet has experienced a recent resurgence in popularity in the epilepsy community, particularly among those suffering from drug-resistant epilepsy.


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. 
I'm reading this in disbelief. I feel kind of numb to be honest. I'm in collection for thousands because of all the medical treatments, surgeries, and travel. For nearly 8 years my wife has worked two and sometimes 3 jobs and every time I was well enough I worked two jobs trying to catch up and still we fell behind. Call it pride or stupidity, but we never asked for help of any kind. I take care of older neighbors and spend much of my free time working with disabled veterans. I feel like I've given everything I had to help others my whole life. Thank You one and all!

These preliminary findings spurred Dr. Good to encourage a more thorough investigation of Kelley’s methods and results. As the project grew in scope, I continued my “Kelley Study” in my spare time during the last two years of medical school, and ultimately brought it to completion while pursuing my immunology fellowship training under Dr. Good at All Childrens’ Hospital in St. Petersburg.
One notes that the patient who didn’t survive 12 months wasn’t much mentioned; so I assume she didn’t demonstrate any clinical improvement. In any case, this study doesn’t really show anything, other than that a ketogenic diet might decrease glucose uptake in some brain tumors. It’s like a Burzynski case report, in which we have no idea whether the patient did better than expected because of the intervention or because she had less aggressive disease.
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