Sharon M. Nickols-Richardson, PhD, RD, , Mary Dean Coleman, PhD, RD, Joanne J. Volpe, Kathy W. Hosig, PhD, MPH, RD, “Perceived Hunger Is Lower and Weight Loss Is Greater in Overweight Premenopausal Women Consuming a Low-Carbohydrate/High-Protein vs High-Carbohydrate/Low-Fat Diet,” The Journal of Pediatrics: Vol 105, Issue 9: 1433–1437; September 2005. http://www.sciencedirect.com/science/article/pii/S000282230501151X.
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].
All trials applied an intention‐to‐treat analysis with varied randomisation methods. The 11 studies recruited 778 patients; 712 children and adolescents and 66 adults. We assessed all 11 studies to be at low to unclear risk of bias for the following domains: random sequence generation, allocation concealment and selective reporting. For the other domains (blinding, incomplete outcome data, other bias) assessments were varied (low, unclear and high risk of bias). We could not conduct a meta‐analysis due to the heterogeneity of the studies and the quality of the evidence was low to very low (GRADE ratings).

Animal research indicates that a ketogenic diet reduces levels of brain amyloid-beta, a misfolded protein that contributes to Alzheimer’s disease, while also restoring mitochondrial function and improving learning and memory. (18, 19, 20) Although fewer studies on a ketogenic diet have been done in humans with Alzheimer’s disease, a recent trial found a ketogenic diet to be both safe and effective for mild Alzheimer’s disease. (21)
Hi Maya. I LOVE your site!! Interesting, informative with fab recipes and ideas. Hubby and I have just started eating low carb and I have to say, we are not finding it too difficult and I already feel sooo much better!! I find the hardest part is choosing low carb veg, I feel as if we are not eating enough. Any suggestions on how to get more veggies into our diet?
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.
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.

Well, I am going to give this another try. I have great difficulty in eating greens , or drinking them, also I am not fond of fats, years and years of low fat diets have totally screwed my metabolism,and taste buds. I will read this page every day to keep my mind focused. Start tomorrow when I get up …… I work nights which can cause me problems as well. When I tried this diet before, I got terrible cramp, now I realise I wasn’t drinking enough water. Anyway.here goes.
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]
Fairly recently, the diet was introduced as a weight-loss diet by an Italian professor of surgery, Dr. Gianfranco Cappello of Sapienza University in Rome. In his 2012 study, about 19,000 dieters received a high-fat liquid diet via a feeding tube inserted down the nose. The study showed an average weight loss of more than 20 pounds in participants, most of whom kept it off for at least a year. The researchers reported a few minor side effects, like fatigue.
There are numerous benefits that come with being on keto: from weight loss and increased energy levels to therapeutic medical applications. Most anyone can safely benefit from eating a low-carb, high-fat diet. Below, you’ll find a short list of the benefits you can receive from a ketogenic diet. For a more comprehensive list, you can also read our in-depth article here >
One of my favorite patients, whom I have discussed at times in my lectures, was diagnosed in August 1991 with stage IV pancreatic cancer, with multiple metastases into the liver, into the lung, into both adrenals, and into the bone. After a lung biopsy confirmed adenocarcinoma, his doctors discouraged chemotherapy, telling him and his wife conventional treatments would only ruin his quality of life while offering no benefit.
Contemporary researchers like Dr. Thomas Seyfried and Dominic D’Agostino have argued that this dysregulated cellular energy production, or cellular metabolism, is actually what induces malignancy and that by extension, if we limit the fuels available for this process of fermentation, and the fuels are glucose, which is derived from carbohydrate in the diet, and glutamine, which is derived from protein in the diet, then we can actually starve cancer cells and either improve the results of conventional treatment or perhaps even address some cancers independently without conventional treatment.
To the surprise of these investigators – at the time no Western scientist believed any human could survive on nothing but meat – this Eskimo diet consisted of virtually 100% animal products, 80% in the form of fat, with much of it saturated, 20% protein, but essentially no carbohydrates. From cradle to grave these traditional Eskimos lived in a state of ketosis.
Ketogenic diets often fall into the same processed-food trap as Atkins. Today you’ll find keto bread, cookies, and pasta. You’ll find exogenous ketone supplements that promise you can get into ketosis in 30 minutes. Don’t fall for the hype: Eating a whole foods diet high in quality fats but also nutrient-dense plant foods creates the best avenue to get you into ketosis and promote health.
The diet can be started as an outpatient and many physician and dietician team centers do this successfully. However, it is important to ensure close proximity of the child to the medical team during the initiation period in case of difficulties. The intense educational process afforded by inpatient initiation may be preferable for some families and ketogenic diet centers. Also, it allows the families time to review the overall medical treatment, spend additional time with their treating neurologist familiarizing him/her with the epilepsy, and also to meet other families starting the diet at the same time (if admissions are done in a group). Most importantly, inpatient initiation allows observation of the child during this big change in metabolism.
After initiation, the child regularly visits the hospital outpatient clinic where they are seen by the dietitian and neurologist, and various tests and examinations are performed. These are held every three months for the first year and then every six months thereafter. Infants under one year old are seen more frequently, with the initial visit held after just two to four weeks.[9] A period of minor adjustments is necessary to ensure consistent ketosis is maintained and to better adapt the meal plans to the patient. This fine-tuning is typically done over the telephone with the hospital dietitian[19] and includes changing the number of calories, altering the ketogenic ratio, or adding some MCT or coconut oils to a classic diet.[18] Urinary ketone levels are checked daily to detect whether ketosis has been achieved and to confirm that the patient is following the diet, though the level of ketones does not correlate with an anticonvulsant effect.[19] This is performed using ketone test strips containing nitroprusside, which change colour from buff-pink to maroon in the presence of acetoacetate (one of the three ketone bodies).[45]
7. Raygan, F., Bahmani, F., Kouchaki, E., Aghadavod, E., Sharifi, S., Akbari, E., . . . Asemi, Z. (2016). Comparative effects of carbohydrate versus fat restriction on metabolic profiles, biomarkers of inflammation and oxidative stress in overweight patients with Type 2 diabetic and coronary heart disease: A randomized clinical trial. PMID: 28607566
The ketogenic diet can reduce the frequency of seizures. In clinical trials of people with treatment-resistant epilepsy — meaning they’ve tried a number of antiepileptic medications and continued to experience seizures — the ketogenic diet typically reduces the number of seizures by 50 percent or more in half of patients. The number of patients that will go on to become seizure-free after adopting a ketogenic diet is much smaller — some studies say it’s as low as 0 percent of patients and in others it’s closer to 20 percent.
The length of time that arteries are exposed to high levels of LDL particles is believed to play a significant role in the development of atherosclerosis. Smaller LDL particles typically spend more time in the bloodstream than larger particles do, making them easier targets for oxidation and incorporation into plaque. Moreover, people who have a lot of small LDL particles tend to have low HDL cholesterol and elevated triglycerides – all of which are markers of insulin resistance and reflect increased cardiovascular disease risk.
The day before admission to hospital, the proportion of carbohydrate in the diet may be decreased and the patient begins fasting after his or her evening meal.[19] On admission, only calorie- and caffeine-free fluids[37] are allowed until dinner, which consists of "eggnog"[Note 8] restricted to one-third of the typical calories for a meal. The following breakfast and lunch are similar, and on the second day, the "eggnog" dinner is increased to two-thirds of a typical meal's caloric content. By the third day, dinner contains the full calorie quota and is a standard ketogenic meal (not "eggnog"). After a ketogenic breakfast on the fourth day, the patient is discharged. Where possible, the patient's current medicines are changed to carbohydrate-free formulations.[19]

Feldman’s theory about why this happens is based on research he’s conducted on himself and hundreds of other low-carbers over the past two years. He states that the higher energy demands, lower body fat stores, and lower glycogen stores in these LMHRs trigger the liver to increase production of lipoprotein particles so that triglycerides (fat) can be transported to cells for use as fuel. Since cholesterol travels along with the triglycerides, blood cholesterol levels rise as the liver pumps out more lipoproteins to keep up with the body’s energy demands.
32••. Qin W, Ho L, Zhao Z, et al. Neuronal SIRT1 activation as a novel mechanism underlying the prevention of Alzheimer disease amyloid neuropathology by calorie restriction. J Biol Chem. 2006;281:21745–21754. This study demonstrates that sirtuins link calorie restriction with disease-modifying effects in a neurodegenerative disorder. [PubMed] [Google Scholar]
Nevertheless, anti-angiogenesis as the answer to cancer remains a big driving force in “biotech” companies, who have developed a whole slew of angiostatin and endostatin offspring, including the drug Avastin, costing up to $10,000 a month, though it doesn’t work particularly well. The clinical studies aren’t impressive, usually reporting several months of improved survival in patients diagnosed with a variety of advanced cancers.
Thank you, Thank you, Thank you!!!!! Your article couldn't have been timed any better. I got my blood panel back from my "western" doctor two days ago and the numbers had me very worried. After reading your post yesterday I felt so much better and sent the results off to my naturopath knowing that everything should be fine. I printed it out for my own reference and for any others, doctors included, who may have doubts and questions. Again, a big thanks for all your research and putting it out there for the rest of us trying to live a longer, healthier life!!

Some children with epilepsy can have disabling seizures―up to hundreds per day―which can severely limit their quality of life and prevent them from participating in school and social activities. Seizure control is the first step in helping kids with epilepsy achieve otherwise normal lives. When medication isn't working and/or the side effects from it are too much to bear, the ketogenic diet might be offered as a treatment option. In fact, the statistics show that it is often more effective than another, new medication, and frequently also improves alertness and behavior.
Frederick F. Samaha, M.D., Nayyar Iqbal, M.D., Prakash Seshadri, M.D., Kathryn L. Chicano, C.R.N.P., Denise A. Daily, R.D., Joyce McGrory, C.R.N.P., Terrence Williams, B.S., Monica Williams, B.S., Edward J. Gracely, Ph.D., and Linda Stern, M.D., “A Low-Carbohydrate as Compared with a Low-Fat Diet in Severe Obesity,” N Engl J Med 2003; 348:2074-2081. http://www.nejm.org/doi/full/10.1056/NEJMoa022637.
No single food can cure cancer, but some research has shown a link between the keto diet and slowed growth of some types of tumors in mice. A few studies in humans with certain types of brain tumors have also shown promise. On the contrary, a very low-fat diet has been found to reduce risk of recurrence for certain types of breast cancer. Some researchers are conducting more clinical trials with cancer patients, looking at how diet affects patients, along with chemotherapy and radiation. We hope that this research, as well as future research, will help us better understand the role that the keto plays in cancer.
Additionally, research suggests that during menopause, women may experience an increased thickening of the carotid intima and media layers of the arteries, a marker of subclinical atherosclerosis. In a study of 249 middle-aged women, those who were postmenopausal or in the late stages of perimenopause were much more likely to show progression of carotid intima-media thickness (CIMT) than those in early perimenopause (11).

I also want to be clear that I’m not making any specific recommendation here for treatment of cancer using ketogenic diet or anything else. As I’ve argued earlier in the podcast, I think cancer is a complex multifactorial disease and varies from individual. The ideology and pathology vary from individual to individual, and treatment decisions should be made with the support of an oncologist and other doctors on the care team. Please don’t take anything that I’ve said in this podcast as a recommendation for your particular situation or somebody in your life that’s struggling with cancer.
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).
The precise mechanisms behind the physiological effects of the ketogenic diet and ketones are not fully understood. It is believed that the ketogenic diet is anti-inflammatory, that it decreases free radical production while enhancing production of the body’s own natural anti-oxidants, and it improves metabolic efficiency.8 9 10 11 12 Specific conditions a ketogenic diet may benefit include:
Further evidence on the effects a low- carbohydrate diet has on lipoproteins and lipids are provided by a clinical study on 29 overweight men following a restricted carbohydrate diet for 12 weeks. At the end of the trial, the LDL cholesterol was decreased by 8.9%, the triglyceride was reduced by 38.6% and the HDL cholesterol was increased by 12%. These findings show that keto diet may decrease the risk for atherosclerosis and coronary heart disease (17).
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 traditional Atkins’ Diet was certainly high fat, in the range of 70% or more, nearly all from animal sources, and with minimal dietary carbs, less than 10%. Dr. Atkins, famed for his all-encompassing emphasis on ketosis during his early years as a diet doctor, insisted his patients routinely check the levels of ketone bodies in their urine several times a day, using special “ketone strips.”
People use a ketogenic diet most often to lose weight, but it can help manage certain medical conditions, like epilepsy, too. It also may help people with heart disease, certain brain diseases, and even acne, but there needs to be more research in those areas. Talk with your doctor first to find out if it’s safe for you to try a ketogenic diet, especially if you have type 1 diabetes.
Jimmy Moore: Yeah, just be in control of your own health. That’s the major theme that I’ve tried to push the last couple years. I’m tired of people advocating their responsibility for their own health to a dietitian, to a doctor, there’s just way too many resources. This YouTube channel you’re watching right now is just unbelievable for content, my podcasts, books, there’s all sorts of information that’s out there. A lot of it for free, take advantage of that because I think the more you know the more empowered you can be and whether doctors and dietitians and all these medical professionals like it or not, the empowered patient is the future of healthcare. I think if we’re going to really make a difference in our own lives, and then collectively as a culture in our health, it has to start with the individual caring again.
You can change that genetics. I can’t change the genetic tendency, it’s going to be there. By golly, I’m going to pay attention to everything that I put in my mouth for that sake alone. Anyone with that kind of history, I don’t think it’s reason to freak out. I don’t think it’s a reason to think it’s an inevitability for you. It’s just one of those things that you have to pay attention to all of your numbers, anal retentively. That’s why I pay attention to my HSCRP so closely, that’s why I run my numbers so often. I know I have that tendency. I probably, had I not lost the 180 pounds in 2004, I would be in an early grave just like my brother.
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