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

Some people on a keto or low carb diet choose to count total carbs instead of net carbs. This makes it more difficult to fit in more leafy greens and low carb vegetables (which are filled with fiber), so you should only try that if you don’t get results with a net carb method. And, start with reducing sugar alcohols and low carb treats before deciding to do a “total carbs” method.


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.


Once the body is adapted to ketosis, constipation and/or diarrhea are the most commonly reported side effects along with increased urination. Continuing to keep your mineral intake high and ensuring adequate water and fiber intake will help to counter these effects. People in ketosis may also notice a sweet or fruity odor on their breath, which is the result of increased production of the ketone acetone, which is a very volatile compound that is eliminated mainly through respiration in the lungs. 50
Fight Cancer with a Ketogenic Diet is a fascinating look at cancer as a metabolic disease and as an attempt to combat it with diet. Davis takes the position that a ketogenic diet can help fight cancer because it eliminates or drastically resists insulin-activating carbohydrates and sugars, allowing the cells to burn fats for energy rather than sugars. It ties in with other research I have done in the importance of eradicating sugar and slowing the metabolism. Unfortunately this won't work for me because of my gall bladder problems. However, for those without gall bladder problems, the ketogenic diet might be of great assistance in battling cancer. It is straightforward and helpful and includes recommended resources.
Epilepsy can be caused by a variety of different conditions including head trauma, infection, brain tumor, and stroke, but by and large most cases of epilepsy have no readily identifiable cause. Epilepsy affects some 2.3 million adults in America and close to half a million children. Further, about one in 26 people will be diagnosed with epilepsy at some point in their lives. It’s been estimated that there are approximately 150,000 new cases of epilepsy diagnosed in the United States each year and overall about $15.5 billion in medical costs as well as lost earnings and production are attributed to this disease.
Ketone bodies synthesized in the body can be easily utilized for energy production by heart, muscle tissue, and the kidneys. Ketone bodies also can cross the blood-brain barrier to provide an alternative source of energy to the brain. RBCs and the liver do not utilize ketones due to lack of mitochondria and enzyme diaphorase respectively. Ketone body production depends on several factors such as resting basal metabolic rate (BMR), body mass index (BMI), and body fat percentage. Ketone bodies produce more adenosine triphosphate in comparison to glucose, sometimes aptly called a "super fuel." One hundred grams of acetoacetate generates 9400 grams of ATP, and 100 g of beta-hydroxybutyrate yields 10,500 grams of ATP; whereas, 100 grams of glucose produces only 8,700 grams of ATP. This allows the body to maintain efficient fuel production even during a caloric deficit. Ketone bodies also decrease free radical damage and enhance antioxidant capacity.
Ketone bodies, acetoacetate, and β-hydroxybutyrate (βOHB), are byproducts of fatty acid oxidation in the mitochondrial matrix of the hepatocytes. There are many theories about the role of KB, but the existence of an anticonvulsant effect is controversial. Some authors have found no relationship between KB and synaptic transmission and seizure control.
I also might offer a thought as to why, from a more esoteric, more biochemical perspective, for most people diagnosed with cancer the ketogenic diet might not work. For the past 150 years, researchers have approached cancer as a disease in which perfectly happy, normal mature cells sitting in some tissue somewhere suddenly go awry, lose their normal regulatory restraint, develop a primitive, undifferentiated appearance or phenotype, begin proliferating without restraint, begin invading through tissues and organs, begin migrating, spreading, creating new blood vessels along the way to feed the rapacious appetite of cancer. But over the past 15 years, gradually, a new, more productive, and I believe more truthful hypothesis has emerged, spearheaded particularly by Dr. Max Wicha at the University of Michigan. Scientists such as Dr. Wicha have discovered that cancer may be a little more complicated than we have thought these long decades. 

Several laboratory abnormalities have been reported in children on the ketogenic diet, although none has been found to have clinical significance. Patients on the ketogenic diet are in a chronic acidotic state, putting them at risk for osteopenia. Some studies have shown a progressive loss of bone mineral content, resulting in osteopenia and osteoporosis; this loss occurred with ketogenic diet treatment despite improved serum vitamin D concentrations.
Jimmy Moore: One thing we’ve not talked about, I alluded to a little bit earlier, is LDL particle size. When people hear LDL, they think “Oh that’s one number.” Uh-uh, it’s actually 2 major numbers, it’s a lot more than 2. It’s about 6 or 8 sub-fractions of LDL sizes. Primarily it’s pattern A and pattern B. Pattern A being the large fluffy kind. Pattern B being the small dense kind.
• Standard ketogenic diet (SKD) — SKD is the type I typically recommend for most people, because it is very effective. It focuses on high consumption of healthy fats: As I explain in my book, "Fat for Fuel," you should aim for having 70 to 85 percent of your total daily calories to come from healthy fats. For your protein intake, the general rule of thumb is to follow the formula of 1 gram of protein for every kilogram of your lean body mass.
However, this diet is gaining considerable attention as a potential weight-loss strategy due to the low-carb diet craze, which started in the 1970s with the Atkins diet (a very low-carbohydrate, high-protein diet, which was a commercial success and popularized low-carb diets to a new level). Today, other low-carb diets including the Paleo, South Beach, and Dukan diets are all high in protein but moderate in fat. In contrast, the ketogenic diet is distinctive for its exceptionally high-fat content, typically 70% to 80%, though with only a moderate intake of protein.
[29:44] – There is increasing evidence for what Dave likes to call, the Alternative Glycogen Store Theory. Do leaner, athletic types of individuals seem to be more likely to be hyper-responders, in particular those with lower levels of triglycerides and high levels of LDL-C and LDL-P? Gary mentions Dr William Davis, from Wheat Belly, post on Lp(a) traits.

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]


One review looked at how the KD and modified Atkins diet (MAD) helped with seizure control in adults. Across the 5 studies reviewed, 32% of KD-treated patients achieved ≥50% seizure reduction while a slightly lower 29% of MAD-treated patients hit that same target. Even more drastic was the 9% KD-treated and 5% MAD-treated patients that achieved >90% seizure frequency reduction.4

You want to keep your cheats to none. Be prepared, make sure you’re eating what you need to be satiated (“full”), and make sure you’re satisfied with what you’re eating. If you have to force yourself to eat something, it will never work out in the end. This is just a guideline on how you can eat on a ketogenic diet, so you’re very welcome to change up what kind of foods you eat!
Overall, 12 studies including 1257 patients examined the impact of a VLCKD on HDL cholesterol. When assessing the data, the individuals assigned to a VLCKD achieved an average increase in HDL of 0.12 mmol/L. This was double the average increase in HDL of the low-fat dieters who achieved an average increase in HDL of 0.06 mmol/L. [11] As a result, the authors concluded that carbohydrate-restricted diets confer cardiovascular benefits because they improve levels on HDL in the body. [11]
Despite the initial warning signs, the media continued its relentless promotion of interleukin-2 for a number of years. In 1992, perhaps due to political pressure more than scientific evidence, the FDA approved the drug for use against cancer, despite the lack of comprehensive controlled trials. Then in the late 1998 a clinical study – completed some 13 years after the initial reporting – showed that interleukin-2, at least with advanced kidney cancer, worked no better than placebo.
When you eat less than 50 grams of carbs a day, your body eventually runs out of fuel (blood sugar) it can use quickly. This typically takes 3 to 4 days. Then you’ll start to break down protein and fat for energy, which can make you lose weight. This is called ketosis. It's important to note that the ketogenic diet is a short term diet that's focussed on weight loss rather than the pursuit of health benefits. 

To make sure the diet is nutritionally balanced, an experienced dietitian works out exactly how much of which foods the person can eat each day. To help with this, people have individual recipes, are given support on how to plan meals, and are guided on which foods should be avoided. As the diet can be quite restrictive, the dietitian will recommend any vitamin and mineral supplements that are needed.


This is where we have to depart! Sorry to say but you’re on your own. You should have plenty of leftovers that are frozen, ready, and waiting! I know a lot of you out there have trouble with timing and are busy people – so making sure that some nights you make extras to freeze is important. All those leftovers you have in the freezer? Use them up! Create your own meal plan, at first using this as a guide, and then completely doing it yourself. Once you get the hang of it, it’ll be a sinch – I promise you 🙂
If you are on, or considering going on, a ketogenic diet, you are probably already aware that it is a hugely powerful way to cut body fat quickly, easily and safely. You may also have read about its other health benefits, including its ability to stabilize blood glucose levels, making you feel energetic all day long and cutting out sugar cravings, as well as helping prevent or manage type 2 diabetes. What you may not have heard about yet, is evidence from a recent study that suggests that a ketogenic diet can prevent cancer, and can slow the growth of existing tumors.
I’m referring to a diet called the ketogenic diet, and an article that’s been making the rounds since last week entitled “Ketogenic diet beats chemo for almost all cancers, says Dr. Thomas Seyfried.” Of course, when I see a claim such as that, my first reaction is, “Show me the evidence.” My second reaction is, “Who is this guy?” Well, Dr. Seyfried is a professor of biology at Boston College, who’s pretty well published. He’s also working in a field that has gained new respectability over the last five to ten years, namely cancer metabolism, mainly thanks to a rediscovery of what Otto Warburg discovered over 80 years ago. What Warburg discovered was that many tumors rely on glycolysis for their energy even in environments with adequate oxygen for oxidative phosphorylation, which generates the bulk of the chemical energy used by cells. I described this phenomenon in more detail in a post I did four years ago about a drug that looks as though its anticancer properties come from its ability to reverse the Warburg effect.
Yes. There is growing evidence showing its usefulness in controlling seizures in adults with medically refractory epilepsy. While some adults may be started on classic ketogenic diet, others will be trained in the modified ketogenic or atkins diet which allows more freedom in dietary choices, and affords them the ability to still enjoy going out to restaurants while maintaining this diet therapy. With proper training and motivation, adults can successfully remain on this diet and gain good control of their seizures. Despite some of the adult ketogenic diets offering a little more flexibility it is still considered a medical therapy and should be initiated and maintained by your medical team.
Jimmy Moore: Exactly. You’re already have a propensity for insulin resistance. It should not surprise you that as you get into this that you’re going to run into some of the manifestation of that, which is this thing called Don Phenomena, where in the morning you have a higher level of blood sugar, that’s totally normal. What tends to happen though, and certainly the people that have asked that question of you, I hope they’re testing later in the day as well. What you’ll see is later in the day, totally normal.
In the mid-1990s, Hollywood producer Jim Abrahams, whose son's severe epilepsy was effectively controlled by the diet, created the Charlie Foundation to promote it. Publicity included an appearance on NBC's Dateline programme and ...First Do No Harm (1997), a made-for-television film starring Meryl Streep. The foundation sponsored a multicentre research study, the results of which—announced in 1996—marked the beginning of renewed scientific interest in the diet.[1]

So far the research has found energy restriction to significantly reduce growth and progression of numerous cancers including mammary, brain, colon, pancreas, lung, and prostate cancer. However, it is important to note that the best results are achieved from severe calorie restriction (<1,000 calories per day). If you are considering using calorie restriction along with your cancer treatment, make sure you consult your cancer care team first.
When you eat foods high in carbohydrates and fat, your body naturally produces glucose. Carbohydrates are the easiest thing for the body to process, and therefore it will use them first – resulting in the excess fats to be stored immediately. In turn, this causes weight gain and health problems that are associated with high fat, high carbohydrate diets (NOT keto).
The Ketogenic Diet (KD) is a modality of treatment used since the 1920s as a treatment for intractable epilepsy. It has been proposed as a dietary treatment that would produce similar benefits to fasting, which is already recorded in the Hippocratic collection. The KD has a high fat content (90%) and low protein and carbohydrate. Evidence shows that KD and its variants are a good alternative for non-surgical pharmacoresistant patients with epilepsy of any age, taking into account that the type of diet should be designed individually and that less-restrictive and more-palatable diets are usually better options for adults and adolescents. This review discusses the KD, including the possible mechanisms of action, applicability, side effects, and evidence for its efficacy, and for the more-palatable diets such as the Modified Atkins Diet (MAD) and the Low Glycemic Index Diet (LGID) in children and adults.

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.


In my book "Fat for Fuel," I sought to educate readers about the benefits of using healthy fats as a catalyst to bring about improved mitochondrial function, thus allowing you to achieve better health. In essence, the book answers WHY it is important for you to consume healthy fats. However, you still need to know HOW to prepare the right ketogenic foods in an appetizing way.
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