What an excellent and helpful article! I had great cholesterol numbers before starting Keto and now my cholesterol is high. My HDL is good and my Triglycerides are low, but my LDL is high. I'm really questioning what I'm doing. I do experience many benefits of Keto, but I have a family history of heart disease and I'm worried and confused. Unfortunately my doctor is no use. She just says follow a Mediteranean Diet. End of story. Or go on Statins, which I would never do. Thanks to your article, I have some new resources to research.
[6:35] – Dave’s experiments and data show how cholesterol scores can be manipulated. How these cholesterol results can cause concern and uncertainty in individuals following the low carb high fat diet and how whilst feeling better than ever on a low carb diet, Dave is researching any possibility of potentially negative effects from raised cholesterol levels.
Con: Results can vary depending on how much fluid you drink. By drinking more water, you dilute the concentration of ketones in the urine and thus a lower level of ketones will be detected on the strips. The strips don’t show a precise ketone level. Finally, and most importantly, as you become increasingly keto-adapted and your body reabsorbs ketones from the urine, urine strips may become unreliable, even if you’re in ketosis.
Since this is my full-time job, donations really help me keep afloat and allow me to post as much to the website as I do. While I do really appreciate any donation you want to give, you can enter $0 in the amount given to download it for free! I’ve added in $5 as the suggested price. I think that’s a very fair price considering other websites are charging in the hundreds of dollars and I’ve seen what they are like on the inside.
Here’s what happens when you eat low carb, high fat, keto. The small LDLP number goes way down. Along with the triglycerides dropping, along with the HDL going up, along with all those other great markers that improve that nobody’s paying attention to in the medical profession, your small LDL goes down. The question that comes into play here is “What about the number of total particles?” That’s the debate that nobody’s going to answer until we do some studies on it.

In both patients, levels of blood glucose decreased to low/normal levels and ketones increased by 20 to 30 times within seven days of starting the ketogenic diet.  Results from scans indicated that there was a 21.8% decrease in glucose uptake at the tumor sites in both subjects. Lower glucose uptake is a strong indicator that a tumor is shrinking in size.

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)

The American Academy of Neurology and the Child Neurology Society recommend adrenocorticotropic hormone (ACTH) as the first line of therapy for infantile spasms. The goals for this medication are to completely stop the infantile spasms and improve the abnormal EEG. In some cases, pediatric neurologists prescribe the seizure medication Sabril® (vigabatrin), especially for patients with tuberous sclerosis. Both drugs work well, but your child's doctor will talk with you about which medicine may be the better choice for your child.
Each of these groups Dr. Price studied seemed well adapted to the available food supply. The Eskimos, as Stefansson earlier had reported and as Price confirmed, thrived on their high fat, no carb, animal-based diet. The Inca descendents, on the other hand, had done quite well consuming grains like quinoa, along with tubers, fruits, and some animal protein and dairy. The Masai flourished on a rather extreme diet consisting, for an adult warrior, of a gallon of raw milk a day with some blood and occasional meat, but no fruits, vegetables, nuts, seeds, or grains.

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.
To obtain the optimum engagement of the family and the patients, providing information and training is essential because the diet is difficult to maintain. Counselors should talk with the family about their expectations and make clear the efficacy rate and adverse events (AE), to reduce the abandonment of the diet. Websites, videos and publications, especially from support groups, can be very helpful and should be encouraged. It is also important to review the medications and change from oral solutions (carbohydrate content) to tablets (Armeno et al., 2014). The KD counseling, evaluation and follow-up should be done by a multidisciplinary team. A pediatric neurologist or neurologist and a nutritionist are the minimum team requirements.
Just this week as I write this, one of my newer patients, a wonderful, creative inventor and computer whiz from the Washington, DC area, came into my office for his regularly scheduled six month re-evaluation appointment. When he started with me in January 2010, three and a half years ago, he had been diagnosed with stage IV metastatic squamous cell carcinoma of the lung, with multiple tumors in both lungs and with evidence of metastases in his ribs. His local doctors in DC had explained he had terminal disease, for which chemotherapy would be useless.
There are thousands of people out there who have healed cancer naturally. I meet natural survivors constantly and even share their stories on this site. Most natural cancer healing protocols involve a radical change of diet and lifestyle that includes “overdosing on nutrition” with juicing, lots of raw plant food, little to no animal food, supplements, and herbal cleanses along with detox protocols. Those are all time-tested methods validated by a large body of long-term survivors.
The ketogenic diet also has been used in glycogenosis type V (McArdle disease), which is caused by a defect in the muscle-specific isozyme of glycogen phosphorylase. Glycogen phosphorylase is necessary to break down glycogen into free glucose for use as an energy source in muscles. When the ketogenic diet was applied to a patient with this disorder (presumably providing an alternative means of energy production), the patient’s exercise tolerance improved and there was a trend toward decreased baseline creatine kinase levels [22, Class III].
In one hypoxia-ischemia model, rats fed a ketogenic diet for 25 days before cardiac arrest had fewer postarrest seizures and myoclonic jerks and less neurodegeneration (determined by Fluoro-Jade staining) than those fed a normal diet [28,29]. The ketogenic diet also appears to have cardioprotective properties in an isolated heart perfusion model designed to mimic global ischemia. These changes were concomitant with increased numbers of mitochondria in cardiac muscle, suggesting that improved capacity to generate energy conferred a protective effect in the face of an ischemic insult [30].

This review aimed to investigate the effect of ketogenic diets on seizure control, cognition (e.g. learning, concentration and academic performance in children; learning, concentration and memory in adults) and behaviour. We also investigated the side effects of the diet and the number of participants who dropped out of the studies and the reasons for this.
Con: Results can vary depending on how much fluid you drink. By drinking more water, you dilute the concentration of ketones in the urine and thus a lower level of ketones will be detected on the strips. The strips don’t show a precise ketone level. Finally, and most importantly, as you become increasingly keto-adapted and your body reabsorbs ketones from the urine, urine strips may become unreliable, even if you’re in ketosis.
The book summarizes, then enlarges upon, the concepts of Otto Warburg, MD, the great German scientist who won the Nobel Prize in Medicine and Physiology in 1931 for his work on cellular oxidation and energy production. No scientist has ever been nominated more frequently for the cherished Prize than Dr. Warburg, but he lost his chance for a second win, according to some sources, in 1944 after Hitler ordered that no German scientist could accept the award.
Blake Donaldson, MD, who ran a general practice for decades on Long Island, New York, began prescribing a ketogenic diet in the 1920s. Donaldson, who was quite familiar with Stefansson’s reports on the Eskimo diet, began recommending an all-meat, high-fat regimen for his patients diagnosed with a variety of complaints such as obesity, diabetes, and heart disease, though he doesn’t appear to have treated cancer specifically. In his 1961 book, Strong Medicine, Dr. Donaldson summarized his findings and his many years of experience recommending a high fat diet.

Russel Wilder first used the ketogenic diet to treat epilepsy in 1921. He also coined the term "ketogenic diet." For almost a decade, the ketogenic diet enjoyed a place in the medical world as a therapeutic diet for pediatric epilepsy and was widely used until its popularity ceased with the introduction of antiepileptic agents. The resurgence of the ketogenic diet as a rapid weight loss formula is a relatively new concept the has shown to be quite effective, at least in the short run.


Ketone production is the body’s natural response to very low or no carbohydrate availability. The ketogenic diet was developed to mimic the effects of fasting while still supplying adequate nutrition to maintain health. The classic ketogenic diet, developed in the early 1900s for children with epilepsy, consisted of a 3 or 4:1 ratio of fats to protein and carbohydrates combined, supplying up to 90% of the daily calories from fats.44 More recently, modified versions have emerged with similar rates of efficacy, and the wider variety of food and flexibility make the diet less arduous. Two such possible modifications are: a 1:1 and 2:1 ratios of fats to combined protein and carbohydrates and/or the addition of medium chain triglyceride (MCT) oil supplements. The medium chain fats that makeup MCTs more readily produce ketones than the long chain fats commonly found in the diet, allowing for a lower amount of total fat intake, and therefore increasing the amount of carbohydrate and protein that can be included in the diet.45


If you’ve decided to move forward in trying the keto diet, you will want to stick to the parameters of the eating plan. Roughly 60 to 80 percent of your calories will come from fats. That means you’ll eat meats, fats, and oils, and a very limited amount of nonstarchy vegetables, she says. (This is different from a traditional low-carb diet, as even fewer carbs are allowed on the keto diet.)
In terms of seizure recurrence among children, the risk of seizures returning in those who are seizure free and stop the diet is 15 to 20%, according to Kossoff. In children who experience less frequent seizures, but are not seizure free, about one-third will have some worsening of seizures when the diet is stopped, though this is sometimes transient.
I think we obsess about numbers because we have been given a range that is supposedly the healthy, right range. Unfortunately there are a lot of mechanisms that we don’t know a lot about right now, that could be going on that makes that happen for some people in the mornings. I’ve just talked to too many of the experts, who say “Don’t worry about that. It’s really not the big deal. Keep an eye on your fasting insulin levels in the morning and even if you want to do a five hour glucose tolerance test, it’s call a 5 hour GTT, could go down to your doctor, please don’t drink that crappy glucose serum, because that will mess you up.” I actually did it one time with my co-author, he actually ran it with me … I wanted to see what would happen to my blood sugar and insulin levels when I had a low carb meal.
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.
Fight Cancer with a Ketogenic Diet is not an academic exercise in what a ketogenic rendition of an anticancer diet should be. The information is firmly based on the science and research of Dr. Thomas Seyfried, who proposes that cancer is a metabolic disease, and on consultation with both Drs. Seyfried and Dominic D’Agostino on design and implementation of a ketogenic diet. Sound biochemical and physiological sciences support the book’s explanations and recommendations.

If your child is helped by the diet and seizures are better controlled, your child may remain on the ketogenic diet for 2 to 3 years, or longer. The length of time on the diet will be determined by several factors, including how well the diet helps your child, whether your child can be weaned off seizure medications, and your willingness to continue the diet.
Copyright © 2019 D’Andrea Meira, Romão, Pires do Prado, Krüger, Pires and da Conceição. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Dr. Josh Axe, DNM, DC, CNS, is a doctor of natural medicine, clinical nutritionist and author with a passion to help people get well using food as medicine. He’s the author of the books “Eat Dirt: Why Leaky Gut May Be the Root Cause of Your Health Problems,” “Essential Oils: Ancient Medicine” and the upcoming “Keto Diet: Your 30-Day Plan to Lose Weight, Balance Hormones, Boost Brain Health, and Reverse Disease” (February 2019, published by Little, Brown Spark). He’s a co-founder of Ancient Nutrition, a health company where the mission is to restore health, strength and vitality by providing history’s healthiest whole food nutrients to the modern world.
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.
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!
While a growing fetus can utilize ketones to an extent, it still requires a steady glucose supply to support normal growth, including crucial brain development. Reduced glucose availability caused by a maternal ketogenic diet may have long-term adverse effects on infant health, including abnormal growth patterns and alterations in brain structure. (40) If you are pregnant and struggling with blood sugar issues, a low-carbohydrate diet that includes moderate amounts of nutrient-dense carbohydrates, such as fruit and starchy tubers, is a safer choice than a ketogenic diet.
To date, evidence from randomized controlled clinical trials is lacking, but needed, to answer the question of whether an adjuvant KD would benefit specific cancer patients. Human data pertaining to KDs and cancer are mostly based on single case reports and a smattering of preliminary clinical studies with small study cohorts, heterogenous study designs, poor compliance to the diet, noncomparable regimens, or without standardized dietary guidance. Even so, results of the first clinical studies support the hypothesis of an anti-tumor effect of KDs. For example, 10 of the 24 (42%) clinical studies included in a recent review [1] provide evidence for the anti-tumor effect of KDs, whereas seven (29%) showed no effect and only one study reported a pro-tumor effect of the KD. The currently available medical literature presents strong scientific evidence for the safe application of a KD only in patients with glioblastoma. However, a clear recommendation for adjuvant use of the KD in glioblastoma patients still requires results from ongoing randomized controlled clinical trials.

Leanne: Even a lot of my friends who went to the dietetics route, as oppose to the holistic nutrition route, we both were taught the exact same thing when it came to protein. Even my physio and my naturopath, there’s been a lot of misconception about protein. Getting back to the cholesterol and heart disease, if somebody has a history of heart disease in their family and they want to try eating high fat, low carbohydrate, keto … awesome. What you’re saying is perhaps for those types of people, look at your inflammation. Get that under control, while you do the high fat, low carb, keto thing and you’re actually doing your body a major service by switching to that eating style, especially if you have a history of heart disease in your family.
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More research needs to be performed to investigate the source of these relationships as well as the molecular mechanisms through which HDL operates. However, there is a general consensus among clinicians and scientists that HDL-cholesterol is healthy for the body and that higher levels of HDL-C are healthy for the body. [8] In fact, one study observed that, with every 1 mg/dL reduction in HDL cholesterol, diabetes risk increased by 4%. [9]


One of these patients, a woman from Appleton, Wisconsin, had been diagnosed in the summer of 1982 with stage IV pancreatic adenocarcinoma, the most aggressive form of this most aggressive disease. A liver biopsy during exploratory surgery confirmed the diagnosis of metastatic cancer, which the Mayo Clinic would later confirm. When the Mayo oncologist on the case said there was nothing that could be done, the patient being looking into alternative approaches, learned about Kelley’s work, and began his therapy.
While I would like to offer a magic bullet for all cancers, a ketogenic diet is not that. The diet does not “cure” cancer. It should not be used to replace traditional treatment. But the diet has shown promise for some cancers especially GBM. So why would a diet help? On a simplistic level, cancer “eats” glucose and needs 20 times more glucose compared to normal cells. Cancer cells cannot make the transition to using ketones, especially in the brain, making them more vulnerable to chemo and radiation.
The ketogenic diet is usually initiated in combination with the patient's existing anticonvulsant regimen, though patients may be weaned off anticonvulsants if the diet is successful. Some evidence of synergistic benefits is seen when the diet is combined with the vagus nerve stimulator or with the drug zonisamide, and that the diet may be less successful in children receiving phenobarbital.[18]

By the time I began medical school in 1979 I had read the pioneering work of Weston A. Price, DDS, the American dentist and researcher. Beginning in the late 1920s, Dr. Price, accompanied by his wife, spent seven years traveling the world evaluating isolated groups of people living and eating according to long-standing tradition. Today such a study would be impossible, since just about everyone everywhere has adopted the “Western” way of living and eating, down to jeans and junk food.


Studies assessing the efficacy of the MAD reported seizure freedom rates of up to 25% and seizure reduction rates of up to 60% in children. One study used a simplified MAD (sMAD) and reported seizure freedom rates of 15% and seizure reduction rates of 56% in children. One study utilised a MAD in adults and reported seizure reduction rates of 35%, but no patients became seizure free (GRADE rating low).
They included participants who were 35-75 years of age and who were not born in Canada but had lived there for at least 5 years. Subjects who suffered from moderate to severe medical conditions such as diabetes, heart diseases, and active cancer were not included. Subjects of all different weights and BMIs were included as long as they were considered healthy.
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.

Increased enterohepatic circulation on high fat means that cholesterol is kept "in play" - bounced back into the bloodstream in ApoB particles - while low enterohepatic circulation, in people with with higher synthesis rates, during weight loss - when cholesterol is being dumped by shrinking cells - means that cholesterol can pile up in the gall bladder faster than it can be conjugated to bile salts and bile acids and faster than it can be extracted by the weak stimulus of low fat food.

The authors defined a VLCKD as a diet lower in 50g of carbohydrates – lower than the daily recommended grams of carb consumption clinicians recommend to diabetics. They included 13 randomized controlled studies with a total of 1,415 subjects. All studies took place for at least a full year and all subjects included were over 18 years old and had a BMI of at least 27.5 kg/m2. In each of these studies, VLCKD diets were compared to low-fat diets.
For most people, the keto diet will result in weight loss, but this might not be the healthiest way to do it. When your body burns fat because it is starved of carbs, it makes ketones. Ketones are a type of acid made by your liver and then sent into your bloodstream. Too many ketones can led to dehydration and alter the chemical balance of your blood.
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.”
Unfortunately that’s wrong. Unfortunately total cholesterol doesn’t tell the whole story. It includes one number that you want to have higher. That is you HDL good cholesterol. When you start eating low carb, high fat, keto, one of the tell tale signs that you’ve done it very well is your HDL, especially you ladies, you’re lucky Leanne … you ladies can make your HDL just go really high. I have to work hard as a guy to get mine in the 70-80 range, which is pretty good for a guy. Most people walking around their HDL is sub 40, and most of them probably sub 20 if they’re not eating enough fat. You have to eat saturated fat in order to raise that good HDL cholesterol. Okay?
Despite continuous advances in the medical world, obesity continues to remain a major worldwide health hazard with adult mortality as high as 2.8 million per year. The majority of chronic diseases like diabetes, hypertension, and heart disease are largely related to obesity which is usually a product of unhealthy lifestyle and poor dietary habits. Appropriately tailored diet regimens for weight reduction can help manage the obesity epidemic to some extent. One diet regimen that has proven to be very effective for rapid weight loss is a very-low-carbohydrate and high-fat ketogenic diet.[1][2][3]

Because people with type 2 diabetes are at an increased risk for cardiovascular disease, there’s a specific concern that the saturated fat in the diet may drive up LDL, or “bad,” cholesterol levels, and further increase the odds of heart problems. If you have type 2 diabetes, talk to your doctor before attempting a ketogenic diet. They may recommend a different weight-loss diet for you, like a reduced-calorie diet, to manage diabetes. Those with epilepsy should also consult their doctor before using this as part of their treatment plan.


Diets aren’t just for weight loss. What, how much, and even when we eat all affect the way our brains work. For people with epilepsy, diet can reduce the likelihood of seizures. Mackenzie Cervenka, a neurologist and director of the Adult Epilepsy Diet Center at Johns Hopkins Hospital, explains what the ketogenic diet is and how it can benefit people with epilepsy.
The anti-angiogenesis love affair not only affected conventional researchers and oncologists, but infiltrated deeply into the “alternative” cancer world. During the late 1990s, I read numerous articles lauding the anti-angiogenic effect of various herbs. Some ten years ago or more, a number of alternative physicians began promoting artemesinin, an herb from Africa long used as a treatment for malaria, as a “natural” anti-angiogenesis supplement.

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.
The ketogenic diet is consistently reduced in carbohydrates, adequate in protein, and high in fat which mimics this fasting state and also produce ketones. Ketones are an indicator of an important metabolic change but alone cannot explain the anti-seizure effect. Researchers are studying additional mechanisms of action to better explain why this diet reduces seizures.
Tumors did not progress at all at all in the five patients that successfully completed the ketogenic trial. This is a positive outcome given the advanced stage of their cancer. Additionally, some of these patients experienced favorable changes in glucose, HDL:LDL ratio, triglycerides, and healthy levels of weight-loss. These findings further support the healthy impact a ketogenic diet may have on cancer.
A study with an intent-to-treat prospective design was published in 1998 by a team from the Johns Hopkins Hospital[20] and followed-up by a report published in 2001.[21] As with most studies of the ketogenic diet, no control group (patients who did not receive the treatment) was used. The study enrolled 150 children. After three months, 83% of them were still on the diet, 26% had experienced a good reduction in seizures, 31% had had an excellent reduction, and 3% were seizure-free.[Note 7] At 12 months, 55% were still on the diet, 23% had a good response, 20% had an excellent response, and 7% were seizure-free. Those who had discontinued the diet by this stage did so because it was ineffective, too restrictive, or due to illness, and most of those who remained were benefiting from it. The percentage of those still on the diet at two, three, and four years was 39%, 20%, and 12%, respectively. During this period, the most common reason for discontinuing the diet was because the children had become seizure-free or significantly better. At four years, 16% of the original 150 children had a good reduction in seizure frequency, 14% had an excellent reduction, and 13% were seizure-free, though these figures include many who were no longer on the diet. Those remaining on the diet after this duration were typically not seizure-free, but had had an excellent response.[21][22]
I knew Bob quite well, and considered him a friend. We first met when I interviewed him for a nutrition story during my journalism days, and later on while I was a medical student, we kept in close contact. During my freshman year at Cornell Medical School – from which Bob had received his own medical degree – I arranged for him to speak as part of a lecture series I had set up on alternative approaches to disease.
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