A high carbohydrate intake can exacerbate irritable bowel syndrome (IBS) and gastroesophageal reflux disease (GERD) by feeding opportunistic and pathogenic bacteria in the gut. (29) These microbes ferment dietary carbohydrates, producing gases that increase intraabdominal pressure, a driving force behind acid reflux and GERD. The gas manufactured by these bacteria also contributes to bloating, abdominal pain, and diarrhea in IBS.
A: The most common ways to track your carbs is through MyFitnessPal and their mobile app. You cannot track net carbs on the app, although you can track your total carb intake and your total fiber intake. To get your net carbs, just subtract your total fiber intake from your total carb intake. I have written an article on How to Track Carbs on MyFitnessPal.
There are other studies, but little or nothing in the way of randomized clinical trials. For instance, a recent retrospective study of 53 patients, of whom only six followed a ketogenic diet while being treated for GBM, concluded that the diet was safe, but no suggestion of efficacy was noted. More recently, a German group examined the effect of a ketogenic diet on 16 patients with advanced cancer of various types who had exhausted all therapeutic options. The treatment didn’t result in any serious side effects, although subjects found it very difficult to maintain the diet, particularly in the context of family life. Only five were able to complete the three month treatment period, and it was reported that these five didn’t have progression while on the diet. Of the remaining 11, two died early, one was unable to tolerate the diet and dropped out very quickly, two dropped out for personal reasons, one couldn’t continue the diet for more than a month and three had disease progression within less than 2 months of starting the diet and one dropped out to resume chemotherapy. As a whole, this study was well-nigh uninterpretable due to the different kinds of cancer, other than to conclude that less than 50% of patients with advanced cancer could adhere to the diet, and that those who could generally had no significant side effects. Of course, it’s unclear whether the diet helped the five who could adhere to it or whether those who adhered to it could do so because they had more indolent, less aggressive disease.
First, as Weston Price proved 70 years ago in his exhaustive epidemiological study, over the millennia different groups of humans adjusted to different types of diets, depending on the locale in which they lived and the available food therein, ranging from high carb to virtual no carb. Though Dr. Price was not evaluating dietary treatments as such for disease, his point should nonetheless be well taken – different humans (for optimal health) need different diets.
Research here is conflicting. While you might think reducing insulin-triggering carbohydrate foods would improve insulin sensitivity, that isn’t always the case. Rodent studies found at least in the short-term, ketogenic diets increased glucose intolerance and insulin resistance. Researchers speculate part of this insulin resistance occurs because of keto-adaptation, and once your body adjusts to ketosis, you become more insulin sensitive. Your mileage will vary, of course, and I believe going too low-carb could create these and other potential dangers.

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I had some eggs and some meat and all this stuff. Then they tested me literally every 30-60 minutes for five hours. I got to see literally what was happening real time after a low carb meal. I think that’s where having the right nutrition really is the basis for knowing where you stand. The other thing for people that are worried about this morning reading, check your A1C. That’s the average of the last 3 months worth of all of your blood sugars, not just the ones in the morning that you’re testing and freaking out about. By the way, when you freak out that also raises your blood sugar.
We have solid evidence showing that a ketogenic diet reduces seizures in children, sometimes as effectively as medication. Because of these neuroprotective effects, questions have been raised about the possible benefits for other brain disorders such as Parkinson’s, Alzheimer’s, multiple sclerosis, sleep disorders, autism, and even brain cancer. However, there are no human studies to support recommending ketosis to treat these conditions.

Red flags or no red flags, it is, of course, possible that Dr. Seyfried is on to something and has let his enthusiasm overwhelm his judgment with respect to whom he associates with and the sorts of statements he makes, many of which sound as though they could have come from Stanislaw Burzynski, Ralph Moss, or Joe Mercola. In actuality, he isn’t totally wrong, but he isn’t totally right, either. As is typical of someone without a medical background, in particular an oncology background, he is, basically, putting the cart before the horse, as you will see.


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).
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.
It was late 1985 when the media broke the story about the next cancer miracle. I was sitting in my apartment overlooking beautiful Tampa Bay, when I read the initial front-page newspaper reports. Dr. Steven Rosenberg, already well-known as Ronald Reagan’s surgeon (the President had a malignant polyp), and a highly regarded basic science researcher running a section at the National Cancer Institute in Bethesda, Maryland, had just revealed to the world – at a press conference, as I remember – his preliminary pilot study results with a new immune modulator, interleukin-2, that would provoke an extraordinary media frenzy. 

The "classic" ketogenic diet is a special high-fat, low-carbohydrate diet that helps to control seizures in some people with epilepsy. It is prescribed by a physician and carefully monitored by a dietitian. It is usually used in children with seizures that do not respond to medications. It is stricter than the modified Atkins diet, requiring careful measurements of calories, fluids, and proteins. Foods are weighed and measured.
I recall so well, this time sitting in my mid-Manhattan office, reading that famous May 3, 1998 front page lead New York Times article (in the upper left of the page reserved for wars, revolutions, and, yes, miracles) by reporter Gina Kolata, announcing Folkman’s preliminary findings to the world, extolling anti-angiogenesis in a tone that one more skeptical writer, Jack Breibart, described as “breathless.”

Dave Feldman recently demonstrated that increasing net carb intake from 30 grams to 95 grams per day – (going from 4% of total calories to 13% of total calories) led to a significant drop in his LDL cholesterol level. Obviously, this level of carb intake isn't ketogenic; however, it is still moderately low carb. On the other hand, this will likely increase your blood sugar and insulin levels to some extent.
Leanne: Yeah totally, chill out. Do a little meditation if you need to get into the zone. Exactly. You mentioned vegetable oils causing inflammation, are there specific fats that will help us, like we’ve talked a little bit about saturated fats, we all know trans fats don’t even go there … the mono poly saturated, unsaturated, is there a certain ratio that we should be aiming for. I know you’re the guy that will just slice off butter and eat it … I am too, a little bit of Himalayan rock salt on there never hurt anyone. Are there specific facts that we should be focusing on?
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