Dr. Gorski's full information can be found here, along with information for patients. David H. Gorski, MD, PhD, FACS is a surgical oncologist at the Barbara Ann Karmanos Cancer Institute specializing in breast cancer surgery, where he also serves as the American College of Surgeons Committee on Cancer Liaison Physician as well as an Associate Professor of Surgery and member of the faculty of the Graduate Program in Cancer Biology at Wayne State University. If you are a potential patient and found this page through a Google search, please check out Dr. Gorski's biographical information, disclaimers regarding his writings, and notice to patients here.
Ketogenic diet is one of the oldest forms of medical treatment for epilepsy. It is a high fat, adequate protein, low carbohydrate diet used in difficult to control epilepsy. There are different versions of the ketogenic diet available but the basic principles are the same. Ketogenic diet therapy may be adapted for cultural diversity, allergies and tube feeding. It is a therapy for both children and adults.
Cholesterol is most commonly transported in the blood by molecules composed of fat and protein called lipoproteins. From least dense to most dense, they come in five forms: chylomicrons, very-low-density lipoproteins (VLDL), intermediate-density lipoproteins (IDL), low-density lipoproteins (LDL), and high-density lipoproteins (HDL). Because VLDL, LDL, and HDL cholesterol are frequently used as clinical indicators, we are going to focus on them.
To identify which genes might be involved, the researchers used microarray "gene chips" to examine changes in gene expression for more than 7,000 rat genes simultaneously. They focused on the hippocampus, a region of the brain known to play an important role in many kinds of epilepsies. More than 500 of the genes they examined were correlated with treatment with the KD. The most striking finding was the coordinated up-regulation of genes involved in energy metabolism.
In conclusion, clinical application of KDs as an adjuvant therapy for cancer patients first requires that the KD be evaluated for its anti-tumor effect for each single type/genetic subtype of cancer in a preclinical setting, as the safety and efficacy of the KD strongly depend on the tumor entity and its genotype. Based on the results of rigorous preclinical and clinical studies performed thus far, the KD would appear to be a promising and powerful option for adjuvant therapy for a range of cancers. Cancer-specific recommendations await the findings of randomized controlled clinical trials.
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.
Conversely, when beginning a diet, motivation is high, and the tendency is to push oneself to the physical and dietary limit. You might decide to cook every meal at home when you typically eat out, or you may sign up for the gym and commit to working out 3 hours a day for 5 days a week. But pushing oneself too hard, especially in the beginning, most often leads to burnout and diet failure.
A systematic review of 26 short-term intervention trials (varying from 4-12 weeks) evaluated the appetites of overweight and obese individuals on either a very low calorie (~800 calories daily) or ketogenic diet (no calorie restriction but ≤50 gm carbohydrate daily) using a standardized and validated appetite scale. None of the studies compared the two diets with each other; rather, the participants’ appetites were compared at baseline before starting the diet and at the end. Despite losing a significant amount of weight on both diets, participants reported less hunger and a reduced desire to eat compared with baseline measures. The authors noted the lack of increased hunger despite extreme restrictions of both diets, which they theorized were due to changes in appetite hormones such as ghrelin and leptin, ketone bodies, and increased fat and protein intakes. The authors suggested further studies exploring a threshold of ketone levels needed to suppress appetite; in other words, can a higher amount of carbohydrate be eaten with a milder level of ketosis that might still produce a satiating effect? This could allow inclusion of healthful higher carbohydrate foods like whole grains, legumes, and fruit. 
For patients interested in Ketogenic diet, it is vitally important that you talk with your health-care providers, says Alice Bender, MS, RDN, AICR’s Director of Nutrition Programs. “A dietitian is best positioned to talk with you about what is known regarding the pros and cons – especially to learn if this diet has any research showing the reasonable application with your particular type of cancer and if the ketogenic diet may even be harmful for you.”
The modified Atkins diet reduces seizure frequency by more than 50% in 43% of patients who try it and by more than 90% in 27% of patients. Few adverse effects have been reported, though cholesterol is increased and the diet has not been studied long term. Although based on a smaller data set (126 adults and children from 11 studies over five centres), these results from 2009 compare favourably with the traditional ketogenic diet.
I mean, they have no real scientific basis for their belief. The idea that high levels of cholesterol is dangerous is known as the Diet Heart Hypothesis. This hypothesis was first put forth by Ancel Keys in 1955. It states that eating high levels of saturated fat will increase your cholesterol, and increased cholesterol will clog arteries and cause heart disease.
Regardless of the efficacy of the KD, most patients discontinue the diet because of its unpalatable and restrictive features. In the last 20 years, new variants of the KD diet have emerged, including the Modified Atkins diet (MAD), a low-glycemic-index diet, which although it has a high fat content, allows more protein and does not restrict calories and fluids. Several studies have shown that the new variants of the KD have a similar efficacy to the CKD (Kossoff et al., 2006; Tonekaboni et al., 2010; Coppola et al., 2011; Miranda et al., 2012; El-Rashidy et al., 2013). As presently understood, the KD is involved in multiple mechanisms responsible for biochemical alterations, including cellular substrates and mediators responsible for neuronal hyperexcitability. However, it is not yet known with certainty whether the success of the KD is due to a single or several mechanisms (Bough and Rho, 2007; Lutas and Yellen, 2013; Rho, 2017; Youngson et al., 2017).
After some 40,000 women underwent the procedure – at a time when 10-30% of patients died from the treatment itself – it was eventually proven to be worthless. The one glowing positive study from 1995, the infamous South African study of Dr. Bezwoda, turned out on closer examination to be a complete fraud, with the creative researcher simply making up the data. The wonderful and frightening book False Hope describes the bone marrow transplant-breast cancer fiasco in great detail, for those with an interest.
Bob wasn’t the only physician, his clinic not the only place, where the ketogenic diet has been applied in modern times. At the Johns Hopkins Medical Center, for many years a group of researchers and neurologists have prescribed a very strict ketogenic diet for children with intractable seizures, that is, seizures unresponsive to currently available medications. For this particular indication, in adults as well as children, the diet works quite well.
Dousing your steak with butter, swigging MCT oil out of the bottle, and putting grass-fed butter and MCT oil into your coffee may be more fat that your body can handle, actually leading to the opposite effect than intended—inflammation. Even on a high-fat diet, too much dietary fat can—and often will—stall fat loss. Dial down that excess dietary fat and include more fiber-rich vegetables, berries, legumes, and non-gluten grains for a healthier, more diverse gut microbiome to keep your weight within a healthy range.
A recent study found that ketone supplementation extended survival in mice with metastatic cancer. But while it’s true that most cancers have a highly anaerobic metabolism, this in not universal. If proven to be effective, it’s likely that ketone supplementation would be an additional treatment rather than a stand alone treatment for cancer, because of its robust nature.
If seizures are well controlled with antiseizure medications and the medications are well tolerated, many people would not wish to consider trying a ketogenic diet. However, in cases where seizures are not well controlled with antiseizure medications, or where the medications result in difficult side effects, or in cases where surgery is not an option, a ketogenic diet may be recommended.
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.
Overall, cancer is a complex disease with many causes and contributors, but it is becoming less mysterious and more understandable as more research is done. Cancer can develop multiple traits that make it more and more resilient, but we also keep making more and more discoveries that provide us with clues as to how we can prevent, manage, and treat various types of cancer — even those that are the most sinister.
The ketogenic diet is a great thing for your health and biomarkers, as shown by research. However, there are many ways you can do it wrong and thus damage yourself. New research is showing that our understanding of cholesterol may be disrupted slightly but it doesn’t mean that too much cholesterol can’t damage your health. It’s still involved in the process of atherosclerosis.
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).
One dubious practice of some keto diet adherents is using urine, blood or breath test kits to check their circulating ketone levels. While those kits can tell you if your body is indeed burning ketones instead of glucose, Westman says there’s no good evidence that one ketone level is better than another. “The level of water in a stream doesn’t necessarily tell you how much water is flowing through it,” he says. “In the same way, measuring the level of ketones in the blood doesn’t tell you the whole story.”
Ketosis is a natural metabolic state where the body uses fat as its primary fuel source. In our studies and others, the ketogenic diet has shown to significantly lower blood glucose. This can trigger anti-inflammatory processes that enhance cellular function and improve overall dog health. The remarkable case studies we saw at the KetoPet Sanctuary indicate that the ketogenic diet can improve outcomes for dog cancer and support overall dog health.
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Our normal healthy cells, be they situated in the brain or the skin of our feet, do prefer glucose as their primary energy source, obtained from the sugar circulating in the blood. That “blood sugar” comes from a variety of sources, including dietary carbohydrates occurring in fruits, starchy vegetables like potatoes, and grains. The complex carbohydrates in such foods are broken down into glucose during the digestive process, catalyzed by a variety of carb-specific enzymes like amylase.
You can make the argument that high cholesterol leads to atherosclerosis because the plaques are created by cholesterol build-up. However, the root cause of the issue is inflammation and arterial scarring in the first place. If you’d have lower CRP, then cholesterol would simply be transported around the body by VLDL and if it’s not needed for nutrition it’d be transited back to the liver by HDL.
Epilepsy is one of the most common neurological disorders after stroke, and affects around 50 million people worldwide. It is diagnosed in a person having recurrent, unprovoked seizures. These occur when cortical neurons fire excessively, hypersynchronously, or both, leading to temporary disruption of normal brain function. This might affect, for example, the muscles, the senses, consciousness, or a combination. A seizure can be focal (confined to one part of the brain) or generalised (spread widely throughout the brain and leading to a loss of consciousness). Epilepsy can occur for a variety of reasons; some forms have been classified into epileptic syndromes, most of which begin in childhood. Epilepsy is considered refractory (not yielding to treatment) when two or three anticonvulsant drugs have failed to control it. About 60% of patients achieve control of their epilepsy with the first drug they use, whereas around 30% do not achieve control with drugs. When drugs fail, other options include epilepsy surgery, vagus nerve stimulation, and the ketogenic diet.
First of all, the “lipoprotein” in this scenario is a special molecule that has one job, transport cholesterol. So when you hear someone talking about HDL or LDL cholesterol, they aren’t really talking about cholesterol, they’re talking about the protein that is wrapped around the cholesterol. These lipoproteins come in different sizes. HDL is a larger protein particle and LDL is a smaller protein particle.
In the first week, many people report headaches, mental fogginess, dizziness, and aggravation. Most of the time, this is the result of your electrolytes being flushed out, as ketosis has a diuretic effect. Make sure you drink plenty of water and keep your sodium intake up.6One of the fathers of keto, Dr. Phinney, shows that electrolyte levels (especially sodium) can become unbalanced with low carb intake.
Hi, I’m still a bit skeptical, I have seen some of my friends do the keto diet, and have had good results. Though I am still not sure about the idea of the fats being eaten. They say they eat meat with the fat and must do so, is this correct? Also isn’t this not good for the body especially for the kidneys? Second, can a diabetic do this diet? There are many questions running through my head.
Protein consumption can also stimulate a little protein present in the body called mTOR (short for mammalian target of rapamycin) which helps regulate cell growth, proliferation, survival, and protein synthesis (among other things). Something as simple as a big juicy steak will cause our body to upregulate (stimulate the increase of) mTOR — and when this happens, the cells can “forget” to do some very important things (like controlling and preventing cancer growth).
Typically known as the “bad cholesterol” to its healthy counterpart HDL cholesterol, increased levels of LDL cholesterol are associated with an increased risk of cardiovascular diseases (CVD).  Some studies show a strong correlation between LDL cholesterol and the risk of cardiovascular diseases in both men and women.  Evidence also suggests that decreasing blood levels of LDL-C reduces the risk of CVD. 
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.
You may find it easy to eat less when all you can eat is protein and fat. But after a while, you may grow tired of bringing your own whole salmon to parties, and wonder what the other 95% of the grocery store is up to. You may start to have fantasies about a threesome: you, Oreos, and chocolate sauce. Not only that, you may be getting some serious scurvy and other nutrient deficiencies.
What we haven’t talked about is what raised inflammation yet. It’s two main things. I call them the twin villains in your health. Number one is, not surprising coming out of my mouth, carbohydrates are dastardly, especially the refined ones. Grains, starches, sugars, they’re just bad news for you and avoid if at all possible because they’re going to raise your inflammation the most. The second one, a lot of my low carb, keto friends are still eating. It disappoints me Leanne, because I think they don’t realize the negative impact that they’re having. It’s in just about every packaged food, even the so called low carb, keto foods. That’s vegetable oils. You really have to eliminate Canola oil, soy bean oil, cotton seed oil, corn oil … I don’t care if the American Heart Association has their stupid heart health symbol on it, it’s not heart healthy. The reason it’s not heart healthy … I’ll tell you why it’s heart healthy in a minute, why they think it is.
Clearly, ketogenic diets are not ready for prime time as a treatment for cancer, either alone or in combination with conventional therapy. Unfortunately, that hasn’t stopped it from being touted by all manner of alternative cancer practitioners (i.e., quacks) and others as a cancer cure that “they” don’t want you to know about or saying things like, “…it’s nothing short of medical malpractice and negligence to fail to integrate this type of dietary strategy into a patient’s cancer treatment plan,” as Joe Mercola did. Dr. Seyfried himself has contributed to the hyperbole quite a bit as well. For example:
Although the high-fat, calorie-restricted ketogenic diet (KD) has long been used to prevent childhood epileptic seizures that are unresponsive to drugs, physicians have not really understood exactly why the diet works. New studies by a research team at Emory University School of Medicine show that the diet alters genes involved in energy metabolism in the brain, which in turn helps stabilize the function of neurons exposed to the challenges of epileptic seizures. This knowledge could help scientists identify specific molecular or genetic targets and lead to more effective drug treatments for epilepsy and brain damage.
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.)
"Most of the work in this field is still pre-clinical, meaning it's been conducted in animal models," Angela Poff, a research associate in the Department of Molecular Pharmacology and Physiology at the University of South Florida, told U.S. News & World Report. "It's been done in various cancer types, but most of the work has been done in brain cancer specifically. But there's very little clinical data all around. There's some case reports and very small preliminary clinical studies in small groups of patients, usually very late-stage patients with various types of cancers. So in the clinical realm, which is the most important in telling us whether this is going to be useful, we have a long way to go."
A recent 2018 online survey of type 1 diabetics or their parents and caregivers has opened the door for others to use the ketogenic high-fat, low-carbohydrate, moderate protein diet to ease the burden of insulin injections and improve the day-to-day life of type 1 diabetics, potentially leading to remission. This was a breakthrough study, as the ketogenic diet has proven itself with diabetes type 2 sufferers, but there has been little looked into with keto for diabetes 1 patients. This study's focus was on serious carb production. Its title is Management of Type 1 Diabetes With a Very Low–Carbohydrate Diet, and it was published by Pediatrics, the "official journal" of the AAP (American Academy of Pediatrics). Dr. Lewis First, chief editor of Pediatrics, provided an article listing the top 10 items published by Pediatrics during 2018. This study was at the top of the list as the most popular article in Pediatrics for 2018.
The ketogenic diet exerts anticancer effects by inducing a metabolic shift in malignant tissues that promotes apoptosis (self-programmed death) of cancer cells, inhibiting angiogenesis (the growth of new tumor-supporting blood vessels), reducing oxidative stress and inflammation, suppressing mTOR (a protein in humans involved in the regulation of cell growth and regeneration), and increasing the sensitivity of certain cancer cell types to chemotherapy. (38)
In terms of weight loss, you may be interested in trying the ketogenic diet because you’ve heard that it can make a big impact right away. And that’s true. “Ketogenic diets will cause you to lose weight within the first week,” says Mattinson. She explains that your body will first use up all of its glycogen stores (the storage form of carbohydrate). With depleted glycogen, you’ll drop water weight. While it can be motivating to see the number on the scale go down (often dramatically), do keep in mind that most of this is water loss initially.
If you lift weights on a ketogenic diet, you might fear losing muscle mass taking in lower amounts of protein. That doesn’t seem to be the case since your body preferentially utilizes fat rather than protein during ketosis. Growth hormone, an anabolic hormone sometimes called your fountain-of-youth hormone because it keeps you lean and toned, plays a major role in regulating muscle growth and development, stimulating muscle protein synthesis. Researchers find a very-low carbohydrate diet with sufficient protein does not affect growth hormone levels, at least in the short-term. If you’re a regular lifter, you might want to consider slightly increasing your protein intake during workout days and supplementing with a branched-chain amino acid (BCAA) supplement. Cyclical keto, where you would eat a higher-carbohydrate diet during your workout days, also makes for a smart strategy to maintain muscle.
The nutritional world then, as it is today, was surely confusing, with various scientists, physicians, and lay authors promoting one diet or another, often – as in the case of Atkins and Pritikin – offering completely contradictory dietary recommendations. Fortunately, when in 1987 Dr. Atkins offered me a job, I had already found what I thought represented a solution to the dilemma of dueling dietary dogma.
Though most of our cells can utilize fatty acids of all stripes via beta oxidation to create ATP energy, our central nervous system is at somewhat of a disadvantage. In fact, long chain fatty acids with 14 or more carbons, which can yield the most ATP from beta oxidation, do not cross the blood-brain barrier. However, in a state of prolonged dietary carbohydrate depletion, the liver begins converting acetyl coenzyme A into various ketone bodies, such as acetoacetate and beta hydroxy butyric acid, which easily penetrate into the brain and which can, like acetyl coenzyme A, be shunted into the citric acid cycle and then the electron transport chain, providing the brain with ATP.
The ketogenic diet achieved national media exposure in the US in October 1994, when NBC's Dateline television programme reported the case of Charlie Abrahams, son of Hollywood producer Jim Abrahams. The two-year-old suffered from epilepsy that had remained uncontrolled by mainstream and alternative therapies. Abrahams discovered a reference to the ketogenic diet in an epilepsy guide for parents and brought Charlie to John M. Freeman at Johns Hopkins Hospital, which had continued to offer the therapy. Under the diet, Charlie's epilepsy was rapidly controlled and his developmental progress resumed. This inspired Abrahams to create the Charlie Foundation to promote the diet and fund research. A multicentre prospective study began in 1994, the results were presented to the American Epilepsy Society in 1996 and were published in 1998. There followed an explosion of scientific interest in the diet. In 1997, Abrahams produced a TV movie, ...First Do No Harm, starring Meryl Streep, in which a young boy's intractable epilepsy is successfully treated by the ketogenic diet.