Notably, there is a relationship between metabolic and epigenetic modifications. Shimazu et al. (2013) observed that βOHB inhibits class I histone deacetylases. During the KD, the elevation of βOHB causes changes in large-scale gene transcription but particularly those linked to oxidative-stress resistance factors. This result emphasizes that the KD has a potential role as a disease-modifying treatment in epilepsy.
I have been on a low carb keto diet for more than a year. As T2DM my A1C dropped from 9% to 5.4% & I discontinued meds. All my lipids improved even with ample healthy saturated fat. More than a year now so I wonder why this would be a short term improvement when its obvious that I will not go back to a high A1C and taking 3 diabetes medications including sulphonylureas. It is clear from this article that you lack the necessary experience that would be gained from wholeheartedly trying the diet or monitoring patients doing it properly like me. I would be probably be facing my first amputation if I believed the negativity in your article. So for people with diabetes who may be dissuaded by your article. Ignore it and take back your health by restricting carbs (<25 g a day) or as low as you reasonably can below 130g while being satisfied that you are getting adequate nutrition.
Just from researching that I have been doing, this information seems to make a lot of sense and I may have found some information that is pertinent as to why many of you have experienced a rise in LDL levels. VLDL become LDLs when they drop the triglyceride. So, as we consume less carbs we start to lose triglycerides and the VLDLs start to become LDLs. I am no professional by any means, but as I read that article it made sense as well. It takes a while for some people’s livers to start to get the picture and send out more HDL to round up the LDL and there are things that we can do to aid that process such as adding olive oil and coconut oil to our diets as well as eating purple produce and exercising, but the LDL count will probably rise at first and slowly drop from thereafter. It will probably drop faster if we are taking steps to raise our HDL. The longer our body (liver) has been exposed to an unhealthy diet, the longer it will take to recover from it.
In contrast to the safe application of KDs reported in various cancer models, our research group recently reported that mice bearing renal cell carcinoma xenografts and with signs of Stauffer’s syndrome experienced dramatic weight loss and liver dysfunction when treated with a KD [4]. Another study investigating the effect of long-term KD treatment on kidney cancer described a pro-tumor effect of the KD in a rat model of tuberous sclerosis complex [5]. Most concerning is the observation that, in a mouse model of BRAF V600E-positive melanoma, tumor growth was significantly increased under the KD [6]. Moreover, the study also demonstrated that the ketone body acetoacetate stimulated the oncogenic signaling of the BRAF pathway. In contrast, the KD had no effect on the progression of NRAS Q61K-positive or wild-type melanoma xenografts [6]. Notwithstanding these observations, in a feasibility trial involving a limited number of patients with advanced malignancies, a patient with BRAF V600E-positive/BRAF-inhibitor resistant melanoma seemed to benefit from the KD [7].

As the authors write, “the protocol was not designed to reverse tumor growth or treat specific types of cancer.” The researchers also acknowledge the patient numbers were too small to allow for meaningful statistical evaluation, even for the avowed purposes. Overall, the discussion centers on the practicalities of implementing the diet and the results of the PET scans.

The second is called LDL-P which measures the number of LDL particles in the blood. Sometimes, there is a correlation – more LDL particles means that you can have higher levels of LDL-C. However, larger LDL molecules can grow and carry more cholesterol – leading to a discordance in which LDL-C and LDL-P are not necessarily proportional. When this happens, LDL-C and LDL-P are said to be “discordant.”

Bulk buy and cook. If you’re someone who doesn’t like to spend a lot of time in the kitchen, this is the best of both worlds. Buying your food at bulk (specifically from wholesalers) can reduce the cost per pound tremendously. Plus, you can make ahead food (bulk cook chicken thighs for pre-made meat, or cook entire meals) that are used as leftovers, so you spend less time cooking.
In this same chapter, there are also two case reports, neither very impressive. The first, written by the mother, tells the story of a four-year old child diagnosed in 2004 with a low-grade (less aggressive) but quite large and inoperable brain tumor. The parents, as the mother writes, entrusted their child into the hands of the experts, who prescribed the usual “gold standard” treatments, which are not clearly described initially but presumably mean chemotherapy and perhaps radiation.
On a “strict” (standard) keto diet, fats typically provides about 70 percent to 80 percent of total daily calories, protein about 15 percent to 20 percent, and carbohydrates just around 5 percent. However, a more “moderate” approach to the keto diet is also a good option for many people that can allow for an easier transition into very low-carb eating and more flexibility (more on these types of plans below).
If you have chronic inflammation and/or stress, you may also have persisting high cholesterol levels which, in most cases, isn’t doing anything but causing more problems. The preponderance of this chronic inflammation and stress is typically caused by a variety of lifestyle factors, from eating foods that trigger inflammation to sleeping poorly. [27]
Fat quantity matters with keto diets, but so does quality. Omega-6 fatty acids, prevalent in popular keto foods like grain-fed beef, farmed salmon, vegetable oils, and roasted nuts and seeds increase inflammation that hijacks your fat-loss plans and promotes systemic disease. Nix those common offenders and focus on foods rich in omega-3 fatty acids, including grass-fed beef, wild-caught fish, freshly ground flaxseed, and (if you’re not sensitive) omega-3-enriched organic pasture-raised eggs.

Because some cancer cells are inefficient in processing ketone bodies for energy, the ketogenic diet has also been suggested as a treatment for cancer.[59][60] A 2018 review looked at the evidence from preclinical and clinical studies of ketogenic diets in cancer therapy. The clinical studies in humans are typically very small, with some providing weak evidence for anti-tumour effect, particularly for glioblastoma, but in other cancers and studies, no anti-tumour effect was seen. Taken together, results from preclinical studies, albeit sometimes contradictory, tend to support an anti-tumor effect rather than a pro-tumor effect of the KD for most solid cancers.[61]
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.
Ketogenic diet is one of the oldest forms of medical treatment for epilepsy. Most ketogenic diet centres have traditionally specialized in treating children ages 0 to 18 years of age. However, there is growing evidence that shows its usefulness in controlling seizures in adults. In the content below, you will find answers to frequently asked questions about the benefits and challenges of this diet therapy. Please note, the ketogenic diet should never be attempted on your own. It should only be attempted with the support of a trained medical team.
Boston Children's Hospital has been named the #1 children's hospital in the nation by U.S. News and World Report for the fifth year in a row! It's an honor that we could not have achieved without you. On behalf of every member of our Boston Children's team, thank you for inspiring us to be bolder, dream bigger, and make the impossible possible for our patients and families.

How ketosis helps with epilepsy isn't known, but it does. Researchers at Johns Hopkins University studied 150 children with epilepsy in one important study. After a year on the ketogenic diet, half of children had 50% fewer seizures. One fourth of the children reduced their seizures by 90%. After a few years on the diet, many of these children no longer needed medications at all.


Another mouse study cited by Seyfried is one in which dietary restriction was reported to promote vessel maturation in a mouse astrocytoma model. Given that tumor angiogenesis is one of my scientific interests and I have a fair number of publications on the topic, I was interested. Unfortunately, I ended up being disappointed. This was another syngeneic model (i.e., a mouse tumor implanted in mice of the same strain from which the tumor was isolated as a cell line, like the one discussed above). Although it showed increased tumor vessel maturation (which is one mechanism by which inhibitors of angiogenesis work), I wasn’t quite convinced, because there was a distinct lack of quantification of the phenomenon, and the microscopy appears not to have been blinded, something that’s critical to avoid unconscious bias in the results. It’s not surprising that this result, which, if more convincing evidence had been obtained, could easily have appeared in Cancer Research, was published in a low tier journal. It’s an OK study, but not fantastic. Certainly it didn’t lead me to smacking myself in forehead and saying, “Of course!”
In 1920 a New York physician, Dr. Galen, reported at the American Medical Association convention that he had had significant success in treating epilepsy by initiating a program of fasting. At that time the only pharmaceutical interventions that were available included phenobarbital and bromides. Interestingly, the patient he treated was actually a young cousin who had aggressive seizures. On the second day of fasting the child’s epilepsy abated and did not return over the next two years of follow-up. Further studies appearing in 1923, 1926, 1928, all confirmed the effectiveness of fasting as an effective treatment for seizures.
You’re transitioning. Your body is equipped to process a high intake of carbs and a lower intake of fat. Your body needs to create enzymes to be able to do this. In the transitional period, the brain may run low on energy which can lead to grogginess, nausea, and headaches. If you’re having a large problem with this, you can choose to reduce carb intake gradually.
There have been a few studies of the modified Atkins Diet in adults with seizure disorders, and the results are similar to studies with children. Interestingly, it was remarked in one of the reports that it was more difficult to keep adults on the diet since they obviously have more control over what they eat. Research is still limited in this area and more trials are needed.
To get the most benefit from the Keto diet, you should stay physically active. You might need to take it easier during the early ketosis period, especially if you feel fatigued or lightheaded. Walking, running, doing aerobics, weightlifting, training with kettlebells or whatever workout you prefer will boost your energy further. You can find books and online resources on how to adapt Keto meals or snacks for athletic training.
Like any trendy diet worth its balanced portion of salt, the keto diet is said to hold transformative powers. Proponents say it can help people lose weight, improve mood and experience fewer epileptic seizures. For the most part, the science seems to back these claims up — though, to be sure, it's not completely understood how exactly the keto diet affects mood (particularly depression), despite anecdotal evidence the diet might lead to clearer thinking and fewer symptoms of depression.
The goal of a ketogenic diet is to transition the body’s primary fuel supply from carbohydrate to fat, creating a state of nutritional ketosis and, eventually, fat adaptation. The degree to which dietary carbohydrates need to be reduced to reach nutritional ketosis varies from person to person. Finding the optimal macronutrient ratios for getting your body into ketosis requires some self-experimentation. I recommend playing around with the ranges listed below to find the ones that work best for you.

The word "ketogenic" refers to ketone bodies that come from the breakdown of fat. The ketogenic diet is specifically planned to meet all of your child's calorie needs for growth and development, but it does contain high fat, low carbohydrate, and adequate protein. Instead of getting energy from sugar, the brain will get energy from the breakdown of fat. Exactly how this helps to control seizures is not known; both high fat and low carbohydrate may be important for seizure control. About half of the patients on this diet have more than 50% reduction in the number of seizures; about 20-30% may have more than 90% reduction in seizures. Less than 10% of patients on the ketogenic diet may have no seizures at all.


So what, exactly, does “ketogenic” mean? The name refers to a specific type of energy-carrying molecule, called a ketone. “Most people are always in a state of glucosis, meaning they’re burning glucose from carbohydrates for energy,” Westman says. “But you determine what your body burns for fuel based on what you feed it.” By severely restricting carbs and increasing your fat intake, your body can shift into a state of “ketosis,” which means it’s burning fat instead of glucose. “Ketosis used to be considered abnormal, but it can actually be very healthy,” Westman says.
The KetoPet Sanctuary was started in 2014 to rescue shelter dogs with terminal cancer and give them a forever home. Once at KetoPet, each dog was placed on a raw ketogenic diet (high fat, adequate protein, very low carbohydrates). We then did something that was never done before: we used PET (positron emission tomography) to image disease and validate our nutrition-first approach. While not a cure, we found a raw ketogenic diet to be effective in improving outcomes for dogs with cancer. Even more, these case studies support our belief that all dogs should eat a raw ketogenic diet optimal health.
The original therapeutic diet for paediatric epilepsy provides just enough protein for body growth and repair, and sufficient calories[Note 1] to maintain the correct weight for age and height. The classic therapeutic ketogenic diet was developed for treatment of paediatric epilepsy in the 1920s and was widely used into the next decade, but its popularity waned with the introduction of effective anticonvulsant medications. This classic ketogenic diet contains a 4:1 ratio by weight of fat to combined protein and carbohydrate. This is achieved by excluding high-carbohydrate foods such as starchy fruits and vegetables, bread, pasta, grains, and sugar, while increasing the consumption of foods high in fat such as nuts, cream, and butter.[1] Most dietary fat is made of molecules called long-chain triglycerides (LCTs). However, medium-chain triglycerides (MCTs)—made from fatty acids with shorter carbon chains than LCTs—are more ketogenic. A variant of the classic diet known as the MCT ketogenic diet uses a form of coconut oil, which is rich in MCTs, to provide around half the calories. As less overall fat is needed in this variant of the diet, a greater proportion of carbohydrate and protein can be consumed, allowing a greater variety of food choices.[4][5]
Some years ago, a patient of mine, a professor at a well-known university, became interested in oxygenation therapies for cancer, used widely in the Mexican Clinics. These “oxygen” treatments were an offshoot of Dr. Warburg’s work, i.e., that cancer cells as obligatory anaerobes can synthesize needed energy supplies only via glycolysis. Therefore, the theory goes, in the presence of oxygen, particularly ozone, a form of hyped up oxygen, cancers cells, unlike normal cells, will be poisoned.
Online resources such as the Charlie Foundation provide a wealth of information about the diet therapy for epilepsy and can connect patients with diet clinics, providing keto-friendly product information and offering diet training and family support. Online forums allow families to support one another, share information about keto-friendly foods and swap recipes.
Jimmy Moore: I wouldn’t fret so much about the blood sugar, I would definitely keep an eye on insulin. Unfortunately there’s just not an easy way to prick your finger and check insulin at home. It doesn’t exist yet. It’s coming real soon. It’s not available yet. I think the big take home is relax, chill out, you’re doing good for your body, especially like we talked about with the cholesterol numbers. If that HDL is going up, if the triglycerides are going down, the small LDL particles are going down, your HSCRP is under 1, why are you worried?

The story behind LDL, or low-density lipoprotein, is more complicated. LDL transports cholesterol produced by your liver and cells throughout your body. Unlike HDL, LDL molecules move slowly through the bloodstream and are vulnerable to oxidizing agents known as “free radicals.” Once oxidized, LDL can easily burrow itself into the walls of your arteries (called endothelium) and impede cardiovascular function. This triggers an inflammatory response in which white blood cells called macrophages rush to eat up the LDL.

Jimmy Moore: 300 is the normal. Yes. That’s 100 points higher than authorities today would say is “normal”. Yet if they put them on cholesterol lowering medication, do you know they would have been at greater risk for heart disease if they took that pill then they’re total cholesterol being 300. I think it all circles back around to it’s not about the cholesterol people, it really is about the inflammation.
• 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.

"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."

In summary, I think the metabolic theory on cancer is really interesting and there’s already some good evidence to support it. Clearly, we need more research. Whether or not this research will get done is the big question because as we know, two-thirds of medical research is sponsored by pharmaceutical companies. It can be difficult for researchers like Dominic D’Agostino to get funding to do this kind of research because nobody can patent the ketogenic diet and fasting. There’s not as much money as there would be in a kind of miracle drug that targets gene therapy and things like that. That’s one of the reasons there isn’t as much research as there might be otherwise.


Although you'll be cutting way back on carbohydrates and sugar, some fruits are still okay to eat on the keto diet (though you'll still want to be mindful about quantity in order to remain in ketosis). The fruits that make the cut contain far fewer carbs than their off-limits cousins such as apples, pears, bananas, pineapples, papayas, grapes, and fruit juices in general.


Cancer is not a single disease, but rather a group of diseases all of which share the common feature of abnormal cell growth. Cancer cells either stay put where they are formed or spread to other parts of the body. In the U.S. alone, it is estimated that nearly 2 million new cases of cancer will have been diagnosed in 2018, while over 600,000 people will have died as a consequence of this disease.7
Other genetic disorders caused by mutations limit the availability of energy substrates but do not necessarily cause seizures. One such disease is phosphofructokinase (PFK) deficiency. PFK is the rate-limiting enzyme in glycolysis for the conversion of fructose-6-phosphate to fructose-1,6-bisphosphate. Patients with mutations in the muscle isoform of PFK demonstrate exercise intolerance with myalgias and stiffness. There also are rare infantile forms, such as a case reported by Swoboda et al. [21, Class III], with myopathy and arthrogryposis. This patient displayed marked gains in muscle strength and improvement in his developmental milestones after being placed on the ketogenic diet. 

In 1920 a New York physician, Dr. Galen, reported at the American Medical Association convention that he had had significant success in treating epilepsy by initiating a program of fasting. At that time the only pharmaceutical interventions that were available included phenobarbital and bromides. Interestingly, the patient he treated was actually a young cousin who had aggressive seizures. On the second day of fasting the child’s epilepsy abated and did not return over the next two years of follow-up. Further studies appearing in 1923, 1926, 1928, all confirmed the effectiveness of fasting as an effective treatment for seizures.

Over half of children who go on the diet have at least a 50% reduction in the number of their seizures. It can start to help after just one week, but more often it can take a few weeks up to several months to judge whether it will be effective. If the diet successfully controls seizures, it may be continued for several years under the supervision of the child's health care team. Many children on the ketogenic diet continue to take seizure medications but on average they require one less medication and often the dosage of remaining ones is lowered.
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)
For someone who has cancer and a big battle ahead, I would recommend Miriam Kalamian's book for getting started, and cronometer.com for tracking what you eat. Then, The Metabolic Approach to Cancer by Nasha WInters, doctor of Naturopathy, is really good - 350 pages from her experience coaching cancer patients. These two women come from a place of their own life-and-death struggles with Keto diet and cancer and it shows in the intensity of their studies. I go back to these two books again and again. They are fine works and for them, I'd pay double what I did if I had to.
The findings below have been limited to research specific to the ketogenic diet: the studies listed contain about 70-80% fat, 10-20% protein, and 5-10% carbohydrate. Diets otherwise termed “low carbohydrate” may not include these specific ratios, allowing higher amounts of protein or carbohydrate. Therefore only diets that specified the terms “ketogenic” or “keto,” or followed the macronutrient ratios listed above were included in this list below. In addition, though extensive research exists on the use of the ketogenic diet for other medical conditions, only studies that examined ketogenic diets specific to obesity or overweight were included in this list. (This paragraph was added to provide additional clarity on 5.7.18.)
Recent studies show that low-carb diets such as keto are more effective at raising good (HDL) cholesterol than low-fat diets [1, 2]. However, there are also studies showing that keto can increase total cholesterol (HDL and LDL) [3]. On the other hand, low-carb, high-fat diets also decrease LDL particle concentration (LDL-P), increase the size of LDL cholesterol and decrease the amount of harmful VLDL cholesterol in the blood [2], all of which have a positive effect on cardiovascular fitness.
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.
Similarly, in a 2015 study, mice receiving a combination of hyperbaric oxygen and dietary ketone supplementation showed a clear reduction in tumor growth rate and metastasis.20 Also, these mice lived twice as long as control animals. Based on these results, the study authors state that further investigation into the effectiveness of this combination therapy as a potential treatment for late-stage metastatic cancers is urgently required.
As far back as the 5th century, Hippocrates noted that fasting reduced seizures, and in the 1920s a diet was developed to mimic changes brought on by fasting that could be maintained long-term, specifically to treat seizures, and thus the ketogenic diet was born.1 This original ketogenic diet was very low in carbohydrates and protein and supplied 80-90% of the calories as fat.2 3 While the original ketogenic diet was successful in treating intractable childhood epilepsy, it fell out of favor when the modern antiepileptic drugs became available. In the 1990s the diet began to see a resurgence as people once again turned to it for difficult-to-treat cases of childhood epilepsy, such as those that do not respond to medication, and as a weight loss tool. The most recent research on the benefits of the ketogenic diet and ketones, in particular, have expanded to examine its possible therapeutic effects on other neurological diseases, cardiovascular disease, diabetes and even cancer.
The current body of research on metabolic cancer treatments using a keto diet continues to grow. Keto or metabolic cancer therapy is somewhat different than the treatment for other illnesses, and is discussed in detail in my book Fight Cancer with a Ketogenic Diet, which is based on the metabolic therapy research of Dr. Thomas Seyfried  and Dr. Dominic D'Agostino. The main idea behind the use of a ketogenic diet to treat cancer is to starve cancer cells of the sugar and other fuels they need to survive, and to provide support and protection for normal energy processes in healthy cells. The advantage of this treatment protocol is that it is non-toxic to the body, and in "wait and see" cases, it can provide an major health support advantage to the patient. The book was written for the patient and has all the details and research in an easy-to-use format.

In my opinion, Bob Atkins knew more about the theory and practice of the ketogenic diet, its benefits and limitations, including as applied to cancer patients, than anyone in the history of medicine. For him, the concept was hardly the musings of a PhD laboratory scientist, but the practical observations of a physician who treated thousands of patients over decades. And for cancer, the ketogenic diet just did not seem to work.
The benefits above are the most common ones. But there are others that are potentially even more surprising and – at least for some people – life changing. Did you know that a keto diet can help treat high blood pressure, may result in less acne, may help control migraine, might help with certain mental health issues and could have a few other potential benefits?

So what do you do about GBM? Standard treatment begins with surgery. After surgery, you are given radiation and chemo. In the meantime, you take other medications to control the side effects. Tick, tick, tick, GBM makes you acutely aware of clocks ticking. You start searching for medical trials. There are many rules to qualify, most extend life by only a few months. Some have a substantial chance of killing you.
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.

In fact, ketogenic diets have been used for nearly a century to treat seizures, says Gary Yellen, a professor or neurobiology at Harvard Medical School. “It dates back to studies from the 1920s that found this kind of diet was like a sustainable form of fasting, which we’ve known, supposedly since antiquity, to be beneficial for epilepsy,” he says.
Weight loss was also irresistible. I actually tried not to lose weight. Based on advanced bro science, I was supposed to maintain my weight if I ate at least 2,000 calories a day. Yet my efforts to stuff myself with gloriously fatty food were futile. I lost 10 kilos and got abs — “blurry” ones though. You still need a bit of imagination to count six.
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